assessment of patient satisfaction and healthcare quality improvement in hanh phuc hospital

HO CHI MINH CITY OPEN UNIVERSITY UNIVERSITÉ LIBRE DE BRUXELLES SOLVAY BRUSSELS SCHOOL OF ECONOMICS & MANAGEMENT MBQPM5 NGUYEN THI NGOC HANH “Assessment of Patient Satisfaction and Healthcare Quality Improvement in Hanh Phuc Hospital” MASTER FINAL PROJECT MASTER IN BUSINESS QUALITY AND PERFORMANCE MANAGEMENT Ho Chi Minh City (2016) STATEMENT OF AUTHORSHIP I would like to confirm that the content presented in this report is the truthful work and has been conducted and interpreted by myself, under the direction of Dr Jacques Martin It had not been made from other people’s work published or presented it in the content of the report without acknowledging the original sources I certify that this report has not been submitted elsewhere in any form for the fulfillment of any other degree or qualification Ho Chi Minh City, 2016 Nguyen Thi Ngoc Hanh ACKNOWLEDGEMENT In the process of preparation of final report, I have received the helps of my teachers, my friends, my family, and my colleagues of Hanh Phuc Hospital I would like to thank all lecturers of the program who offered me valuable knowledge during the course My especial thankfulness to the instruction of Dr Jacques Martin – Academic Director and Tutor who guided me on the method and content to this subject I also would like to thank my family, and my classmates who are always willing support me during the time taking part this program I express the gratitude to management and colleagues of Hanh Phuc hospital who greatly support me in the process of collecting data to the report and provide me opportunity to complete the course I strongly believe that the project is helpful for the process of improving customer care in Vietnam in general and in Hanh Phuc hospital in particular and the contribution in the journey to seek patient’s loyalty and satisfaction Sincerely Nguyen Thi Ngoc Hanh Comments of Academic Tutor: TABLE OF CONTENTS Abbreviations .9 List of Tables, Figures and Appendix .10 Abstract 11 Introduction .12 Overview 12 Background of Hanh Phuc Hospital (HPH) 13 Patient satisfaction survey process in HPH 15 PART THE PATIENT SATISFACTION ASSESSMENT PROCESS Chapter I Patient satisfaction and healthcare service quality 18 Healthcare quality management system 18 Patient satisfaction and service quality in healthcare 19 Relationship between patient satisfaction & service quality .20 Dimensions of service quality and customer satisfaction perspectives in healthcare organization 21 Chapter II: Structure of the process 24 Workflow of the process .24 Description the process 25 Chapter III: Methodology of patient satisfaction survey and analysis .27 Participants 27 Instruments 27 Procedure of survey patient satisfaction 28 Analysis methods 39 PART FINDINGS AND DISCUSSIONS Chapter I: Findings 30 Overview .30 Overall satisfaction 30 Patients satisfaction with appointment and registration process 31 Patients satisfaction with hospital facilities .32 Patients satisfaction with hospital environment 32 Patients satisfaction with waiting time 33 Patients satisfaction with hospital staff .34 Other comments of patients 35 Chapter II: Discussions and suggestion for quality improvement 37 Healthcare quality improvement process 37 Discussion and suggestion solutions for quality improvement 39 Conclusion .45 References 48 ABREVIATIONS CQI : Continuous Quality Improvement JCI : Joint Commission International MOH : Ministry of Health PCA : Patient Care Associate HPH : Hanh Phuc International Hospital HR : Human resource LAB : Laboratory QI : Quality Improvement WHO : World Health Organization 10 LIST OF TABLES, FIGURES AND APPENDIX Figure 1: Healthcare Management System Framework, 18 Figure 2: Service quality and customer satisfaction perspectives in healthcare 23 Figure 3: Overall satisfaction rate 31 Figure 4: Satisfaction on hospital environment 33 Figure 5: Satisfaction with waiting 34 Figure 6: Satisfaction of patients with hospital staff .35 Figure 7: Quality Improvement process 38 Figure 8: Patient’s satisfaction with staff instruction and education to patients 42 Figure 9: Satisfaction with staff skills and professionalism 44 Appendix A: Customers’ Satisfaction survey 51 Appendix B: Satisfaction to appointments & registration process 54 Appendix C: Satisfaction to waiting time .55 Appendix D: General satisfaction to hospital staff 56 Appendix E: Satisfaction to hospital staff: skill and professionalism 57 Appendix F: Satisfaction to facility 58 Appendix G: Patient consultation process 59 11 ABSTRACT Patient satisfaction is an important component of the healthcare service quality especially in the competitive environment of modern healthcare today, according to Vietnam MOH and JCI (2015) patient satisfaction is considered as an important criterion to evaluate reputation and quality of a hospital, appraisal of patient satisfaction has been advocated as a reliable and inexpensive way to assess and obtain opportunities for improvement The paper aims to identify the levels of patients’ satisfaction and to develop the framework to assess and improve services’ quality in Hanh Phuc Hospital In this study, 152 participants are randomly selected from patients/ patients’ relatives in Hanh Phuc hospital, the questionnaire basically designed and based on dimension s of SERVQUAL model, integrated into perspectives of healthcare management system instructed by World Health Organization (WHO) and 5-points Likert scales for measuring The questionnaire attempts to obtain the information how to enhance patient’s satisfaction and how to improve hospital services Generally, the results show that over 59 % (n=89) respondents satisfied and very satisfied with hospital services, besides, 9% (n=14) respondents are unsatisfied, these findings requested hospital managers have to be taken into account to deeply investigate the current hospital situations, where are the gaps and come out the appropriate solutions for improvement The limitations of this paper also are presented and suggestions are given for further researches 46 technical skills and professionalism of nursing staff that may bring harm to patients Thus, assessment patients experiences with nursing services in terms of patient care, communication and instruction are necessary in the process quality improvement in Hanh Phuc The findings show that 6% patients unsatisfied with nursing skills and professionalism; besides, numbers of comments regarding on technical skills of nurses in the open-ended question such as “nurses are not skillful to injection”, “Nurses did not explain before performing injection”, “problems of technical skills or nursing staff” or “ Not keep patients informed in case of changes”, “ Not explain clearly about treatment and care process” To improve hospital services, the solutions have been proposed to hospital managers for consideration and improvement During conducting the report, due to face with some constraints like time limitation, human resources, and permission to access some confidential data; the expected report will be much more reliability and validity if data collected focusing on staff’s job satisfaction in order to find the relationship between staff’s satisfaction and patients’ satisfaction In addition, as most of respondents are hospital patients who come to the hospital faced with their pain, unhealthy etc., that may affect to the process of getting their survey, to make as patients feels uncomfortable to answer a long questionnaire addition, utilize the SERVQUAL model used to identifies attributes of patient satisfaction to get patient perception /experienced of services the report done investigate the gaps between patients expectation and perception In fact, 47 several study to identify the gaps between patient expectations in healthcare setting had been done by Vietnam MOH, the questionnaire developed also refer from the instruction of customer satisfaction questionnaires To obtain the goal of quality improvement, the hospital should inspire raising questions, improving data collection procedures, understanding and analyzing results and identifying actions for improvement 48 REFERENCES References in English Abramowitz, Cote and Berry (1987) Analyzing Patient Satisfaction: A multitanalytic approach Quality review American Society for Quality 2008 “Basic Concepts Glossary.” Retrieved on Apr 2016, www.asq.org/glossary/q.html Cronin, J.J & Taylor, S.A (1992), "Measuring service quality: a re-examination and extension", Journal of marketing, Vol 56, No 3, pp 55-68 Donabedian, A (1988) Quality assessment and assurance: Unity of purpose, diversity and means Inquiry, 25(1), 173-192 Edwards PJ, et al (2008) Maximizing your investment in EHR: Utilizing EHRs to inform continuous quality improvement JHIM; 22(1):32-7 Ghylin, K.M., et al (2006) Clarifying the dimensions of four concepts of quality, Theoretical Issues in Ergonomics Science, (1), p.73-94 JCI (2015), Hospital Quality Management Standards, Joint Commission International Langabeer, J R (2008) Health Care Operations Management: A Quantitative Approach to Business and Logistics Boston: Jones and Bartlett Publishers Massoud, R et al.(2001)A modern paradigm for improving healthcare quality Bethesda, (MD), published for the U.S Agency for International Development (USAID) by the Quality Assurance Project, (QA Monograph 49 Series, No 1(1); http://www.qaproject.org/pubs/PDFs/improhq601bk.pdf, accessed January 2007 Medicare (2009) Wait Times: Causes and Cures, Retrieved from http://medicare.ca/wp-content/uploads/2009/05/factsheet2-2009.pdf (10 Apr 2015) Oliver, R (1981), “Measurement and evaluation of satisfaction process in retail setting”, Journal of Retailing, Vol 57, pp 25-48 Parasuraman, A., Zeithaml, V.A & Berry, L.L (1985), "A Conceptual Model of Service Quality and its Implication for Future Research", Journal of Marketing, Vol 49, pp 41-50 Parasuraman, A., Zeithaml, V.A and Berry, L.L (1988), "SERVQUAL: a multiitem scale for measuring consumer perceptions of the service quality", Journal of Retailing, Vol 64, No 1, pp 12- 40 Sreenivas, T., & Babu, N S (2012) A Study on Patient Satisfaction in Hospitals International Journal of Management Research and Bussiness Strategy, 1(1), 101-118 Van Iwaarden, J., van der Wiele, T., Ball, L., and Millen, R (2003), "Applying SERVQUAL to web sites: An exploratory study", International Journal of Quality & Reliability Management, Vol.20, No.8, pp 919-935 Wicks, A M., & Roethlein, C J (2009) A Satisfaction-Based Definition of Quality Journal of Business & Economic Studies, Vol 15, No 1, Spring 2009, 82-97 50 WHO, (2008) Strategic Plan for Strengthening Health System in the WHO Western Pacific Region References in Vietnamese Quy Chế Bệnh Viện, Bộ Y Tế Việt Nam (2001) Tiêu Chuẩn Đánh Giá Chất Lượng Bệnh Viện Bộ Y Tế Việt Nam (2015) Hanh Phuc Hospital 51 Customers’ Satisfaction survey Customer Services Dept APPENDIX A We are carrying out our Patient Satisfaction Survey to help us identify areas for improvement within hospital services, any information provided will be kept confidential ad used only for the purpose of this survey The survey should only take few minutes to complete YOUR LOCATION OF VISIT □ Obstetrics Clinic □ Pediatrics Clinic □ Obstetrics wards □ Wellness Center □ Gynecology Clinic □ Emergency Dept □ Pediatrics wards □ Others………… Very Satisfied Adequate Unsatisfied Very satisfied Unsatisfied Please tick appropriate box (√) (1) (2) (3) (4) (5) A YOUR APPOINTMENT Ease of making appointments by □ □ □ □ □ phone getting care for illness/injury as soon □ □ □ □ □ as you wanted it Keeping you informed if your □ □ □ □ □ appointment time was delayed Ease of getting a referral when you □ □ □ □ □ needed Getting after-hours care when you □ □ □ □ □ needed it B YOUR WAITING TIME Waiting time in the reception area □ □ □ □ □ Waiting time in the exam room □ □ □ □ □ Waiting for LAB results □ □ □ □ □ Waiting for Nursing care □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ 10 Waiting for billing & charging C OUR STAFF: C.1 Medical Secretary/Registration staff 11 The courtesy of the person who took your call 12 The friendliness and courtesy of the receptionist 52 13 The helpfulness of the people who assisted you with billing or insurance 14 Delivery information /Instructions C.2 Medical Staff-Doctor/Surgeon □ □ □ □ □ □ □ □ □ □ 15 Courteousness □ □ □ □ □ 16 Respect your confidentiality □ □ □ □ □ 17 Explain of your health and procedures □ □ □ □ □ 18 Courteousness □ □ □ □ □ 19 Respect your confidentiality □ □ □ □ □ 20 Care & Concern towards your needs □ □ □ □ □ 21 Clearly instructions/Advices regarding medication/follow-up /stay healthy care □ □ □ □ □ 22 Attentiveness & Efficiency response your calls □ □ □ □ □ 23 Skill and Professionalism □ □ □ □ □ C.4 Allied Service staff Lab Technicians/ Physiotherapist/ Radiographer 24 Courteousness □ □ □ □ □ 25 Respect your confidentiality □ □ □ □ □ 26 Care & Concern towards your needs □ □ □ □ □ 27 Clearly instructions □ □ □ □ □ 28 Skill and Professionalism □ □ □ □ □ 29 Courteousness □ □ □ □ □ 30 Respect your confidentiality □ □ □ □ □ 31 Care & Concern towards your needs □ □ □ □ □ C.3 Nursing staff C.5 Pharmacy 53 □ □ □ □ □ 33 Welcoming & Friendly □ □ □ □ □ 34 Cleanliness □ □ □ □ □ 35 Noisy □ □ □ □ □ 36 Consultation room □ □ □ □ □ 37 Overall comfort (Lifts, Trolley, wheelchairs, Beds, Toilet, Bathroom) □ □ □ □ □ 38 Adequate parking □ □ □ □ □ 39 Signage and directions easy to follow □ □ □ □ □ F YOUR OVERALL SATISFACTION WITH US: □ □ □ □ □ 32 Clearly instructions/explanation about medications D OUR ENVIRONMENT E OUR FACILITY: G ANY OTHERS COMMENT SOME INFORMATION ABOUT YOU: GENDER YOUR AGE ARE YOU: □ Male □ Under 18 □ Your first visit in Hanh Phuc □ Female □ 18-30 □ A returning patient □ 31-40 □ 41-50 □ 51-60 □ Over 60 Thanks very much for your helpful information! 54 APPENDIX B SATISFACTION TO APPOINTMENTS & REGISTRATION PROCESS Questionnaires Very Satisfied Adequate Unsatisfied Very Unsatisfied 5% 55% 36% 4% 0% 34% 45% 31% 0% 0% 4% 57% 34% 5% 0% 22% 65% 23% 0% 0% 23% 45% 32% 0% 0% satisfied Ease of making appointments by phone getting care for illness/injury as soon as you wanted it Keeping you informed if your appointment time was delayed Ease of getting a referral when you needed Getting after-hours care when you needed it 55 APPENDIX C SATISFACTION TO WAITING TIME Questionnaires Very satisfied Satisfied Adequate Unsatisfied Very Unsatisfied Waiting time in the reception area 7% 34% 45% 12% 2% Waiting time in the exam room 12% 43% 34% 11% 0% Waiting for LAB tests 8% 47% 32% 13% 0% Waiting for Nurse responses 5% 54,5% 45,5% 5% 0% Waiting for billing & charging 11% 56% 21% 12% 0% 56 APPENDIX D GENERAL SATISFACTION TO HOSPITAL STAFF Questionnaires Very satisfied Satisfied Adequate Unsatisfied Very Unsatisfied Medical Secretary/Registration staff 25% 49% 26% 0% 0% Medical Staff-Doctor/Surgeon 15% 51% 33% 1% 0% Nursing staff 12% 47% 38% 3% 0% Allied Service staff Lab Technicians/ Physiotherapist/ Radiographer 11% 44% 43,5 1,5% 0% 57 APPENDIX E SATISFACTION TO HOSPITAL STAFF: SKILL AND PROFESSIONALISM Very satisfied Satisfied Adequate Unsatisfied Very Unsatisfied Doctors 38% 54% 15% 3% 0% Nurse 20% 42% 33% 5% 0% Pharmacists 32% 39% 27% 0% 0% Reception staff / Medical Secretary 51% 29% 20% 0% 0% Allied staff 42% 42% 14% 2% 0% Questionnaires 58 APPENDIX F SATISFACTION TO FACILITY Questionnaires Consultation room Very satisfied Satisfied Adequate Unsatisfied Very Unsatisfied 32% 47% 21% 0% 0% 54% 44% 2% 0% 0% Adequate parking 36% 52% 12% 0% 0% Signage and directions easy to follow 22% 73% 5% 0% 0% Overall comfort (Lifts, Trolley, wheelchairs, Beds, Toilet, Bathroom) 59 APPENDIX G PATIENT CONSULTATION PROCESS [...]... integrated into healthcare quality management system and 5-points Likert scales to develop the instrument for measuring service quality and patient satisfaction of Hanh Phuc hospital and to be used in this report 13 Background of Hanh Phuc Hospital (HPH) Hanh Phuc International Hospital (HPH) is a private hospital, established in 2011, located in Binh Duong province, with almost 450 staff including more... valid and reliable for evaluating HPH hospital performance and assessing quality of hospital care c) Collect and analysis of data from patients to determine how patients’ integration can help in improving service quality of hospital 17 The report includes 2 main parts with 5 chapters: Chapter Description INTRODUCTION - General introduction of the report Background of Hanh Phuc Hospital The interesting... patient parties evaluating the hospital service In Hanh Phuc hospital, as a new and private hospital, under pressure of competitive environment, enhance patient satisfaction and quality improvement is crucial to maintain and keep business growth Customers are the most important asset of any organization, Hanh Phuc hospital is not excepted, measuring and reporting on patient satisfaction about health... improving the quality of hospital service, “reduced medical errors and improved patient safety” are crucial to obtain higher level of patient satisfaction (Langabeer, 2008) Patient satisfaction surveys help to evaluate the patients' perceptions of services of a healthcare organization Continually improving of patient care are vital and necessary activities by gauging level of patient s satisfaction and. .. major in healthcare industry in general and in HPH in particular; hospital performance is focus on patient comfort, complaint mechanisms and continuity of care Consideration of goals and business strategy, analyses patients’ satisfaction data that based on patients’ survey and feedbacks (Appendix A), the strategic objectives of HPH is focus on: 16 - Increase patients satisfaction - Increase loyalty of. .. to seek Joint Commission International (JCI) Accreditation Healthcare Quality Standard Vision: To be the hospital of choice for women and children by committing integrated services for patients and their family Mission: To provide high standards of clinical quality care and personalized service with respect, compassion and understanding 15 Patient satisfaction survey in HPH In the event of patients... THE PATIENT SATISFACTION ASSESSMENT PROCESS Chapter I Patient satisfaction and healthcare service quality The chapter aims to present and review the theories of healthcare quality management system, service quality, customer satisfaction, the relationship between service quality and customer satisfaction, finally, describe dimensions of service quality and customer satisfaction perspectives in healthcare. .. QUALITY IMPROVEMENT Chapter I Findings The chapter describes the results of survey and demonstrates findings though charts, graphics, tables Summary of the main results of the study, offer a number Chapter II Discussion and of improvement suggestion of implications for hospital suggestion for Quality managers Improvement CONCLUSION - Summary of findings Points out the limitations of the study and suggest... THE PATIENT SATISFACTION ASSESSMENT PROCESS CHAPTER I PATIENT SATISFACTION AND HEALTHCARE SERVICES QUALITY 1 Healthcare Quality Management System Quality management is a way of doing business that continuously improves products and services to achieve better performance According to American Society for Quality (2008), the goal of quality management in any industry is to achieve maximum customer satisfaction. .. promote quality of care and patient satisfaction, it is important to identify the patients’ needs, acknowledge the degree of satisfaction that can be used as a means of assessing the quality of health care and reflects the ability of the health care provider to meet the patients’ expectation (Sreenivas & Babu, 2012, p 102) 2 Patient satisfaction and service quality in healthcare Oliver (1981) defines satisfaction