Patient Satisfaction with Public Healthcare | Literature

Patient Satisfaction with Public Healthcare | Literature Literature Review: Alian A. Alrasheedy, Mohammed Azmi Hassali, et al., published a research study in Australasian Medical Journal, 2014 entitled as â€Å"Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia†. They conducted a cross-sectional study to assess patients’ level of satisfaction with public healthcare services and to determine the factors that may affect patient satisfaction among convenience sample of general public. They developed a questionnaire which consists of five sections including demographic data, patients’ perceptions of their relationship and interaction with healthcare professionals in the public healthcare sector, patient perception of skills of healthcare professionals, patients’ assessment of the amenities, accessibility to and facilities available in the public healthcare sector and general satisfaction of patients with public healthcare services. To perform the statistics they used chi-square test and for it ems expected to have lower frequency, Fisher’s exact test was used. The findings showed that almost half of the participants were satisfied with current health care services in public hospitals and clinic. It shows a significant association between satisfaction and some participants’ characteristics such as age, gender, waiting time. Other factors influencing satisfaction level includes the length of consultations and process of patient registration. The limitation of the study is that illiterate people were not included in this study as it is a self-administered questionnaire. It concludes that improving the health services which leads to shorter waiting time may increase the patients’ satisfaction level. Krupal Joshi, Kishor Sochaliya, et al., performed a cross-sectioanl study to identify the factors that affect patient satisfaction regarding health care services. The study was entitled as â€Å"Patient satisfaction About Health Care Services: A Cross Sectional Study of Patients Who Visited the Outpatient Department of a Civil Hospital at Surendranagar, Gujarat† which was published in International Journal of Medical Science and Public Health, 2013. The patient were interviewed using pre-structured questionnaires which can be replied in choices like satisfactory/unsatisfactory, yes/no, good/moderate/poor, adequate/inadequate. The study revealed that overall the patient satisfaction was good regarding the quality of the services provided by the hospital. But revealed mild to moderate satisfaction regarding waiting time and specialist availability. Patient satisfaction was considered to be important in both evaluation and shaping of health care. Mansour Alturki, Tahir M.Khan published a study entitled â€Å"A study investigating the level of satisfaction with the health services provided by the pharmacist at ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia† in Saudi Pharmaceutical Journal,2013. They conducted a cross sectional study to evaluate the satisfaction of the patients related to pharmacy services provided to the patients at the hospital pharmacy. A self-administered 15-item questionnaire was used in the study which comprises of three sections which considered patient demographic data, information about health status of respondents, pharmacist-patient interaction level. The results were analyzed using independent sample t-test and one-way ANOVA. This study shows that the patient were majorly satisfied about the availability of the pharmacist and the explanations/clear labeling of drugs, politeness and prompt services of the pharmacist. The elderly patients were highly satisfied with the services p rovided by the pharmacy than the other age groups. But overall the satisfaction levels of the Saudi patients were least than that of the Egyptian and others and it may associate with the demographic features such as age, sex, and level of the education. Sumeet Singh, Paramjeet kaur, et al., conducted a study entitled â€Å"Patient satisfaction levels in a tertiary care medical college hospital in Punjab, North India.† It has been published in International Journal of Research and Development of Health, 2013. The study was aimed to assess the patients’ satisfaction regarding care provided in the hospital, behaviour of medical, nursing and supportive staff and availability of necessary services and amenities in the hospital. A cross-sectional study based on a pre-designed and pre-tested Indoor Patient Feedback Form was done. This study shows that most of the patients were more satisfied with the behaviour of doctors. The major problem was found to be in identifying the location of various areas mainly labs in the hospital. Satisfaction regarding the service and the behaviour of the paramedical staff was found to be high. This study shows that assessing patient satisfaction is simple, easy and cost effective for evaluatio n of hospital services. Afolabi MO, Afolabi ERI, et al., published a study in African Health sciences, 2012, entitled as â€Å"Construct validation of an instrument to measure patient satisfaction with pharmacy services in Nigerian hospitals†. The study aimed to develop a questionnaire used to assess the quality of the pharmacy services provided by the hospitals and to define the scale construct validity with an opinion to identify the factors that affect the target users. First they developed a 35-item Patient Satisfaction Survey questionnaire and then based on the pilot study conducted to assess the internal consistency reliability there was a reduction of items on the scale to 25 items. They used Cronbach coefficient Alpha, Spermann Brown’s and Guttmann’s coefficients to determine the reliability of the scale and Scree plot was also carried out for the final 25-item scale. The reliability coefficients attained for the instrument by means of various methods were comparable and statist ically significant. The final scale which consists of 25 items showed stable and significant correlation coefficients and produced six consequent dimensions of patient satisfaction which includes attitude of pharmacy personnel, accessibility and convenience of pharmacy location, quality and cost of the drugs, conducive physical environment, and availability of prescribed drugs and timeliness of service delivery. This study established a scale to evaluate satisfaction of the patients regarding pharmaceutical services. Amany M. Abdelhafez, Lina Al Qurashi et al., published a study in American Journal of Medicine and Medical Sciences, 2012, entitled â€Å"Analysis of factors affecting the satisfaction levels of patients toward food services at general hospitals in Makkah, Saudi Arabia†. This study aims to determine the factors that the satisfaction levels of the patient with the food services in a sample of general hospitals. They performed a cross-sectional study using an interview questionnaire. Spearman correlation was used to identify the relationship between the various aspects of food and food services and the overall satisfaction. In this study the temperature of the food was one of the determinants of overall dissatisfaction. Overall satisfaction levels can be increased by increasing the quality of food and hospital food services. As hospital malnutrition is a main problem, so hospital services should be considered as an important part of the patient treatment plan and hence it is imp ortant to evaluate patient views to make sure that the expectations of the patients regarding the food services were achieved. M V Kulkarni, S Dasgupta, et al., had done a study entitled â€Å"Study of Satisfaction of Patients Admitted in a Tertiary Care Hospital in Nagpur† which was published in National Journal of Community Medicine, 2011. It states that patient satisfaction is one of the important tools to measure the success of the services provided in the hospital. They performed a hospital based cross sectional study to evaluate the satisfaction of the patients admitted in the hospital regarding behaviour of the medical, nursing, and supportive staff, and other services provided in the hospital. They used a pre-designed and pre-tested â€Å"Indoor Patient Feedback Form† which was filled up by the patient through an interview on the day of the discharge. They analyzed the data using Epi-Info statistical software by calculating chi-square test and proportions. Their study reveals that the most of the patients were satisfied with the provided hospital services, behaviour of the doctors but s howed dissatisfaction towards the cleanliness in the toilets, quality of the food. Leticia R. Moczygemba, Jamie C. Barner, et al., published a study entitled â€Å"Patient satisfaction with a pharmacist-provided telephone medication therapy management program† in Research in Social and administrative pharmacy, 2010. They conducted a non-experimental and cross sectional survey to measure the patient satisfaction with pharmacist-provided telephone MTM program. They mailed the questionnaire developed to measure the patient satisfaction on MTM program. Descriptive statistics have been used to calculate the patients’ responses. The study revealed that the patient were pleased about the services provided by the pharmacist during MTM consultation. And also the patients are willing for face-face to consultation to learn more about their medications. From this study it is proved that for some patients MTM program can be carried out in telephone without compromising patient satisfaction. Mehrnoosh Akhtari-Zavare, Mohd Yunus Abdullah, et al., performed a study entitled â€Å"Patient Satisfaction: Evaluating Nursing Care for Patients Hospitalized with Cancer in Tehran Teaching Hospitals, Iran† in Global Journal of Health Science, 2010. The study was aimed to assess the relationship between cancer patients’ satisfaction and the nursing care in order to assist nurses in defining more clearly their roles. They performed a cross-sectional study in which a proportional stratified sampling method was used to collect the data from face-to-face interviews based on validated Patient Satisfaction Questionnaire. In this study, they conducted binary logistic regression to predict factors that influence the satisfaction level. It was seen that patients receiving chemotherapy were more satisfied with the nursing care than patients receiving other type of treatment such as radiotherapy, surgical etc. Though the study found that most of the patients were satisfied with t he nursing care, they suggested some improvements regarding interpersonal relationship which may improve patient satisfaction. Z Iliyasu, IS Abubakar, et al., published a study entitled â€Å"Patients’ satisfaction with services obtained from Aminu Kano teaching hospital, Kano, Northern Nigeria† in Nigerian Journal of Clinical Practice, 2010. Their study aimed to evaluate the patient satisfaction and their relatives with the hospital services. They considered satisfaction was from the perspectives such as ease with which patients’ accessed care, time of waiting, patient-health care provider relationship, payment and facilities provided by the hospital. The data was collected by a cross-sectional survey based on structured questionnaires which were distributed to the patients and focus group discussions with the patient relatives. The results shown that most of the patients were satisfied about the accessed care, patient provider relationship, inpatient services and the hospital facilities. And the patients were asked for the complaints which were mostly related to the waiting time and th e payment cost. In focus group discussions most of the patients relatives complained about the missing of laboratory data and delay in the laboratory data. Overall the satisfaction of the patients and patient relatives showed a high satisfaction level with the tertiary care services. Ranjeeta Kumari, MZ Tdris, et al., published a study entitled â€Å"Study on Patient Satisfaction in the Government Allopathic Health Facilities of Lucknow District, India† in Indian Journal of Community Medicine, 2009. They performed a cross-sectional survey to detect the areas and reasons of low satisfaction among the patient and to suggest methods for improvement. By using a multi-stage stratified random sampling technique three representative hospitals (Tertiary level hospital, Secondary level hospital and a primary level hospital). A quantitative structured interview schedule was used to record information from the patients attending the health care facilities. Data was analyzed using Epi-info software (version 6). From the results it was seen that the most important factor for them to visit the secondary and tertiary level of health facilities was the trust on doctors or health facility, availability of the specialists whereas the closeness of the health facility to thei r homes, belief on doctors or health facility and cost-effectiveness were crucial at the primary level. They concluded that, there is a need to communicate effectively with patients about their disease and treatment and to clarity their doubts and fears to achieve good standards of health. Juan Francisco Marquez-Peiro, Carmen Perez-Peiro published a study entitled â€Å"Evaluation of Patient Satisfaction in Outpatient Pharmacy† in Farm Hosp in 2008. The main objective of this study is to identify the satisfaction and dissatisfaction levels among patients receiving care from the Outpatient pharmacy. Dissatisfaction has been defined as the lack of correspondence between the patient expectations and their final perception of the healthcare service provided. They conducted a cross-sectional study to establish patient satisfaction levels by using a valid questionnaire and patient dissatisfaction were established from the complaints made by the patients attending the outpatient pharmacy. The reasons for complaint were grouped based on the classification system created by Pichert et al and also on the items described in the patient satisfaction survey. Patient satisfaction was evaluated with the help of a patient satisfaction indicator Satisfaction index recognized by the Regional Ministry of Health for the Autonomous Community of Valencia. The results show the high patient satisfaction index with the services provided by the outpatient hospital pharmacy department. The aspects scoring least points in patient satisfaction were mainly dispensing area (waiting room and access to the OP) and the dispensing process (waiting time and the consultation hours) which were also the main reasons for dissatisfaction. Pharmacist’s technical expertise and professional attitude are the most valued aspect in the patient satisfaction survey. Pharmacist’s professional competence and the pharmacist-patient relationship were the reasons for complaints made by the patients to the Patient Service Department of the hospital. The features that require improvement are area and process at the dispensing and the increased structural and human resources required. They concluded that, although the satisfaction index high and is useful for identifying what impro vements are needed, it is also important to identify the reasons for dissatisfaction to complement this information. Maria Luz Traverso, Mercedes Salamano, et al., published a study in the journal International Journal for Quality in Health Care, 2007, entitled â€Å"Questionnaire to assess patient satisfaction with pharmaceutical care in Spanish language†. The main objective of their study was to design and validate a questionnaire in Spanish language, to assess patient satisfaction with pharmaceutical care provided by the community pharmacies. A questionnaire of 27 items, with randomly assigned order consisting give dimensions which includes general satisfaction, explanation, managing therapy, consideration and setting was designed. The reliability of the instrument’s scale was assessed with Cronbach’s alpha and to determine the questionnaire construct validity, Mann-Whitney test was applied to compare the data form two groups of pharmacies. Although overall results of the construct validity test did not presented significant changes among the two groups of pharmacies in whic h one group provides pharmaceutical care and other group do not provide pharmaceutical care, but 23 items presented significant variances among the two groups of pharmacies. The results suggest that the developed questionnaire was found to be a reliable and valid instrument in Spanish to evaluate patient satisfaction related to pharmaceutical care in community pharmacies. R.K.Sharma, conducted a study to identify the patient satisfaction level in both out-patients and in-patients entitled â€Å"Patient satisfaction- A case study of zonal hospital† which was published in Nursing and Midwifery Research Journal, 2005. They assessed the patient satisfaction in terms of services and amenities. In this study it was observed that most of the indoor and outdoor patients were dissatisfied with most of the amenities. Most of the patients were satisfied with the behaviour and attention given by the doctors but were not satisfied with the behaviour of paramedical staff and other employees of the hospital. And most of the patients were not dissatisfied with the availability of the medicines in time. It concludes that frequent patient satisfaction surveys are essential to make necessary improvements on basis of opinions and suggestions given by patients. C Jenkinson, A coulter, et al., performed a study entitled â€Å"Patients’ experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care† which was published in Quality and Safety in Health Care, 2002. The purpose of their study was to determine what aspects of health care provision are most likely to influence the satisfaction with care and willingness of the patient to recommend hospital services to others and also to determine the extent to which satisfaction is a significant indicator of patients’ experience of healthcare services. They had done a postal survey in which the questionnaires based on picker survey of patient experiences questionnaire was used. From the descriptive statistics it is evident that there is an association between the level of satisfaction and the number of item completed in the questionnaire. The study states that patient satisfaction scores and the related issues of willingness to recomm end a hospital to others present a limited and optimistic picture. It also suggests that detailed questions about specific aspects of patients’ experience are more beneficial for observing the performance of different departments of the hospitals and which helps in improving the health care delivery. Differences Between Leadership and Management | Tesco Differences Between Leadership and Management | Tesco Management is a function that must be exercised in any business (Maccoby, 2000, pp57-59) management is a process of planning, organising, commanding, coordinating, and controlling and it is a systematic way of doing things. According to Mullins (2010, p429) Fayol describes these elements as: Planning examining the future, deciding what needs to be achieved and developing a plan of action. Organising providing the material and human resources and building the structure to carry out the activities of the organisation. Command maintaining activity among personnel, getting the optimum return from all employees in the interest of the whole organisation. Co-ordination unifying and harmonising all activities and effort of the organisation to facilitate its working and success. Control verifying that everything occurs in accordance with plans, instructions, established principles and expressed command. Leadership is an attempt to influence group or individuals (Russell C, Richard J, 2002, p406) he further explains that leadership gets organizations and people to change. Leadership is communicating to people their worth and potential so clearly that they are inspired to see it in themselves. Differences between Leadership and Management Mullins demonstrated the differences of leadership and management. Managers tend to adopt impersonal or passives attitudes towards goal. Leaders adopt a more personal and active attitude towards goals. In order to get people to accept solutions, the managers needs continually to co-ordinate and balance in order to compromise conflicting values. The leaders create excitement in work and develop choices that give substance to images that excite people. In their relationship with other people, managers maintain a low level of emotional involvement. Leaders have empathy with other people and give attention to what events and actions mean. (2010, p374) Leadership differs from management in a sense that: Management includes focus on function, authority relationship and creates stability. However, for a business to excel leadership is vital, because leaders motivate, secure commitment and inspire people. Relationship between Management and Leadership Leadership and management are the terms that are often considered synonymous. Leadership is defined as the potential to influence and drive the group efforts towards the accomplishment of goals. This influence may originate from formal sources, such as that provided by acquisition of managerial position in an organization. According to Mullins (2010, p374) Despite a continuing debate on differences between management and leadership, there is a close relationship between them and it is not easy to separate them as distinct activities. He further describes management and leadership, they overlap and you need both qualities. Increasingly, management and leadership are being seen as inextricably linked. It is one thing for a leader to propound a grand vision, but this is redundant unless the vision is managed so it becomes real achievement. A manager must have traits of a leader. Leaders develop strategies that build and sustain competitive advantage. Organizations require strong leadership and strong management for optimal organizational efficiency. Both managers and leaders aim to achieve goals, mobilize and utilize resource. Section 2 Managers have to perform many roles in an organization, how they handle various situations will depend on their style of management. According to Mullins (2010, p381), there are many dimensions to describe leadership style and he simplified three fold heading; The authoritarian (autocratic) Style: The manager alone exercises decision making and authority for determining policy, procedures for achieving goals, work tasks and relationships, control of rewards or punishments. The democratic Style: The leadership functions are shared with members of the group and the manager is more part of team. The group members have a greater say in decision making, determination of policy, implementation of systems and procedures. A laissez faire (genuine) style: The manager consciously makes a decision to pass the focus of power to members, to allow them freedom of action to do as they think best, and not to interfere; but is readily available if help needed. There is an often confusion over this style of leadership behavior. The word genuine is emphasized because this is to be contrasted with the manager who could not care, who deliberately keeps away from the trouble spots and does not want to get involved. From my own experience of working in ABA Beverages, management decided to implement HACCP using autocratic style of leadership style. This decision of quality control was taken to attract new customers and satisfy existing customers. According to Wikipedia (ONLINE: http://en.wikipedia.org/wiki/Hazard_analysis_and_critical_control_points) HACCP (Hazard analysis and critical control points), is a systematic preventive approach to food safety and pharmaceutical safety that identifies physical, allergenic, chemical, and biological hazards in production processes that can cause the finished product to be unsafe, and designs measurements to reduce these risks to a safe level. In this manner, HACCP is referred as the prevention of hazards rather than finished product inspection. A key role of the quality manager in the company is to maintain the food safety. He has vital responsibilities and challenges to achieve HACCP. In order to achieve HACCP, he uses autocratic style of leadership. This autocratic style was necessary because it is a matter of food safety. Employers view this safety principal as a critical, therefore use autocratic style. Employees must comply with instructions at all times. The positive impacts food safety is met, objective of customer satisfaction met. If they do not use autocratic style, quality would be compromised and customers would not be satisfied. Sri Lanka Red Cross Society SLRCS (Sri Lanka Red Cross Society) (ONLINE: http://beta.redcross.lk/vision-mission.asp) has operated since 1936. The SLRCS covers all 25 administrative districts of the Sri Lanka and the total membership 100,000.The total number of active volunteers 6,500. From my own experience of working in SLRCS, during the war in 2007 in Sri Lanka, it was involved to help victims who affected by war. They have divide teams and work under a coordinator. The coordinator gives freedom to the team leader to take appropriate actions within agreed boundaries (within set time limit and safety clearance). For example teams have to reach the camp and distribute all foods to beneficiaries. In case any problem arises team leaders have to make the decision. At this point Laissez Faire style help to achieve the scope of the organization. Here, team leader is trusted to make decision by the coordinator follows laissez faire style. On the other hand, when the team is in dangerous war zone, for the safety of team members team leader follows an autocratic style of leadership. For example if the supply not distributed on the agreed time limit or if the situation becomes dangerous, team leader take own decision either stay or leave for the camp and team members fol low his autocratic style of leadership. Tesco Tesco is a British multinational grocery and general merchandise retailer in United Kingdom. One of the business objectives of Tesco is customer satisfaction. Tesco is a customer-orientated business. It aims to offer products that provide value for money for its customers and to deliver high quality service. Tesco wants to attract new customers, but it also wants to keep its existing customers happy. To keep at the top of its game and to maintain its number one spot in the market, the company needs skilled staff at all levels and in all roles. The style of leadership can vary depending on the task. Some managers allow teams to take charge of their own decision-making for many tasks. Team leaders will set the objectives but empower team members to decide how these objectives are achieved. This has several advantages. It helps to motivate individuals in the team and it draws on the expertise of the members of the team. Berian manages a team of 17 in a Tesco in-store bakery. One of the key challenges of Berians job is to ensure his team produces the right products to meet demand at key times. His usual management approach is to allow the team to take responsibility for achieving the desired result. In this way, the team not only buys into the activity, but also develops new skills. For example, when the bakery expanded its product range and Berian needed to ensure that all the products would be on the shelves by 8.00 am, rather than enforce a solution, he turned to the team for ideas. The team solved the problem by agreeing to split break times so that productivity could be maintained. Berians approach produced a positive outcome and increased team motivation. (ONLINE: http://businesscasestudies.co.uk/tesco/developing-appropriate-leadership-styles/management-and-leadership.html#axzz2DWoXdm7O) Berian uses democratic style of leadership to achieve the target. This style encourages ideas, feedback, suggestion and team sprit from all team members. Words 525/ 1480