The rise and fall of one unit's patient satisfaction scores.

Lessons may be learned from analyzing how a medical unit dramatically improved patient satisfaction scores, only to have the scores drop in future years. This article describes one hospital's experience in improving patient satisfaction by employing a parallel learning structure that promoted innovation and employee involvement. The reasons that gains in patient satisfaction and quality were not sustained are analyzed, and change management theory is used to explain what healthcare managers can do to prevent such capitulation in their own improvement efforts.