SUMMER TRAINING AT

1. SUMMER TRAINING AT PULKIT KATHURIA (PG/11/O75)

2. INTRODUCTION

3. OPD PATIENT SATISFACTION SURVEY

4. 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

5. RATIONALEOF 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.

6. REVIEWOF 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.

7. 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.

8. Study Period- 09-04-2012 to 25-04-2012 • Data collection: primary data was collected using structured questionnaire with closed ended questions.

9. STUDY FINDINGS

10. 1. INFLUENCE OF CHOICE OF HOSPITAL

11. 2. SATISFACTION ON ARRIVAL

12. 3. AVERAGE WAITING TIME FOR APPOINTMENT/WALK IN PATIENTS

13. 4. AVAILABILITY OF PRESCRIBED MEDICINES N= 53

14. 5.. OVERALL RATING OF BASIC AMENITIES

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

16. 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.

17. RECOMMENDATIONS • 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.

18. CASE STUDY OBSERVTION OF VARIOUS DEPARTMENTS

19. Objective- To observe various departments understand their working, find out the loopholes and give recommendations for improvement. Methodology- Observational

20. FRONT OFFICE/help desk • 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

21. Strengths: • Well trained staff • Owing to humanity, equal respect has been given to every religion by placing idols of all religion 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

22. 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.

23. 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

24. MRI DEPARTMENT Time taken for MRI scan: • Sample Size: 40 patients

25. BOTTLE NECKS: REASONS FOR DELAY IN MRI SCAN

26. 1.Patient Shifting MRI stretcher can be made available in wards

27. 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

28. 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.

29. 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.

30. 5.Technical delay The monitor got off twice during the period of study. It took 15 minutes for the monitor to restart.

31. Recommendations-: • MRIstretchers 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.

32. 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 • PrahladRaiSodani, 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 • SrilathaSivalenka, Patient Satisfaction Surveys in Public Hospitals in Andhra Pradesh, India, 1999-2000.