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Measuring Patient and Staff Satisfaction Before and After Implementation of a Paperless Registration System

Lulejian, Armine, PhD, CHES; Cantor, Michael, N., MD

Journal of Healthcare Management: May-June 2018 - Volume 63 - Issue 3 - p e20–e30
doi: 10.1097/JHM-D-16-00027

EXECUTIVE SUMMARY While many aspects of patient care have transitioned to digital technology, the patient registration process often is still paper based. Several studies have examined the effects of changes in clinic workflows and appointment scheduling on patient satisfaction, but few have investigated changes from a paper-based to a paperless registration process. The authors measured patient and staff satisfaction before and after implementation of a new, tablet-based registration process at NYU Langone Health's Center for Women's Health in New York City. Mean preimplementation patient satisfaction scores on the six questions related to the registration process (1-5 scale, with 5 being the highest score) ranged from 4.0 to 4.5. Postimplementation satisfaction scores on the nine questions (six premeasure questions and three additional questions related to the tablet-based process) ranged from 4.4 to 4.6, with four of the six premeasures showing statistically significant improvement in patient satisfaction. Staff satisfaction was generally lower (2.8-3.6 preimplementation and 2.8-4 postimplementation), with no statistically significant difference between time frames. Patient satisfaction was relatively high under the paper registration process, and it improved significantly in some respects under the paperless process, while staff satisfaction did not change. The convenience and ease of use of a paperless registration system can help maintain or increase patient and staff satisfaction while introducing new workflows and improving the efficiency of the outpatient registration process. In adopting technology that can lead to changing workflows, organizations should train staff members and support them during the process.

assistant professor and coordinator of healthcare administration in public administration, Kean University, Union, New Jersey

director of clinical research informatics and associate professor (clinical) of medicine and population health, NYU School of Medicine, New York

For more information about the concepts in this article, contact Dr. Cantor at

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the text and are provided in the HTML and PDF versions of this article on the journal's website (

© 2018 Foundation of the American College of Healthcare Executives
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