If I Could Alter One Thing...

writes about patient's views of hospital conditions compared with those of'-pital staffs and committees HOW closely do patients' views on hospital conditions correspond with those of staff and committees? It is important to know these priorities for action, when a choice has to be made between various desirable changes. One ward may need redecoration, better lavatories and bathrooms and a television set, but the hospital cannot afford all these improvements at once. Which is most needed, in the opinion of the patients, the doctors, the nurses or the hospital management commit-tee? At the same time, are there certain organisational changes that may cost nothing in money or staff-time, but which are strongly desired by the patients? AIMS AND METHODS To obtain some indications of relative priorities, I undertook an attitude-survey (under the auspices of the Royal College of Nursing and National Council of Nurses) in four general hospitals in London. All had about 400 beds, and were in old buildings that had been partly modernised; they had training schools for nurses attached, but were not medical teaching hospitals. The survey findings were consistent between the four hospitals, but do not necessarily hold for any other type of hospital. About 1,100 people were seen: 500 patients and 600 others?medical, nursing, administrative and domestic staff and committee members. In each hospital, all the patients from nine acute wards were invited to participate , unless they were too ill or were new to the ward. Invitations were also sent to a sample of staff and committee members. With all groups, except the medical staff and committee members, about 98% agreed to be interviewed; of the doctors, about 70% accepted. A fair number of the committee members refused, almost always because they said they knew too little about the details of patients' condi" to be helpful.