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Assessing and Addressing Patient Satisfaction in a Longer-term Inpatient Psychiatric Hospital: Preliminary Findings on the Menninger Quality of Care Measure and Methodology

Madan, Alok PhD, MPH; Fowler, J. Christopher PhD; Allen, Jon G. PhD; Ellis, Thomas E. PsyD; Hardesty, Susan MD; Groat, Michael PhD; O'Malley, Flynn PhD; Woodson, Harrell PhD; Mahoney, Jane PhD, RN; Frueh, B. Christopher PhD; Oldham, John MD, MS

doi: 10.1097/QMH.0000000000000034
Original Articles

Patient satisfaction is increasingly used as an indicator of health care quality. Few measures are available to assess characteristics unique to inpatient psychiatric hospitals, especially those that provide longer-term care. Furthermore, there is limited guidance on how to utilize patient satisfaction data to guide quality improvement initiatives. The authors developed the 20-item, Menninger Quality of Care measure at The Menninger Clinic in Houston, Texas. Psychometric analyses were based on responses from 337 adult inpatients. The measure has excellent internal reliability (Cronbach α = 0.92) with adequate concurrent and construct validity. We present a methodology to identify targeted quality improvement efforts by (1) highlighting the perspective of patients who are generally satisfied but had at least some reservations regarding the care they received and (2) highlighting areas of concern that are most associated with overall quality of care. We discuss our findings in light of national health care quality trends.

The Menninger Clinic, Houston, Texas (Drs Madan, Fowler, Allen, Ellis, Hardesty, Groat, O'Malley, Woodson, Mahoney, Frueh, and Oldham); Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas (Drs Madan, Fowler, Allen, Ellis, Hardesty, Groat, O'Malley, Woodson, Mahoney, and Oldham); and Department of Social Sciences, University of Hawaii, Hilo, Hawaii (Dr Frueh).

Correspondence: Alok Madan, PhD, MPH, The Menninger Clinic, 12301 S Main St, Houston, TX 77035 (

This research was partially supported by the Menninger Foundation and McNair Medical Institute. Drs Frueh, Fowler, and Madan are McNair Scholars. The study follows the guidelines on good publication practices. The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or manuscript. Thus, the authors were independent from study sponsors in the context of the research. For the remaining authors, none were declared.

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