Clients and clinician satisfaction with laboratory services at selected government hospitals in eastern Ethiopia

A quasi-experimental study to improve health service quality: implementing communication and self-efficacy skills training to primary healthcare workers in two counties in Iran

BACKGROUND

Service satisfaction ratings from clients are a good indicator of service quality. The present study aimed to investigate the impact of communication skills and self-efficacy training for healthcare workers on clients' satisfaction.

METHODS

A quasi-experimental study was conducted in health centers of Saveh University of Medical Science in Iran. Primary Healthcare (PHC; N = 105) workers and service recipients (N = 364) were randomly assigned to intervention and control groups. The intervention group received four 90-min training sessions consisting of lecture, film screening, role-playing, and discussion group. Before and 3 months after the intervention, a multi-part questionnaire (including demographics, self-efficacy and communication skills in PHC workers; and satisfaction questionnaire in service recipients) was completed by participants in both intervention and control groups.

RESULTS

PHC worker mean scores of self-efficacy and communication skills after the educational program were increased in the intervention group compared to the control group (p < 0.05). Also, mean satisfaction scores for service recipients of the intervention group (PHC workers) generally significantly increased compared to the control group (p < 0.001).

CONCLUSIONS

The educational program improved the self-efficacy, and communication skills in health workers and improved client satisfaction overall. Our results support the application of self-efficacy and communication skills training for other medical groups who wish to improve clients satisfaction as an important health services outcome.

Factors Affecting Quality of Laboratory Result During Ordering, Handling, and Testing of the Patient's Specimen at Hawassa University College of Medicine and Health Science Comprehensive Specialized Hospital

BACKGROUND

The increase of medical laboratory test errors represents the increase of all defects within the process. An error can be any defect during the entire process, from ordering to reporting. It may have negative effects on patient care, by contributing to inappropriate treatment, an increase in lengths of hospital stay, and dissatisfaction with healthcare services. Therefore, this study aimed to determine factors affecting the quality of laboratory results through the entire process.

METHODS

A cross-sectional study was conducted at Hawassa University hospital from October 2018 to May 2019. Data were collected by using structured questionnaires and checklist and entered and analyzed using SPSS version 21. P-values less than 0.05 were considered statistically significant.

RESULTS

A total of 455 individuals participated in this study. During the actual observational assessment, 72.5% of laboratory professionals identify their patients correctly and 62.5% of them label the sample before collection. In multivariate logistic regression, labeling of sample before collection (AOR=1.357, 95% CI=1.09, 1.58, P- 0.017), use of unmixed (AOR=4.364, 95% CI=1.950, 20.036, P- 0.049) and hemolyzed blood for testing (AOR=1.403, 95% CI=1.096, 1.692 P- 0.021) were associated with laboratory test errors. The clinical service providers who requested the test believed, lack of efficient laboratory service (P=0.005), unable to use manuals (P=0.025), and incorrect interpretation of reference booklets were associated with laboratory errors. Patient residence and frequency of first and second visits of the hospital were statistically associated with laboratory errors.

CONCLUSION

The occurrence of laboratory errors in our study was demonstrated by the distribution pattern, the preanalytical, analytical, and post-analytical steps. But changes have occurred in the types and frequencies of errors in these phases of testing by laboratory professionals, clinicians, and patients in the current study. Therefore, the hospital administrations, laboratory professionals and clinicians should work harder and closer to solve the identified problems.

Physicians' satisfaction with clinical laboratory services at public hospitals in Ethiopia: A national survey

Introduction

Physician is a central figure in the client list of clinical laboratory. Monitoring physicians’ satisfaction with laboratory service is an important indicator of the quality management system and required by international laboratory standards. However, there is no national data on physician satisfaction with laboratory services in Ethiopia. Therefore, the aim of this national survey was to assess satisfaction level of physicians with laboratory services at public hospitals in Ethiopia.

Methods

Institutional based cross-sectional study design was employed from November 1-30/2017. A total of 327 physicians were randomly selected from 60 public hospitals from all regions of Ethiopia. Data was collected using pre-tested self-administered questionnaire and analyzed with SPSS version 23 software. Logistic regression model was fitted to identify predictors of physician satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant.

Results

Overall, 55% of physicians were satisfied with the clinical laboratory services. More than half of the physicians were satisfied with the existing laboratory request form (69%), legibility and completeness of laboratory report (61%), notification of new test (78%) and test interruption (70%). On the other hand, many physicians were dissatisfied with the absence of laboratory hand book (87.5%), the existing test menu (68%), lab-physician interface (62%), availability of referral and/or back up service (62%), notification of Turn Around Time (TAT) (54%), timely notification of panic result (55%), long TAT (33.1%), provision of urgent service (67%), and timely advisory service (57%). Most of the physicians perceived that consistent quality of service was not delivered at all working shifts (71%). At 5% level of significance, we did not find enough evidence to conclude that sex, age, marital status, education level, and experience were statistically associated with physician satisfaction (p-values > 0.05).

Conclusion

This national survey revealed nearly half of the physicians were unsatisfied with laboratory service at public hospitals in Ethiopia, which mainly related to lack of adequate test menu, laboratory hand book, on time notification of panic result, provision of urgent service, timely advisory service, delivery of quality services in all working shifts and weak lab-physician interface. Therefore, hospital management should address the gaps and improve the needs of physicians for better patient health care. In addition, laboratories should evaluate and monitor physician satisfaction level at regular interval.

Evaluation of corrective actions of feedback from clinicians on Clinical Laboratory Services at Bamenda Regional Hospital Laboratory, Cameroon

Background

Customers’ satisfaction is imperative for success. Clinical laboratories continuously strive to attain very high levels of customer satisfaction to serve their clients and maintain accreditation. The concept of customer satisfaction has not yet been asserted in most clinical laboratories in Cameroon.

Objectives

Our objectives were to assess the satisfaction of clinicians with the laboratory services at the Bamenda Regional Hospital Laboratory, identify important challenges, corrective actions implemented and changes in satisfaction.

Methods

This retrospective study reviewed secondary data from clinician satisfaction survey records from March 2017 and November 2017. Challenges and implemented corrective actions were identified for assessed statements of dissatisfaction (dissatisfaction rates ≥ 20%) on the March 2017 survey. Satisfaction rates in March 2017 and November 2017 were compared.

Results

High levels of dissatisfaction were observed for general satisfaction, waiting time, communication, duty consciousness, specimen collection and approach on the March 2017 survey. The main challenges identified were: lack of respect for the expected length of the waiting time, poor attitude, inadequate information, staff shortage and inadequate supervision. Statistically significant reductions in rates of dissatisfaction were observed for general satisfaction, waiting time, communication, response to emergencies, issuing of results, specimen collection, approach and duty consciousness.

Conclusion

Waiting time is a major cause of clinician dissatisfaction with laboratory services. The identification of clinicians’ challenges and the effective implementation of corrective actions contribute to improvements in clinician satisfaction.

Patient satisfaction with antiretroviral therapy services and associated factors at Gondar town health centers, Northwest Ethiopia: an institution-based cross-sectional study

Background

The Human Immunodeficiency Virus (HIV) with which over 37 million peoples are living is the leading cause of morbidity and mortality worldwide. The rapid expansion of antiretroviral treatment has dramatically reduced HIV related deaths and transmissions. Patient satisfaction could be an indispensable parameter used to measure patients’ desired fulfillment by the services. Hence, this study aimed to determine the level of patient satisfaction with antiretroviral therapy services and determinants at Gondar town health centers.

Methods

An institution-based cross-sectional study was conducted from November 1 to 30, 2018. The systematic random sampling technique was used to select 663 HIV/AIDS patients on antiretroviral therapy follow-ups. Data were collected using a pretested interviewer-administered questionnaire and patient medical document reviews. Summary statistics such as means, medians and proportions were calculated and presented in the form of tables, graphs, and texts. Bivariate and multivariable logistic regression analysis was fitted and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to assess the strength of association. Variables with p-value 0.05 at multivariable logistic regression considered significant determinants of patient satisfaction.

Results

The overall patient satisfaction with antiretroviral therapy services was 75.4% (95%CI, 71.9 to 79%). Patients’ age 38–47 years (AOR = 5.90, 95%CI: 3.38,10.31) and ≥ 48 years (AOR = 2.66, 95%CI:1.38,5.12), absence of signs and directions to ART clinic (AOR = 0.53,95%CI:0.35,0.82), Azezo health center (AOR = 2.68,95%CI:1.47,4.66) and Teda health center (AOR = 4.44,95%CI:1.73,11.30), and travel that took more than 1 h (AOR = 0.56;95% CI:0.32,0.97) were determinants of patient satisfaction with the services.

Conclusion

The overall patient satisfaction with antiretroviral therapy service was lower than the national target of 85% with the marked difference among health centers. Older age, absence of signs and directions to ART clinics, and longer travel from home to health centers were factors influencing patient satisfaction with antiretroviral treatments. This suggests that further improvement of accessibility is likely needed to increase patient satisfaction.

Patients' satisfaction with clinical Laboratory Services in Public Hospitals in Ethiopia

Background

Knowing customers’ level of satisfaction is relevant to improve and provide quality health care services. In the clinical laboratory, monitoring customers’ satisfaction is an important indicator of the quality management system and required by international laboratory standards. However, in Ethiopia, there has not been baseline data about the satisfaction level of patients’ with laboratory services at the national level. The aim of this national level survey was to assess patients’ satisfaction level with laboratory services at public hospitals in Ethiopia.

Methods

A national survey was conducted using an institutional based cross-sectional study design was employed from 01 to 30 November 2017. A total of 2399 patients were selected randomly from 60 public hospitals. Data was collected using structured questionnaire, entered in Epi Info and analyzed with SPSS software. Multiple logistic regression model was fitted to identify predictors of patients’ satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant.

Result

Overall, 78.6% of the patients were satisfied with the clinical laboratory services. Patients were dissatisfied with cleanness of latrine (47%), long waiting time (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%) and latrine location (20%), availability of requested service (18%), unfair payment of service (17%) and missing of result (12%). The educational status (P = 0.032), and distance (P = 0.000) were significantly associated with client overall satisfaction level.

Conclusion

Most laboratory patients’ were satisfied with the service provided by public hospital laboratories in public hospitals in Ethiopia. However, patients’ were dissatisfied with the accessibility of sites, adequacy of waiting area, cleanness of latrine, long TAT, communication, missing of results, availability of requested service and cost of service. Therefore, responsible bodies in each level should act on the identified gaps and improve the need of patients in each hospital laboratory. In addition, all hospital laboratories should conduct a satisfaction survey and meet the needs of laboratory patients.

Patient satisfaction with clinical laboratory services and associated factors among adult patients attending outpatient departments at Debre Markos referral hospital, Northwest Ethiopia

Objectives

There is limited evidence on patient satisfaction with clinical laboratory services in Northwest Ethiopia. This study aimed to assess patient satisfaction with clinical laboratory services and associated factors among adult patients attending outpatient departments at Debre Markos hospital, Northwest Ethiopia. Cross-sectional study was conducted among 391 patients from April 09–16, 2019 using interviewer-administered questionnaire. Systematic random sampling technique was used. Data were entered into Epi-Data software version 4.2, and analyzed using SPSS 23. Binary logistic regression analysis was employed. Variables having p-value < 0.05 were considered as statistically significant.

Results

Overall level of patient satisfaction towards clinical laboratory services was 48.3%. Patients with no occasion of missing laboratory results [AOR: 2.10; 95% CI (1.13, 3.83)], had diplomas and above educational level [AOR: 0.38; 95% CI (0.15, 0.96)], and who reported no place in the laboratory to put personal things [AOR: 0.37; 95% CI (0.21, 0.54)] were significant factors. Hospital administration and laboratory department in Debre Markos hospital should strengthen their effort to improve patient satisfaction focusing on educational status of patients, missing laboratory results, and the availability of places to put personal things in the blood drawing room.

Assessment of Clinicians' Satisfaction With Laboratories at a Public Sector Hospital in Karachi, Pakistan

Objective The goal of this study was to assess the level of satisfaction of clinicians regarding the provision of information, accessibility, and services by clinical laboratories at a public sector hospital in Karachi, Pakistan. Methods We conducted a cross-sectional survey of 151 participants from a public sector hospital in Karachi to assess their satisfaction regarding the associated laboratories. A five-point Likert scale questionnaire, consisting of 18 study items total, was used. Apart from the sociodemographics, the questionnaire was divided into three main sections: Services, Accessibility, and Provision of Information. The study lasted six months from October 2018 to March 2019. Results Most study participants were women. Less than one-third of the participants were consultants (21.9%). The overall satisfaction score was 62/90, indicating that the respondents were satisfied with most of the items on the scale. Factors such as notification about abnormal test results and courier services provided by the laboratories had the lowest satisfaction score. Conclusion Laboratory services are lacking in certain areas, specifically notifications and courier services, that need development and improvement, both of which can be achieved through seminars and clear communication between the laboratory staff and the associated clinicians.

Three-year customer satisfaction survey in laboratory medicine in a Chinese university hospital

BACKGROUND

Customer satisfaction is a key quality indicator of laboratory service. Patients and physicians are the ultimate customers in medical laboratory, and their opinions are essential components in developing a customer-oriented laboratory.

METHODS

A longitudinal investigation of customer satisfaction was conducted through questionnaires. We designed two different questionnaires and selected 1200 customers (600 outpatients and 600 physicians) to assess customer satisfaction every other year from 2012 to 2016. Items with scores <4 were considered unsatisfactory, and corrective actions should be taken.

RESULTS

The completion rates of physicians were 96.8% in 2012, 97% in 2014 and 96.5% in 2016, whereas the rates of patients were 95.3%, 96.2% and 95.2%, respectively. In 2012, the most dissatisfaction items were test turnaround time (3.77 points) and service attitude (3.87 points) from physicians, whereas waiting time (3.58 points) and examination environment (3.64 points) were the most dissatisfaction items from patients. After corrective actions were taken, the result of satisfaction in 2014 was better, which illustrated our strategy was effective. However, some items remained to be less than 4, so we repeated the survey after modifying questionnaires in 2016. However, the general satisfaction points of the physicians and patients reduced in 2016, which reminded us of some influential factors we had neglected.

CONCLUSIONS

By using dynamic survey of satisfaction, we can continuously find deficiencies in our laboratory services and take suitable corrective actions, thereby improving our service quality.

Analysis of Patient's Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement

Introduction

Patient's satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine.

Aim

To assess the patient's satisfaction with phlebotomy services in a neuropsychiatric hospital by a structured questionnaire with grading scale. Also, identify the problems causing dissatisfactions and to undertake necessary Corrective and Preventative Action (CAPA).

Materials and Methods

Total 1200 patients were randomly selected over a period of two months (June and July 2016). A structured self designed questionnaire (feedback form) was devised in both Hindi and English languages containing ten questions with a grading scale for each question. It also included suggestions from the users. All the selected patients or their attendants filled up this questionnaire. At the same time, they were also interviewed by phlebotomy staff. A statistical analysis was conducted using SPSS version 16.0 software and Likert scale.

Results

A total of 94% of the patients were satisfied with the phlebotomy services. Almost 30.0% patients found the phlebotomy services to be very good, but the majority of them (40.5%) found it to be good and another 23.5% found it to be satisfactory while, 4% found the services to be poor and 2% found it to be very poor. The highest rate of satisfaction (4.21) was noted in case of parameter-ease to find collection sample room and lowest rate of satisfaction (3.92) was scored by the parameter-staff's wearing proper uniform. Depending upon the deficient areas some corrective actions were suggested such as strict compliance of personal protective equipments, regular training to improve technical skill, knowledge and behaviour with emphasis on cleanliness of work area.

Conclusion

Even though the overall patient's satisfaction was high, there were areas which needed our attention such as waiting time for phlebotomy procedure, lack of proper sitting arrangement, techniques of sample collection, knowledge of universal precautions etc. Appropriate corrective and preventive actions were taken to solve the problems. Thereby, feedback proved effective in maintenance and improvement of phlebotomy services.

Patient satisfaction with clinical laboratory services at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BACKGROUND

Monitoring patient satisfaction is an important and useful quality improvement tool for clinical laboratories in particular and health care organizations in general. Thus, this study aimed to assess patient satisfaction toward clinical laboratory services at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted and a convenient sampling technique was applied to recruit study participants. A total of 210 patients who had received laboratory services were included. A self-administered predesigned, pretested, structured questionnaire was used, and data were collected through face-to-face interviews. A 5-point Likert scale with 1 and 5 indicating the lowest and highest levels of satisfaction, respectively, was used and their weighted average was used to categorize the satisfaction level of the patients. Chi square test was used (taking P≤0.05 as the statistically significant level) to find out if any association existed between the level of satisfaction and different attributes. Data were analyzed using SPSS version 20.

RESULTS

The overall level of patient satisfaction toward clinical laboratory services in this study was 59.7% with a response rate of 210 (100%). The Likert scale results of patient satisfaction of the laboratory services revealed that the mean rating values ranged from 3.05 (±1.12) to 4.12 (±1.08) out of a possible 5. Among the different indicators, patients were highly satisfied with the cleanliness of facility (82%), maintenance of privacy and confidentiality (83.2%), and the cost of the laboratory service (86.5%), while they were dissatisfied with the location of the laboratory (56%), latrine accessibility and availability (58.4%), and latrine cleanness and comfort (63.8%).

CONCLUSION

The whole availability of requested tests, availability of place in blood drawing room to put personal things, and waiting time for specimen collection were found to have a statistically significant association with the overall satisfaction of patients toward clinical laboratory services. Therefore, these could be the possible determinants among others that account for the dissatisfaction of patients with clinical laboratory services.

The clinical laboratory service: medical practitioners' satisfaction in southern Ethiopia

OBJECTIVES

To evaluate medical practitioners' satisfaction with the clinical laboratory services by health institution in southern Ethiopia.

METHODS

A questionnaire-based cross-sectional survey was undertaken from June 2013 through April 2014, which involved 290 medical practitioners from 19 health institutions.

RESULTS

The mean (SD) overall satisfaction score was 3.36 (0.87) of 5.0. For most of the specific service categories, the highest rating was "good." The highest mean (SD) score was for clarity and readability of results (4.09 [0.99] of 5.0), while the lowest was for blood bank service (1.72 [1.88] of 5.0).

CONCLUSIONS

This study identified wide room for improvement by the services provided from clinical laboratories. Corrective actions for the less satisfied service categories and continuous monitoring of laboratory activities are essential for the development of quality in clinical laboratories of health institutions in southern Ethiopia.

Patients' perception and satisfaction on quality of laboratory malaria diagnostic service in Amhara Regional State, North West Ethiopia

BACKGROUND

The most effective strategies in the fight against malaria are to correctly diagnose and timely treat the illness. A diagnosis based on clinical symptoms alone is subjected to misuse of anti-malarial drugs, increased costs to the health services, patient dissatisfaction and also contributes to an increase in non-malaria morbidity and mortality. Among others, inappropriate perception and inadequate satisfaction of patients are significant challenges reported to affect the quality of laboratory malaria diagnostic services.

METHODS

A facility-based, cross-sectional study was conducted from November to December 2013 among 300 patients. Their level of satisfaction was measured using both pre-tested structured and open ended questionnaires. A 5-point Likert scales and their weighted average were used to categorize satisfaction level of the patients. Data were entered in Epi-Info version 3.5.3 and analysed using SPSS version 20. Chi-square test was used to see the association between the outcome variable and independent and the strength of the association was identified using odds ratio in the binary logistic regression. In addition the open ended questionnaire findings were coded and analysed thematically.

RESULTS

Over half (52.6%) of the patients were satisfied with the malaria diagnostic service with a 98.7% response rate. The majority (89.3%) of patients perceived they were well diagnosed in facing fever upon giving blood for laboratory malaria diagnosis within 30 min waiting time in most (62.5%) of the patients. Ethnicity, residence, knowing malaria diagnosis after consulting clinician, and time period to receive malaria result were the independent predictors for patient satisfaction (p<0.05). The open ended questionnaire responses also revealed providing precise laboratory result timely, availability of the right treatment, presence of health professionals performing the laboratory test upon request in the health facility were among the major enabling factors for patients' satisfaction.

CONCLUSION

The observed level of satisfaction in the current study though encouraging when compared with some previous studies conducted in eastern Ethiopia on general laboratory services, still it requires scale-up in the enhancement of malaria laboratory diagnostic service in the fight against malaria.