Q. How does the QIS methodology compare with customer satisfaction surveys?


A.  As the importance of resident-centered care has become more widely acknowledged across the entire range of long term care stakeholders, so has the importance of being able to measure its quality. The QIS, resident assessment instruments (such as MDS 3.0), and satisfaction survey instruments have all increased coverage of resident-centered care.
In the process, domains of long term care have often been segmented into two groups, quality of care (QOC) and quality of life (QOL). Methods for measuring QOC have long been thought of as “objective” or, more specifically, measured in terms of outcome, procedure, and staff performance.
On the other hand, measurements of QOL have traditionally been through more “subjective” methods that solicit respondents’ opinions about QOL areas. QIS has introduced measurement methods of QOL areas for both state surveyors and providers that are constructed in the more objective model of what has been done in the past for QOC.
There are similarities between the QIS and customer satisfaction survey methodologies. Both are statistical and both require testing for reliability, accuracy, and validity. However, the language and grammar must be designed very carefully to ensure that the intended target of the question is actually measured. Both typically allow comments to be entered while measurements are conducted so they can be reported in various formats.
One main difference between QIS and customer satisfaction survey methodology is in the construct of the items. For satisfaction surveys, a 4-point or 5-point scale is often used to indicate respondents’ level of agreement with a statement or their rating of the item. In QIS, the constructs are almost all dichotomous items that have either a yes or no response or otherwise require respondents to choose one of two responses.
In this way, QIS respondents are indicating the existence, or not, of the service associated with the QOL area, as opposed to rating or evaluating their satisfaction with it.
Another main difference is that satisfaction surveys typically contain substantially fewer items than the QIS. This facilitates shorter satisfaction surveys that improve response rates, but doesn’t provide the direct tie to regulation and replication of the state survey process that conducting QIS protocols affords. Surveys are conducted for facility staff to provide very important insight into drivers of workforce satisfaction, which QIS does not cover.
Both QIS methodologies and satisfaction surveys provide valuable tools for providers to assess and improve the operation of their organizations in the eyes of all stakeholders.