Infection Control & Hospital Epidemiology


Table 2. Comparison of Top Box HCAHPS Patient Experience Scores for Patients in Isolation With Those Not in Isolation %Top Boxa


Patients Not in Isolation


Satisfaction Domains Nursing communicationg


Nurses treated with courtesy/respect


Nurses listened carefully Nurses explained


Physician communicationg


Doctors treated with courtesy/respect


Doctors listened carefully Doctors explained


Hospital environmenth Cleanliness of the hospital Quietness of the hospital Responsiveness relatedg


Help toileting as soon as you wanted


Call button help soon as wanted


Pain well controlled


Staff do everything help with pain


Miscellaneous itemsh


Staff talk about help when you leave


Info re: symptoms/prob to look for


Staff describe medicine side effect


Tell you what new medicine was for


Overallg Rate hospital (0–10)


84 93 49 79 85 91 48 76 .2529 .0006 0.284 .0167 1.10 (0.94–1.29) 0.99 (0.81–1.20) 0.99 (0.87–1.12) 0.97 (0.83–1.12) .26 .92 .85 .66 1.07 0.19 1.11 0.10 1.08 0.07 1.01 0.84 88


80 78


69 63


63 61


63 79


85


74 73


61 58


51 51


56 70


<.0001


<.0001 .0001


<.0001 .0006


<.0001 <.0001


<.0001 <.0001


0.90 (0.78–1.04)


0.82 (0.73–0.93) 0.96 (0.85–1.08)


0.88 (0.79–0.99) 0.98 (0.88–1.10)


0.78 (0.67–0.90) 0.79 (0.71–0.88)


0.89 (0.78–1.00) 0.77 (0.67–0.89)


.08 0.0007i .43


.02 .79


.0009 <.0001 .039 .0001 0.95


0.94 1.01


0.99 1.00


1.01 1.00 .30


.13 .90


.83 .93


.87 .90


1.02 0.63 1.01 0.73


87


77 77


84


72 72


.0002


<.0001 <.0001


0.89 (0.77–1.03)


0.86 (0.76–0.97) 0.88 (0.78–0.99)


.06 007 0.04 0.96


1.01 0.98


.41


.86 .63


(n=18,816), %b


Patients in Isolation


(n=1,784), %b,c


P Value for Unadjusted Comparison


Adjusted Odds Ratiod


P Value for Adjusted Comparisond


Odds Ratioe


P Value


197


Dose Responsef


80


73


<.0001


0.80 (0.71–0.91)


<.0001


0.96 0.26


aPercentage of patients responses that were “always” or “definitely yes” or “9” or “10” on the HCAHPS survey items. bNumber of responses varied across different items for both group. cPatients were considered isolated if they spent greater than 50% of their hospital stay on isolation status. dAdjusted for age, sex, race, payor type, length of stay (LOS), all-payer refined diagnosis-related group–severity of illness (APR-DRG SOI) and clinical service type. P<.0046 was significant


(calculated using Bonferoni correction). eOdds ratio for a Top Box response for each 25% increase in time spent in isolation (no. of days in isolation/length of stay). fAll patients who were in isolation at any point in their hospital stay were include in the dose response analysis. gItems analyzed for primary analysis. hItems analyzed for exploratory analysis. iBold P value indicates statistical significance (P<.0046).


for most items related to nursing, physician, hospital environ- ment, and discharge can probably explained by patient demo- graphic factors and illness severity.


The dose-response analysis did not show worse experience on


any of the items with increasing percentage of hospital stay spent in isolation. This finding raises the possibility that isolation status


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