Assessing the applicability and usability of patient satisfaction levels as a tool for judging quality of service in a medical college hospital in Punjab, North India

Assessing the applicability and usability of patient satisfaction levels as a tool for judging quality of service in a medical college hospital in Punjab, North India Singh S.1*, Verma V.2 DOI: https://doi.org/10.17511/ijphr.2016.i5.02 1* Sumeet Singh, Senior Resident, Department of Community Medicine, Government Medical College, Patiala, Punjab, India. 2 Verinder Verma, Assistant Professor, Department of Community Medicine, Government Medical College, Patiala, Punjab, India.


Introduction
The primary goal of the tertiary care hospital as a highest level of health care provision is to provide best possible health care to the patients. The modern era where it is the right of every patient to demand best possible care in Government hospitals, it is the duty of every staff member of the hospital to deliver his optimum efforts to the entire satisfaction of the patient and its assessment will give us an opportunity to find loopholes in our services and future ratification.
It is the nature of a human being that by fulfilling one motive, another one takes the place which is to be fulfilled and the process goes on

Materials and Methods
To achieve the objectives a comparative review study of patient satisfaction rates was planned. The assessment of patient satisfaction levels was Most of the wards now have shades and curtains in between the adjacent beds. 2nd round of survey was then conducted to assess the changes. Table 1 showed that most of the admitted patients     Regarding the availability of basic amenities and services at the hospital as shown in Table 6 there is much scope of improvement, as unavailability of essential medicines is still a weaker area despite being raised at multiple forums and even in this study in 2013. Situation of unavailability of drinking water has worsened as now 72 % respondents are claiming unavailability of drinking water. Rest of the aspects like availability of toilets / hand washing facility in the wards, cleanliness in the toilets and wards, adequacy of Fans / Lights in the wards has been stated to be much improved by the patients.

Results
Patients are now more satisfied with the timely change of bed sheets. Dissatisfaction with the convenience of parking has also decreased. But This is the reason behind apparent enhancement in satisfaction rates for the laboratory work. This change has also helped the lab workers and hospital staff, which is also evident in their timeliness of providing lab results. This can be further enhanced through adequate sign boards indicating direction of departments and room no. of designated labs at the entrance gate of the hospital. Patients are also satisfied up to a larger extent with service provision by staff nurses and other paramedical staff, which might not be so upright but fulfills the expectations of the patients.
Although much improvement in patient satisfaction can be seen in the area of provision of basic amenities but these are most important areas to be considered as these are quite apparent, represents the managerial abilities of hospital administrators because other things like staffing and medical care are much complicated in public sector hospital. Moreover they present the face of the hospital, determine the clientele of the hospital and their provision is a must for patient and attendants to allay problems to those who are already suffering. Provision of essential medicines despite various measures by State govt. is still a weaker area. It was reported in the first phase (2013) also and since then Punjab Govt. has prepared a list of essential medicine to be provided at every level of health care delivery system but due to hierarchical and structural gaps as medical college hospital are working as a separate unit under department of medical education and research, is lacking in regular availability. Situation of unavailability of drinking water has worsened which is of grave concern and should be immediately handled because patient and attendants are forced to purchase packaged water or collect water from far-off locations.
With satisfaction surveys as a tool for finding the scope for improvement [10].

Applicability and
Usability of Patient satisfaction surveys at this hospital as a tool for Quality of service.
As presently no such system of regular collection of responses from patients and analyzing patient satisfaction rates is there in this hospital. So to suggest whether such kind of exercise will be beneficial to this hospital and should be done as a regular practice, we have to learn from experiences from these two phases. is of definite opinion that it must be incorporated in routine hospital functions because of the above found benefits and no such negative factor has been found to suggest any risks associated with it.
A review of patient satisfaction surveys in Pakistan also concludes that prompt attention to patients' expectations, enhancing responsiveness of health care system and consideration of patient's perceptions is of utmost importance to increase patient satisfaction outcomes [11]. Sajid et al in their study opines that Service characteristics effecting patient's perception of quality should be included while designing service. Majority of patients in public sectors hospitals are from lower income groups, service characteristics should be targeted toward lower income rather than elites [12].

Conclusions & Recommendations
Assessing satisfaction of patients is simple and cost effective way for evaluation of hospital services. The findings of the present reveal that patients were more satisfied with behavior and function of doctors and staff. But problem lies with the availability of basic amenities and dissatisfaction was found to be more regarding provision of essential medicines, drinking water, retiring room and parking issues. These are some urgent issues needing concern.
Regarding applicability and usability of such patient satisfaction survey, we conclude that it must be incorporated in routine hospital functions.

Limitations
This is only a baseline study with a small sample as it was a self -funded project. A continuous ongoing process of evaluating the services at the time of discharge is required for getting definitive results.
We believe the scores obtained from the present study can serve as baseline against which to compare the results from future surveys.