My dessertation ppt

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  • According to WHO- “Hospital is an integral part of a social and medical organization ,the function of which is to provide the population complete healthcare both curative and preventive with outpatient services reaches out to the family in its own environment and also to carry out training of health workers/functionaries and the bio social reasearchINTRODUCTION
  • Researchers have generally agreed that expectations serve as reference points in consumer’s service performance by examine the
  • Researchers have generally agreed that expectations serve as reference points in consumer’s service performance by examine the
  • Operational Definition:Internal patient includes employee of Sanjay Gandhi Post Graduate Institute Lucknow and their dependantExternal patient includes other than employee of Sanjay Gandhi Post Graduate Institute Lucknow and their dependant
  • My dessertation ppt

    1. 1. 1Dr. Priyanka SrivastavaDepartment of Hospital AdministrationSanjay Gandhi Post Graduate Institute of Medical SciencesLucknowStudy of Assessment of Satisfaction amongthe selected population utilizing Out-PatientServices of The General Hospital of aTertiary Care Teaching Institute inThe State Capital of Uttar Pradesh
    2. 2. 2INTRODUCTION
    3. 3. “Hospital is an integral part of a social and medicalorganization, the function of which is to provide the populationcomplete healthcare both curative and preventive with outpatientservices reaches out to the family in its own environment and alsoto carry out training of health workers/functionaries and the biosocial research” – World Health Organization The Outpatient Department (OPD) is first point of contactbetween the hospital and the patient and patient satisfactiondepend on the standard of the health facility and care they receiveat the OPD.3
    4. 4.  Patient’s satisfaction depends on many factors such as quality ofclinical services provided, availability of medicine, behavior ofdoctor and other health staff, cost of services, hospitalinfrastructure, physical comfort, emotional support and respectfor patient Assessment of the patients’ satisfaction is important in order toidentify reasons for dissatisfaction and guide us to eliminatethem. As an administrator to it is important to identify causes ofdissatisfaction in order to alleviate level of satisfaction amongclients.. 4
    5. 5.  Multi sectorial development have increased level of information aboutmedical facilities and Patients awareness about their rights. Expectations from health care facilities are ever changing and scalingnew heights. It is important to understand causes of dissatisfaction among patientsutilizing OPD services to take corrective measures. This study intendsto find: Availability and extend of utilization of outpatient services in general hospital byinternal and external patients. Source of information for external patients. Reasons of satisfaction/dissatisfaction among the internal and external patient atoutpatient services. Waiting time for the internal and external patient at outpatient services in variousprocess and Recommend corrective measures to enhance the patient satisfaction5RATIONALE
    6. 6. 6REVIEW OF LITERATURE
    7. 7. Sonu Goel et al in their study to improve quality of care at public-health facilities in Chandigarh Measuring patient satisfaction aboutoutpatient services and found out that among 1200 exit interview withvariable like general satisfaction, technical quality, interpersonalbehavior, communication, financial aspects, time spent with doctor,accessibility and convenience etc.Overall patients’ satisfaction on various parameters of quality of carewas 86%. (Sub centre- 95%, Dispensary- 89.5%, Community HealthCenters- 87.7%, General Hospital- 83.8% and Polyclinic-82%).There was significantly more score of satisfaction in General hospitalas compared to other secondary level health facilities. However, thedifference in satisfaction score was not significant between different agegroup.7
    8. 8.  Talluru Sreenivas et al in their study “Patient Satisfaction - AComparative Study” conducted in three different selected hospitals inHyderabad city based on ownership. 270 respondents were selected out of 300 respondents of OsmaniaGeneral Hospital (Omanis), completely owned by Government, similarly90 respondents out of 100 respondents from Deccan HospitalsCorporation Limited (Deccan) which runs under the control of privatemanagement and 240 respondents from Nizams Institute of MedicalSciences (Nizams) which runs on corporate lines under the control ofState government were selected . it is found that the t-value for all types of responses and for all pairs ofhospital under study were significant at 5% level Journal of the Academy of Hospital AdministrationVol. 15, No. 2 (2003-07- 2003-12) 8
    9. 9.  Study on Evaluation of Service Quality of Hospital OPD Services wasconducted at a peripheral service hospital to ascertain any service gapbetween consumer expectations and perceptions in respect of thehospital service outpatient department. Service quality gaps were identified to exist across all the fivedimensions [expectations and perception, quality gaps, servicequality, SERVQUAL(of the survey instrument, with statisticallysignificant gaps across the dimensions of ‘tangibles’ and‘responsiveness’) The quality gaps were further validated by a totalunweighted SERVQUAL score of (-) 1.63.]. Significant service quality gaps existed in the delivery of the hospitalOPD services, which need to be addressed by focused improvementefforts by the hospital management.(Medical Journal Armed Forces India volume 67, Issue 3, Pages 221-224, July 2011)9
    10. 10. 10AIM AND OBJECTIVES
    11. 11. AIM- Study of Assessment of Satisfaction among the selectedpopulation utilizing Out-Patients Services of General Hospital ofa Tertiary Care Teaching Institute in The State Capital Of UttarPradesh. OBJECTIVES:-1. To study availability of Out-Patient Services and its extent ofutilization by Internal and External Patients.2. To find out the Source of information about the General Hospitalto the External Patients.3. To evaluate the waiting time and the reasons of dissatisfactionamong the Internal and External patient at Out-Patient Services.4. To recommend corrective measures to enhance the patientsatisfaction.11
    12. 12. 12METHODOLOGY
    13. 13.  STUDY SETTING - Sanjay Gandhi Post Graduate Institute of MedicalSciences, Lucknow Study Area - General Hospital STUDY DESIGN - Descriptive Study done Prospectively TIMELINE- Study Span: November, 2012- June, 2013 Data Acquisition: January, 2013 - March, 2013 STUDY POPULATION – The Patients utilizing Out-Patients Services. SAMPLING TECHNIQUE – Population Proportion Sampling STUDY SAMPLE – Internal and External Patient SAMPLE SIZE - The sample for observation was taken on the basisSample size (N) = (Z 2) * p (1-p)d2p = 0.12q= (1-p) = 0.88z =1.96 as per table of area under normal curve for confidence level of 95 %d = allowable error, since estimate should be within 5% of true value=0.05Sample size (N) = (1.96)2 * 0.05 (1 - 0.05) = 384(0.05)213
    14. 14. 14Gen.Medicine28%Gen.Surgery18%Pediatrics12%Gynea. &Obst.21%Dermatology21%N= 1,75,284Internal, 74.61External, 25.39Gen. Medicinen=48,026Internal, 58.75External, 41.25Gen. Surgeryn=31,925Internal82.83External, 17.17Pediatricsn=20,945Internal41.15External 58.85Gynea. & Obst.n=37,464Internal, 61.60External, 38.40Dermatologyn=36,924
    15. 15. Gen. MedicineInternal, 143Gen. MedicineExternal, 49Gen. SurgeryInternal, 75Gen. SurgeryExternal, 53PediatricsInternal, 69PediatricsExternal, 14Gynea. & Obst.Internal, 62Gynea. & Obst.External, 88DermatologyInternal, 91DermatologyExternal, 57SAMPLE SIZE DISTRIBUTION15Sample size = 70114815084127192
    16. 16. TOOLS AND TECHNIQUES:16
    17. 17. Tools:Interview schedule for internal patients & external patientsSample size calculatedExit patient interview (It included questions about following categories- The general information such as Staff/non staff, name, age, sex.The profile of the patient as-District, resident either urban/ruralSpecific information as-Source of information, reason for selection of hospitalThe questions pertaining to patient satisfaction includes such as-Problems atregistration counter and problem with behavior of registration clerk, seatingarrangement, general cleanliness, drinking water facility , toilet facility, satisfactionwith concern Doctor and sample collection technician17TECHNIQUECollection of Secondary data in the form of documents and records and registers
    18. 18.  Question pertaining to waiting time in various process such as-Time inqueue and process at registration counter, in doctor consultation, inlaboratory, in pharmacy, in payment Entry and exit time in OPD andtotal time in OPD Suggestion if any)Data acquisitionData sorted and analyzed using Microsoft Office Excel andStatistical Package For Social Sciences (SPSS)And following findings were observed18
    19. 19. OBSERVATION19
    20. 20. 20MALE, 27.96FEMALE, 72.03EXTERNAL PATIENTMALEFEMALEMALE, 39.09FEMALE,60.9INETRNAL PATIENTMALEFEMALEMALE35%FEMALE65%TOTALGENDER PROFILE OF THE PATIENTS UTILIZING OUTPATIENT SERVICESOF GENERAL HOSPITAL OF SGPGIMS
    21. 21. 79.529.4220.482.005.41 3.9997.92 100.00 98.0094.5986.022.08 0.57Age Profile of patients utilizing outpatient services (%)CHILDHOOD(0-12) ADOLOSCENT(13-18) ADULT(19-60) SENIOR CITIZEN(>60)21
    22. 22. GENMEDICINE20%GENSURGERY20%PEDIATRICS0%GYNAEAND OBS20%DERMATOLOGY40%NEPAL22GENMEDICINE28%GENSURGERY18%PEDIATRICS12%GYNAEAND OBS21%DERMATOLOGY21%UP GENMEDICINE12%GENSURGERY24%PEDIATRICS4%GYNAEAND OBS28%DERMATOLOGY32%BIHAR JHARKHAND -1(Dermatology) MP-1 (Dermatology) UTTRAKHAND-2 (Gen surgery)NAME OF THE STATAE OF THE PATIENTS UTLIZING OUTPATIENTSERVICES (%)
    23. 23. FINDINGS23
    24. 24. OBJECTIVE 1-To study availability and extent of utilization ofoutpatient services in general hospital by staffand non staff patients24
    25. 25. 25010,00020,00030,00040,00050,00060,00070,00080,000Gen.Medicine Gen. Surgery Pediatrics Gynea. & Obst. Dermatology Grand Total12,193 13,1703,59622,04714,17872,410INTERNAL PATIENTSNo.ofpts.020,00040,00060,00080,000100,000120,000GEN MEDICINE GEN SURGERY PEDIATRICS GYNAE N OBS DERMATOLOGY GRAND TOTAL35,83318,755 17,349 15,417 22,746110,100No.ofpts.EXTERNAL PATIENTSExtent of Utilization of Outpatient Services of General Hospital, SGPGIMS (2008-2012)
    26. 26. 260204060801001201402008 2009 2010 2011 2012No.ofPatientsin,00 TREND OF OUPATIENT SERVICES UTILIZED BYINTERNALAND EXTERNAL PATIENTS (2008-2012)Gen.Medicine Internal Gen.Medicine External Gen. Surgery InternalGen. Surgery External Pediatrics Internal Pediatrics ExternalGynea. & Obst. Internal Gynea. & Obst. External Dermatology InternalDermatology External
    27. 27. 27OBJECTIVE-To Explore The Source OfInformation For External Patients Utilizing OPDServices at General Hospital Of SGPGIMS
    28. 28. 280.010.020.030.040.050.060.070.0EMPLOYEEOF SGPGIOLDPATIENTREFERRAL NEWS PAPER HEALTHPERSONALOTHERs5.020.362.81.9 2.37.7external patientEMPLOYEE OF SGPGIOLD PATIENTREFERRALNEWS PAPERHEALTH PERSONALOTHERsINPERCENTAGE
    29. 29.  OBJECTIVE-To evaluate the waiting time andthe reasons of dissatisfaction among the Internaland External patient at Out-Patient Services29
    30. 30.  Response of the patients about the behavior of registration clerk30020406080100120140STAFF NONSTAFFSTAFF NONSTAFFSTAFF NONSTAFFSTAFF NONSTAFFSTAFF NONSTAFFGEN MED GEN SURGERY PEDIATRICS GYNAE N OBS DERMATOLOGY4 1 2 0 4 1 1 5 2 1139487353651361838956PROBLEM REGISTRATION CLERK YES PROBLEM REGISTRATION CLERK NONumberofpts.Reason – Rude / Partial behavior
    31. 31. 31020406080100120140INTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTGEN MED GEN SURGERY PEDIATRICS GYNAE N OBS DERMATOLOGY13849755368146286905750 0 0 1 0 0 2 1 0YES NONumberofpts.RESPONSE OF THE PATIENTS ABOUT THE SEATING ARRANGEMENTReason –Less / Dirty chairs
    32. 32. 32020406080100120140INTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTINTERNALPATIENTEXTERNALPATIENTGEN MED GEN SURGERY PEDIATRICS GYNAE N OBS DERMATOLOGY13849755368146286 905750 0 0 1 0 0 2 1 0SATISFIED WITH GENERAL CLEANLINESS YES SATISFIED WITH GENERAL CLEANLINESS NONumberofpts.RESPONSE OF THE PATIENTS ABOUT THE GENERAL CLEANLINESSReason - Unhygienic
    33. 33. 33020406080100120140INTERNALEXTERNALINTERNALEXTERNALINTERNALEXTERNALINTERNALEXTERNALINTERNALEXTERNALGEN MED GENERAL SURGERY PEDIATRICS GYNEA AND OBST DERMATOLOGY13746664861145977 78566 395 80 311 131YESNONumberofpts.RESPONSE OF THE PATIENTS ABOUT THE TOILET FACILITYReason –Unhygienic / Fewer in number
    34. 34. SATISFACTION/DISSATISFACTION WITH CONCERN DOCTOR34020406080100120140160INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNALGEN MED GENERAL SURGERY PEDIATRICS GYNEA AND OBST DERMATOLOGY14248755368136187 88561 1 0 0 1 1 1 1 3 1YES NOReason –Unpunctual/UnavailabilityNumberofpts.
    35. 35. SATISFACTION/DISSATISFACTION WITH SAMPLE COLLECTIONTECHNICIAN35020406080100120140160INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNALGEN MED GENERAL SURGERY PEDIATRICS GYNEA AND OBST DERMATOLOGY14248755268146286 90571 1 0 1 1 0 0 2 1 0YES NOReason – Unpunctual / UnavailabilityNoofpatients
    36. 36. 36OBJECTIVE- TO STUDY WAITING TIME FOR THEEXTERNALAND INTERNAL PATIENT ATOUTPATIENT SERVICES
    37. 37. 37TOTAL TIME SPENT IN OUTPATIENT SERVICES BY INTERNALANDEXTERNAL PATIENT INCLUDING PHARMACY0.010.020.030.040.050.060.070.080.090.0100.0INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNALGEN MED GENERAL SURGERY PEDIATRICS GYNEA AND OBST DERMATOLOGY65.042.926.029.376.892.969.429.592.380.729.434.712.0 14.523.27.124.251.17.715.85.622.41.017.36.519.30.03.5<=2Hrs >2-4Hrs >4Hrs%
    38. 38. TIME SPENT IN OUTPATIENT SERVICES WITHOUTPHARMACY BY INTERNAL AND EXTERNAL PATIENTS380.010.020.030.040.050.060.070.080.090.0100.0INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNAL INTERNAL EXTERNALGEN MED GENERAL SURGERY PEDIATRICS GYNEA AND OBST DERMATOLOGY77.649.076.043.492.8 92.979.029.595.680.721.738.821.332.17.2 7.119.455.74.415.80.712.22.724.51.614.80.03.5<=2hrs >2-4 hrs >4hrs%
    39. 39. OBJECTIVE-TO RECOMMEND THE CORRECTIVEMEASURES TO ENHANCE THE PATIENT SATISFACTION39
    40. 40. OBJECTIVE-TO RECOMMEND THE CORRECTIVEMEASURES TO ENHANCE THE PATIENTSATISFACTION Enquiry counter and hospital map should be present Transport facility should be provided from main gate to the general hospital USG and X-RAY facility should be provided In the hospital Token system should be present for queue and registration Manpower should be increased PHARMACY COUNTER- Manpower should increased All counter should be open All medicine should be available Worker should behave proper HOSPITAL INFORMATION SYSTEM(HIS)- Don’t work properly Takes too much time AMBULANCE FACILITY- Not available at time40
    41. 41. OBJECTIVE-TO RECOMMEND THE CORRECTIVEMEASURES TO ENHANCE THE PATIENTSATISFACTION TOILET FACILITY- Hygiene should be maintained Number and ladies toilet should be increased Cantene facility should be increased SEATING ARRANGEMENT – Number and space should be increased Behavior and punctuality-41
    42. 42. Thank you42

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