DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182295

Measuring patient experience with patient care coordinators during decongestion of outpatient department of an apex tertiary care referral public hospital in India

Rahul Ranjan, Kausar Mohammad, Angel R. Singh, D. K. Sharma

Abstract


Background: Specialized hospitals are faced with overcrowding in OPDs, improper behaviour of staff and navigation difficulties. In an apex tertiary care referral public hospital of India, Patient care coordinators (PCCs) were introduced to help patients navigate as a part of an OPD decongestion project. A novel concept involving patient interaction, called for measuring patient experience, to provide a baseline measurement, further improvements needed and benchmarking. For this, the model for decongestion also needed to be studied.

Methods: A descriptive and cross-sectional study was conducted. Direct observations were conducted to study decongestion model and expectations from PCCs. Patient experience was measured from 400 patients using a 27-item questionnaire designed by researcher. A 5-point Likert’s scale was used for their availability, politeness, promptness, guidance, information accuracy, emotional support, etc. Dichotomous scale was also used to measure competence of PCCs.

Results: A patient reception centre with three different zones was created based on status of appointments, unique hospital identification number (UHID) and new or re-visit patients. Waiting areas were created and crowd distributed based on handling capacities of sub-waiting areas dynamically adjusting to service time of doctors. PCCs facilitated navigation to right destinations. Patients had positive experience irrespective of age, gender and educational status. It related positively with a confident next visit.

Conclusions: Introduction of PCCs is an effective way for assisting patient navigation. The study contributes by providing a measure of experience and benchmarking. It succinctly describes a model for decongesting OPD that may be adopted in similar settings.


Keywords


Outpatient department, Overcrowding, Patient experience, Patient care coordinators

Full Text:

PDF

References


Mensah J, Asamoah D. Optimizing patient flow and resource utilization in outpatient clinic: a comparative study of Nkawie Government Hospital and Aniwaa Health Center Kwame Nkrumah University of Science and Technology Akua Amponsaa Tawiah Kwame Nkrumah University of Science. J Appl Bus Econ. 2014;16(3):181-8.

Kumar MA, Mahesh S, Kamalraj T, Azhagiri M. Patient treatment time prediction for out patient department OPD. Int J Eng Sci Com. 2017;7(4):6238-42.

Gopal R, Bedi SS. Impact of Hospital Services on Outpatient Satisfaction. Int J Res Bus Manag. 2014;2(4):37-44.

Schultz EM, McDonald KM. What is care coordination? Int J Care Coord. 2014;17(1-2):5-24.

Friedman A, Howard J, Shaw EK, Cohen DJ, Shahidi L, Ferrante JM. Facilitators and barriers to care coordination in patient-centered medical homes (PCMHS) from coordinators’ perspectives. J Am Board Fam Med. 2016;29(1):90-101.

Skillings LN, MacLeod D. The patient care coordinator role: An innovative delivery model for transforming acute care and improving patient outcomes. Nurs Adm Q. 2009;33(4):296-300.

Haggerty JL, Roberge D, Freeman GK, Beaulieu C. Experienced continuity of care when patients see multiple clinicians: A qualitative meta summary. Ann Fam Med. 2013;11(3):262-71.

de Silva D. Measuring patient experience. Heal Found. 2013;(18):1-50.

Wolf J a, Niederhauser V, Marshburn D, Lavela SL. Defining patient experience. Patient Exp J. 2014;1(1):7-19.

Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: A systematic review. Syst Rev. 2015;4(1).

Moosa S, Luiz J, Carmichael T, Peersman W, Derese A. Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa. African J Prim Heal Care Fam Med ISSN Afr J Prm Heal Care Fam Med. 2016;8(1):2071-936.

Scales CD, Schulman KA. Triggering Management for Quality Improvement. Health Serv Res. 2014;49(5):1401-6.

Rao KD, Peters DH, Bandeen-roche K. Towards patient-centered health services in India-a scale to measure patient perceptions of quality. Int J Qual Heal Care. 2006;18(6):414-21.

Bowling A, Rowe G, Lambert N, Waddington M, Mahtani K, Kenten C, et al. The measurement of patients’ expectations for health care: a review and psychometric testing of a measure of patients’ expectations. Health Technol Assess (Rockv). 2012;16(30):i-xii:1-509.

Honeyford K, Greaves F, Aylin P, Bottle A. Secondary analysis of hospital patient experience scores across England’s National Health Service–How much has improved since 2005?. PloS one. 2017 Oct 26;12(10):e0187012.

Bleich SN, Ozaltin E, Murray CJL. How does satisfaction with the health-care system relate to patient experience? Bull World Health Organ. 2009;87(4):271-8.

Peltzer K. Patient experiences and health system responsiveness in South Africa. BMC Health Serv Res. 2009;9:1-12.

Hsu CC, Chen L, Hu YW, Yip W, Shu CC. The dimensions of responsiveness of a health system: A Taiwanese perspective. BMC Pub Health. 2006;6:1-7.

Peltzer K, Phaswana-mafuya N. Patient experiences and health system responsiveness among older adults in South Africa. Heal Technol Assess. 2013;3(7):1-9.

Bao Y, Fan G, Zou D, Wang T, Xue D. Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding. Li D, editor. PLoS One. 2017 Feb 16;12(2):e0171684.

Kumar R, Srivastava J, Sharma L, Sodani P. Measuring patient satisfaction: A case study to improve quality of care at public health facilities. Indian J Community Med. 2010;35(1):52.

Price RA, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71(5):522-54.

Bertolini M, Bevilacqua M, Ciarapica FE, Giacchetta G. Business process re‐engineering in healthcare management: a case study. Bus Process Manag J. 2011 Feb 8;17(1):42-66.

Benneyan JC. An introduction to using computer simulation in healthcare: patient wait case study. J Soc Health Syst. 1997;5(3):1-15.

Packwood T, Pollitt C, Roberts S. Good Medicine? A case study of business process re-engineering in a hospital. Policy Polit. 1998 Oct 1;26(4):401-15.

Khodambashi S. Business process re-engineering application in healthcare in a relation to health information systems. Procedia Technol. 2013;9(2212):949-57.

Francis SD, Alley PG. A “patient focus review” of surgical services: Business process re-engineering in health care. Bus Process Manag J. 1996;2(1):48-62.

Ikwunne TA, Onyesolu MO. Optimality test for multi-sever queuing model with homogenous server in the Out-Patient Department (OPD) of Nigeria teaching hospitals. Mod Educ Comput Sci. 2016;4(April):9-17.

John Kofi Poku JK. Queuing theory and the management of waiting-time: a case study of out-patient department of Komfo Anokye Teaching Hospital Polyclinic Kumasi. Kwame Nkrumah University of Science and Technology; 2015.

Vadhana M. Assessment of patient satisfaction in an outpatient department of an autonomous hospital in Phnom Penh, Cambodia. Ritsumeikan Asia Pacific University; 2012.

Khayyam KU, Patra S, Sarin R, Singla R, Behera D. A study on overcrowding of out-patient department of a tertiary care tuberculosis institute in Delhi. Indian J Prev Soc Med. 2014 Jan;45(1-2):19.

Khamis K, Njau B. Patients’ level of satisfaction on quality of health care at Mwananyamala hospital in Dar es Salaam, Tanzania. BMC health services research. 2014 Dec;14(1):400.

Sharma SK, Chowhan SS. Patient survey to measure the quality of care provided by health care providers in OPD of tertiary care hospitals. Indian Journal of Research. 2013 Feb;2(2):208-9.

Aldana JM, Piechulek H, Al-Sabir A. Client satisfaction and quality of health care in rural Bangladesh. Bull World Health Organ. 2001;79:512-7. Available from: http://www.who.int/bulletin/archives/79(6)512.pdf.