TOPIC ASSESSMENT OF CLIENT SATISFACTION WITH OUT PATIENT CARE, A

STUDY AT ST. MICHAELS HOSPITAL, PRAMSO

GROUP MEMBERS ASANTE ERNEST OBENG ERIC OPPONG DUAH KWAKU 8034605 8038505 8038805

BACKGROUND TO THE STUDY The Out-Patient Department (OPD) is the very prime point of contact of a client to any health facility. Patients judge the standard of the health facility by the care they receive at the OPD (Ackon, 2001). In the world over, all institutions; being health, agriculture, banking or educational, has the fore aim of providing good-quality services to their customers due to the competition in our changing technological world.

Health professionals measure quality of care on factors such as; Speedy recovery of patients Low mortality rate Low re-attendance rate Minimal complications of treatment (e.g. wound infections) and better health indices Clients on the other hand perceive quality in terms of satisfaction which is based on considerations such as; Respecting patients and their rights

Good staff attitude

Safety of health care procedures Affordable fees

 Satisfaction implies the achievement of a basic minimum

expectation of the health care recipient.

Client satisfaction is a critical component of quality service because it provides information on the providers success at meeting those client expectations Evaluation of the quality of care or patient satisfaction at the OPD is now becoming of more interest to health care providers and

administrators in Ghana as competition keeps on increasing in the

health care market.

PROBLEM STATEMENT There is a lot of expressed client dissatisfaction at the OPD in recent times. Traditionally, assessments have ignored the reports of patients in preference to technical and physiological reports of outcome. Client satisfaction studies from other countries identified causes of dissatisfaction as technical competence, bureaucracy, outcome of care and availability of drugs (Maime, 1992). In Ghana, most clients complain about the care they receive from the various health facilities. According to the Administrator of St. Michaels Hospital, there is a reduction in the attendance to the OPD of late. This necessitated the evaluation of client satisfaction at the OPD.

OBJECTIVES
General objective This study aims to assess clients satisfaction with OPD care at St. Michaels Hospital.

Specific objectives

To determine clients expectations of care at the St. Michaels Hospital. To assess factors that lead to satisfaction with care. To assess factors that influence dissatisfaction with care. To make recommendations to policy makers to improve satisfaction.

METHODOLOGY
Study Area This study was conducted at the St. Michaels Hospital, Pramso in the Bosomtwe-Atwima Kwawoma District of the Ashanti Region of Ghana. Study Population The study population consisted of male and female OPD attendants. The ages of the target population ranged from 18-65 years. Study design A descriptive study was used to assess clients satisfaction with out-patient care. By simple random sampling, 100 respondents were interviewed on their exit from the hospital.

Data collection tool/technique

A questionnaire was used as a tool or instrument for data collection. It was read out and explained to those who cannot read and write.

FINDINGS AND ANALYSIS Results on clients expectation of care

Expectations on staff conduct Percent 100 80 60 40 20 0 1 8 2 89

The staffs are harsh towards patients

The staffs are polite and approachable

The staffs are Others (Some are slow in hardworking) performing their duties

Expected waiting time

Less than an hour 1-2 hours

As soon as possible

As long as it takes me
14% 26%

31%

29%

Expectation on waiting
55 35

1 Others (Less noise, news papers)

comfortable Patients The OPD seat and would be seen would be television to on first come overcrowded watch first serve basis

Expectation on drugs
Percent
82

12

All my drugs Some of my I only needed None of the would be drugs would be the prescription drugs would be obtained from obtained from to buy the drugs obtained at the the hospital the hospital outside hospital pharmacy pharmacy pharmacy

Consulting room expectations

The clinician would explain my condition and treatment to me The clinician should just prescribe the drugs for me I would have privacy and confidentiality during consultation

The clinician will do a thorough physical examination

40%

36%

13%

11%

Expectations on the hospital Beautiful flowers and lawns in the premises Affordability of health care The toilet and urinary facilities will be hygienic The hospital environment would be neat and tidy
9

11

72

RESULTS ON SATISFACTION WITH CARE

Consultation satisfaction
How the clinician explained my condition to my understanding The way the clinician examined me physically The clinician telling me the date of review The privacy I obtained at the consulting room

22% 38% 7% 33%

Staff attitude
Percent

They see patients on first come first serve basis They are polite and show concern toward patients They work fast enough

26

39

30

Their number is encouraging

Conditions of satisfaction

50 40 30 20 10 0 The time I The neatness The availability The spent waiting of the hospital of prescribed affordability of before environment drugs at the health care receiving pharmacy

Satisfaction level
Very satisfied Satisfied
9% 2% 41%

Grade of Satisfaction level

Not sure
1 2 3 7% 13% 20% 4 5

Not satisfied

33%

48% 27%

RESULTS ON DISSATISFACTION WITH CARE

Dissatisfaction with waiting time Twenty-four percent of patients waited for over 4 hours, 25% spent

between 3-4 hours, whilst 34% and 18% spent between 1-2 hours
and less than one hour respectively

Displeasure with the conduct of staff Thirty-four percent said the number of staff is small, 21% could not

specify what they didnt like about the staff, 19% said the staff do
not work on first come first serve basis, 17% said that the staff work slowly and 9% said that the staffs are harsh and unconcerned.

Consultation dissatisfaction

44 36

10

5 Others

The clinician The clinician There was no It took more did not explain did not privacy during than 15 the condition conduct any consultation minutes to me physical examination

CONDITIONS OF DISPLEASURE IN THE HOSPITAL 70% did not obtain all their prescribed drugs at the hospital pharmacy, 17% complained of expensive healthcare, 7% said the hospital environment was not hygienic, and for 4%, the OPD was overcrowded.
Grade of Dissatisfaction level 1 2 12% 3 4 0% 5

34%
21%

33%

Comparison of indicators
Expectation
89%

Satisfaction with care

82%
69% 48%

Dissatisfaction with care

70%

72%

39%

36% 38%

40% 33%

44%

43% 25%

9%

13% 5%

19% 7% 11%

17%

DISCUSSION OF FINDINGS The findings on the various indicators in terms of client expectations, satisfaction and dissatisfaction are as follows:

Staff Attitude Eighty-nine percent expected good staff attitude,

39% were satisfied with the staff attitude because staff were polite,
worked fast and saw patients on first-come-first-serve basis. 9% were dissatisfied due to the reasons outlined: staff were harsh, worked slowly and did not see patients on first-come-first-serve basis.

Waiting Time

Sixty-nine percent expected not to wait too long,

13% were satisfied because they were seen on first come first serve basis, had comfortable seat and the staff worked fast 48% were dissatisfied due to the following: no first come first serve, low staff strength, staff working slowly and delay at

medical records and pharmacy

Drug Availability Eighty-two percent expected to get all drugs 25% were satisfied because they obtained all their drugs 70% were dissatisfied due to the fact that they had to buy some drugs outside

Explanation Of Condition 36% expected explanation of condition 38% were satisfied because explanation of their conditions was done 5% were dissatisfied because their conditions were not explained to them Affordability Of Health Care Eleven percent expected the hospital charges to be affordable 43% expressed satisfaction with the charges and 17% were dissatisfied due to the fact some charges were above their expectation

Physical Examination
Forty percent expected to be physically examined thoroughly 33% were satisfied because they were physically examined 44% were dissatisfied because physically examination was not conducted

Hospital Environment
Seventy two percent expected the hospital environment to be very neat and tidy 19% were satisfied with the neatness of the hospital environment 7% were dissatisfied

Conclusion
From the survey at the St. Michaels Hospital, it is observed that the overall satisfaction level is 89% Factors: good staff attitude, health care affordability, physical examinations, explanation of diagnosis, The dissatisfaction level is 11% Factors: Delays, not getting all medications at hospital, no physical examination, no explanation of diagnosis

Recommendations
Establishment of quality assurance team by the management of the hospital Recruitment of additional staff to the medical record and the pharmacy departments by the hospital management Regular checks on stock of drugs by the pharmacist in-charge to avoid shortages