SECTION 2: MEASUREMENT Neonatal Intensive Care: Satisfaction Measured From a Parent’s Perspective

Health care systems today are complex, technically proficient, competitive, and market-driven. One outcome of this environment is the recent phenomenon in the health care field of “consumerism.” Strong emphasis is placed on customer service, with organized efforts to understand, measure, and meet the needs of customers served. The purpose of this article is to describe the current understanding and measurement of parent needs and expectations with neonatal intensive care services from the time the expectant parents enter the health care system for the birth through the discharge process and follow-up care. Through literature review, 11 dimensions of care were identified as important to parents whose infants received neonatal intensive care: assurance, caring, communication, consistent information, education, environment, follow-up care, pain management, participation, proximity, and support. Five parent satisfaction questionnaires—the Parent Feedback Questionnaire, Neonatal Index of Parent Satisfaction, Inpatient Parent Satisfaction–Children’s Hospital Minneapolis, Picker Institute-Inpatient Neonatal Intensive Care Unit Survey, and the Neonatal Intensive Care Unit-Parent Satisfaction Form—are critically reviewed for their ability to measure parent satisfaction within the framework of the neonatal care delivery process. An immense gap was found in our understanding about what matters most and when to parents going through the neonatal intensive care experience. Additional research is required to develop comprehensive parent satisfaction surveys that measure parent perceptions of neonatal care within the framework of the care delivery process. Pediatrics 1999;103:336–349; parent satisfaction, questionnaires, neonatal intensive care, pediatric. ABBREVIATIONS. NICU, neonatal intensive care unit; NIPS, Neonatal Index of Parent Satisfaction; NICU–PSF, NICU Parent Satisfaction Form; SD, standard deviation. Health care systems today are characterized as complex, in flux, technically proficient, competitive, and market-driven. One outcome of this environment is the recent phenomenon in the health care field of “consumerism.” Strong emphasis is being placed on customer service, with organized efforts to understand, measure, and meet the needs of customers served. Evidence of this phenomenon is found in the numerous publications that focus on patient satisfaction as a key outcome measure of health care. Patient satisfaction, defined as the perception of patient needs and expectations being met, is rapidly becoming a primary indicator for evaluation and comparison of quality in health care plans.1,2 Currently, efforts are underway in the national accrediting organizations for unified, standardized patient satisfaction measures, thus supporting the importance of measurement of customer needs and expectations. One newly developed satisfaction survey, Consumer Assessment of Health Plans, is being lobbied widely as a leading instrument for comprehensive measurement of patient (adult) satisfaction and for standardized comparisons of quality health plans.3–6