SUMMER TRAININGAT

PULKIT KATHURIA (PG/11/O75)

INTRODUCTION

ISIC, a 145 bedded hospital, running successfully for the past 15 years.

Brainchild of Major HPS Ahluwalia.

Perhaps, the only hospital in India designed by a patient for a patient, providing everything that a spinal injured patient would need

One of the most advanced Spine, Orthopaedic and Neuromuscular Surgical centre in India with the latest state of the art diagnostics and surgical equipments

OPD PATIENT SATISFACTION SURVEY

OBJECTIVES OF STUDY

General objective: To determine the level of satisfaction among the walk in/ appointment

patients regarding major aspects of service delivery

Specific objective: To identify the factors which influence patient satisfaction To determine the level of satisfaction related to overall quality of care and

value for money To suggest how can the patient satisfaction level be improved  

RATIONALE OF THE STUDY

Age of consumerism, patient dictates what is acceptable and what is not.

From managerial point of view, patient satisfaction- fundamental requirement for clinical and financial success.

Patient satisfaction- also adds to system performance contributing to total quality management.

Therefore this study was carried out amongst the OPD patients at ISI and suggest areas of improvement.

REVIEW OF LITERATURE

Study was conducted in M.P to measure satisfaction among OPD patients in Public health care facilities. It was concluded that proximity, infrastructure, inexpensiveness were main reason and the patients were satisfied with satisfied with doctors.

Another study was done among 200 patients in a private health facility. It was observed that people were satisfied with doctors consultation, support services, nursing care etc. While there was delay in consultation and needs to be improved.

METHODOLOGY

Study Design: Cross-sectional, descriptive study.

Study Area: Indian Spinal Injury Centre, Vasant Kunj

Sampling method: Convenient sampling method.

Sampling Tool: Questionnaire.

Study Population: 70 OPD patients at ISIC.

OPD patients of following 4 departments were surveyed- Spine, Ortho,

Neurology and Rheumatology. The average footfall of these four

departments is 90 patients/day.

Study Period- 09-04-2012 to 25-04-2012

Data collection: primary data was collected using structured

questionnaire with closed ended questions.

STUDY FINDINGS

1. INFLUENCE OF CHOICE OF HOSPITAL

45.71

4.29

38.57

2.86 8.57

WORD OF MOUTH

NEWSPAPER/MAGZINE

ADVERTISEMENT

INTERNET

REFFERAL FROM DOCTOR

BOTH (WORD OF MOUTH & INTERNET)

BOTH (WORD OF MOUTH & REFFERAL)

2. SATISFACTION ON ARRIVAL

Guidance to

Suita

ble Consulta

nt

Greeting on Arri

val

Promptness

of Attnention

Waiting Room Comfort

Consulta

nt Servi

ces

1

1.5

2

2.5

3

3.5

4

4.5

5

3.9 3.9 3.7 3.64.3

MEA

N S

CORE

3. AVERAGE WAITING TIME FOR APPOINTMENT/WALK IN PATIENTS

Appointment Patients Walk In Patients0

10

20

30

40

50

60

70

80

90

36

82.8

Tim

e ( I

n M

inut

es)

4. AVAILABILITY OF PRESCRIBED MEDICINES

YES NO0

5

10

15

20

25

30

35

40

38

15

Mea

n Sc

ore

N= 53

5.. OVERALL RATING OF BASIC AMENITIES

TOILET FACILITIES FACILITIES FOR DISABLED CAFETERIA1

1.5

2

2.5

3

3.5

4

4.5

5

3.9 3.7 3.5MEA

N S

CORE

6. OVERALL RATING OF QUALITY OF CARE AND VALUE FOR MONEY

QUALITY OF CARE VALUE FOR MONEY

1

1.5

2

2.5

3

3.5

4

4.5

5

4.13.5M

ean

Scor

e

FINDINGS-:

At ISIC, most of the patients are satisfied with the overall quality of care and consultant services.

Significant number of patients were dissatisfied with the overall cost of the services.

More BTL activities to be pursued with round the year hoarding and visual marketing.

CRM (Customer relationship management) should be followed rigorously as 91% patients do comeback.

As the waiting time is high, more of patients/attendant’s engaging material like newspapers, etc should be placed in the opd waiting area.

Drug formulary needs to be revised and pharmacy department as well as the doctors need to follow it.

LEDs should be placed in the waiting lounge.

Air Conditioners should be installed in cafeteria as many people complain about the high humidity in cafeteria.

RECOMMENDATIONS

CASE STUDY

OBSERVTION OF VARIOUS DEPARTMENTS

Objective- To observe various departmentsunderstand their working, find out the loopholes and give recommendations for improvement.

Methodology- Observational

General Observations:

Separate billing counters for IPD,OPD and corporate present

Location map of various depts. present in the main lobby

Consultant’s name and timings for consultation displayed in the main lobby

Display of Specialities and facilities available in the main lobby

‘May I Help You Desk’ present just at the entrance

Accessibility to labs, radiology department

FRONT OFFICE/HELP DESK

Recommendations:

Wall clock can be placed at Main Reception Area.

STD/PCO facility can be provided in or around front office.

There should be a defined protocol for billing of diagnostic procedures identified.

Photocopy machine for convenience of patients

Strengths:

Well trained staff

Owing to humanity, equal respect has been given to every religion by placing idols of all religion

PHARMACY General Observations: Substitution is only allowed in few cases ( not in high risk medicines and costly medicines)

ABC Inventory method is followed, that is medicines are kept in Alphabetical Order

Narcotic drugs are kept in double lock and key shelf as per Schedule “X”.

Syrups, Eye/Ear/Nasal Drops, Powder are stored in separate shelves.

Strengths:

Well trained staff

One can easily locate the medicines.

Customer handling of the pharmacist is commendable.

24*7 Availability

Recommendations:

Credit/Debit Card Machine should be made available

There should be a separate counter for receiving the medicines

Refrigerator should be of large capacity

MRI DEPARTMENT

40%

55%

5%

<20 mins

20-40 mins

>40 mins

Time taken for MRI scan:

Sample Size: 40 patients

Patient

shifting

Ward boy

availability

Patient

preparation

Technical

error

Patient

posture

BOTTLE NECKS: REASONS FOR DELAY IN MRI SCAN

• IPD

1

• METALLIC STRETCHER

2• MRI

STRETCHER

3

• PATIENT TABLE

4

MRI stretcher can be made available in

wards

1.Patient Shifting

2. Ward boy availability

For patient shifting (IPD pt.), 3 human resources are required.

In 4 out of 40 cases, it was observed that ward boy left the patient in

MRI room before the scan started.

The technician had to leave his work and assist in patient shifting

PATIENT

Doesn’t follow

instructions

TECHNICIAN

Doesn’t give proper

instructions

3. Delay due to posture: It might be due to:

In 3 out of 40 cases, patient did not follow the instructions and moved

during scan which led to delay in completion of scan.

4. Patient preparation Magnetic coils should be arranged right the very first time.

In 5 out of 40 cases, magnetic coils had to be re-arranged during the scan which led to delay in completion of scan.

Also, assistant should be available during the scan.

Dysfunction of water cooled

chillers

Monitor and

magnetic coil stop working

Takes time to restart

5.Technical delay

The monitor got off twice during the period of study. It took 15

minutes for the monitor to restart.

MRI stretchers which are plastic sealed should be made available in the wards.

Proper instructions should be given to patient in the beginning of scan. Ward boy should remain available with IPD patients.

Working of water chillers should be checked on regular basis.

Recommendations-:

References-:

•http://isiconline.org/aboutus.aspx•Sonal Shukla’s article on “Streamlining OPD”, Express Healthcare, April 2008.•Dr. S. K. Jawahar’s, A study on out patient satisfaction at a super specialty hospital in India”, Indian Journal of community Medical update, volume-2, Jul-Dec 2007•Preston M. Simmons “Managing a Hospital and the Role of the Hospital Pharmacist”, February, 2006•http://www.prospects.ac.uk/hospital_pharmacist_job_description.htm•Dr. Hari Singh’s Article on “Out Patient Department”.• Presentation by John A. Armitstead’s “ The Role of Pharmacist in Hospital Setting”, October, 2006•Prahlad Rai Sodani, Rajeev K Kumar, Jayati Srivastava,1 and Laxman Sharma’s, Measuring Patient Satisfaction: A Case Study to Improve Quality of Care at Public Health Facilities (Indian Journal of Community Medicine)•A. Deva, M. Haamid, patient satisfaction survey in outpatient department of a tertiary care institute, 2010•Srilatha Sivalenka, Patient Satisfaction Surveys in Public Hospitals in Andhra Pradesh, India, 1999-2000.