Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

The influence of diagnoses on patient satisfaction during inpatient stays: A prospective study

The aim of this study was to assess patient satisfaction relating to inpatient stays. In this prospective observational study, adult patients with oncological (oral cancer, medication-related osteonecrosis of the jaw) and non-oncological (mandibular fracture) diagnoses, and who had undergone surgery, were contacted 4 weeks after discharge. Two validated questionnaires were used: EORTC QLQ-C30 for quality of life and IN-PATSAT32 for patient satisfaction. For quality of life, the mandibular fracture group had a lower impairment of physical functioning (M = 83.59, SD = 24.44; p = 0.029) in comparison with both other groups (M = 68.84, SD = 26.24; M = 59.33, SD = 24.43, for oral cancer and osteonecrosis, respectively). Regarding patient satisfaction, patients with oral cancer were slightly more satisfied with doctors' availability (M = 48.91, SD = 24.11; p = 0.583) compared with the other groups (M = 36.54, SD = 19.11; M = 46.67, SD = 20.86, for mandibular fracture and ostenecrosis, respectively). Patients with an unplanned inpatient stay following an acute event tended to be less satisfied than patients with a planned inpatient stay. Within the limitations of the study it seems that knowledge of these influencing external factors and their effects can support physicians and nursing staff in providing improved patient care.

Assessment of Quality of Care Using Information on Patient Satisfaction at Adult Oncology Center of Tikur Anbessa Specialized Hospital, Ethiopia: A Cross-Sectional Study

BACKGROUND

Cancer is one of the leading causes of morbidity and mortality in the world. It results in considerable mental, physical, and emotional stress for patients. Because of the nature and impact of the disease, and its treatment, measurements of patient satisfaction are important to bring to the attention of health-care providers in order to improve care.

OBJECTIVE

To assess patient satisfaction at the adult oncology center of Tikur Anbessa Specialized Hospital, Ethiopia using the EORTC PATSAT-C33 tool.

METHODS

A facility-based cross-sectional study was conducted from January 2019 to May 2019. A consecutive sampling technique was employed to recruit a total of 384 study participants. Informed consent was obtained for each participant and data were collected using an interviewer-administered questionnaire. Ethical clearance and approval of the study protocol were obtained from the institutional ethics review board of the school of pharmacy. Descriptive statistics was used to summarize the data, while multivariate linear regression analysis was employed to explore factors affecting patient satisfaction. P<0.05 was considered as statistically significant.

RESULTS

Among a total of 384 study participants, the majority were female (65.9%) and the median age was 49 years. In most (65.9%) participants, the health-care service cost was covered by patients themselves; the majority of them were treated for gynecological malignancy (37.2%) and most received chemotherapy + surgery (37.2%). The mean score for the EORTC-PATSAT33 scales for overall satisfaction was 44.8 out of 100. Place of residence, gender, type of cancer, duration since treatment started, age and source of health-care costs were factors associated with patient satisfaction and all together explained 83% (adjusted R square=0.830, P<0.0001) of variance. Of these, residence (where patients came from) accounted for most (78.7%) of the variance (adjusted R square=0.787, P<0.0001).

CONCLUSION

The mean overall satisfaction of patients with the services provided at the outpatient adult oncology center of TASH was significantly lower than previously reported in the world literature, which was >70. Hence, a concerted effort must be made to understand and improve patient satisfaction in oncology health-care services in Ethiopia.

Decreasing Time to Initiation of Chemotherapy for Patients Electively Admitted to a Hematologic Malignancy Service

PURPOSE

Delays in initiating elective inpatient chemotherapy can decrease patient satisfaction and increase length of stay. At our institution, we observed that 86% of patients who were admitted for elective chemotherapy experienced a delay-more than 6 hours-with a median time to chemotherapy of 18.9 hours. We developed a process improvement initiative to improve time to chemotherapy for elective chemotherapy admissions.

METHODS

Our outcome measure was the time from admission to chemotherapy administration in patients who were admitted for elective chemotherapy. Process measures were identified and monitored. We collected baseline data and used performance improvement tools to identify key drivers. We focused on these key drivers to develop multiple plan-do-study-act cycles to improve our outcome measure. Once we started an intervention, we collected data every 2 weeks to assess our intervention.

RESULTS

At the time of interim analysis, we observed a median decrease in time to chemotherapy administration from 18.9 hours to 8.85 hours (P = .005). Median time to laboratory results resulted decreased from 3.17 hours to 0.00 hours. There was no change in time from signing chemotherapy to nurse releasing the chemotherapy. We noted that more providers were signing the chemotherapy before patient admission.

CONCLUSION

By implementing new admission workflows, optimizing our use of the electronic medical record to communicate among providers, and improving preadmission planning we were able to reduce our median time to chemotherapy for elective admissions by 53.2%. Improvement is still needed to meet our goals and to ensure the sustainability of these ongoing efforts.

Relationship of treatment satisfaction to health-related quality of life: findings from a cross-sectional survey among hypertensive patients in Palestine

BACKGROUND

Evaluation of the association between treatment satisfaction and health-related quality of life (HRQoL) may enable health-care providers to understand the issues that influence quality of life and to recognize the aspects of hypertension treatment that need improvement to enhance the long-term treatment outcomes.

OBJECTIVE

The aim of this study was to determine the relationship between HRQoL and treatment satisfaction in a sample of Palestinian hypertensive patients.

METHODS

A cross-sectional study was conducted, adopting the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) for the assessment of treatment satisfaction and using the European Quality of Life scale (EQ-5D-5L) for the assessment of HRQoL. Descriptive and comparative statistics were used to describe socio-demographic and disease-related characteristics of the patients. All analyses were performed using SPSS v 15.0.

RESULTS

Four hundred and ten hypertensive patients were enrolled in the study. This study findings indicate a positive correlation between all satisfaction domains and HRQoL. Significant differences were observed between this study variables (P < 0.001). After adjustment for covariates using multiple linear regression, an increase of one point in the global satisfaction scale was associated with a 0.16 increase in EQ-5D index scores (r = 0.16; P < 0.001).

CONCLUSIONS

Patients with reportedly higher satisfaction scores have reported relatively higher EQ-5D-5L index values. These study findings could be helpful in clinical practice, mainly in the early treatment of hypertensive patients, at a point where improving treatment satisfaction and HRQoL is still possible.

Patients' satisfaction with fast-track surgery in gynaecological oncology

This study investigates the experience and satisfaction with care of fast-tracked gynaecological patients. The Sydney Gynaecological Oncology Group, New South Wales, Australia, has previously shown the benefits of a fast-track surgery programme for gynaecology patients with both complex benign gynaecological pathology and gynaecological malignancy. The question of whether these benefits translate into a positive experience for fast-tracked patients, in the context of their hospital stay and healthcare team care, has not been previously explored in detail. A self-administered satisfaction questionnaire incorporating the European Organisation for Research and Treatment of Cancer (EORTC) cancer in-patient satisfaction with care measure (INPATSAT-32) questionnaire with additional questions was administered to 106 gynaecology participants at Royal Prince Alfred Hospital. Participants reported high levels of satisfaction with patient care and support received from doctors, ward nurses and the hospital as a service and care organisation, within the context of a fast-track surgical programme. Early hospital discharge after gynaecological surgery results in both enhanced recovery after surgery (ERAS) and high levels of patient satisfaction.

Satisfaction Level and Perception of Quality in Cancer Care

Consumer’s perception of health care quality and his satisfaction is being identified as an important issue in health care industry. Studies addressing patients’ perceptions of quality are available but there is paucity of data regarding the perception of health care providers (service-providers) towards their own services. This study was undertaken to compare the satisfaction level between the patients and health care providers from a radiation oncology department.

A common 16-item questionnaire was served to 40 patients and 40 staff members. The responses were statistically evaluated to assess the satisfaction level among the two groups and the scores were compared to assess the agreement between two groups. Overall, satisfaction level of both groups regarding quality of services ranged from ‘good’ to ‘excellent’. A high level of agreement was observed between the two groups. The physician’s ability to give explanation to patients, helping attitude of the staff and the staff’s concern for patient safety were the most satisfying features of the department while inconvenience during scheduling of appointments, billing and registration process, status of the changing rooms and inter-department coordination were the least satisfying features.

A high level of satisfaction may be achieved from the consumers if service providers are trained to assess the needs and expectations of consumers and to critically evaluate themselves. The service-providers’ perception regarding their own services may serve as a preliminary indicator of overall quality. Future studies in different settings with more number of patients may further explore our results.

Fast-track surgery in gynaecology and gynaecologic oncology: a review of a rolling clinical audit

Clinical audit is the process by which clinicians are able to demonstrate to themselves, their patients, hospital administrators, and healthcare financial providers the outcome and safety of their clinical practice. It is a process by which the public can be assured of safety and outcomes. A fast-track surgery program was initiated in January 2008, and this paper represents a rolling clinical audit of the outcomes of that program until the end of June 2012. Three hundred and eighty-nine patients underwent fast track surgical management after having a laparotomy for suspected or confirmed gynaecological cancer. There were no exclusions and the data presented represents the practice and outcomes of all patients referred to a single gynaecological oncologist. The majority of patients were deemed to have complex surgical procedures performed usually through a vertical midline incision. One third of patients had a nonzero performance status, median weight was 68 kilograms, and median BMI was 26.5 with 31% being classified as obese. Median operating time was 2.25 hours, and the median estimated blood loss was 175 mL. Overall the median length of stay (LOS) was 3 days with 95% of patients tolerating early oral feeding. Four percent of patients required readmission, and 0.5% were required to return to the operating room. Whilst the wound infection rate was 2.6%, there were no ureteric, bowel or neurovascular injuries. Overall there were 2 bladder injuries (0.5%), and the incidence of venous thromboembolism was 1%. Subset analysis was also undertaken. Whilst a number of variables were associated with reduced LOS, on multivariate analysis, benign pathology, shorter operating time, and the ability to tolerate early oral feeding were found to be significant. The data and experience presented is the largest and most extensive reported in the literature relating to fast-track surgery in gynaecology and gynaecologic oncology. The public can be reassured of the safety and improved outcomes that can be achieved after the introduction of such a program.