A dissertation report on analysis of patient satisfaction max polyclinic by mohammad yaser hussain
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Hospitals are increasingly becoming sensitive to the needs of the patients as will the community. It is no longer the sellers [providers] market. Except for the totally free service provided by the Government run hospitals and a few hospitals run by the civic hospitals.
According to Dona Bedian
“Patient satisfaction may be considered to be one of the desired outcomes of care, even on element of health status itself” and that “information about patient satisfaction should be as indispensable to assessment of quality as to the design and management of health care system.
During the recent years the use of patient satisfaction surveys has increased in health care industry due in part to the belief that perception of quality is an important factor in demand for services and that survey result may have significant effect on provider behaviour. According to Ware “patient satisfaction is a determinant of a healthcare provider or system. Use of services complaints and malpractice suits”.
Use of patient satisfaction survey as a tool for quality improvement has become extensive in almost all western countries. Most hospital have a system of obtaining routine feedback from all the discharge patients. The quality improvement task force of the joint commission of accreditation of the health care organization in USA is also encouraging hospitals to mandate surveys are conducted in private hospitals.
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A dissertation report on analysis of patient satisfaction max polyclinic by mohammad yaser hussain
1. a Dissertation Report
on
ANALYSIS OF PATIENT SATISFICATION IN I.P.D.
MAX POLYCLINIC AND DIABETIC CENTRE- HYDERABAD
Submitted by
MOHAMMED YASER HUSSAIN
Regd. No: 1308018481
Academic session 2013-2015
in partial fulfillment of the requirement
for the award of the degree
MASTER OF BUSINESS ADMINISTRATION
in
HEATH CARE SERVICES MANAGEMENT
2. From
SIKKIM MANIPAL UNIVERSITY
DECLARATION
I hereby declare that the project report entitled submitted on
“ANALYSIS OF PATIENT SATISFICATION IN I.P.D. MAX
POLICLINIC AND DIABETIC CENTRE HYDERABAD ”here by
solemnly declare that this dissertation is an original work of mine and
this has not been submitted to any other institute / university towards
any other degree /diploma .Partial fulfillment of the requirements for the
degree of Master of Business Administration (MBA) to Sikkim- Manipal
University, India, is my original work and not submitted for the award of
any other degree, diploma, fellowship or any other similar title or
prizes.Whatever information furnished in this project is true and to the
best of my knowledge.
Place : HYDERABAD Course title - MBA (HCSM)
SIKKIM MANIPAL UNIVERSITY
Academic session 2013-2015
3. ACKNOWLEDGEMENT
Every endeavor in itself is an impression of the efforts of not only those
who pursue it but of those as well who provide guidance and motivation
towards its successful completion. Likewise,this project bears an imprint
of all those who helped me at various stages and it would be unfair on
my part not to thank them .
I would like to extend a word of gratitude towards Dr. M A Wahab
Zubair. Director of Max Poly Clinic and Diabetic Centre, for giving me
an opportunity to undergo this dissertation project with Max poly clinic.
I sincerely thanks to Dr. M A Wahab Zubair for guiding me and my
project guide ,who provided me with his unending support from the very
beginning of the project,which helped in timely completion of the
project.
I sincerely thanks and unbounded gratitude towards my family for
giving me support and moral encouragement for enlightening my way
whenever any kind of support was required to complete the project.
Finally, I thanks to the staff of Max Polyclinic and Diabetic Centre for
their co-operation.
MOHAMMED YASER HUSSAIN
B-PHARM -MBA
4. Bonafide Certificate
Certified that this project report titled” Analysis of patient
satisfication in IPD” is the Bonafide work of “ MOHAMMED
YASER HUSSAIN ”with ROLLNO -1308018481 who carried
out the project work under my supervision.
Signature Signature
HOD Faculty in charge
5. CONTENTS
Chapter 1. Introduction. 6
1.1 Project Introduction.
1.2 Max Ploy Clinic and Diabetic Centre Profile.
1.3 Executive Summary.
Chapter 2. Aims and Objectives 10
Chapter 3. Review of Literature. 12
Chapter 4. Methodology 42
4.1 Research Design.
4.2 Data Collection Method.
4.3 Sampling Design.
Chapter 5. Analysis, Interpretation, Finding and Discussion. 45
Chapter 6. Conclusion and Recommendation. 60
Appendix 65
Bibliography 67
6. CHAPTER 1
1.1 INTRODUCTION OF THE TOPIC
Hospitals are increasingly becoming sensitive to the needs of the patients as
will the community. It is no longer the sellers [providers] market. Except for the
totally free service provided by the Government run hospitals and a few hospitals
run by the civic hospitals.
According to Dona Bedian
“Patient satisfaction may be considered to be one of the desired outcomes of care,
even on element of health status itself” and that “information about patient
satisfaction should be as indispensable to assessment of quality as to the design and
management of health care system.
During the recent years the use of patient satisfaction surveys has increased
in health care industry due in part to the belief that perception of quality is an
important factor in demand for services and that survey result may have significant
effect on provider behaviour. According to Ware “patient satisfaction is a
determinant of a healthcare provider or system. Use of services complaints and
malpractice suits”.
Use of patient satisfaction survey as a tool for quality improvement has
become extensive in almost all western countries. Most hospital have a system of
obtaining routine feedback from all the discharge patients. The quality
improvement task force of the joint commission of accreditation of the health care
organization in USA is also encouraging hospitals to mandate surveys are
conducted in private hospitals.
But the actual value of patient satisfaction surveys, as a tool for continuous
quality improvement is a matter of debate among the academicians and hospitals
managers.
7. DETERMINANTSOFPATIENT SATISFACTION
From the search of cotemporary literature, the major determinants of the
patients satisfaction identified by different researchers could be summarized as
follows. In order to evaluate the quality of survey Wolley emphasized on the
follow determinants.
Satisfaction with out come
Continuity of care
Patient Expectation
Patient relationship with doctors, nurses and other staff.
The advances in science and technology made hospitals highly labour intensive
and capital intensive. This made much of the hospitals in the private hospitals force
to comply with the concept of TQM.
The core concept of TQM is customer satisfaction i.e., patient satisfaction as far
as the hospital is considered. The mindset of the customer [patient] coming to a
hospital is quite different to a customer coming to other service industries like
hotel, or airlines.
The approach and behaviour of tea stall, the physical and technological facilities,
general cleanliness and hygiene, cost of treatment etc has a significant impact on
the satisfaction of the patient.
Patient satisfaction can be effective to assess and measure following factors
such as:
Major source of attraction for patients coming to hospital
Satisfaction of various services
Demographic factors
Geographic factors
Patient satisfaction survey is reliable, a yardstick to assess the quality of health
care extended by health institute. Such surveys manifest the patients’ perspective of
ganging the quality of health care provided, their expectation and their need. It also
8. enables to infer as to how well equipped doctors, hospitals and health planners are
in satisfying the patients needs and expectations measure of patients satisfaction
become imperative in modern days as the patients in the central customer and
information and experience provided from his perspective enables the healthcare
provided to identify the area of strength and improvement opportunities within a
single system.
Secondly it helps to measure satisfaction as an out come of care and helps to
patient’s behavior.
Thirdly it generates doctor for theoretically importance and for practical
purpose such as planning administration as an evaluation of health care services.
Satisfaction is a subjective method to assess the need and out come of the care
provided by the healthcare systems. Satisfaction itself encompasses the perceived
need of patient expectations of care provided by the hospital experience of care
during the stay in hospital.
Since measuring satisfaction is a subjective assessment of health care and not
the final out come, survey using patient satisfaction. Schedule interview a tool,
which is used to measure patient satisfaction as amore objective way to assess the
satisfaction level.
In these days of intense of competition, hospital will find it very difficult to get
patient. Retaining the already exiting patients is also very important in enhancing
the profit and for this patient satisfaction has to be ensured at high level. Some
studies have found out that its cost 5times more to get a new customer than it to
keep a current customer.
There is quoted statement in the patient satisfaction if you don’t measure it, you
can’t improve the quality of patient satisfaction survey needs to be conducted
regularly.
EXECUTIVE SUMMARY
9. Max Polyclinic & Diabetic Centre
The Max Polyclinic was started in the year 2008 by a team of highly professional
doctors to provide health care to the population at a rate they can afford. It
conducts the free health care camps on certain days in a month.
The diagnostic facilities include the pathology department which has separate
sections for the clinical pathology, microbiology and histopathology with
equipment like automated biochemistry analyzer, ABG and electrolyte analyzer,
computerized stress analyzer and ECG etc. are also available.
The polyclinic is of 45 bed strength. The facilities include,
Pediatrics
General medicine
Diabetic services
Day care centre
Diagnostic laboratory
Asthma clinic
Poisoning Care
Chapter 2
AIMS AND OBJECTIVE
o To study the patient are satisfied from the services provided by the
maxployclinic and diabetic centre.
o To increase the efficiency of the hospital
o To determine the hospital image
Chapter3
10. REVIEW OF LITERATURE
Patient satisfaction: The Indispensable Outcome
Surveys say a lot about quality and are continuously conducted by HMOs
and accrediting bodies. The authors suggest medical groups follow suit.
BY ROGER BOLUS, PH.D., AND JENNIFER PITTS, PH.D.
“Why measure satisfaction when the health plans we contract with already do it?”
“How can we conduct a satisfaction survey that won’t disrupt office work
flow?”
“How
“How do we translate satisfaction findings into something that will make a
difference?”
Questions like these reflect just a few of the concerns that many medical groups
have about measuring patient satisfaction. While most large managed care
organizations collect satisfaction data continuously for purposes of accreditation
and quality assurance, the medical groups that contract with them often survey
only irregularly, if at all.
They often fail to realize the potential benefits of regular surveys. If not
already, then very soon, this will be an area of concern for medical groups as they
are increasingly being held accountable for the satisfaction data collected by
MCOs they contract with. Groups that do understand the advantages certainly face
a number of challenges.
Let’s consider the growing importance of patient-satisfaction data for medical
groups, and look at sine innovative approaches that may help provider groups see
satisfaction as a valuable management tool. The yardstick
Patient-centered outcomes have taken center stage as the primary means of
measuring the effectiveness to health care delivery. It is commonly acknowledged
that patients reports of measuring the effectiveness of health care delivery. It is
commonly acknowledged that patients reports of their
11. Heath and quality of life, and their satisfaction with the quality of care and
services, are as important as many clinical health measures.
Health care organizations are operating in an extremely competitive
environment, and patient satisfaction has become key to gaining and maintaining
market share. All major players in the health care arena use satisfaction
information when making decisions. Also, because much satisfaction data reflects
care delivered by physician and other provider groups, this information is receiving
close attention from MCOs, consumers, employers, and accrediting organizations.
The scrutiny is based on data collected by MCOs, which may or may not
accurately reflect the care delivered by individual provider groups. This
underscores the need for medical groups to collect reliable and unbiased
satisfaction information from their own patients on an ongoing basis.
External review
Accountability has become the buzzword of the 90s. More physicians are
compelled to show that they have acceptable levels of patient satisfaction. In fact, a
number of standards-setting organization and consumer groups have begun using
patient satisfaction as a key indicator of health care quality.
Without acceptable levels of patient satisfaction, health plans may not get
full accreditation and will lack the competitive edge enjoyed by fully accredited
plans. Most MCOs now undergo some kind of formal accreditation, and therefore
measure satisfaction.
Feeling increasing pressure, many health plans are beginning to provide
incentives to physicians to produce high levels of patient satisfaction.
U.S.Healthcare was among the earliest to factor satisfaction with physicians into its
annual .
Compensation formula.
Similarly, Health Net, a large network-model HMO in California, has
offered significant annual bonuses to medical groups that perform particularly well
on its annual patient survey. [See “The Increasing Importance of Measuring Patient
Satisfaction” for evidence of this trend.]
12. It may be prudent for smaller provider groups to collect their own physician-
specific data to demonstrate acceptable satisfaction levels to the MCOs with which
they contract. Valid patient-satisfaction information can provide practices with
leverage in negotiating future contract with MCOs, and supplies ammunition that
can be used to counter unfavorable evaluations. By conducting their own surveys,
practices will also be able to identify and resolve potential patient-satisfaction
problems before they are recognized as problematic by MCOs.
The reality is that medical groups face a number of challenges implementing
patient-satisfaction survey programs. While most large health plans have the
resources to conduct surveys or to hire vendors, measuring patient satisfaction can
be costly for small practice groups, especially in the face of shrinking operating
margins.
Provider groups often lack the expertise necessary to plan and manage the task,
and tight budgets may limit their ability to outsource. Other challenges include
ensuing that data collection creates minimal hassle for practice staff, obtaining
acceptable response rates and reliable data, properly analyzing and reporting
survey findings, and translating findings into information that can be used for
program planning and quality-improvement efforts. [See” Critical Decisions in the
Survey Process, “for some decisions that a group must make when designing a
survey [program,.]
Technological solutions
Recent technological advances provide managers with solutions to many of the
problems associated with measuring satisfaction, including development of new
survey instruments with known reliability and validity, use of innovative data-
gathering technologies, improvement in measurement and statistical applications,
and technologies that simplify development of interesting and effective
presentations of survey findings.
Today’s health care consumers are more sophisticated than in the past and now
demand increasingly more accurate and valid evidence of health plan quality.
With this in mind, the National Committee for Quality Assurance has
developed a member-satisfaction survey as a part of its HEDIS quality standards,
13. and is in the process of reviewing an updated version based on the Consumer
Assessment of Health Plans Survey for 1999. CAHPS was developed through a
cooperative agreement with the Agency for Health Care policy, Rand Corp.,
Research Triangle Institute, and Harvard University.
A lot of work went into developing these questionnaires, resulting in lessons that
can be applied to satisfaction survey programs at the medical-group level. Focus
groups described issues of most relevance for patients; and cognitive testing
determined the most understandable wording of questions. Tests determined the
validity of the instruments.
While the NCQA and CAHPS questionnaires were developed for use with health
plan populations, and many of the questions may have applicability for medical
group practices, measures have been specifically designed for office-practice
settings. For example, the American Medical Group Association supports a well-
validated 13-item visit-specific standardized survey of patient satisfaction.
Findings can be reported at the clinic, department, or physician level, or in
the context of national and regional satisfaction benchmarks. In this manner,
medical groups and physicians can see how they compare to relevant peer groups.
Each of these surveys provides different information about consumer
perceptions of health care the distinction between the surveys is important and
should be carefully weighed when considering the intended use of survey findings.
These questionnaires can be used off the shelf by medical groups, or they
can provide a starting point for customized instruments. If there is reason to
believe that standardized surveys don’t fully reflect medical groups, patient
population, patient experiences, or the particular office setting, it may be wise to
use supplemental questions or a customized survey designed to provide additional
information.
The lessons learned from the NCQA and CAHPS projects can be applied
when designing new questions or questionnaires.
New ways to collect data
14. Don’t underestimate the expense of collecting satisfaction data. Reliance on
paper-and pencil survey methods often resulted in disruption of office work flow
and burdened an already overworked staff. Recently, however, a number of
technological innovations have been developed to reduce staff burden and long-
term costs. Examples include in-office computer kiosks [i.e., cabinets that allow
patients to see a computer monitor
And type on a keyboard] and hand-held devices that present one question at a time
to patients and require hen to press one key to respond
Patients can use this equipment to complete satisfaction surveys immediately
after their office visits with minimal direction from office staff. Even the Internet
has served as a means for efficiently collecting patient-satisfaction data select
populations.
Patients with Internet access can complete satisfaction surveys online after
returning home, or they fan gain access through a computer terminals in the
doctor’s office. The data collected with each of these technologies are
automatically entered into a data file that is ready to be processed and analyzed.
This can cut down dramatically on the time and costs associated with
transferring data from paper-and-pencil questionnaires. Even paper-and-pencil
surveying can be automated; for example, a fax machine can transmit patient
responses to a central processing and reporting service. All of the technologies
described above reduce the administrative burden faced by medical offices, which
is especially important when implementing a program.
Effective reporting
Whether medical groups produce their own survey reports or use the
services of a vendor, report content will depend on the goals of the satisfaction
program. To get the most out of the data, groups may want to compare findings for
their own patients with external norms or standards or with internal benchmarks
they may want to make a longitudinal analysis.
For example, if a standardized survey is used that has normative
information available; it will be possible to compare group-level data with regional
or national populations. For selected surveys, norms may even be available by
15. medical specialty. With either customized or standardized surgery’s it is possible to
compare group-level findings with internal benchmarks or objectives. Data can
also be compared before and after program improvement or process change to
determine its effectiveness. It is also valuable to report findings for different
subgroups within a medical group; for example, satisfaction levels for different
specialty categories, different office sites, or even individual physicians.
Developing and implementing a sound patient-satisfaction measurement
program that takes advantage of many of these innovations may require expertise
not often available in medical-practice settings. In response to this and other
market needs, service organizations have recently been created that provide
products and services to support efforts to measure patient satisfaction.
Groups considering implementing a satisfaction-survey program will need to
consider several factors including cost-effectiveness objectivity, and program
quality. Outside resources can address each of these Considerations.
Using outside experts to design, implement, and maintain a satisfaction-
survey program can actually be cost-effective because it allows staff member to
conduct thief daily business uninterrupted A serious consideration id the need for
independent objective assessment.
NCQA now recognizes the importance of objectivity in satisfaction measurement
and requires that satisfaction data used for health plan accreditation purposes be
collected by an outside survey vendor.
Finally, an outside expert can be expected to employ rigorous evacuation
methods to ensure data quality and effective reporting of satisfaction findings.
As we move into the next millennium, the measurement of patient
satisfaction is becoming less of a luxury and more of a necessity for medical
groups. It is increasingly important that a patient-patient-satisfaction program be
done well, using sound protocol and methods
Survey findings can be used for accreditation and marketing. In this era of
increasing competition and high patient demand for health care excellence, medical
16. groups cannot afford to forgo the insights they can derive from patient-satisfaction
surveys.
About the authors: Roger Bolus, Ph.D., is direct or of outcomes and analytic
services for Pfizer Health Solutions. His responsibilities include designing and
carrying out evaluation activities associated with the various PHS products.
Jennifer Pitts, Ph.D., is a senior project scientist at Pfizer Health Solutions.
Before joining PHS, she was an Agency for Health Care and Research postdoctoral
fellow at the UCLA School of Medicine.
Pfizer Health Solutions, which has 30 professionals on its staff, is a wholly
owned subsidiary of Pfizer Inc.
The new health care accountability: Voice of the patient has a new
legitimacy Member satisfaction is measured as a part of the National Committee
for Quality Assurance s HEDIS quality analysis.
Employing the Consumer Assessment of health Plans Survey, member
satisfaction is factored into the formulas for decisions regarding accreditation. In
collaboration with specialty, state, and local medical societies, the AMA has
developed American Medical Accreditation Program, in which physicians who
meet strict quality standards can receive individual accreditation In addition to
standardized measures of clinical results and health status, patient satisfaction is
considered a key result of patient care.
The Foundation for Accountability is a not-for-profit organization whose
stated mission is to help consumers make better health care decisions. FACCT is
comprised of consumer organizations and health care purchasers calculated to
represent nearly 80 million consumers. Among its many efforts, FACCT has
developed consumer-focused quality measures that include a patient satisfaction
instrument. The increasing importance of measuring patient satisfaction one needs
only to look at the available data to realize the growing importance of monitoring
patient satisfaction. Beginning in 1996,
Hewitt Associates, the international management consulting firm, began to
develop an extensive health plan database: the Health Value. The database includes
health plans responses to an extensive questionnaire about operations, quality-
17. improvement programs, provider contracting, and other activities. The survey has
been conducted annually since 1996 and contains responses from over 500 plans.
Among the questions that have been asked:
Whether plans feed satisfaction-survey results to medical groups [for plans
with data for 1996 and 1998] whether member satisfaction with providers is
incorporated unto the compensation formula [for plans with data in 1996, 1997,
and 1998]
The HHV1 survey indicates a growing trend in the use of satisfaction data
by health plans. Over 80 percent of the reporting health plans now feed this
information back to medical groups as part of quality important, a similar
percentage include this data as part of physician reimbursement
When the perceived out come of care meets with expectation, quality is
considered high. Continues quality improvement is the work towards achieving
needs and wants of the patients as for as hospitals are concerned.
In view of patient satisfaction patient relationship management acquires
great significance. For managing relationship with patient, the hospital
management has to first identify the different occasions when representatives of
the organizations have opportunities to interact with the patients and bystanders.
Often hospitals tend to look at the services of doctors and nurses alone, but as for
as patients are concerned, the service of the security staff to receptionist, lift
operator, waiter in the canteen, house keeping staff etc. have an impact as they
assess the quality of the hospital. The impression a patient and by standees forms
about the hospital depends on how the hospital employees and representatives
deals with the patient and by-standard’s at the various interactions. Johan Calzon
calls this interaction as “moments of truth”
18. Primary reasons for a hospital existence is to provide care for patients and
satisfy their needs “Satisfaction is measure of the patient attitude towards his
physician the medical care being received and the health care system”
With the increasing emphasis on quality health care there is a tendency to
involve the patient to a greater extend in evaluating the quality of care provided.
Thus patient satisfaction has been suggested as criteria for measuring quality of
care.
Every patient should feel that he is considered and cared for. To give
satisfaction the nurse should recognize the carious needs of the patient and meet
them with out any delay
The main purpose of the ward/room is to satisfy the wants and needs of the
patient the ward/room must provide the best possible atmosphere for the patient
satisfying the social as well economic need of the patient within acceptable cost.
Every patient admitted to the hospitals should be considered as unique person in
terms of both personal needs and extent of illness. Anthropologist Clyde
Kluckhohn wrote. Every man in certain respect like no other man: every man
certain respect like some other man: every man in certain respect like all other
man. There is a tendency among nurses to identify the patient either by bed number
or by the disease they suffer from. It is very important that nurses should address
the patients by his or her name.
Now we have to see why continuous quality improvement is needed as far as
hospitals are concerned. In earlier days hospital was set to poor and weaker section
of the society in those days there was only little advance in medicine. And
hospitals were mainly a shelter for destitute.
The environment in with the hospital are working has also underwent change
the supreme Court of India’s ruling that the hospital can also come under the
preview of the consumer protection act 1986, has forced hospitals to take steps to
improve the quality, witch otherwise would give the hospital loss of money as well
reputation. Again the introduction of Insurance Regulatory Bill [IRB] will be
another change in the government as far as hospitals are concerned. The private
insurance companies will go in for various health insurance schemes, which would
force to hospital to undergo quality improvement programmes. These and other
19. rapid change in the external environment would force to hospital to undergo
continuous quality improvement and thereby bring change in the organization.
To day there is tough competition between the hospital different hospitals to
attract patient. The hospitals are forced to accept the patients [customers 0 as king,
for their survival. To serve them better we have to understand the concept of the
service better. Though a service is obviously different from physical product it is
still product. A service product-any incident of doing for other for fee can be
distinguished from a commodity by one or more, and usually several of the
following service characteristics.
1. A service is produced at the instant of delivery it can’t be created in advance
or held in the readiness.
2. A service cannot be centrally produced inspected, stock pilled or ware
housed. It usually is delivered wherever: the customer is, by people who are
beyond the immediate influence of management.
3. The service cannot be demonstrated, nor can be sample be sent for
customers in advance of service.
4. The person receiving the service has nothing tangible; the value of service
depends on his or her personal experience.
5. The experience cannot be sold to a third party, but the nature of the
experience can be conveyed to third party.
6. If improperly performed, a service cannot be re called or repeated, and then
reparations or apologies are only means of recourse for customer
satisfaction.
7. Quality assurance must happen before production, rather than after
production, would be the case in manufacturing industry where service is
delivered at instance
20. 8. Delivery of service usually require human interaction to a greater extend.
Service provider and service receiver comes in a contact in a personal way to
create service.
9. Receives expectations of the service are integral to his or her satisfaction
with the out come. The quality of service is a subjective matter.
10.The more the customer must encounter during the delivery of the service, the
less likely it is that he or she will be satisfied with the service.
The three important characteristics that differentiate outstanding service
organizations from mediocre one includes.
Though a service organization, the service provided by the hospital is
different from other service organizations such as bank, hotels and restaurants.
People may go to hotels and restaurants in a happy mood, while going to
hospital is a nightmare for almost for all persons. So the mindset of the patient
in the hospital will be different, unlike the customers of service organizations.
Now let us consider the concept of patient satisfaction as per the opinion of
eminent authors
According to Philip Kotler “satisfaction is a state felt by a person who experienced a
performance or out come that has fulfilled his or her expectations.”
Mrs. Prem Misra says, “The literal meaning of satisfaction is to fulfill the desire
expectations. Needs ordemand of person. Satisfaction is a psychological phenomenon resulting from
meeting the basic needs of human beings. The needs may be physical, psychological, social or
spiritual. All these needs are interrelated and inter dependent. The fulfillment of one need affects the
need in the other area”.
Dr O.P. Sharma in his improving patient satisfaction says, “In the current era
of scarce hospital resource, high cost of hospital operations and increasing
demand of hospital services. The improvement of patient satisfaction assumes
great significance for the hospital administrators in particular and the public in
general. Patient and their relatives can be almost fully satisfied in existing
21. conditions available in our hospitals. No extra funds are necessary. Change in
attitude and approach is required.”
Dr. C.M. Francis says,” patient satisfaction is often a better indictor of
quality of art of car, quality of nursing care, quality of facilities provided then
quality of technical aspects of care per se”.
As per S.I Goel and R, Kumar “The inpatient services are the costliest in
terms of expenditure in a hospital and therefore must be used judiciously and
effectively make the patient feel that a word is a temporary home to the patient, till
they are discharged.”
When a hospital has to undergo a charge, it must find out the needs of the
patients. Need assessment can be done through patient satisfaction survey. Though
this needs, wants and attitudes of the patient can be found out an assessment of
consumers need is necessary steps that precede the provision of service.
Health care organization must systematically study patient needs, wants,
perceptions, preferences and satisfaction, using surveys, focus groups and other
means. A marketing orientation holds that the main task of the organization is to
determine the needs and wants of the target market and to satisfy through the
design, communication, pricing and delivery of appropriate and competitively
viable services.
Mac Stravic indicates four errors that hospitals and related health care
organizations often make concerning needs.
It may ignore unmet needs and satisfy itself that as long as it serves all who
enters its door it has fulfilled its obligation.
It may provide service in excess of need, perhaps excusing itself on the
ground that is providing what the consumer wants.
It fully accepts its obligation to serve community but fail to ration the
communities scares resources.
The biggest danger in health care services facilities need oriented approach
is that obligating not cost is usually placed first.
Another important aspect of patient satisfaction is the awareness of the patient
rights awareness should be on the patient that they are free and equal partners in
22. the health care process. The patient has the right to consider it, respectful care of
all time with recognition of his personal dignity regardless of race, creed, sex, or
ability to pay. He has the right to obtain the minute details regarding his treatment
and various investigative procedures.
The strive for continuous improvement should be in the mind of every
employee in the organisation. There has to be commitment of “Do it right the first
time”. They have to be made understood they won’tget a second chance to create a
first impression, which will be the impression in the mind of the patient. The
customer would push for better price, improved service, speedier delivery of
service.
Hospitals are increasingly becoming sensitive to the needs of patients as well
as the community it is no longer the seller’s [providers] market, except for the
totally free service provided by the Govt. run hospitals and a few hospitals run by
the civic authorities.
According to Dona Bedian “patient satisfaction may be considered to be one
of the desired outcome of care, even an element of health status itself and that
information about patient satisfaction should be as indispensable to assessment of
quality as to the design and management of healthcare systems.”
During the recent years the use of patient satisfaction survey has increased in
health industry due in part to the belief that perception of quality is an important
factor in the demand for services and the survey result may have significant effects
on provider behaviour according to Ware “Patient satisfaction is a determinant of a
healthcare provider or system. Use of services complaints and malpractice suits”
Use of patient satisfaction survey as a tool for quality improvement has
become extensive in almost all western countries. Most hospital have a system of
obtaining routine feedback from all the discharge patients. The quality
improvement task force of the joint commission of accreditation of the health care
organization in USA is also encouraging hospitals to mandate surveys are
conducted in private hospitals.
23. But the actual value of patient satisfaction surveys, as a tool for continuous
quality improvement is a matter of debate among the academicians and hospitals
managers.
Vouri’ Listed following deficiency in patient’s satisfaction measures.
Patients lack knowledge to accurately assess the technical competence of
medical personal further more their physical or emotional status can easily impede
judgment
Patients are influenced by non-medical factors such as the interpersonal skill
of the provider. A good beside manner can easily mask doubtful technical quality.
Patients are often too reluctant to disclose what they really think because of
their sense of dependency or prier failure in patient-physician communication.
Patients cannot accurately recall aspects of the delivery process more over
patient surveys or even face interviews are impact means for measuring highly
subjective phenomena”.
Surveys generally very widely in design. Content, administration and overall
sophistication in analysis and computation of result. The usefulness of the survey,
instruments, administration and analysis.
According to Irwin Press “Patient satisfaction is good medicine & good
business.”
These words close Irwin Press’comprensive book about patient satisfaction,
and they say it all: patient satisfaction is required to succeed in today’s health care
industry. In his book, Irwin Press, who is an icon in patient satisfaction, answer
every conceivable question about measuring patient satisfaction. More valuable, he
debunks the usual excuses for mediocre or poor patient satisfaction [our patient are
sicker, we have a trauma centre, our patients are less sophisticated, etc] and he
provides concrete examples of ways other organizations have made marked
24. improvements in their patient satisfaction scores- to the benefit of patients,
employees and the bottom line us studies that indicate satisfied patients often
recover faster and better from treatment this leads to goodwill for the organization,
positive word-of mouth promotion, and more customers at your hospital. When
patients are satisfied it also indicates that the staffs are content with their jobs and
they perform their jobs well, resulting a decreased turnover, are and less money
spent on finder’s fees.
In today’s health care market the traditional term for referring has changed.
In many private health care organizations the term customer has replaced the word
patient when the term customer is used it is considered inclusive of all individuals
who receive services. For hospital similar to the healthcare organizations, the
primary aim of health service delivery is clearly satisfying the customer.
FACTORSAFFECTING PATIENTSATISFACTION
Hospitals must be conscious of the need to provide in the service re ndered
by them all time. The process involves all activities and all departments in the
hospitals. All functions must be carried out so that they are done right at the first
time. The medical care there may There are several factors, which are affecting the
standard of patient satisfaction these include,
Physical factors.
Service factors.
Technological factors.
Costfactors.
Communication.
PHYSICAL FACTORS:
To provide quality care the basic physical infrastructure is necessary. The
location of the hospital is an important physical factor. Ideally it should be away
from densely populated area. But at the same time it should be easily accessible by
various modes of transportation such as road, rail etc.
25. The lay out should be provided with sufficient ventilation, good light and
ventilation to enter fresh air. The physical structure and good environment will
create of good impression in the minds of the people. Hospital should provide
seating arrangements, adequate toilet and drinking facilities. Here should be
signboards since the patients may find it difficult to identify the various places they
have to go.
The availability of good physical facilities attracts not only new patients it
will also help the old patient to remain with the hospital. Supplies and equipments
are also essential to facilitate the service and the service and they should be always
in working conditions to give maximum out put besides these there are several
other factors which provides satisfaction to the patients like waiting room with
adequate seating arrangement, parking facilities with adequate patients like waiting
room with adequate seating arrangement, parking facilities with adequate space,
good front office with inquiry of reception staff. Availability of specialist doctors,
availability of facilities, like modern equipments machines etc are very important
inpatients satisfaction.
Physical facilities to be provided include public telephone booth with STD/ISD
facilities, recreation facility, newspaper etc. Assisting the patient with those
physical services necessary for his well being and comfort which cannot for
himself unaided and planning such services to meet his individual, needs as they
are affected by his physical condition and his emotional reaction”
The physical facilities of the hospital should be such that the attendants and their
relatives feel secure and comfortable within and around hospital. Another aspect
that is concerned with the physical facility is with the cleanliness of the hospital.
Only in proverbial terms cleanliness in next to godliness. But so far as hospitals are
concerned cleanliness equally important along with being good. The toilets, the
floor, the canteen etc should be kept clean always. The physical facility of the
hospital should be such that the patients and relatives feel secure and comfortable
within and around hospital. They should have a feeling that hospital is a second
home.
SERVICE FACTORS:
26. Service factors includes professional services as well I as nursing service A
service is defined as any activity or benefit that one can offer to another that is
essentially intangible an does not result in the ownership of anything. Its
production May of may not be tied to a physical product”
The performance of the hospital is measured only by quality of service provided
to the public. Hospital should try to, establish cordial equitable and therefore
mutually profitable relations between the hospital and their beneficiaries, the
patients mostly complain of discourteous behavior of hospital staff, especially at
the lower level. This irritates the patient and there relatives. The test of efficiency
of a hospital is the satisfaction of the patients and the relatives.
The sympathetic and courteous behavior of the hospital staff would have a
good and lasting effect on the patients and relatives. The hospital today is more
than the combination of medical and therapeutic treatment by specialist, greater
and refined medical and surgical knowledge and ever better and more effective
facilities and equipments it includes these factor as the care of its efficient
operations but an additional dimensions one which is to be ignored or at least
minimized is the human and social element in the structure of the organization”
Health care organization need to know wants perception and preference of
the customer. After knowing this health care organizations can provide according
to their needs wants which should give satisfaction to the patient. They may expect
better performance for their satisfaction. “A responsible organization is the one that
makes the every effort to sense, serve and satisfy the needs and wants of its clients
and the public and the publics, within the constrains of its budget and good clinical
practice”
The medical, nursing, paramedical and other staffing the in the hospital
should be skilled and competent. Their attitude should be customer friendly. The
commitment to the organization to quality of service must be clearly
communicated to all its employees.
It is very important for the hospital to have a clear ‘service strategy” “A
service strategy is a distinctive formula for delivering service. Such as strategy is
27. keyed to a well-chosen benefit premises that is valuable to the customer and that
establish an effective competitive position”
The ability to define and articulate a vision of service is more and more
needed in hospitals. The premium will be on setting the strategy direction of the
company in terms market oriented service strategy. Another way of defining
service strategy is to describe it as an organizing principle that allows people in a
service enterprise to channels their efforts to better oriented service that makes
significant difference in the eyes of the customer. This principle can guide every
one from the top management on the down to in and staff employees. The principle
must take assessment that says this is what we are, this is what we do and this is
what our believe in” Adherence to this principle helps the hospitals make service
decision within its realm of concern. Another aspect of service is the value the
hospital is offering to its customers.
This point of view focuses on the nature of customers experience with the
service it revolves around the notion that value in the mind of the customer is what
counts an not necessarily value in the eyes of the company.
TECHNOLOGICAL FACTORS:
The twentieth century saw rapid advancement in science and technology.
The advancement of medical sciences indeed revolutionizes the concept of hospital
itself. New and new investigations procedures and being worked out. Many
hospitals are finding it difficult to cope with rapid change in technology.
Technology is needed to a greater extend, but amount of modernized
techniques or sophisticated equipments may not contribute to the satisfaction of the
patient. Even while using technology the human aspect of care should be
considered. Technology only assists in giving correct diagnosis and treatment. The
socio economic aspect the patient should be considered when we go in for high
tech treatment.
The pace at which medical technology is advancing the entire process of
patient care is becoming mire and more compels. The advance in medical science
and technology have become to the rescue lf modern government in organizing
28. massive combat against disease, both individually and collectively on an
international scale and have raised the life expectancy rates every were, by creating
better conditions form modern living thus the quests for meeting new demands of
health become an on going process as long as man and nature war each other
The advent of science and technology has made the modern hospital
situation more and more complex.
COST FACTOR
One of the important aspects with the patient satisfaction is the economic
satisfaction of the patient, there should be balance between quality and cost. With
the advancement of technology the cost of treatment is becoming high as a result
of which high-class treatment is becoming unaffordable to the vulnerable sections
of the society.
Usually a person undergoing treatment will be in a financially
disadvantageous position; during his days in the hospital have will be deprived of
his income. Many a times the patient will have to depend on his near ones for his
treatment. Along with physical pain, the financial burden will cause agony to the
patient and the hospital will have to consider this also.
“The current trend in rising cost of medical care is publishing it of a level
beyond the reach of the majority which is incompatible not only with demand on
spend able income, but also with social, policies availability of access to health
services. Health is recognized as an investment, as improved health of the people
contribute to enlarging the resources and out put of the economy. It is also accepted
fact that improved health care and modern society decreases that access to
healthcare and modern society decreases that access to health care as a human
right, regardless of person’s ability to pay. This big challenge to today’s health care
administration and the need to deal with the variable and un budget able nature of
medical care cost”
A hospital must accurately determent the cost of providing all it service
through a proper system of accounting. An important administrative function is to
determine then schedule of changes for the service to be rendered. The change
29. must be reasonable at sufficient income must be generated. The first requirement as
to find out the actual cost for providing each of the service”
In addition to the price of fees which we collect patients incur three other costs:
The time cost and trouble of looking into information locating the hospital
and traveling, which could be termed as effort cost.
The fear about his disease and treatment, trouble and pain, side effects,
recovery time and extend of recovery could be termed as efforts cost.
Waiting time of the patient has to be considered as waiting cost.
This effort psychic and waiting cost also influence patient satisfaction to
greater extend.
Adam Smith rightly said, the real price of everything what every thing real costs
to the man who wants to acquire it, it is the tool and the trouble of acquiring it”
COMMUNICATION FACTORS:
Like any other service industry, communication is an important factor of
customer satisfaction in hospitals too. Even the attitude of employee is an
important aspect of communication. Communications with individuals and families
in the community allow as gaming their confidence as well as to change the
attitude and behavior for adapting useful health practices.
“Communication is the touching of mind by mind, of person with person
whether it-be one man to a thousand. It can include conversation. Interview,
dialogue, visual technique carefully used: This is of great significance as any
wrong communication or misunderstanding can be responsible for damages to
patient as well as to the hospital. There is a need to issue orders, instructions, and
prescriptions to be carried out clearly and understandably.
Better techniques of communication can contribute to the improvement of
health management by securing the floe of information needed for the effective
functioning of the organization at minimum cost. Communication such as
signboards, information enquiry ect s important. The lack of ability of Doctors,
30. nurses and other staff to explain the things properly is a major source of
dissatisfaction by many patients.
Efficient communication is essential to all aspects of effective
administration. Staff must be adequately and currently informed about plans,
methods, schedules, problems and progress. It is clear that instructions, knowledge
and information be so clearly presented as to make misinterpretation to
misunderstanding impossible. Training should be imparted to staff to enhance their
communication skills.
PATIENT SATISFACTION IS THE MAIN GOAL OF TOM
A family physician approach to total quality management [TQM]
TOM in the family practice is an organized approach to achieve maximum
patient satisfaction, by involving and respecting the patient. Doctors, suppliers and
the staff member in the clinic. Total quality management enables continuous
improvements in the process used to prepare and deliver clinic s products and
services to its patients. Theemphasis is on preventing problems and not waiting for
them to occur. In a nutshell patient satisfaction is the primary objective of TOM.
Family physicians in India he interested in practicing TQM
All family physiciansin the subcontinent would like to have a list of satisfied
patients by improving [he quality of practice. They would like to deliver more
professional satisfaction, improve the employee productivity and moral, augment
the clinic revenue and recognized as a quality conscious doctor. Therefore, I see
every reason that family physicianswould be keen to practice TOM which is going
to give more personal satisfaction, improve the employee productivity and morale.
Among the clinic revenue and he recognized and quality conscious doctor.
Therefore, I see every reason that family physical would be keen to practice TOM,
which is going to be the mantra of the next millennium.
31. TQM is going to play such an important role in the 21st century
In the process of having professional skills little did we know that in addition to
academicqualification and clearing to the responsibilities of being a physician, we
would also have to fit into the roles of chief executive officer, chief financial
controller and director of HR chances are all these extra responsibilities are eating
into our personal times. Time that could be better utilized by learning the rules of
efficient TOM in our practice instead of waiting in crises management.
TQM in family practice
Patient from the basis of survival for healthcare provider. Patient
satisfaction is destined to become the number one criteria used for selecting heath
provider a satisfied patient is loyal customer. A dissatisfied, patient could make a
break your facility or practice. Patient dissatisfaction could stem from office setting
employee and physician attitudes, quality, and healthcare offered.
Chapter 4
METHODOLOGY
“Research Methodology” is a way to systematically solve the research
problem. It may be understood as a science of studying how research is done
scientifically.
1.1 RESEARCH DESIGN
A research design specifies the methods and procedures for conducting a
particular study. The research should specify the approach he or she intends to the
proposed study. Research design applied in this study is exploratory research.
EXPLORATORY STUDY
32. The exploration is particularly useful when researchers a lack a clear concept
of the problems they would encounter during the course of study. Through
exploration, researcher would develop concepts more clearly, establish priorities,
develop operational definitions and improve the final research design. Exploration
may also save time and money.
Exploration serves other purposes as well. The area of investigation may be
so new or so vague that researcher needs to do an exploration just to learn
something about the dilemma to be faced by the manager. Important variables may
not be known or thoroughly defined. Hypothesis for the research may be needed.
Also, the researcher may explore to make sure that it is practical to do a formal
study in the area. An exploration to discover if industry executives would divulge
adequate information about their decision making on this topic was essential for
the study’s success.
1.2 DATA COLLECTION METHOD
This is a process of collecting data from various sources.
SOURCES OF DATA COLLLECTION
Questionnaire: - Questionnaire is most common type of survey method. As its
name implies Questionnaire consists of several items designed to elicit the require
information
The I.P.D patient Questionnaire consists of 20 questions related to the hospital
services provided to the patient. Some questions are open ended some are closed
ended. [Based on Excellent, Good, Satisfactory, Unsatisfactory]
PROCEDURE: - survey samples of 70 IPD patients were taken. Single patient
was conducted at a time and after establishing the good rapport with the patient
Questionnaire were conducted on the patient.
33. METHOD OF DATA ANALYSIS:- scoring will be based on the calculation of
the response given to the various attributes by the patient.
SAMLING DESIGN:-
A sample design is a definite plan for obtaining a sample from the given
population. It refers to the technique or the procedure the researchers would adopt
in selecting items for the sample
SAMPLING UNIT: MAX POLYCLINIC AND DIABETIC CENTRE,
HYDERABAD
SIZE OF SAMPLE: 70 IN-PATIENTS
TYPE OF SAMPLING: RANDOM SAMPLING
CHAPTER. 5
ANALYSIS, INTERPRETATION, FINDINGS AND DISCUSSION
Exploratory Data Analysis [EDA]:- is search for clues and evidences.
Exploratory data analysis is the first step in the search for evidence. EDA shares a
commonality with exploratory designs not formalized ones. It is free to take many
paths in unraveling the mysteries in the data to shift the unpredictable from the
predictable.
A major contribution of the exploratory approach lies in the emphasis on
visual representations and graphical techniques over summary static.
34. The present Exploratory Study involves identification of the level of
satisfaction of the In-patient and problem facing by the In-patients and data
presentation by using pie charts and graph charts.
Q .1 is this your first visit to this hospital?
[a] Yes
[b] No
Findings: out of 48-70% patient have visited more than one time so that
phenomena shows the good image of the Poly Clinic Centre and satisfaction of the
patient. And 52% are new comers it gets still to patient. With this one can say that
the popularity of Poly Clinic is high.
Q .2 why have you selected this Poly Clinic?
[a] Facilities [b] Location
[c] Recommendation [d] Tie up with private company
48%
52%
1
2
35. Findings: the graph represent out of 70 patients 46% have come here because of
its facilities and 43% were recommended by other doctors who shows good image
and have super specialties in Polyclinic. Only 7% and 4% .
Q .3 you are admitted through.
[a] OPD [b] Emergency
[c] Other Institute Referred
Findings: 46% of patients are admitted through OPD that shows Polyclinic has got
good, experienced and efficient doctors in OPD. 31% patients are admitted through
emergency its efficient ambulatory services. 23% patients are admitted through
46%
7%
43%
4%
1
2
3
4
OPD 46%
Other
Institute
Refered
23%
Emergency
31%
1
2
3
36. other institute it shows polyclinic marketing plays vital role in the promotion of
polyclinic.
Q .4 you are admitted through.
[a] OPD [b] Emergency [c] other institute or referred
Findings: This graph shows 81% patients say there is an immediate admission
formality that shows efficiency and competency of the employees.
Q .5 Total serviced provided through the hospital.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
1
3%
2
10%
3
6%
4
81%
1
2
3
4
37. Findings: this chart shows out of 70 patients 46% patient says excellent, 35%
patients say good. So we can say that services provided through the hospital are
good.
Q.6 Communication through the staff.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings: this chart shows out of 70 patients 56% says good and 24% says
excellent, 18% says satisfactory and 2% says UN satisfactory that shows nursing
staff are polite caring for patient.
Satisfactory.
18%
Un
satisfactory,
2%
Excellent, 24%
Good, 56%
1
2
3
4
Good,, 35%
Satisfactory, 19%UN satisfactory, 0%
Excellent, 46%
1
2
3
4
38. Q .7 Behaviour of staff, consultant and other doctor.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings: this figure depicts doctor, nurses and other staff is good in nature and
keeping the patient always happy with their attitude.
Q .8 Explanation about your health, illness and treatment.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Satisfactory, 2,
11%
Un satisfactory,
3, 1%
Good, 1, 52%
Excellent, 4,
36%
1
2
3
4
39. Findings: this diagram shows 27% patient says excellent 54% says good so we can
say doctors are taking good care and also explaining the illness and treatment of
the disease. And 16% are satisfied with these services.
Q .9 Listening to your problem.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Good, 1, 54%Excellent 4, 27%
Satisfactory, 2,
16%
Un satisfactory, 3,
3%
1
2
3
4
Un satisfactory,
4, 0%
Satis factory, 2,
15%
Excellent 3,
23%
Good , 1, 62% 1
2
3
4
40. Findings : 23% patient says excellent, 62% say good, 15% says satisfactory and
no-one is un satisfied it shows all the nurses and doctorare doing their work
properly i.e. they are doing their work efficiently and also effectively.
Q .10 Time period taken by the doctors for your treatment
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings : 23% patients says excellent,53% says good, 22% say satisfactory and
2% says unsatisfactory that shows, doctorand nursing staff are attending the
patient in time.
Q .11 Services and facilities in the ward.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Un satisfactory,
2, 2%
Excellent 3, 23%
Satisfactory 1,
22%Good , 4, 53%
1
2
3
4
41. Findings: 31% patients says excellent, 49% says good, 17% says satisfactory
and 3% says unsatisfactory that shows the hospital employees are performing their
task in good manner and hospital accessories are in order.
Q .12 Preparation of the room
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Excellent 3, 31%
Unsatisfactory 2,
3%
Satisfactory, 1,
17%
Good, 4, 49%
1
2
3
4
Unsatisfacto
ry2, 2%
Excellent 3,
28%
Satisfactory
1, 23%
Good4, 47%
1
2
3
4
42. Findings: 28% patients says excellent, 47% says good, 23%say satisfactory and
2% say un satisfactory that shows good co-ordination among the housekeeping
staff.
Q .13 Toilet facilities in the ward
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings: 12% patients say excellent, 48% says good, 20% says satisfactory, and
20% says unsatisfactory that shows house keeping staff is effective but not
efficiently performing task.
Q .14 Diagnostic services in the poly clinic
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Good 3, 48%
Excellent 2,
12%
Unsatisfactor
y 1, 20%
Satisfactory
4, 20%
1
2
3
4
43. Findings: 66% patient say good, 21% say excellent 1% un satisfactory 12% say
satisfactory,
Q. 15 Discharge procedure:-
[1] Time taken by the doctors and staff
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Good1,
66%
Satisfactor
y2, 12%
Un
satisfactor
y 3, 1%
Excellent4,
21%
1
2
3
4
44. Finding: this chart shows the information that hospital administration should look
after billing process and need to speed up the billing activity.
[2] Attitude of billing staff.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings: this diagram shows that the billing staff attitude is good. And are polite
in nature
Un
satisfactory1
, 2%
Excellent2,
10%
Good 3, 29%Satisfactory
4, 59%
1
2
3
4
Good, 4,
57%
Excellent, 3,
5%
Unsatisfaco
ry, 2, 1%
Satisfactory
1, 37%
1
2
3
4
45. [3] Charges of the hospital services
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Findings: this chart shows room charges are okay but the general ward charges are
slightly high that should be reduced to some extent.
Q .16 Hygiene status of the poly clinic
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Un
satisfactory
1, 54%
Satisfactory,
2, 7%
Excellent1, 3,
4%
Good 4, 35% 1
2
3
4
46. Findings: this chart reveals that 38% patients say excellent, 48% say good, 14%
say satisfactory no-one say unsatisfactory that shows good hygienic conditions in
the poly clinic. Hygiene status is notable issue in the hospital- --[poly clinic] that
has been maintained here properly.
Q .17 Would You RecommendThis Poly Clinic to Others?
[a] Yes [b] No
Good 1, 48%
Satisfactory2,
14%
Un
satisfactory,
3, 0%
Excellent, 4,
38% 1
2
3
4
No1, 4%
Yes 2, 96%
1
2
47. Findings:Most of the patients i.e. out 70, 97% patients are interested to
recommend the polyclinic if any body falls sick.
Chapter 6
CONCLUSION & RECOMMENDATION
Overall views about the polyclinic
Basically, the Max polyclinic & Diabetic Centre is run by a union of three doctors
specialized in three different specialties.
Management system has well designed fragments of different units. On the other
hand all units effectively and harmoniously are to overcome the one goal, customer
satisfaction.
Inner view about Polyclinic:
All the clinical staff [nurses and other employees], consultants should have better
co relation and create patient friendly ambience, whereas in practicality, it has been
observed that there is a communication gap.
Toilet services and regular cleanliness is the status of hygiene of a polyclinic.
There is not enough toilet facility in patients relatives waiting area.
In short toilet facility of the clinics should be redesigned well to maintain hygiene
status of a clinic.
The waiting area seems to be congested to accommodate the waiting patients and
need to be renovated suitably.
Even though all departments are performing their tasks up to the mark, there is a
need to do process improvements. Process improvements are major and first and
foremost concept in the Total Quality Management [TQM].
48. To endure in the 21st century market, most of the organizations are practicing the
Total Quality Management concepts. The hospital administration needs to practise
the TQM to give sophisticated services to the patients not only efficiently but also
effectively.
MAXPOLYCLINIC AND DIABETIC CENTRE
HYDERABAD
PERFORMA FOR IN-PATIENT
Q.1 Details of the Patient
o Patient name
o Address
o Phone no.
Q.2 Is this your first visit to this hospital?
[a] yes [b] No
Q.3 why have selected this hospital?
[a] Facilities [b] location
[c] Recommendation [d] Tie up with private company
Q .4 you are admitted through.
[a] OPD [b] Emergency [c] other institute or referred
Q .5 Admission formalities were completed.
[a] Immediately [b] Delay
49. [c] After receiving the deposit
[d] Any other
Q .6 Total serviced provided through the hospital.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .7 Communication through the staff.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .8 Behaviour of staff, consultant and other doctor.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .9 Explanation about your health, illness and treatment.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .10 Listening to your problem.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .11Time period taken by the doctors for your treatment
[a] Excellent [b] Good
50. [c] Satisfactory [d] Unsatisfactory
Q .12 Services and facilities in the ward.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .13 Preparation of the room
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .14 Toilet facilities in the ward
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .15 Diagnostic services in the poly clinic
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q. 16 Discharge procedure:-
[1] Time taken by the doctors and staff
[a] Excellent [b] Good
51. [c] Satisfactory [d] Unsatisfactory
[2] Attitude of billing staff.
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
[3] Charges of the hospital services
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .17 Hygiene status of the poly clinic
[a] Excellent [b] Good
[c] Satisfactory [d] Unsatisfactory
Q .18 Please gives your valuable suggestion so we can make best tomorrow
better than today.
PATIENT’S SUGGESTION
There are no facilities specially designed by the hospital for senior citizen
and retired employees.
Doctors should explain patient’s relatives about patient’s health in more
detailed manner by giving them enough time.
Juice shop should be provided in hospital.
Discharge and billing procedure is taking long time so it should be reduced.
Toilets should be cleaned regularly and fresheners should be used.
52. In private ward relatives bed is congested and furniture should be re
organized.
Make sure that water services like taps and lights services like fans,
switchboards are in order.
Visiting hours must be started in the morning.
Even though services provided by nurses and supporting staff are
satisfactory there is a scope for improvement. They need to be more helpful
to the patient as well as their relatives
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