A study of patient satisfaction at a tertiary care medical college hospital

 

Iswarya S¹, Muruganand P^2*, Ravikumar T³, Swaminathan P⁴, Gunasekaran T A⁵

 

{^1,2Assistant Professor, ⁵Health Educator, Department of Community Medicine} {³Professor and HOD, Department of Medicine} {⁴Dean, Government Medical College & ESI Hospital, Professor & HOD, Department of Surgery} Government Medical College & ESI Hospital, Coimbatore, Tamil Nadu, 641015

 

Abstract               Background: The health care industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of its patient population. Patient satisfaction is deemed to be one of the important factors which determine the success of health care facility. It is easier to evaluate the patient’s satisfaction towards the services provided than to evaluate the quality of medical services that they receive. Research on patient satisfaction can be an important tool to improve the quality of services. Hence this study was conducted with an objective to study satisfaction of patients regarding, cleanliness, behaviour of hospital staff and time taken to avail services Methodology: The study was a cross sectional study conducted in the outpatient department of Government Medical College and ESI Hospital, Coimbatore, Tamil Nadu. Exit interview was conducted among patients attending outpatient department at Government Medical College and ESI Hospital. Participants were interviewed using semi-structured questionnaire by trained investigator in their local language after obtaining written informed consent. Questionnaire elicited patient satisfaction regarding cleanliness of hospital, behaviour of hospital staff and time taken to avail the services. Results: Our study included 100 patients who attended OPD in GMC and ESI Hospital. Out of these 100 patients 56% were males and 44% were females. A total of 59% were in age group between 19-40 years and 16% were more than 60 years. 89% of them were satisfied with general cleanliness in the hospital premise. Majority (96%) of Patients were satisfied with behaviour of doctors. With regard to waiting time 81% of patients were satisfied with time taken to consult doctor. Conclusion: Conducting Patient satisfaction survey at regular intervals will help health care organizations to deliver quality care.

Key Words: Patient Satisfaction, behaviour, Cleanliness.

 

 

 

INTRODUCTION

The health care industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of its patient population.¹ Continuous improvement of quality to make services more efficient, effective and consumer friendly is not an option but a necessity for health-care providers. Patient satisfaction is deemed to be one of the important factors which determine the success of health care facility.²Satisfaction is a psychological concept and patient satisfaction depends upon many factors such as: Quality of clinical services provided, availability of medicine, cleanliness, behavior of doctors and other health staff, cost of the services, hospital infrastructure, physical comfort, emotional support, and respect for patient preferences.³It is easier to evaluate the patient’s satisfaction towards the services provided than to evaluate the quality of medical services that they receive. The care in the OPD is believed to indicate the quality of services of a hospital and is reflected by patients’ satisfaction with the services being provided. OPD is the first point of contact with a patient and serves as the window to any health care services provided to the community. Ultimately the knowledge about quality of services in OPD will serve two purposes: identifying areas of improvement in quality of services so offered, and highlighting the need for corrective actions.⁴Research on patient satisfaction can be an important tool to improve the quality of services. Hence this study was conducted with an objective to study satisfaction of patients regarding, cleanliness, behaviour of hospital staff and time taken to avail services.

MATERIAL AND METHODS

Study setting: Employee State Insurance Scheme is a multidimensional social security system based on the principle of ‘pooling of risks and resources’. The ESI Corporation is providing medical facilities to the insured persons and their family through large network of hospitals and dispensaries all over India. Nearly 28 lakh beneficiaries are availing Benefits under the ESI Scheme in Coimbatore Sub-Region. State of the art Medical college and hospital with all modern facilities for comprehensive medical care for ESI Beneficiaries is implemented in phased manner at ESI hospital Coimbatore since 2016.

Study Design: The study was a cross sectional study conducted in the outpatient department of Government Medical College and ESI Hospital, Coimbatore, Tamil Nadu. The study was conducted from December 2017 to January 2018

Sample size: The sample size was calculated by assuming the level of satisfaction among the study population as 50%. The minimum sample size for this study using the formula, n = z2 pq/d2, where n = minimum sample size; z = 1.96 at 95% confidence interval obtained from standard statistical table of normal distribution; p= level of satisfaction in a given population (50% or 0.5); q=precision i.e. (1–p) or 0.5 and d=relative error of 20%. Using this formula the minimum sample size calculated was 96. In the present study, data was collected from 100 individuals

Data collection and Analysis: Exit interview was conducted among patients attending outpatient department at Government Medical College and ESI Hospital. Patients were selected by simple random technique. All the participants above 18 years of age and willing to participate were included in the study. Participants were interviewed using semi-structured questionnaire by trained investigator in their local language after obtaining written informed consent. Questionnaire included demographic details, questions to elicit patient’s perception regarding cleanliness of hospital premise, outpatient department, Inpatient department and toilets. Respondents were also asked about behaviour of doctors, staff nurse, lab technician, and group for workers towards them. Respondents were also asked about their perception about time take at registration counter, to consult doctor, lab investigation and at pharmacy to collect medicines. Data collected was entered in Microsoft Excel Spread Sheet. The study questionnaire was checked for completeness and correctness of data before entering into the worksheet. The variables were described in the form of proportion

Ethical issues: The study was conducted after obtaining the approval of Institutional Ethical Committee. The confidentiality of the study participants were maintained at all the stages of the study.

 

RESULTS

Table 1: Socio-demographic profile of respondents (N=100)

Characteristic		No of Respondents
Age	19-40	57
	41-60	27
	>60 years	16
Sex	Male	56
	Female	44

Table 2: Patient satisfaction regarding cleanliness of the hospital (N=100)

Table 3: Patient satisfaction regarding behaviour of hospital staff (N=100)

 

Table 4: Patient satisfaction regarding the waiting time (N=100)

Our study included 100 patients who attended OPD in GMC and ESI Hospital. Out of these 100 patients 56% were males and 44% were females. A total of 59% were in age group between 19-40 years and 16% were more than 60 years.  Patients satisfaction regarding the cleanliness of the hospital [Table: 2] reveals 89% of them were satisfied with general cleanliness in the hospital premise. Patient’s satisfaction was better regarding cleanliness of OPD and IPD (91% and 87% respectively). However 37% of patients were not satisfied with cleanliness of toilets. Majority of Patients were satisfied with behaviour of doctors and staff nurse (96% and 91% respectively). Most of the patients were satisfied with behaviour of lab technician, group IV workers. However 15% and 12% of respondents were not satisfied with behaviour of lab technician and group IV workers respectively [Table: 3]. With regard to waiting time 81% of patients were satisfied with time taken to consult doctor but 22% were not satisfied with time taken at the registration counter. Most Patients were satisfied with time take for lab investigation and time taken get medicines in pharmacy. About 12% and 8% of respondents were not satisfied with time taken in lab and pharmacy respectively [Table: 4]. When asked suggestions for improvement patients felt it is necessary to have help desk to give directions to patients to access various services. Most patients also felt the nurses to be more courteous towards them. Patients felt toilets need to be cleaned more frequently.

DISCUSSION

The results of the study indicate that most of the respondents interviewed were satisfied with the services they received. Patients are satisfied when they receive quality care and services when it meets their expectation. In present study 89% and 91% of respondents were satisfied with cleanliness of the hospital and OPD respectively. Study conducted by Prasana KS et al in outpatient department of private college hospital at Mangalore reported 96% patients satisfied with cleanliness in the OPD.⁵ Joshi K in their study conducted in outpatient department at civil hospital in Gujarat reported 95% of the patients were satisfied with cleanliness of the hospital.⁶Jadhav SB in a study conducted in outpatient department at government medical college Maharashtra reported 78.2% of respondents were satisfied with cleanliness of OPD.⁷ A study conducted at super special speciality hospital in Thiruvananthapuram reported 50% of patients were highly satisfied with cleanliness of the hospital.⁸Patavegar BN in a study conducted in OPD of government tertiary care hospital reported 55% of patients were satisfied with cleanliness in waiting area.⁹ Study conducted in a tertiary care hospital at Nagpur by Kulkarani MV reported 44% of respondents were satisfied with cleanliness of toilets, in the present study 63% of the respondents were satisfied with cleanliness of toilets.¹⁰Arshad et al in their study done in Srinagar reported that only 29.25% respondents were satisfied with cleanliness of toilets.¹¹ Study conducted in Government hospital at Lucknow by Kumari R et al reported 27% were not satisfied with cleanliness of toilets.²Quereshi W et al reported 12% of respondents were dissatisfied with cleanliness in toilets.¹² In the present study 37% of respondents were not satisfied with cleanliness of toilets. In the present study majority of respondents were satisfied with behaviour of doctors, staff nurse and class four workers (96%, 91% and 88% respectively) which is similar to study by Arpita Bhattacharya et al conducted in tertiary referral hospital which reported 98% of respondents were satisfied with behaviour of doctors.¹³ M V Kulkarni et al, reported 87.8% patients were Satisfied with behavior of doctors.¹⁰ Study conducted by Arvindsharma at tertiary care hospital in Madhya Pradesh reported 78% were satisfied with behaviour of consultants, 64% of them satisfied with behaviour of staff nurse and 84% of them satisfied with clerical and other workers.¹⁴ Study by Sanjibgobi reported 97% of patients were satisfied with behaviour of doctors towards them, 68.6% were satisfied with staff nurse whereas only 38.6% of respondents were satisfied with behaviour of class four workers.¹⁵Arshad et al in their study found the satisfaction level towards doctor’s behaviour to be 66.75%.¹¹ Another study by Sign et al reported 82% of respondents were satisfied and felt doctors was friendly and courteous.¹⁶In the present study 88% of respondents were satisfied with behaviour of group four workers, whereas in study conducted at hospital in Andhra Pradesh only (9.7%) of respondents were satisfied with behaviour of ward boys and sweepers.¹⁷ In the present study respondents were satisfied with time spent for registration, to consult doctor, for lab investigation and to get medicines pharmacy (78%, 81%, 88% and 92% respectively). Study by Arvindsharma conducted in tertiary care hospital in Madhya Pradesh reported 92% of respondents were satisfied with time taken to get OPD slip.¹⁴Jadhav SB found 54% of respondents were not satisfied with time taken for registration, 38.9% respondents were unsatisfied with time taken for investigation while 48.7% of respondents were not satisfied with time spent in phararmacy.⁷ A study conducted in Multispecialty hospital in North East India showed 81% of respondents were satisfied with registration time and 70% are satisfied with time taken to consult doctor.¹⁵ Similar findings were reported in the study by Josh et al.¹⁸ In contrast study by Sreenivas et al found 66% were dissatisfied with registration.¹⁷ Study by Sumeetsingh reported 81% and 70% of respondents were satisfied with time taken for registration and to consult doctor respectively.¹⁹

 

CONCLUSION

Overall the study showed a good level of satisfaction of patients with services obtained from this tertiary care centre. Based on the specific feedback received from patients we have implemented changes to improve the quality of care. Appropriate and on-going data collection and analysis would help in optimizing utilization of outpatient services to achieve better outcomes. Conducting self-assessment survey at regular intervals will help health care organizations to deliver quality care. Patient satisfaction survey in addition to the delivery of quality care also helps the organization to get NABH, NABL, JCI and various other accreditations.

 

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