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 To assess the patient satisfaction level in emergency dept in level one trauma center in India : shallu chauhan
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To assess the patient satisfaction level in emergency dept in level one trauma center in India : shallu chauhan

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Abstract …

Abstract

To assess the patient satisfaction level in emergency
department of a level 1Trauma Centre in India.

Shallu Chauhan, Dr.Deepak AgrawaL.

JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi-110029, India

Introduction
Patient satisfaction is an important indicator of the quality of care and service delivery in the
emergency department (ED). The objective of this study was to evaluate patient satisfaction
level in the E.D. of a level 1 Trauma Centre,AIIMS,New Delhi.To determine the effects of
actual waiting time,perception of waiting time,information delivery and expressive quality on
patient satisfaction.
Methods
This study was carried out for 2 months during all shifts mostly for those patients who triaged
as green.We made two groups:1) control group{ not explained anything to the patient} and
2) test group{patient explained for time management & treatment}. Patients/relatives were
asked to complete the questionnaire prior to discharge. For the first month, eight questions
were based on descripitve information were distributed to the control group { questions
including explanation of procedures to the patient,communication of staffs,problems faced
by patient/relatives, and overall patient satisfaction level}.Then, following second month
another study questionnaire included 11 questions based on a Likert scale concerning
waiting time{ie,overall time management,waiting for X-ray or C.T,scan,review by doctor, for
discharge & treatment},promptness & behaviour of staff and cleaniness of hospital given to
the test group.
Observation
Ninety patients who attended our ED were included in this study.The perception that waiting
times for placebo injection & T/t were less than expected was associated with a positive
overall satisfaction rating for the ED encounter[p is 0.033] as compared to actual waiting
time.Actual waiting time were not predictive of overall patient satisfaction. The highest
satisfaction rates were observed in cleaniness of hospital in both the groups and most of them
rated it as very good. For overall treatment, in control group 34% rated as poor & fair and
67% rated as good and very good,whereas in test group only 22% rated as poor and fair
but78% rated as very good and excellent.At the same time,both the groups were rated as
good for overall time management but they were not satisfy with the time taken by doctor
to review the reports and 33% rated as fair in control group and 22% rated as fair in test
goup.The assigned waiting time for particular physician to review a report was 60minutes
but average time taken to consult a particular physician was >60mins which mostly occur
in control group.The overall satisfaction rate was dependent on the mean waiting time. The
highest waiting time for a low rate of satisfaction of patient was 180minutes and for very
good level of satisfaction was just 15minutes. In control group,30% and 17% of patients
rated as fair and poor

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Transcript

  • 1. Shallu Chauhan, Deepak Agrawal JPNATC, AIIMS, New Delhi ,India 01/06/12
  • 2.
    • .
    01/06/12 Patient satisfaction is an important indicator of the quality of care and service delivery in the emergency department (ED).
  • 3.
    • To evaluate patient/relative satisfaction level in the ED at JPNATC, AIIMS,New Delhi.
    01/06/12
  • 4.
    • To determine the effects of actual
    • waiting time, perception of waiting
    • Time and information delivery on patient satisfaction.
    01/06/12
  • 5.
    • Prospective Observational study
    • Study period: 2 months{1 st july 2011 to 1 st September 2011} during all shifts.
    • Study Population: P atients who were triaged as green.
    01/06/12
  • 6.
    • Two groups:
    • Test group
      • {patient explained for time management & treatment}.
    • Control group
    • { not explained anything to the patient}.
    01/06/12
  • 7.
    • Test group
    • Patient /relatives were told that an injection was required to be administered after 2 hours.
    • Told to wait for 2 hours for the injection
    • Placebo (Inj Voveron) given after 2 hours
    01/06/12
  • 8.
    • DATA COLLECTION:
    • Month 1: Control Group
    • Month 2: Test group
    01/06/12
  • 9. 01/06/12 1.Explanation of procedures to the patient. 2.Communication of staffs. 3.Problems faced by patient/relatives and 4. overall patient satisfaction level.
  • 10.
    • Following next month of first 15 days questionnaire based on a Liker scale concerning waiting time, promptness of staff, cleanliness of hospital and behaviour of staff given to the control group and then for next 15 days same questionnaire given to the test group.
    01/06/12 QUESTIONS BASED ON TIME CONCERN: 1.Overall time management. 2.Waiting for X-ray or C.T.scan, dressing/suturing and injections 3.Reports review by doctor. 4.Time taken for discharge & giving treatment etc.
  • 11. 01/06/12 MATERIALS AND METHODS Questionnaire Used
  • 12. 01/06/12 Ninety patients were included in this study. The highest satisfaction rates were observed for cleanliness of hospital in both the groups and most of them rated it as very good.
  • 13. 01/06/12 Overall treatment Control Group 34% in control group 34% rated as poor & fair 67% rated as good and very good Test group 78% rated as very good and excellent. 22% rated as poor and fair
  • 14. 01/06/12 OBSERVATION Comparing both groups
  • 15.
    • Both the groups rated as good for overall time management
    • Time taken by doctor to review
    • 33% rated as fair in control group
    • 22% rated as fair in test goup.
    01/06/12
  • 16. 01/06/12 OBSERVATION AVERAGE TIME TIME MAXIMUM TIME MINIMUM TIME CONTROL GROUP [FOR 30 PATIENTS] 180 MINUTES 30 MINUTES TEST GROUP [FOR 60 PATIENTS] 120 MINUTES 15 MINUTES
  • 17. 01/06/12 OBSERVATION STAFF BEHAVIOUR 7% rated as an excellent/good in control group 36% rated as an excellent/good in test group.
  • 18. 01/06/12 OBSERVATION PROMPTNESS OF STAFF BEHAVIOUR OF STAFF
  • 19. 01/06/12 BRIEF OVERVIEW * Mann-Whitney Test Test Group (n=60) Control Group(n=30) P value* Median (Min., Max.) Median (Min., Max.) Overall Treatment 4(1-5) 3(1-5) 0.033 Overall Time Management 3(1-5) 3(1-5) 0.149 Waiting for X-ray or CT 4(2-5) (n=58) 3(1-5) (n=28) 0.012 Waiting for Dr. reviews 3(1-5) 2(1-5) 0.016 Waiting for Discharge or Treatment 3(1-5) 3(1-5) 0.623 Waiting for Dressing or Suturing 3(1-5) 2.5(1-5) 0.002 Cleanliness 4(2-5) 4(2-5) 0.416 Promptness of Staff 3.5(1-5) 2(1-5) 0.002 Behavior of Staff 4(1-5) 3(1-5) 0.121
  • 20. 01/06/12 RESULTS Actual waiting time were not predictive of overall patient satisfaction . Relatives/ patients who were explained about the need for waiting and given plcebo had significantly better satisfaction levels Most of the patients were not satisfied by waiting for doctor review,promptness of staff and their behaviour as it was long time they had to wait for doctor consultation and face problems due to shortage of staff. Most of the patients were not satisfied by waiting for doctor review,promptness of staff and their behaviour as it was long time they had to wait for doctor consultation and face problems due to shortage of staff.
  • 21. 01/06/12 * Providing information, managing time perceptions and expectations may be a more effective strategy to achieve improved patient satisfaction in the ED than decreasing actual waiting time.
  • 22. 01/06/12 CONCLUSIONS
    • The study findings indicated the need for evidence-based interventions in emergency care services in areas such as medical or nursing care, courtesy of staff, comfort of the patient and waiting time.
    • Efforts should focus on shortening waiting intervals and improving patients' perceptions about waiting in the ED.
  • 23. 01/06/12