The effect of patient qualifications and number of patient accompanist on patient's satisfaction

Relationship between inpatient satisfaction and the quality of surgery

Background

This study sought to investigate the correlation between inpatient satisfaction and surgical quality evaluation indicators, and explore the factors affecting inpatient satisfaction.

Methods

A total of 5,000 inpatients who underwent surgery at 10 tertiary. A hospital in Chongqing were randomly selected and asked to complete an inpatient satisfaction questionnaire developed by our team in a previous study. A logistic regression was undertaken to analyze the factors affecting inpatient satisfaction, and the relationship between inpatient satisfaction and evaluation indicators of surgical quality.

Results

The overall satisfaction level of inpatients undergoing surgery was high. Specifically, the satisfaction level was 88.7%, and the dissatisfaction level was 11.3%. A univariate analysis showed that age, marital status, education level, monthly family income, the source of medical costs, the average length of the hospital stay, first hospitalization or not, doctor-patient communication, the quality of surgery, service attitude, 30-day postoperative mortality, major and minor complications, the rescue failure rate, readmission, and the incision infection rate affected the patient satisfaction, and the difference between satisfied and dissatisfied patients in each group was statistically significant (all P=0.000). The results of the logistic regression analysis showed that the factors related to the satisfaction of surgical quality indicators were postoperative 30-day mortality, major and minor complications, the rescue failure rate, the incision infection rate, and the average length of the hospital stay (all P<0.05), and the factors related to a decrease in inpatient satisfaction were increased postoperative 30-day mortality, a high incidence of major and minor complications, a high rescue failure rate, and a high incision infection rate.

Conclusions

There was a significant correlation between inpatient satisfaction and surgical quality evaluation indicators (i.e., 30-day mortality, major and minor complications, the rescue failure rate, the incision infection rate, and the average length of the hospital stay).

Quality of Care of Medical Imaging Services at a Teaching Hospital in Ghana: Clients' Perspective

BACKGROUND

The Ministry of Health of Ghana is committed to delivering client-focused, quality-driven, and results-oriented medical imaging services. However, there remained a lack of empirical evidence regarding the state of the various dimensions of quality needed to establish evidence-based strategies to strengthen the medical imaging system. This study assessed the quality of care of medical imaging services from clients' perspective at a teaching hospital in order to inform policy.

METHODS

This research was a descriptive cross-sectional study using a mixed method approach based on the dimensions of quality of care in medical imaging: capacity and sustainability, timeliness, safety, equity, patient centeredness, and effective communication.

QUANTITATIVE METHOD

A 5-point Likert scale questionnaire was used. A total of 191 clients aged ≥18 years were recruited during medical imaging services at the imaging department of the hospital. A simple random sampling technique was used to select participants. Data were analyzed using Stata version 13. Descriptive analyses were carried out.

QUALITATIVE METHODS

Purposive sampling strategy was applied to recruit 12 in-depth interview participants. Reflective interview guide starting with demographic characteristics and followed by the dimensions of quality of care was used. Qualitative data were analyzed using thematic analysis.

QUANTITATIVE RESULTS

Overall, there is low quality of care 2.8 (standard deviation [SD] = 0.6). There is low quality with regards to timeliness 2.8 (SD = 0.4), patient centeredness 2.7 (SD = 0.7), equity 2.8 (SD = 0.2), effective communication 2.7 (SD = 0.7), and safety 2.5 (SD = 0.3). Quality of care in relation to capacity and sustainability is high 3.4 (0.6). Only 73 (38.2%) of the clients are currently satisfied with the quality of care, and only 39.8% will recommend others to access care at the imaging department. Only 66 (34.6%) of clients are of the view that staff behavior instills confidence.

QUALITATIVE RESULTS

The qualitative study shows a lack of equity, timeliness, and patient-centeredness in terms of care and privacy. There is a perceived lack of compliance with radiation protection protocols, and there exist wide communication gaps between clients and staff. Furthermore, there is a lack of capacity and sustainability in relation to the reliability and availability of functional equipment. There is, however, high appraisal from clients regarding the neatness and availability of staff.

CONCLUSION

A majority of clients are not satisfied with the quality of care of the medical imaging services. Improved interaction with clients, availability of functional equipment, and effective communication during the care process between the patients and the imaging professionals such as provision of timely information during the waiting period and explanation of procedure will help enhance the quality of care.

Improving patient satisfaction: the virtual breakthrough series collaborative

PURPOSE

The purpose of this paper is to improve the Siloam Hospitals' (SHs) patient satisfaction index (PSI) and overcome Indonesia's geographical barriers.

DESIGN/METHODOLOGY/APPROACH

The topic was selected for reasons guided by the Institute of Healthcare Improvement virtual breakthrough series collaborative (VBSC). Subject matter experts came from existing global quality development in collaboration with sales and marketing, and talent management agencies/departments. Patient satisfaction (PS) was measured using the SH Customer Feedback Form. Data were analysed using Friedman's test.

FINDINGS

The in-patient (IP) department PSI repeated measures comparison during VBSC, performed using Friedman's test, showed a statistically significant increase in the PSI, χ² = 44.00, p<0.001. Post hoc analysis with Wilcoxon signed-rank test was conducted with a Bonferroni correction applied, which resulted in a significant increase between the baseline and action phases ( Z=3.317, p=0.003) between the baseline and continuous improvement phases ( Z=6.633, p<0.001), and between the action and continuous improvement phases ( Z=3.317, p=0.003), suggesting that IP PSI was continuously increasing during all VBSC phases. Like IP PSI, the out-patient department PSI was also continuously increasing during all VBSC phases.

RESEARCH LIMITATIONS/IMPLICATIONS

The VBSC was not implemented using a control group. Factors other than the VBSC may have contributed to increased PS.

PRACTICAL IMPLICATIONS

The VBSC was conducted using virtual telecommunication. Although conventional breakthrough series might result in better cohesiveness and commitment, Indonesian geographical barriers forced an alternative strategy, which is much more cost-effective.

ORIGINALITY/VALUE

The VBSC, designed to improve PS, has never been implemented in any Indonesian private hospital group. Other hospital groups might also appreciate knowing about the VBSC to improve their PSI.

Contextual and individual factors associated with dissatisfaction with public emergency health services in Brazil, 2011-2012

The Brazilian network of emergency care, in recent years, has shown significant progress. The objective was to evaluate contextual and individual factors associated with the satisfaction with public emergency health services. This was a cross-sectional multilevel study carried out between June 2011 and January 2012. Data were collected via telephone at the ombudsman’s office of the Brazilian Unified National Health System (SUS). Telephone numbers were randomly selected from a telephone company database. Health services, socioeconomic, and individual demographic variables were evaluated, in addition to information about the municipalities. The outcome variable was dissatisfaction with public emergency health services in Brazil. Multilevel logistic regression was performed and 7,027 individuals from 61 municipalities answered the survey. The prevalence of perceived dissatisfaction was 48.1% (95%CI: 46.9-49.3). Variables that remained significantly associated with the outcome are: age up to 20 years, 16 or more years of education, lives in the Central region, non-resolved demands, longer waiting times, and accessing emergency in a primary care service. Prevalence of a perceived dissatisfaction is predominantly associated with care’s waiting time and the length needed to resolve the demand.