Date of Award


Scholarly Projects

Projects: SPU Access Only

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

Mary Coucoules

Faculty Reader

Vicki Aaberg

Executive Summary

Executive Summary

Background: There are approximately 1400 free clinics across the US, and the services they provide are in high demand due to the large amount of individuals in the US lacking health insurance (NAFC, 2015). Due to the increased need and utilization of free clinic settings, evaluation of quality of healthcare services provided in free clinic settings is paramount. The Centers for Medicare and Medicaid Services (CMS) has emphasized obtaining the patient’s perception of care through the use of a patient satisfaction survey in order to evaluate care provided (CMS, 2017). Patient satisfaction survey data can be used for cost reduction, improved strategic decision-making, evaluation of the effectiveness of health plans, and improvement in aspects of the healthcare organization and workflow (Al-Abri & Al-Balushi, 2014). Since free clinics often function with a limited budget, a patient satisfaction survey is a valuable tool in the strategic planning process.

Problem and Purpose Statements: A free clinic in rural Western Washington did not have a process to evaluate patient satisfaction such as through a survey tool in order to evaluate quality of care and services provided by the clinic. The purpose of this scholarly project was to develop and implement an effective and sustainable patient satisfaction survey tool to improve the quality of care provided by the clinic team.

Methods: This scholarly project took place in a free clinic in rural Western Washington. Semi-structured interviews were conducted with nine clinic staff members. Themes from these interviews, obtained through thematic qualitative analysis, and recommendations from current research were utilized to develop a 10-item patient satisfaction survey that included one open-ended question. The survey was administered to clinic patients through a real-time electronic format through SurveyMonkey, a paper format available in the clinic, and an emailed survey. Fifteen patient satisfaction surveys were completed over a five-week period. The survey results were quantified and shared with clinic staff, and then an electronic questionnaire was administered to clinic staff to gauge the effectiveness of the patient satisfaction survey. Four clinic staff members completed this questionnaire.

Results/Outcomes: Patients that completed the patient satisfaction survey indicated that the clinic staff treated them with respect, addressed their concerns, and that they would recommend the clinic to others. For the open-ended question responses, patients indicated how grateful they were for having the free clinic as a resource and that more days of clinic availability would be helpful. The clinic staff that completed the questionnaire indicated that the survey data provided them with adequate information that aspects of the clinic were working well and that aspects could be addressed for quality improvement. The recurring suggestion for survey data that would be helpful to have further insight on was what days and hours the patients would want if the clinic could open during additional hours, since this was an item that patients gave feedback on.

Sustainability: The patient satisfaction survey developed through this project is sustainable due to the electronic version on SurveyMonkey being cost-efficient. SurveyMonkey also has features for analysis of suvey data. However, additional dedicated equipment is needed for a real-time electronic survey, and dedicated staff for a paper survey. Although the literature indicated that real-time surveys have a higher response time and take less time to complete, the electronic surveys may be most practical in the free clinic setting (Pena & Lawrence, 2017).

Implications: There is limited literature on patient satisfaction survey development in a free clinic setting (Kamimura et al., 2015). This quality improvement project provides insight on the process for developing a patient satisfaction survey in the unique setting of a free community clinic, the evaluation of the survey tool, and its applicability to the clinic setting through feedback obtained from clinic staff. The findings from this project could be utilized as a reference to develop and implement a patient satisfaction survey in similar community, rural, and free clinic settings.