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Anita Savidan-Niederer ESOPE, Unisanté Lausanne

Portrait

Anita Savidan-Niederer on the way to work and with her colleague Dr Federico Cathieni.

Anita Savidan-Niederer, you were actually due to retire in the spring of 2021. What motivated you to continue working?

The most important reason: I find my job fascinating! Thanks to the ‘extension’, I have been able to oversee the current patient satisfaction measurement right to its conclusion and to write the National Comparison Report for it. It was also important to me to be able to train my successors Chiara Storari and Julien Junot properly. Of course, our Chief Physician Prof. Isabelle Peytremann-Bridevaux, who has been here since the beginning of the measurements, is also helping to ensure a seamless transition.

Are there any professional highlights that you would particularly like to look back on?

Being able to immerse myself in a new topic was always a highlight. That’s why I also found the analysis of satisfaction surveys in other countries, which I was recently able to do on behalf of the ANQ, so fascinating. I’ll also cherish the memories of collaborating with my colleagues. Their many different perspectives were always very enlightening.

You’re a renowned expert in satisfaction surveys. Do you still participate in surveys yourself?

Yes, I enjoy taking part in online surveys. But only if the topic is relevant to me and I feel that my answers could make a difference. I usually avoid very short and very extensive surveys. But if the topic is close to my heart, it doesn’t matter how long the survey is.

You have been working with ANQ’s patient satisfaction measurement since 2016. How have the results evolved during this period?

The national results – due to the large number of responses – are very constant. In acute care alone, we receive around 30,000 responses, individual ‘outliers’ are therefore of no real consequence. At hospital level however, changes are much more likely. Most often, it’s the response rate that changes. In 2011 in acute care, this was almost 50%, today – 10 years later – it’s less than 39%. The falling response rate is a general problem. The big question is how this trend can be stopped.

«Being able to immerse myself in a new topic was always a highlight.»

What do you suggest?

Participants need to know that their responses will actually achieve something. That’s why I find it great when hospitals publish improvements made as a result of patient feedback on their websites. But there isn’t a one-size-fits-all way to increase the response rate. Because not everything that benefits the response rate benefits the quality of the responses. For example, more surveys may be filled out when staff are present but there is a risk that the responses may be biased: it may be that instead of expressing what they really think, survey participants give a response that they consider the majority will give or that they think they are expected to give. This is known as the social desirability effect.

What are the challenges facing data analysis and reporting?

The biggest challenge is timing. Every work step is precisely planned, carefully coordinated with measurement logistics centre w hoch 2 and aligned with the ANQ’s schedules. The evaluation of the data, the creation of the funnel plots, the writing of the reports and the translations is all very time-intensive. Even when much is automated, there are always various additional evaluations or changes that we have to carry out manually.

You mentioned the analysis of satisfaction measurement in other countries. What are the most significant trends?

The response rate is a huge challenge in all the countries analysed. Most use online questionnaires. In some countries, patients receive these via email, in others via text message. Size is also an issue across the board. Answering the questions shouldn’t be too time-consuming but at the same time, there needs to be a certain depth to the answers. The issues surveyed and the response scales in the countries analysed are comparable but there are differences in the presentation of the results.

What recommendations have you taken from this for Switzerland?

The final report includes a list with concrete recommendations. I’d like to pick out three: patients should be involved in the development of the survey itself, not only in testing the question items. This makes sure that the topics surveyed are considered relevant. We also recommend including a manageable number of quality dimensions and asking several questions for each dimension. Open questions may also be useful. Although open questions are challenging to evaluate, they can provide hospitals and clinics with important information. They also give patients the opportunity to express their personal opinion and to ‘offload’ any possible frustration.

Thinking about your retirement – what will you miss? And what are you looking forward to the most?

I’m a little sad that I’ll no longer be able to see at first hand how the ANQ patient satisfaction measurement is progressing. But I’m really looking forward to being able to plan my day the way I want. Although, as I’ll now have more commitments with friends and family, I’m curious to see just how great my new-found freedom will actually be ...

Anita Savidan-Niederer, PhD, studied biology to PhD level at the University of Neuchâtel. This background provided a great basis for working in a wide range of jobs, she reports. Before she came to Lausanne in 2014, she worked for the Krebsregister St. Gallen-Appenzell (now the Krebsregister Ostschweiz). At Unisanté, she had various responsibilities, including the register of anaesthetists and the Cochrane Schweiz mandate. Since 2016, she has also been responsible for the evaluation of the ANQ patient satisfaction measurement.

More information: ESOPE final report covering literature review and inventory of existing surveys

Photos: © Geri Krischker / ANQ