The following is a summary of “What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences,” published in the January 2023 issue of Rheumatology by Kumar, et al.


Providers provide after-visit summaries (AVS), patient-specific papers that outline the main points of consultations. Despite its extensive usage, more was needed about the preferred AVS content and style among rheumatic patients. For a study, researchers sought to determine patient preferences and develop a Kano-based AVS specifically for rheumatology.

There were four aspects to the initiative to increase quality. To create a list of prospective attributes, investigators first spoke with clinic employees and veterans. Second, veterans were given a Kano questionnaire to complete that gauged their happiness with each feature’s availability or absence. Third, aspects were classified as obligatory, appealing, performative, or indifferent using qualitative and quantitative Kano analyses. Fourthly, in light of these conclusions, an AVS was created, delivered to Veterans, and accompanied by a survey to gauge their satisfaction with its readability, aesthetic appeal, and substance.

About 15 attributes were selected by 9 doctors, 5 veterans, 5 schedulers, 3 nurses, and 3 medical assistants for inclusion in a Kano-style questionnaire. 50 Veterans were given the questionnaire by successive sampling. Quantitative Kano analysis showed that 6 indifferent characteristics were removed while 4 required, 2 performance and 3 appealing features were eventually included in AVS. 50 Veterans who participated in a post-intervention survey gave the AVS content (4.3/5), visual appeal (4.6/5), and readability (4.4/5) good satisfaction ratings.

The Kano approach was used to identify the 9 essential, alluring, and performance elements they had to incorporate into the AVS. Veterans expressed great satisfaction with the AVS’s substance, aesthetic appeal, and readability.

Reference: journals.lww.com/jclinrheum/Abstract/2023/01000/What_Do_Rheumatology_Patients_Want_in_an.9.aspx