“A STUDY ON PATIENT SATISFACTION IN THE OUTPATIENT DEPARTMENT

OF MULTI-SPECIALITY HOSPITAL”
AHMEDABAD

A MAJOR PROJECT REPORT

SUBMITTED IN- FULFILLMENT OF THE DEGREE OF

MBA IN HOSPITAL & HEALTH CARE MANAGEMENT

SUBMITTED BY-
[Link] PANCHAL
SEM 4(2019-2021)
(000MTMBHC0002)
SUBMITTED TO :

INSTITUTE OF MANAGEMENT & TRANING

NATIONAL FORENSIC SCIENCES UNIVERSITY(NFSU)
SECTOR-9,
GANDHINAGAR.

TABLE OF CONTENTS

SR NO. CONTENTS PAGE NO.

1 PROJECT PROFILE 3

2 LIST OF ABBREVATIONS 4

3 PREFACE 5

4 ACKNOWLEDGEMENT 6

5 ABSTRACT 7

1
 6 CHAPTER 1:GENERAL INTRODUCTION 8

7 CHAPTER 2: BACKGROUND OF THE ORGANIZATION 15

8 CHAPTER 3: LITERATURE REVIEW 17

9 METHODLOGY 51

10 DATA ANALYSIS AND INTEREPRETATION OF DATA 53

11 DISCUSSION 70

12 SUGGESTIONS RECOMMENDED 71

13 CONCLUSION 75

14 REFERENCES 76

PROJECT PROFILE

PROJECT TITLE: A STUDY ON PATIENT SATISFACTION IN OUTPATIENT

DEPARTMENT AT MULTI-SPECIALITY HOSPITAL”

ORGANIZATION FOR PROJECT: KUSUM BEN DHIRAJLAL HOSPITAL(KD,HOSPITAL)

FIELD OF PROJECT: OPERATIONS MANAGEMENT

METHODS USED: CROSS-SECTIONAL AND OBSERVATIONAL STUDY

TOOLS USED: MICROSOFT EXCEL

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 GUIDE(INTERNAL) :DR. ASHWINI PANDIT

SUBMITTED BY: MS RIYA PANCHAL

JCAHO: JOINT COMISSION ON ACCREDITATION OF HEALTHCARE

ORGANIZATION

IOM: INSTITUE OF MANAGEMENT

LIST OF ABBREVATIONS:
TARPs: TECHNICAL ASSISTANT RESEARCH PROGRAM

NABH: NATIONAL ACCREDITATION ON BOARD OF HOSPITALS

NRC: NATIONAL RESEARCH CO-OPERATION

CATH CATHERITIZATION LABORATORY

LAB:

LASIK: LASER IN-SITU KERATOMILEUSIS

UPS: UNINTERRUPTED POWER SUPPLY

NICU: NEWBORN INTENSIVE CARE UNIT

PICU: PAEDIATRIC INTENSIVE CARE UNIT

IVF IN VITRO FERTILIZATION CENTRE

CENTRE:

EMBASE: EXCERPTA MEDICA DATABASE

PRISMA: PREFERED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND

META-ANALYSIS

CINAHL: CUMULATIVE INDEX OF NURSING AND ALLIED HEALTH

LITERATURE
JCOS: JUNIOR COMISSION OFFICER
3
MEDLINE MEDICAL LITERATURE ANALYSIS AND RETRIVAL SYSTEM ONLINE
 PREFACE

This Project Report has been prepared in partial fulfillment of the DISSERTATION of
MASTER OF BUSINESS & ADMINISTRATION IN HOSPITAL AND HEALTH CARE
MANAGEMENT, semester 4, batch of 2019-2021.
For preparing this Project Report, I had been working with KD HOSPITAL;
a multi-speciality hospital during the suggested duration to avail the necessary
information from the hospitals taken under the study. This report is an attempt to show the ideal blend of
learning and knowledge
acquired during my practical study at the hospital. The rationale behind this study is to know and study its
implications for patient satisfaction in outpatient department of KD Hospital.

ACKNOWLEDGEMENT:

First and foremost, I would like to express my special thanks to team of KD Hospital, Ahmadabad for
providing me with unfailing support and continuous encouragement throughout my major internship.
This accomplishment would not have been possible without them.

I would also like to extend my gratitude to MR. HIMESH PATEL (OPERATIONS MANAGER) and DR.
TANVI MEHTA (ASSISTANT OPERATIONS MANAGER) for providing and guiding me with all the
facility that was required to do my project work at KD HOSPITAL.

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 This project would not have completed without their enormous help and worthy experience. Whenever I
was in need, they were there behind me. I would like to thank all the those who have indirectly or directly
supported me in completing my project. Lastly, I also thank all the staff of KD HOSPITAL for always
being co-operative to complete my project. Without their warm attitude and support, this would have been
a distant dream.

My sincere thanks goes to the Course director, DR. S.O JUNARE, Course Coordinator, DR. KALGI
SHAH and special thanks to our project guide, DR. ASHWINI PANDIT, for her support and consultative
help, constructive suggestion on matter in this project.

I must express my profound gratitude to my parents and friends for providing me with unfailing support
and continuous encouragement throughout my project.

Finally, I want to apologize in advance to anyone I may unwittingly fail to notice.

ABSTRACT

TOPIC: Patient satisfaction in Outpatient Department in K.D Hospital, Ahmedabad.

The main aim of this objective is to assess the level of patient satisfaction with Outpatient Department’s
services regarding physician – patient interaction, nurse – patient interaction, and patient’s satisfaction in
term of convenience, courtesy, and quality of care in KD Multi-specialty Hospital.

Objective:

- To assess the level of satisfaction with services provided by the Outpatient Department in KD
Hospital.
- To identify the strategies to help the hospital to increase their patient satisfaction scores.

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 - To describe the patient’s opinions and suggestions on improving the services in OPD of KD
Hospital, Ahmedabad.

Method:

It is going to be a cross-sectional study design in the OPD Department. This design will be particularly
aimed to find out the levels of patient’s satisfaction and its relationship with independent variables and
dependent variables using Ordinal level of measurement.

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 CHAPTER 1: INTRODUCTION

INTRODUCTION

The main objective of any health care organization is to provide best possible health care to the patients.
The study of the patient satisfaction with care received is of paramount importance in the context
providing quality patient care services. It is difficult to measure the satisfaction and gauze responsiveness
of the health systems as not only clinical but also nonclinical outcomes of care do influence the patient
satisfaction. Patient satisfaction is an important and commonly used indicator for measuring the quality in
health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice
[Link] care.

The practice and system of medicine has evolved over centuries. There are certain significant
developments which have taken place in the health systems in recent times. Chief among them are:

a. the establishment of corporate hospitals equipped with the latest facilities

b. the advent of third-party payers (insurance companies, governments, companies, etc.); increasing
awareness among patients

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c. availability of information It affects the timely, efficient, and patient-centered delivery of quality
through the internet, and higher expectations of patient care, and finally

d. the increasing litigation for unsatisfying results.

All these factors have resulted in a challenging profile for the health care industry - away from the
traditional concept of a noble profession toward a service industry.

However, patient satisfaction as an indicator of quality of healthcare has evolved as an outcome measure
and patient satisfaction surveys are being increasingly identified to be established yardsticks to measure
success of the service delivery system functional at hospitals.

Satisfaction is a psychological concept and patient satisfaction depends upon many factors such as:
Quality of clinical services provided, availability of medicine, cleanliness, behavior of doctors and other
health staff, cost of the services, hospital infrastructure, physical comfort, emotional support, and respect
for patient preferences. In general, patient satisfaction has been defined as an evaluation that reflects the
perceived differences between expectations of the patient to what is actually received during the process
of care. Disparity between patient expectation and the service received is related to lessened satisfaction.
Therefore, assessing patient perspectives gives them a voice, which can make public health services more
responsive to people’s requirements and expectations. For health care organization to be successful,
monitoring of customer’s perception is a simple but important strategy to assess and improve their
performance.

Patient satisfaction gained popularity and usefulness as it provides the chance to health-care providers and
managers to improve the services in the public health facilities. Patient’s feedback is necessary to identify
problems that need to be resolved in improving the health facilities.

Patient satisfaction matters because Improving patient satisfaction has become one of the primary goals
for a lot of healthcare providers. The reason is simple: patient satisfaction level is directly linked to key
success metrics for hospitals and individual healthcare providers. Patient satisfaction impacts clinical
outcomes, patient retention and reimbursement claims.

Thanks to the Internet and social media platforms, patients are now aware of the care quality that their
providers are offering. Patients are setting new expectations for convenience, transparency and
collaboration, and healthcare facilities are developing strategies to meet these new demands.

While acknowledging the need to improve patient satisfaction is an important first step, from there it can
be a tough task to understand what changes will yield the best results. Providers need to have an honest
assessment of what their practice and services look like from when a patient first schedules an
appointment all the way through follow-up with a doctor. Changes, big and small, during this process can
improve a patient’s overall experience.

ASSESSMENT OF QUALITY OF HEALTH CARE

In a major report published in 2001 (“Crossing the Quality Chasm”, the Institute of Medicine (IOM) set
forth six aims for a quality health care system patient safety: (a) safe; (b) equitable; (c) evidence based;
(d) timely; (e) efficient; and (f) patient centered. The latter three factors directly influence patient

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satisfaction. This article focuses on patient satisfaction, its assessment, and its effects on health care
delivery, particularly with reference to dermatological and esthetic practice.

PATIENT AS A CONSUMER

Under these circumstances, would it be more appropriate to address the patients as “consumers”? The
word “consumer” is derived from the Latin word “consumer” which literally means one who acquires
commodities or services. Similarly, the word customer is also defined as “a person who purchases goods
or services.” Today the patient sees himself as a buyer of health services. Once this concept is accepted,
then there is a need to recognize that every patient has certain rights, which puts a special emphasis on to
the delivery of quality health care,

This explains why many hospitals, especially those in the corporate sector, have begun to function like a
service industry. The hospital industry has begun to employ HR professionals and management graduates.
Third-party payers too have recognized that patient satisfaction is an important tool for the success of
their organization and are regularly monitoring patient satisfaction levels among their customers. In USA,
physician bonuses are linked to patient evaluation of their doctor's personal interaction with them. These
players have recognized that higher patient satisfaction leads to benefits for the health industry in a
number of ways, which have been supported by different studies:

1. Patient satisfaction leads to customer (patient) loyalty.

2. Improved patient retention - according to the Technical Assistant Research Programs (TARPs), if
we satisfy one customer, the information reaches four others. If we alienate one customer, it
spreads to 10, or even more if the problem is serious. So, if we annoy one customer, we will have
to satisfy three other patients just to stay even. Change the reference number.
3. They are less vulnerable to price wars. There is sufficient evidence to prove that organizations
with high customer loyalty can command a higher price without losing their profit or market
share. In fact, in a study conducted in Voluntary Hospitals of America, nearly 70% of patients
were willing to pay more money if they had to consult a quality physician of their choice.
4. Consistent profitability - it is estimated that, in USA, loss of a patient due to dissatisfaction, can
result in the loss of over $200,000 in income over the lifetime of the practice.
5. Increased staff morale with reduced staff turnover also leads to increased productivity
6. Reduced risk of malpractice suits – an inverse correlation has been reported for patient
satisfaction rates and medical malpractice suits.
7. Accreditation issues – it is now universally accepted that various accreditation agencies like
International Organization for Standardization (ISO), National Accreditation Board for Hospitals
(NABH), Joint Commission on Accreditation of Healthcare Organizations (JCAHO), etc., all
focus on quality service issues.
8. Increased personal and professional satisfaction - patients who improve with our care definitely
make us happier. The happier the doctor, the happier will be the patients.

SERVICE EXCELLENCE

Service excellence revolves around three factors: doctor, patient, and organization.

Doctor

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Undoubtedly, the physician has twin responsibilities of giving the best health care to the patient, and
leading the team or the organization in attaining the goal of satisfying the patient. Listed below are few
“house rules” to handle the patient so as to attain a satisfying and a non-complaining patient:

a. Break the ice: make eye contact, smile, call people by name, express with words of concern.
b. Show courtesy: Kind gestures and polite words make a patient very comfortable.
c. Listen and understand: encourage patients to tell their problem. Invite and answer their questions.
d. Inform and explain: it promotes compliance. People are less anxious when they know what's
happening.
e. See the whole person: see beyond illness the whole person.
f. Share the responsibility: risks and uncertainty are facts of life in medical practice.
Acknowledging risks builds trust.
g. Pay undivided attention: this reduces distractions and interruptions as much as possible.
h. Secure confidentiality and privacy: watch what you say, where you say, and to whom you say.
i. Preserve dignity: treat the patient with respect. Respect modesty.
j. Remember the patient's family: families feel protective, anxious, frightened, and insecure. Extend
yourself, reassure, and inform.
k. Respond quickly: Keep appointments, return calls, and apologize for delays.

Patient

A patient's liking the doctor has a lot to do with the patient getting better. A patient's expectations of a
good service depend on age, gender, nature of illness, hour of the day, his or her attitude toward the
problem and the circumstances.

In general, patients expect their doctors to keep up the timings, behave cordially, and communicate in
their language. They expect care, concern, and courtesy in addition to a good professional job.

Understanding a patient

Certain tips can help a doctor or a hospital to understand the patients better:

I. Recognize that patients expect a personal relationship that shows compassion and care.
II. Recognize that the patient has got certain rights. Various regulatory authorities and hospitals have
drawn a charter of rights for the patients.
III. Make sure a patient has got a good first impression of you and your set up.
IV. Step into your patients′ shoes; see through their eyes and hear through their ears.
V. Minimize the patient's waiting time to the least possible.
VI. Try to make your problem-solving system to be functional.
VII. Always obtain feedback from your patients and correct shortcomings if any.

Hospital

Many a times it happens that with a competent doctor and a compliant patient, the problems persist
because of the policies, work culture, and attitude shown by the hospital. Traditionally, hospitals have had
discrete functional services such as house-keeping, dietary services, pharmacy, laboratory, etc.
Unfortunately, this specialization has led to more fragmentation, costly care, and less than ideal customer

10
service. A study describes that during a typical 3- to 4-day stay in a large hospital, a patient may interact
with 50-60 employees. Building and sustaining a service-oriented organizational culture is important for
the success of any organization. Several changes are being seen in the management strategies with the
goal of serving better and improving the service quality.

There are certain areas where minimum requirements and standards have to be maintained.

Telephone service

Ensure that a smart, competent, and intelligent person is placed to handle the telephone for he or she will
be the voice of the practice. Establish standards to ensure that the telephone is picked within a certain
time, mode and tone of speech are cordial, and a triage protocol is followed which helps to ward off the
unnecessary calls when the doctor is busy in his or her professional work. Periodically, a survey can be
made to monitor how these standards are followed.

Office appearance

An aesthetically designed office, which is well-furnished, properly spaced with good interiors, well
equipped with lighting, water, furniture, etc., and well-dressed, ever-smiling, and pleasant staff go a long
way in bringing the patient to the doctor's office. Patients may not remember what you said to them;
patients may not remember what you did to them; but they always remember how you made them feel.

Waiting time

The amount of time the patient spends in the waiting corridor area plays a very important role in
determining the outcome of patient satisfaction. With so many choices available, few people will stick to
a doctor who has no respect for their time. The waiting time depends on a lot on factors, like the doctor's
style of working, the kind of patients he or she sees, the locality where he or she practices, and the
efficacy of the supportive staff.

Doctor-patient interaction

This is perhaps the most important indicator to determine the patient satisfaction outcome. Improving the
physician's interpersonal skills can increase patient satisfaction, which is likely to have a positive effect
on treatment adherence and health outcomes. Up to 25% of patients have comorbid psychosocial
problems. Such patients require more time from the dermatologist. Doctors frequently end up prescribing
more and talking less to the patient. In one study, insufficient communication was recognized by psoriasis
patients as a major cause of dissatisfaction with treatment.

Patient education

Typically, today's patients are more educated, computer savvy, and much richer. It is essential to clear all
their rightly or wrongly earned doubts with much patience and compassion. According to a National
Research Corporation (NRC) survey, on a scale of 10, patients listed willingness to explain things as the

11
most important criterion in selecting a physician. Other factors used in the study were reasonable fees,
telephone access, friendly office, convenient appointments, and convenient location; the willingness to
explain things was given a rating of 9.6, well above the others. Incomplete, improper, and poor
communication may lead to unrealistic goals and expectations which in turn can lead to dissatisfaction
especially in cosmetic and chronic disorders.

Successful education increases patient satisfaction and results in improved adherence to treatment and
thus to a better outcome. Various methods like verbal education, written information (handouts, articles in
popular magazines, etc.), group-based learning, audiotapes, videotapes, computer-assisted education, and
the internet can be used to educate the patient about the disease.

Problem solving

This is perhaps the most important among all the patient-related issues. To have accreditations to
organizations like JCAHO, NABH, ISO, etc., a hospital should have a good system for handling
complaints.

According to the JCAHO manual:

a. A mechanism must exist for receiving complaints.

b. Patients must be informed of this mechanism and of their right to complain.
c. The organization must respond to significant complaints and take appropriate actions; patients
cannot be penalized for complaining.
d. All health care facility providers must document patient complaints and their responses to them.

The TARP has conducted a survey of assessing the loss sustained by an organization to measure the
financial consequence of dissatisfied customers. According to the report, if 150 complaints are voiced in a
year, for every complaint voiced, an additional 26 complaints are not voiced. That means there are 150 ×
26 or 3900 complaints in that period. Approximately, 1 complaint in 5 is serious. That means of the 3900
complaints, about 780 are serious. If 50% of the people with serious complaints go elsewhere the next
time, they need service, that means 390 people will choose another doctor or hospital next time. It is
estimated that 40% of these patients or their close family members will need hospitalization in the next
12-month period. Thus, the financial implication will be too heavy for the doctor and the organization.

So, when there is a lapse in the service delivered, one should always try to accept and acknowledge the
mistake with grace. While acknowledging the lapse, one is expressing the regret only for the process.
Apologizing doesn′t mean that one is accepting the guilt. Steps should be taken to ensure, that such lapses
do not recur.

Feedback

The feedback given by the patient helps to improve the work of the physician, place, and also the system.
Despite the advantages of self-assessment, dermatologists rarely have a system to analyze and evaluate
quality of care rendered in the practice. Patient feedback can be obtained by patient questionnaires,
follow-up phone calls, suggestion box, referral physician's survey, etc.

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Chapter 2: BACKGROUND OF THE ORGANIZATIONS

ABOUT KD HOSPITAL:

VISION

Ensuring ‘well being’ as a humane commitment to enliven humanity.

MISSION

The ‘well being’ ensured by extension of Available, Accessible, Affordable, Safe, Efficacious,
Professional and Ethical comprehensive healthcare through state-of-art facilities.

CORE VALUES

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Team Work

Integrity

Responsibility

Compassion

Ethics

OVERVIEW

KD Hospital (Kusum Dhirajlal Hospital) is a multi/super speciality hospital located at the prime location
of Vaishnodevi Circle, SG Road, Ahmadabad; with state-of-the-art facilities & treatments at an affordable
cost, encompassing wide spectrum of accurate diagnostics and elegant therapeutics created on the
philosophical edifice of patient and ethical centricity ensuring humanistic dispensation.

Under the aegis of Shri Harihar Maharaj Charitable Trust, KD Hospital is spread over a massive 6 acre
campus providing 300+ beds and catering for nearly 45 super-specialties, all under one roof. A multi-
speciality approach enables each speciality to have the comfort of collaborating on complex cases thereby
ensuring a comprehensive assessment/ treatment of the patient. Patients are provided with multiple
options for treatment, the most suitable of which are arrived at through a collaborative case assessment
approach that decides the best course of treatment for the best outcomes.

KD Hospital is proud to have some of the most eminent and experienced doctors of the world who are
authorities in their respective fields of specialization. We have the top 10 surgeons in India who are well
experienced in performing all types of critical surgeries.
With a group of committed staff and versatile cohort of doctors, each and every member of KD Hospital
is focused to ensure the ‘Well-being’ of the patients, which is assured by extension of Available,
Accessible, Affordable, Safe, Efficacious, Professional and Ethical comprehensive healthcare through
state-of-the-art facilities.

Our surgical team comprising of the top 10 surgeons in India is specialized in general surgery,
neurosurgery, bariatric surgery, urosurgery, cardiothoracic surgery, joint replacement surgery,
paediatrician surgery, spine surgery, gynaecology and obstetric surgery, plastic and reconstructive surgery
to name a few.

Our exclusive health check up packages, Visa health check up services, critical care and emergency care
team which is available 24x7, high-tech laboratory, state-of-the-art radiology department, modular OTs,
advanced CATH lab, and the top 10 surgeons in India are our greatest assets. Apart from this we have an
exclusive dialysis unit, sleep laboratory, LASIK removal of spectacles with refractive surgery using the
Carl Zeiss Mel 90 excimer laser, lithotripsy unit, two endoscopy suites, and a dedicated stroke centre.

All types of gastroenteritis investigations and gastrointestinal surgeries can be carried out at our multi-
speciality centre. We are fully equipped for dealing with all kinds of emergencies, be it surgical, cardiac,
neurological, traumatic, respiratory, infectious, environmental, or toxicological. Other USPs of our

14
hospital are fully equipped cardiology department, ultramodern IVF centre, pain management centre,
exclusive NICU and PICU. Access to physiotherapy, dental, occupational health, and smoking cessation
services is also available.

All healthcare facilities can be accessed here under one roof, making KD Hospital a one point contact for
all your healthcare needs. Our team of top 10 surgeons in India is ever ready for ensuring ‘well being’ as
a humane commitment to enliven humanity. We provide transparent services at an affordable prices so
that everyone can get access to the best services. By providing correct and timely diagnosis, treatment,
and care facilities and creating awareness for imbibing a healthy lifestyle, we aim to fulfil our vision.

CHAPTER 3: LITERATURE REVIEW

15
LITERATURE REVIEW

ARTICLE-1

Author/ Theoretical/ Research Methodology Analysis Conclusions

Date Conceptual Question(s)/ &
Framework Hypotheses Results

Sheloj Joshi, A study on To evaluate As a cross - The patients Maximum

Mahesh patient the level of sectional had the highest number of
Kumar Joshi satisfaction patient descriptive level of respondents
in out satisfaction study, we have experience had very good
patient with OPD taken patients from medicine experience
department services in who were department while just
of terms of registered in OPD about small number
secondary describing the Medicine helpfulness of of respondents
care experience of outpatient nurses, about had poor
hospital of patients about department of light and experience and
Bhopal medicine OPD Jaiprakash ventilation majority of the
services and Hospital of inside the patients had
accessibility to Bhopal over a OPD and good
services period of two about the good accessibility
among the months. The communicatio regarding
patients who research n from the waiting time,
attended the instrument for a pharmacist. service process

16
medicine OPD data collection The poor and working
of Jaiprakash was a structured experience hours.
hospital. questionnaire was from the
for assessing number of
the patient doctors in
satisfaction. OPD and
The experience about the
and diagnostic
accessibility place. As far
were as accessibility
categorized into is concerned,
good and poor 66% of
while patients had
satisfaction into good
high and low accessibility
using best towards
criteria. medicine OPD
Statistical while
analysis: Conve remaining
nience sampling 34% had poor
done for accessibility
selection of towards
patients Medicine
registered in OPD.
Medicine OPD.
The data was
analysed on
statistical
software SPSS
VS.20.

17
ARTICLE-2

Author/ Theoretical/ Research Methodology Analysis Conclusions

Date Conceptual Question(s)/ &
Framework Hypotheses Results

Kelvin I. The methods The consumer- Existing

Afrashtehfar, Patient of the current satisfaction patient-
Mansour K. Satisfaction in article are literature satisfaction
A. Assery, Medicine and based on a describes questionnaires
nd S. Ross Dentistry narrative satisfaction have been non
Bryant review of the through the critically
literature lens of a borrowed from
strategy. A consumer’s marketing
literature subjective theories, so it
review was decision, is not
conducted which relates surprising that
using both to his or her they have not
EMBASE and expectation been that
Medline and a definite useful in
databases up to understanding health fields,
July 12, 2020, of the since customer
by combining merchandise and patient
keywords and or service satisfaction are
terms related likely
to “satisfaction dissimilar
theories” and concepts.
“patient
satisfaction,”
and
“medicine” or
“dentistry/sto
matology/odon
tology.”

18
ARTICLE-3

Author/ Theoretical/ Research Methodology Analysis Conclusions

Date Conceptual Question(s)/ &
Framework Hypotheses Results

Enkhjargal Determinants This systematic We found Health care

Batbaatar , of patient review several service quality
Javkhlanbaya satisfaction: a followed the number of indicators were
r Dorjdagva , systematic guidelines of determinants the most
Ariunbat review the Preferred of patient influential
Luvsannyam Reporting satisfaction determinants of
, Matteo Items for investigated patient satisfaction
Mario Savino Systematic in a wide across the studies.
, Pietro Reviews and diversity of Among them,
Amenta Meta-Analysis studies. health providers'
(PRISMA) However, interpersonal care
statement. The study results quality was the
search was were varied essential
conducted in due to no determinant of
PubMed, globally patient
CINAHL, and accepted satisfaction.
Scopus in formulation Sociodemographic
October 2014. of patient characteristics
Studies satisfaction were the most
published in and varied in the
full in peer measurement review. The
reviewed system. strength and
journals directions of
between associations with
January 1980 patient satisfaction
and August were found
2014 and in the inconsistent.
English Therefore, person-
language were related
included. We characteristics
included 109 should be
articles for the considered to be
synthesis. the potential
determinants and
confounders
simultaneously.
The selected
studies were not
able to show all
potential
characteristics
which may have
had effects on

19
 satisfaction. There
is a need for more
studies on how
cultural,
behavioral, and
socio-
demographic
differences affect
patient
satisfaction, using
a standardised
questionnaire.

ARTICLE 4

20
 Author/Date Theoretical/ Research Methodology Analysis & Conclusion
Conceptual Question(s)/ Results s
Framework Hypotheses

Enkhjargal Conceptualizat This article The study used a Results showed Researcher
Batbaatar , ion of patient is a first part systematic that most of the s brought
Javkhlanbaya satisfaction: a of a two- review method, patient satisfaction satisfaction
r Dorjdagva , systematic part series meta-narrative theories and theories
Ariunbat narrative of research review, based on formulations are from other
Luvsannyam literature with a goal the RAMESES based on fields to
, Pietro review to review a guideline with marketing theories the current
Amenta current the phases of and defined as healthcare
conceptual screening how well health literature
framework evidence, service fulfils without
of patient appraisal patient much
satisfaction evidence, data expectations. adaptation.
and to bring extraction and However, review Thus, there
the concept synthesis. Patient demonstrated that is a need to
for further satisfaction a relationship attempt to
operationali theoretical between define the
zation articles were expectation and patient
procedures. searched on the satisfaction is satisfaction
The current two databases unclear and the concept
article MEDLINE and concept from other
aimed to CINAHL. expectation itself perspective
review a Inclusion criteria is not distinctly s or to
theoretical were articles theorised as well. learn how
framework published patients
that helps between 1980 evaluate
the next and 2014, and the care
article to English language rather than
review papers only. struggling
determinant There were 36 to describe
s of patient articles selected it by
satisfaction for the synthesis. consumeris
for t theories.
designing a
measuremen
t system.

ARTICLE 5

21
 Author/ Theoretical/ Research Methodol Analysis Conclusions
Date Conceptual Question(s)/ ogy &
Framework Hypotheses Results

Athar Patient Data for the study was Study JCOs Statistically
Mohd, satisfaction collected over a period of was predominantly significant
Surg Lt with four months, every third conducte expressed differences
Cdra, and services of patient reporting to the d by lower have been
Abhijit the Main Dispensary after using a satisfaction identified by
Chakravart outpatient OPD consultation being pre- judgement this study
y, Brig department selected for the study. structure with several against various
Every day one Officer, d attributes. study
one JCO and one OR or questionn Overall attributes as
their dependents were aire with satisfaction well as overall
selected for exercising 120 judgement impression
the study instrument to samples. with towards OPD
maintain the continuity Samples Outpatient services
and avoiding any bias were Department among the
during sample selection. further services were study groups,
All respondents, who stratified rated lower by which need to
consented to participate into sub- JCOs (2.56) be addressed
in the study, were populatio when by the hospital
assured of complete ns of compared with leadership to
anonymity and Officers, Officers and achieve
confidentiality. Only Junior ORs (3.10), consumer
serving personnel and Commiss the difference delight.
their dependents ioned being
attending various service Officers statistically
OPDs were included for (JCOs) significant.
the study, whereas Ex- and
servicemen and in- Other
patients were excluded. Ranks
Moreover, it was ensured (ORs)
that all respondents including
answering the dependen
questionnaire have ts as
utilized service OPD of study
the hospital at least twice populatio
in last one year. n.
Statistical analysis of
data was carried out
using Minitab version
16.0 software and logical
conclusions drawn from
such analysis.

ARTICLE-6

22
Author/ Theoretica Research Methodology Analysis & Conclusion
Date l/ Question(s)/ Results s
Conceptua Hypotheses
l
Framewor
k

Smarand Measuring The participation Descriptive research Out of the 2305 The present
a Adina Patients’ in the interview is commonly used to respondents, 83% research
Cosma Perception was voluntary and identify status, used the offers a
Marius and the perceptions reflect a general Romanian HS in support in
Bota Satisfactio and attitudes overview, the past 12 understandi
Cristina n with the recorded during characterize and months and 58% ng,
Fleșeriu Romanian the interviews offer information of the evaluating
Claudiu Healthcare were used only for about the actual respondents did and
Morgov System the purpose of the phenomenon on the not trust the improving
an present paper. market representing system. The the services
Mădălin Participants were a foundation for accommodation, offered by
a informed in the problem solving . A food, and other the
Văleanu questionnaire descriptive cross- facilities of Romanian
and briefing what are sectional study was Romanian healthcare
Dan the research conducted to hospitals were system. Our
Cosma objectives and identify the factors perceived as results can
their rights to that influence being at a low bring a
privacy and patients’ level. One third valuable
confidentiality and satisfaction. The of the contribution
protection of investigation was respondents were to further
personal data. also used as a unsatisfied and studies on
Thus, the research method for very unsatisfied patients’
participants data collection, in with respect to satisfaction
understood that by the form of face to the overall that can be
filling in the face interviews with impression of the improved
questionnaire they Romanian patients. Romanian HS. by a more
give their written Data were collected in-depth
consent to take between 2017 and approach,
part in the 2018. but also
research and offer
understand their practical
rights. They were implication
given the s and
possibility to managerial
withdraw at any recommend
time during the ations
filling in of the especially
questionnaire. The for
present research authorities
collected only and related
non-identifiable institutions
patient and private
information. All businesses
data are in their

23
 anonymized. planning for
further
developmen
t. Like other
previous
studies
highlighted
, the
following
recommend
ations that
can
improve the
level of
patient
satisfaction
could be
formulated
for the
policy-
makers:
increasing
the
financing of
the HS,
including
the level of
salaries of
doctors, the
developmen
t of medical
emergency
structures,
as well as
the
professional
ization of
the
managemen
t of health
units.

ARTICLE-7

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &

24
 Framework Hypotheses Results

Arvind PATIENT The most A cross- Most of the OPD services

Sharma, P K SATISFACTI important sectional study respondents in a hospital
Kasar, Richa ON ABOUT reason to was carried were satisfied need to be
Sharma HOSPITAL conduct out in 100 with improved by
SERVICES: A patient randomly availability of developing
STUDY satisfaction selected services, patient
FROM THE surveys is that patients. They professional feedback
OUTPATIEN they provide were care, waiting system.
T the ability to interviewed at time, behavior
DEPARTME identify and the exit point of consultant,
NT OF resolve of outpatient nurses,
TERTIARY potential department paramedical
CARE problems during the staff and other
HOSPITAL, before they period from staff. The
JABALPUR, become 21/09/2013 to overall
MADHYA serious. This 25/09/13. The satisfaction
PRADESH, study was data were level was 73%
INDIA designed to collected on excellent to
assess the predesigned good, 22%
patient and pretested average and
satisfaction questionnaire. 94%
regarding the respondents
services answered ‘yes’
provided in to the question
outpatient - ‘would you
department recommend
this hospital to
friends and
family’. Out of
total 68%
respondents
were
unsatisfied
with toilet
facility and
56% were
unsatisfied
with drinking
water facility.

ARTICLE – 8

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &

25
 Framework Hypotheses Results

Dr. Fatima PATIENT To determine A sample of Majority of the The patients

Mukhtar, Dr. SATISFACTI the level of 250 patients patients i.e 232 were highly
Aftab ON OPD patient was selected (94%) reported satisfied with
Anjum, Dr. services in a satisfaction by employing being satisfied their doctors
Muhammad Tertiary Care towards OPD systematic with the and were ready
Aslam Hospital of services with random doctor. A vast to re-visit the
Bajwa, Lahore reference to sampling majority hospital. It is
Shahzana doctor-patient technique. The agreed that recommended
Shahzad, interaction, patients were hospital was that further
Shahzeb registration interviewed clean 233 studies should
Hamid, desk, waiting and data was (94%) and be conducted
Zahra area, and collected using adequately to assess
Masood, overall health a pretested ventilated 224 patient
Ramsha facilities. questionnaire. (90%). The satisfaction in
Mustafa Data was hospital staff the secondary
analyzed using in the waiting and primary
the statistical area was found care health
package for to be facilities and
social sciences respectful 220 efforts should
(SPSS) version (89%) and fair be made to get
16.00. Data 198 (80%) regular
was presented towards the feedback from
in figures and patients. The the patients.
tables. It was patients had no
described difficulty
using locating the
frequencies, reception desk
percentages of the health
and mean. facility 235
(95%). A large
proportion of
patients i.e.220
(89%) said
they would re-
visit the
hospital.

ARTICLE-9

Author/Date Theoretical/ Research Methodology Analysis Conclusions

26
 Conceptual Question(s)/ &
Framework Hypotheses Results

Tonio Determinants Data used Global patient The results The analysis
Schoenfelde of patient were obtained satisfaction of the identified key
r , Joerg satisfaction: a through a self- was measured analysis determinants that
Klewer, study among administered, by a single showed should be altered
Joachim 39 hospitals in post-visit item question. that there first in order to
Kugler an in-patient questionnaire Attributes of are 10 improve global
setting in by random medical determinan patient
Germany sampling aspects of care ts of global satisfaction. The
during the were measured patient results also
period of using 12 items, satisfaction indicate that some
January 2009 performance . The aspects of the
to September of service outcome of hospital stay are
2009. using 3 items treatment not seen as
and different was relevant by
dimensions of overall, the patients and
patient most therefore are
expectations salient unrelated to
using 12 items. predictor satisfaction
Medical followed ratings. The
aspects of care by nursing findings suggest
and kindness as that variables
performance the second measuring
of service most patients'
items were important perceptions of
entered into component care are more
logistic . Items important
regression reflecting determinants of
analysis to informatio global patient
identify n receiving satisfaction in
determinants about the comparison to
of patient undergoing demographics and
satisfaction. treatment visit
do not characteristics.
have a Results of the
major present study have
influence implications for
on patient health providers
satisfaction aiming at
. improving the
service quality and
quality of care.

ARTICLE – 10

Author/Date Theoretical/ Research Methodology Analysis Conclusions

27
 Conceptual Question(s)/ &
Framework Hypotheses Results

Munawar Patient Pre-designed A descriptive The overall According to

Hussain Satisfaction questionnaires cross-sectional opinions about patient’s
Soomro, with Health were used and pilot study was the satisfaction opinion, the
Mansoor Care Services were also pre- undertaken level of study revealed
Magsi, in Outpatient tested. The during the patients for that the degree
Oussama Department of questionnaires month of May availability of of satisfaction
Lahmar. A Dental had semi- 2015 in the health services was
College structured, OPD of Bibi in the hospital satisfactory
Hospital in open-ended Asifa Dental were good. As with respect to
Pakistan and closed College and location of the waiting time
questions Hospital, hospital and and
which Larkana, timings of the availability of
includes; 1. Pakistan. A OPD were the doctors in
Socio- randomly convenient to the hospital,
demographic selected 100 the most of the which need to
characteristics patients were patients 86% be further
(to know the interviewed by and 93% explored and
distribution of using pre- respectively. corrected.
study structured Availability of
population questionnaires. the doctors
according to The was also found
different questionnaires adequate.
indicators). 2. had semi- However,
Approach to structured, regarding
the hospital open-ended seating
and doctors. 3. and closed arrangements
Out-patient questions. one fourth of
department While the total
timings and analyzing, patients were
processes of they were found to be
registration. 4. grouped into unsatisfied.
Services categories like Efficiency of
provided and availability of the doctor was
behavior by services, found
the health care clinical care, satisfactory by
providers waiting time 83%, while
and cost. majority of the
patients did
not faced any
kind of
language
problem.

ARTICLE – 11

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &

28
 Framework Hypotheses Results

Vanessa A. Improving The objectives All methods Results were Patient

Theurer Patient of this study used in this then used to satisfaction is
Satisfaction in were to: 1) study received identify the the highest
a Hospital identify the prior approval lowest scoring priority at
patient food, service, from St. areas of STMH and
Satisfaction in and patient Mark’s foodservice. foodservice
a Hospital variables that Hospital Low-cost quality plays a
Food service contribute to Institutional interventions large roll in
System vice foodservice Review Board were the overall
System Using dissatisfaction and Utah State implemented hospital stay
Low-Cost utilizing a University to address the experience
Interventions: validated Institutional areas of (McLymont et
Determining patient survey; Review Board. needed al., 2003;
Whether a 2) plan and improvement. Williams et 34
Room Service implement Patient al., 1998). For
System is the cost-effective satisfaction considerable
Next Step changes in the was reassessed improvement
foodservice by re-issuing in foodservice
based on surveys. satisfaction, it
survey results; Group T-tests may be
3) monitor were used to necessary for
foodservice compare the STMH
satisfaction results of the foodservice
scores; 4) baseline and administrators
determine and follow-up to consider
recommend surveys higher-cost
further (P<0.05). interventions.
changes on to Low-cost Based on this
improve interventions study, it was
patient were not recommended
foodservice shown to be that a room
satisfaction to effective in service system
administrators. significantly be considered
improving as a way to
patient truly meet and
foodservice possibly
satisfaction. exceed the
foodservice
expectations of
patients.

ARTICLE – 12

Author/Date Theoretical/ Research Methodology Analysis &amp; Conclusions

Conceptual Question(s)/ Results
Framework Hypotheses

29
Demiss Factors of A private wing A comparative The overall Patient
Mulatu patient is an annex or institution patient satisfaction at
Geberu, satisfaction in an extension based cross- satisfaction was the private
Gashaw adult within a public sectional study 89.3% (95% CI: wing and
Andargie outpatient hospital where was conducted 87.2–91.2). At regular adult
Biks, departments of medical from March to the regular and OPDs’ of
Tsegaye private wing services are April 2018. A private wings of public
Gebremedhin and regular provided to total of 955 outpatient hospitals had
& services in patients systematically departments it no
Tesfaye public through their selected was 88.3% statistically
Hambisa hospitals of full coverage patients were (95% CI: 85.4– significant
Mekonnen Addis Ababa, of the service interviewed by 91.2) and 90.4% difference.
Ethiopia: a payment . In using an (95% CI: 87.6– Female sex
comparative most regions interviewer- 93), and
cross-sectional and at the administered respectively. At information
study federal level in structured regular service on the
Ethiopia, questionnaire. OPD, patient prevention of
public Binary logistic satisfaction was recurrent
hospitals are regression affected by illnesses
allowed to analysis was female sex were factors
open and performed. In (AOR: 7.78; positively
operationalize the multi- 95% CI: 2.89– affected
private wings variable 20.93), long patient
with the logistic waiting time satisfaction at
primary regression (AOR: 0.22; regular
objectives of analysis p 95% CI: 0.07– services,
improving value < 0.05 0.73), whereas at
health worker and adjusted information on private wing
retention, odd ratio the prevention OPDs’ age,
providing (AOR) with of recurrent attended
alternatives 95% illnesses (AOR: elementary
and choices to confidence 14.16; 95% CI: school, and
private health interval (CI) 4.58–43.83), accessibility
service users, were used to and information of latrines
and generating identify the on drug use and were factors
additional associated side effects that
income for factors. (AOR: 0.22; positively
health 95% CI: 0.08– affected
facilities [46]. 0.63). In private patient
At the private wing, it was satisfaction.
wing, patients affected by
have the being in the age
opportunity to group of 38 to
choose their 47 years (AOR:
health 22.1; 95% CI:
personnel and 2.39–203.6),
expect to be attended
satisfied by elementary
services, but school (AOR:
some studies 4.69; 95% CI:

30
 globally 1.04–21.26),
showed that availability of
patient drugs (AOR:
satisfaction at 0.14; 95% CI:
regular 0.04–0.58), and
outpatient the accessibility
departments of latrines
(ROPD) was (AOR: 6.56;
higher than 95% CI: 1.16–
that of at 37.11).
private wings

ARTICLE – 13

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

Krupal Joshi Patient A randomly The overall According to

31
Kishor satisfaction selected 100 opinion about patient’s
Sochaliya about health patients were the efficiency opinion, the
Shyamal care services: interviewed by of hospital was study revealed
Purani A cross using pre- satisfactory in that the degree
Girija Kartha sectional study structured 92% of of satisfaction
of patients questionnaires patients. 68% was mild to
who visit the at the end of respondents moderate with
outpatient their O.P.D. said that the respect to
department of visits for 5 time of waiting time
a civil hospital days from coming to and
at 16th- 20th hospital and availability of
Surendranagar, January, 2012 consulted by specialist in
Gujarat at Civil doctor was too the hospital,
Hospital, long. Although which need to
Surendranagar. in 75% of be further
While patients the explored and
analysing, they time devoted corrected.
were grouped by doctor was
into categories only between
like 0-5 min., the
availability of communicatio
services, n and
clinical care, explanation of
waiting time disease by
and cost. doctors were
found
satisfactory in
80% and 91%
respectively.
The need of
investigations
was necessary
as per 90% of
patients. Time
required to
locate and get
medicines
from
pharmacy was
satisfactory in
nearby all
patients.

ARTICLE – 14

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s) &amp;
Framework / Results
Hypotheses

32
 Laith The Mediating Patient perception Results Study has
Alrubaiee Effect of of healthcare confirm the demonstrated
Patient quality was varying how the
Satisfaction in measured using importance of SERVQUAL
the Patients' modified some socio- instrument
Perceptions of SERVQUAL demographic could help
Healthcare model and results variables on hospitals
Quality – indicate that it patient identify the
Patient Trust appears to be a perception of healthcare
Relationship consistent and healthcare service
reliable scale. quality, patient characteristics
Finding indicate satisfaction, that are
that, while patient and patient considered
perception of trust. It has important by
healthcare quality also been patients. In
has a strong and found that this way,
positive impact on private hospitals can
the patient hospitals have improve their
satisfaction and higher overall level of quality
patient trust , healthcare and the
patient quality than effectiveness
satisfaction has public of the model
also significant hospitals. can be
impact on patient monitored
trust. Moreover, over time, with
patient resources
satisfaction being shifted
appears to play an to those areas
important which most
mediating role in heavily
increasing the influence
strength of the patient
association perceptions of
between service quality.
healthcare quality
and patient trust
in healthcare
service provider.

ARTICLE – 15

Author/Date Theoretical/ Research Methodology Analysis &amp; Conclusions

Conceptual Question(s)/ Results
Framework Hypotheses

V. A The overall : The study After open Our findings

33
Raftopoulos., GROUNDED aim of a was carried coding of the support the
RN, MBA, THEORY conceptual out at two data obtained need to
PhD, FOR model is to hospitals, a from the develop a
Hellenic PATIENTS’ make research capital hospital interviews, we conceptual
Centre for SATISFACTI findings and an urban identified five framework
Infectious ON WITH meaningful one in Greece. categories: food, for patients’
Diseases QUALITY OF and There were 24 nursing care, satisfaction
Control, HOSPITAL generalizable1 elderly medical care, interpretation
Athens, CARE 6 . The general patients, with a room , based on
Greece goal of a mean age of characteristics, their own
grounded 70±6.02 years and quality of
theory old. The treatment/diagn care
research is to methodology osis. These five assumptions.
construct for the data categories are This is the
theories in analysis was common first step for
order to similar to the whether we the
understand one described measure elderly development
complex by Corbin and perceived of a valid and
phenomena17, Strauss for quality of reliable scale
18. The theory grounded hospital care or for
is considered theory patient measuring
grounded analysis. In satisfaction. quality of
when it is order to assure Second-level care.
validated the quality of categorization
against the our qualitative (axial coding)
data and research we included
mapped out used patients’
narratively and triangulation feelings
when states of (in-depth regarding each
transition and interviews, of the five care
intervening focus group dimensions that
conditions are and direct are the
incorporated observation). subcategories of
as well Content the previous
analysis of the categories.
interviews was These feelings
primarily could be
based on positive,
conceptual negative, neutral
analysis of the or they may feel
two main indifferent. The
concepts: final stage of
patients’ data analysis
perceived was selective
quality of care coding
and patients’ categorization
satisfaction containing
with care. direct comments
for each
category. This
third-level

34
 categorization
contains specific
dimensions of
nursing and
medical care
such as:
patients’ respect
as a human
being, staff
technical skills,
staff effective
communication,
therapeutic
touch and
empathy.

ARTICLE – 16

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

R The concept of Using Results Access is

Penchansky, access: interview data provide strong presented here

35
 J W Thomas definition and on patient support for the as a general
relationship to satisfaction, view that concept that
consumer the differentiation summarizes a
satisfaction discriminant does exist set of more
validity of among the five specific
these areas and that dimensions
dimensions is the measures describing the
investigated. do relate to the fit between the
phenomena patient and the
with which health care
they are system. The
identified. specific
dimensions are
availability,
accessibility,
accommodatio
n, affordability
and
acceptability.
Using
interview data
on patient
satisfaction,
the
discriminant
validity of
these
dimensions is
investigated.

ARTICLE –17

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

Ks Prasanna , Consumer To assess the A 27-item pre- The Recommendations

Ma Bashith, Satisfaction consumer tested availability of are required for

36
S Sucharitha about Hospital satisfaction questionnaire services and reduction of time
Services: A regarding the was given to clinical care spent in the
Study from the services 100 patients was found to pharmacy and the
Outpatient provided in (caretakers in be satisfactory. cost of
Department of our outpatient pediatric 81% of the investigations to
a Private department in patients) at the respondents improve consumer
Medical terms of end of their found the satisfaction.
College clinical care, O.P.D visit communicatio
Hospital at availability of from 3 to 4 pm n by the doctor
Mangalore services, for 5 days good, 97% of
waiting time, from the
and cost. November 7, respondents
2005 to were satisfied
November 11, about the
2005. The explanation of
items in the the disease by
questionnaire the doctor The
referred to average time
particulars of required for
the patients consulting the
such as age, doctor was
sex, 46.5 +/- 20.9
occupation, min. But when
department time spent in
requested, lab, pharmacy was
and medical considered, it
stores. While was not
analyzing, significantly
they were satisfactory.
grouped into The cost of
categories like investigation
availability, was
clinical care, significantly
waiting time, moderate or
and cost. The high in 97% of
responses were the
expressed in respondents.
proportions.

ARTICLE –18

Author/ Theoretical Research Methodology Analysis &amp; Conclusion

Date / Question(s Results s
Conceptual )/
Framework Hypothese
s

Hassan Emergency This study was Five hundred patients The study

37
Soleiman department carried out for 1 who attended our ED findings
pour, patient week during all were included in this indicated
Changiz satisfaction shifts. Trained study. The highest the need for
Gholipour survey in researchers used the satisfaction rates were evidence-
i, Shaker Imam Reza standard Press observed in the terms based
Salarilak, Hospital, Ganey of physicians' intervention
Payam Tabriz, Iran questionnaire. communication with s in
Raoufi, Patients were asked patients (82.5%), emergency
Reza to complete the security guards' care
Gholi questionnaire prior courtesy (78.3%) and services in
Vahidi, to discharge. The nurses' communication areas such
Amirhoss study questionnaire with patients (78%). as medical
ein Jafari included 30 The average waiting care,
Rouhi, questions based on a time for the first visit nursing
Rouzbeh Likert scale. to a physician was 24 care,
Rajaei Descriptive and min 15 s. The overall courtesy of
Ghafouri, analytical statistics satisfaction rate was staff,
Maryam were used dependent on the physical
Soleiman throughout data mean waiting time. comfort and
pour analysis in a number The mean waiting waiting
of ways using SPSS time for a low rate of time.
version 13. satisfaction was 47 Efforts
min 11 s with a should
confidence interval of focus on
(19.31, 74.51), and for shortening
very good level of waiting
satisfaction it was 14 intervals
min 57 s with a and
(10.58, 18.57) improving
confidence interval. patients'
Approximately 63% of perceptions
the patients rated their about
general satisfaction waiting in
with the emergency the ED, and
setting as good or very also
good. On the whole, improving
the patient satisfaction the overall
rate at the lowest level cleanliness
was 7.7 with a of the
confidence interval of emergency
(5.1, 10.4), and at the room.
low level it was 5.8%
with a confidence
interval of (3.7, 7.9).
The rate of satisfaction
for the mediocre level
was 23.3 with a
confidence interval of
(19.1, 27.5); for the
high level of
satisfaction it was 28.3

38
 with a confidence
interval of (22.9,
32.8), and for the very
high level of
satisfaction, this rate
was 32.9% with a
confidence interval of
(28.4, 37.4).

ARTICLE – 19

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

A Bowling , The Major Narrative A total of These findings

G Rowe, N measurement electronic review, semi- 20,439 titles have
Lambert, M of patients' databases structured and 266 implications
Waddington, expectations including the exploratory abstracts were for

39
K R Mahtani, for health care: British study and identified, of establishing
C Kenten, A a review and Nursing Index, surveys of GP which 211 the quality of
Howe, S A psychometric EMBASE, patients and were included health services
Francis testing of a MEDLINE, hospital in the review. and informing
measure of PsycINFO and outpatients Most research their
patients' the Applied immediately designs were improvement.
expectations Social before and weak, with Awareness of
Sciences Index after their small or the patient's
and Abstracts surgery/clinic selected met and unmet
were searched visit to samples, and a expectations
between 2000 measure their theoretical should enable
and 2009. pre-visit frame of staff to
expectations reference was understand the
for their health rarely stated. patient's
care and their The origin of perspective
post-visit questions and improve
experiences about communicatio
(expectations expectations n. This study
met and was often examined the
satisfaction absent, perspective of
with visit) (site questions were the patient
specific). frequently only; it is not
untested and possible to
those with examine the
reported extent to
reliability or which any
validity data expectations
had generally might have
mixed results. been
In the survey unrealistically
data the too high or too
expectations low. This is a
measures met challenge for
acceptability future
criteria for research.
reliability; all
exceeded the
threshold of α
= 0.70, in each
mode of
administration
and sample
type. Items
and sub-scales
also correlated
at least
moderately
with those
variables that
they were
expected to be

40
 associated
with,
supporting
their validity.

ARTICLE 20

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

M. Rajeswari Assessment of To assess the Structured PA's provide Research

Mannu Patient Patient questionnaires satisfactory concluded that
Princy A.S Satisfaction by Satisfaction of are used to care to their the role of
Physician Physician collect data patients while Physician
Assistants in Assistants in from being Assistant can
Super Super 100english courteous and be utilized in

41
 Specialty Specialty speaking respectful, the Indian
Hospital Hospital. patients who having a good healthcare
Understand were above 18 understanding sector to
evolution, role years of age. of the patient's compensate
and growth of Secondary problem, for the
physician data from the explaining to deficiency of
assistant year 1960 to patients and physicians in
professionals 2018 was using simple the healthcare
in the hospital. analyzed words that are outreach areas.
which is nontechnical
available in and have
the internet proven
database in themselves to
English be an asset to
literature is the hospital.
taken in to
account to
understand the
role. Survey
and
discussions
methods are
also used to
get updated
data from the
healthcare
team.

ARTICLE – 21

Author/Date Theoretical/ Researc Methodology Analysis &amp; Conclusions

Conceptual h Results
Framework Questio
n(s)/
Hypothe
ses

H Singh, N Patient A survey Results show that there The services in

Mustapha, E satisfaction at was is an overwhelmingly greatest need
D Haqq health centres conducted of large percentage of of

42
 in Trinidad 1500 health unemployed persons improvement
and Tobago centers in (80.4%) and women are the
Trinidad and (75.9%) among the pharmacy and
Tobago to users of health centres. doctor
evaluate the The elderly is well services,
impact of represented, with 25.4 especially
health percent of the sample through
centers on being over 60 years of reducing the
clients and age. Also, long waiting
characteristic occupational status of period. When
s of clients. family wage earners the doctors,
and educational nurses and
attainment levels of pharmacists
respondents reflect a were
disproportionately compared with
higher number from respect to
lower socio-economic "courtesy and
groupings among consideration',
health centre users. On "Skills and
the other hand, Competence'
proportions of and "advice
different ethnic and provided',
religious groups results show
among the respondents that the
bear a striking generally high
similarity to the levels of
general population of satisfaction are
Trinidad and Tobago. remarkably
Respondents appear to similar in all
be generally satisfied three cases.
with the services of the
health centres.

ARTICLE – 22

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

Dr. S. K. A Study on The study was Out of Patients attending each

Jawahar Out Patient conducted 200 hospital are responsible
MHA Satisfaction among 200 patients for spreading the good
(AIIMS), at a Super patients surveyed, image of the hospital
DNB (Health Specialty attending OPD 90-95% and therefore

43
 Administrati Hospital in of Sree Chitra of patients satisfaction of patients
on) India Tirunal were attending the hospital is
Institute for satisfied equally important for
Medical with the hospital management.
Sciences and service Various studies about
Technology, offered in Out Patient Services
Thiruvanantha the have elicited problems
puram, Kerala, hospital. like overcrowding,
India during This study delay in consultation,
the period also proper behavior of staff
from showed etc. In this study, it is
01/10/2004 to that some found that majority of
25/11/2004. of the the patients are satisfied
The patients patients with the services
were selected waiting provided. They were
randomly from time were satisfied with the
various prolonged guidance, logistic
specialties. and the arrangements, support
friendline services, nursing care,
ss of the Doctors consultation
nursing etc. Wherever, there is
staff delay in consultation, it
needs to is to be explored to elicit
be the lacunae. It is
improved. worthwhile to note that
there is scope for
improvement of the Out
Patient Department
Services. Therefore it
can be concluded that
the OPD services form
an important component
of Hospital services and
feedback of patients are
vital in quality
improvement.

ARTICLE – 23

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

Pankaj Assessment of Perception of A total of 500 Present study Present study

Kumar, patient the patients, showed 78% regarding
Anjan satisfaction in beneficiaries attending of the study patients’
Adhikari, outpatient in any different OPD population was satisfaction
Moumita department of healthcare in a tertiary satisfied with towards

44
 Ray, Rania a tertiary care setup provides care hospital the service quality health
Indu, Sangita hospital in impact for were randomly received and care concluded
Bhattacharya, West Bengal, refining the selected for an 81% opined that optimal
Anup Kumar India: a system. The observational, that clean care can be
Das questionnaire assessment of questionnaire environment provided by
based study the patients’ based was effectively combining
satisfaction on interview maintained in both medical
different issues study, initiated the hospital and social
regarding in 2016. Some premises and aspects,
healthcare predictors for different influencing the
services patients’ outpatient psychological
provides satisfaction departments. factors of the
insight about like ‘outpatient 83%, 84% and patients. A
the drawbacks department 75% of the separate
of different services’, patients were system should
healthcare ‘waiting time’, satisfied be developed
systems. This ‘cleanliness’, regarding the on assessment
could assist to ‘privacy’ and registration of “need of the
upgrade the ‘any problem process, patient” as
quality of faced during services well as guiding
services health received from the patient for
through checkup’, the doctors proper use of
different ‘overall and pharmacy, the health
interventional satisfaction’ respectively. facilities.
measures. were However,
evaluated. waiting time
was too long
and privacy
was not
maintained
properly.

ARTICLE – 24

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question( &amp;
Framework s)/ Results
Hypothes
es

Bishwalata Patient's cross-sectional A total of 751 Although the

Rajkumari, satisfaction study was patients were satisfaction

45
Polly Nula with care in a conducted among interviewed level of
government all eligible with males physician and
health facility in-patients of a constituting nursing care
in North East government health 275 (36.6%). domains were
India: A cross- care facility in Almost high
sectional study North East India one-third 244 management
during March and (32.5%) of the needs to
April 2015 using a patients were improve on the
semi-structured highly comfort and
questionnaire satisfied with cleanliness of
assessing seven the overall the wards and
domains related to care received. quality of food
patient care Patient service to
services. education bring an
Descriptive domain was overall
statistics such as unsatisfactory improvement
mean, standard for 185 in the quality
deviation, (24.6%) of the of care
percentiles, and patients. provided and
percentages were Patients to augment
generated and admitted to patients’
Chi-square test was surgery and loyalty
applied to look for allied
association departments
between the level showed a
of satisfaction and significantly
other variables such higher
as income, gender, satisfaction
age, and level (P <
department 0.001) with
admitted. Ethical care received
approval was than those
obtained from the admitted in
Institutional Ethics other
Committee. departments.

ARTICLE – 25

Author/Date Theoretical/ Research Methodology Analysis &amp; Conclusion

Conceptual Question(s)/ Results s
Framework Hypotheses

Ranjeeta Study on To Multistage The accessibility was The level of

Kumari, MZ Patient determine stratified difficult in 42% patient
Idris, Vidya Satisfaction in the areas random patients and waiting satisfaction
Bhushan, the and causes sampling was time more than 30 is severely

46
 Anish Government of low used to select min for 62.5% of deficient in
Khanna, Allopathic satisfaction the those attending the several
Monika Health among the government tertiary level health areas and
Agarwal, SK Facilities of patients and allopathic facility. The needs
Singh Lucknow suggest health satisfaction with the improveme
District, India methods for facilities of duration of the nt for the
improveme Lucknow outpatient department achievemen
nt. district and (OPD) (64.6%) and t of optimal
systematic the presence of health of
random signboards (46.6%) the people.
sampling for was also found to be
the selection low. The overall
of the satisfaction regarding
patients for the doctor-patient
the interview. communication was
more than 60% at all
the levels of health
care facilities but that
with the examination
and consultation was
less than 60% at the
primary level as
compared to more
than 80% elsewhere.
The most important
motivating factor for
the visit to the tertiary
(48.2%) and
secondary level
(71.9%, 67.1%) of
health facilities was
the faith on doctors or
health facility.

ARTICLE – 26

Author/Date Theoretical/ Research Methodology Analysis Conclusions

Conceptual Question(s)/ &amp;
Framework Hypotheses Results

Surg Lt Patient Patients' Study was JCOs Statistically

CdrAtharMo satisfaction satisfaction is conducted by predominantly significant
hdaBrigAbhij with services a useful using a pre- expressed differences
itChakravarty of the measure to structured lower have been

47
outpatient provide an questionnaire satisfaction identified by
department indicator of with 120 judgement this study
quality in samples. with several against various
healthcare and Samples were attributes. study
thus needs to further Overall attributes as
be measured stratified into satisfaction well as overall
frequently. sub- judgement impression
The aim of the populations of with towards OPD
study was to Officers, Outpatient services
analyse and Junior Department among the
compare the Commissioned services were study groups,
level of Officers rated lower by which need to
satisfaction of (JCOs) and JCOs (2.56) be addressed
patients Other Ranks when by the hospital
attending the (ORs) compared with leadership to
Outpatient including Officers and achieve
Department of dependents as ORs (3.10), consumer
a Hospital. study the difference delight.
population. being
statistically
significant.

48
 CHAPTER 3: METHODOLOGY

MATERIALS AND METHODOLOGY

This study was conducted for a period of three months January (19-2021), February, March, April(19-
2021) at KD Multi-specialty Hospital, Ahmedabad.

SAMPLE SIZE: The study sample constitutes of 400 respondent from the outpatient department. Data
collected by administering questionnaire.

STUDY DESIGN: The sampling design adopted is probability sampling in which stratified random
sampling is used. Structured questionnaire which contains of open ended questions, multiple choice and
dichotomous questions is used to get data. Therefore, Questionnaire is the data gathering instrument used

49
in this study. All the questions in the survey are formulated in such a way as to give rise to all the relevant
evidence needed for analysis.

INCLUSION CRITERIA: The departments which are included are Ophthalmology OPD, Health
Checkup OPD, General Medicine OPD. The patient or their relatives attending the OPD of the hospital.
Only the willing patients or relatives of age more than 18 years of age who consented verbally to
participate in the study were included.

STUDY POPULATION: The study was performed in a Multi-specialty hospital which provides a basic
specialties and super specialties. The out-patient departments are run by qualified doctors. The study was
conducted among patients in the outpatient department (OPD) of the Multi-specialty hospital during their
visit to the hospital. A total of 400 patients from various outpatient departments were randomly selected
by stratified sampling within three month of the study period. In order to get the specific details from the
patients, a questionnaire which was already designed by the hospital which include the questions like
waiting time, privacy, cleanliness, support and diagnostic services and any problem faced during health
check-up were given to each patient or their relatives who fulfilled the inclusion criteria.

STATISTICAL ANALYSIS: The statistical methods used to analyze the data collected are a basic
Percentages and Charts. Details for the analysis were collected using a questionnaire. The questionnaire
was distributed to a 300 group of patients and 170 patients responded to the study.

50
 CHAPTER 4

DATA ANALYSIS AND INTERPRETATION

OF DATA

DATA ANALYSIS AND INTERPRETATION OF DATA

The Results of the survey conducted, in Private Multi-Speciality Hospital are as follows.

Type of Hospital: Information collected through questionnaire is about type of hospital where Health care
services are provided. This Health care provider is Private hospital. A Private hospital is one which

is owned and governed by a person or many people who are managing the whole finances on their own.
Not just finances, even the whole funds process, administration, staff and doctors is under the control of
that private body.

TABLE1: Distribution of Respondents according to Gender

51
 GENDER No. Of PERCENTAGE
respondents (%)

MALE 128 76%

FEMALE 42 24%

TOTAL NO. OF 170

PATIENTS

This information is presented using a pie-chart diagram as shown below:

Distribution of Respondents
according to Gender
25% FEMALE
MALE

75%

INTERPRETATIONS:

From the gender part among 170 respondents, it can be seen that there is much difference among
respondents: 76% are male and 24% are female.

TABLE 2: Distribution of Age Groups according to Age Categories

Age group: For the survey the patients were divided into six categories, age wise. All respondents are
divided into 18 to 25 years and 26 to 33 years were put into young category, the respondents between 34
to 41 years were put in the middle age category and all the age groups which are 42-49, 50 - 59 years, 60
-69 years were put int the Elderly Category.

AGE GROUP FREQUENCY PERCENTAGE

18 - 25 20 12%

26 - 33 41 24%

52
 34 - 41 41 24%

42 - 49 43 25%

50 - 59 24 14%

60 - 69 1 1%

TOTAL 170

This Information is presented using clustered column diagram as shown below

DISTRIBUTANTS OF AGE GROUPS OF THE

RESPODENTS
30%
25%
20%
15%
10%
5%
0%
18 - 25 26 - 33 34 - 41 42 - 49 50 - 59 60 - 69 TOTAL

PERCENTAGE

INTERPRETATION:

The overwhelming majority of respondents are ranked from the age group of 42-49, that composes 25%
of the sample. The percentage of respondents in the group between 26-33 and 34-41 equals to 24%. The
groups of people from the age 50-59 are 14%, while 18-25 are 12%. In this, the lowest number of
respondents was from 60-69 which is 1%.

TABLE 3: Distribution of CITY of health care Centre visited by the study participants.

Area of Respondent- Here, the respondents are divided into the cities Ahmedabad, Amreli, Anand,
Dabhoi, Dhandhuka, Gandhidham, Gandhinagar, Halvad, Jodhpur, Kuli, Nadiad, Nandej, Surendranagar,
Vavol.

CITY FREQUENCY PERCENTAGE

AHMEDABAD 146 0.858823529

AMRELI 2 0.011764706

ANAND 1 0.005882353

53
DABHOI 2 0.011764706

DHANDHUKA 2 0.011764706

GANDHIDHAM 1 0.005882353

GANDHINAGAR 6 0.035294118

HALVAD 1 0.005882353

JODHPUR 1 0.005882353

KULI 1 0.005882353

NADIAD 4 0.023529412

NANDEJ 1 0.005882353

SURENDRANAGAR 1 0.005882353

VAVOL 1 0.005882353

TOTAL 170

This Information is presented using pie-diagram as shown below

54
 AHMEDABAD AMRELI
ANAND DABHOI
DHANDHUKA GANDHIDHAM
GANDHINAGAR HALVAD
JODHPUR KULI
NADIAD NANDEJ
SURENDRANAGAR VAVOL

INTERPRETATIONS:

Above PIE CHART indicates that out of 170 respondents, the highest number of patient were from
Ahmedbad and the lowest from Anand, Gandhinagar, Halvad, Kuli, Jodhpur, Kuli, Nandej, Surendranagr,
Vavol.

TABLE 4: Distribution of Respondents who took appointment for Doctor’s consultation

55
 FREQUENC PERCENTAG
Y E

CALL 100 59%

EMAIL 37 22%

FACEBOOK 1 1%

PUBLIC 1 1%
AWARENESS CAMP

SELF 3 2%

WALK-IN 25 15%

TOTAL 170

This Information is presented using BAR GRAPH as shown below

WALK-IN 15%

SELF 2%

PUBLIC AWARENESS CAMP 1%

FACEBOOK 1%

EMAIL 22%

CALL 59%

0% 10% 20% 30% 40% 50% 60% 70%

PERCENTAGE

INTERPRETATIONS:

Here, the Bar Graph shows that most patients preferred to take appointment via CALL which is shown
59% in the Bar Graph and the least was of Public Awareness Camp and Facebook which is 1%.

TABEL 5: PERCENTAGE OF RESPONDENTS ACCORDING TO DEPARTMENTS

56
 PERCE
COUN
NTAGE
T OF
DEPART OF
RESPO
MENT RESPO
NDENT
NDENT
S
S

GENERA
L
82 47.90%
MEDICI
NE

HCP 50 29.20%

OPTHAL
MOLOG 38 22.20%
Y

This Information is presented using PIE CHART as shown below

PERCENTAGE OF RESPONDENTS

22%
GENERAL MEDICINE
HCP
48% OPTHALMOLOGY

29%

INTERPRETATIONS:

This pie chart depicts that among 170 respondents, 48% were from General Medicine, 30% from Health
Checkup, 22% from Opthalmology.

57
TABLE 6:

PERCENTAGE RATE OF OVERALL SATISFACTION OF RESPONDENTS WITH HOSPITAL

SERVICES

PERCENTAGE
RATE OF
SERVICES OVERALL
SATRISFACTION
OF RESPONDENTS

DEPARTMENTAL
80.29%
SERVICES

CLINICAL SERVICES 71.83%

SUPPORT SERVICES 77.67%

This Information is presented using BAR GRAPH as shown below

PERCENTAGE RATE OF OVERALL

SATRISFACTION OF RESPONDENTS
82.00%
80.00%
80.29%
78.00%
77.67%
76.00%
74.00%
72.00%
71.83%
70.00%
68.00%
66.00%
DEPARTMENTAL SERVICES CLINICAL SERVICES SUPPORT SERVICES

PERCENTAGE RATE OF OVERALL SATRISFACTION OF RESPONDENTS

INTERPRETATIONS:

58
As shown in the graph, patients were more satisfied with the Departmental services of the hospital, while
least satisfied with clinical services.

TABLE 7:

7.1 SATISFACTORY RATE OF GENDER WITH DEPARTMENTAL SERVICES

In this table, the Departmental services which includes Registration, Maintenance, Staff Behaviour,
Privacy during test, Adequacy information, Billing counter, Tariff explanation

DEPARTMEN
GOO AVERA
TAL POOR NA
D GE
SERVICES

60.43
MALE 6.00% 0.29% 8.00%
%

19.71
FEMALE 2.71% 0.93% 1.29%
%

This Information is presented using BAR GRAPH as shown below

DEPARTMENTAL SERVICES
65.00%

55.00%

45.00%

35.00%

25.00%

15.00%

5.00%
GOOD AVERAGE POOR NA
MALE 0.6043 0.06 0.0029 0.08
FEMALE 0.1971 0.0271 0.0093 0.0129

59
INTERPRETATIONS:

This Bar Graph shows satisfaction of both male and female in the Departmental Services of the Hospital.
So,in this males have higher satisfactory rate than females.

TABLE 7.2: OVERALL SATISFACTORY RATE OF RESPONDENTS

Here, in this table the overall satisfaction of Respondents with Departmental services are shown.

AVE
DEPARTMENTAL GO PO
RAG NA
SERVICES OD OR
E

91
REGISTERATION 9% 0% 0%
%

84
MAINTENANCE 15% 1% 0%
%

95
STAFF BEHAVIOR 5% 1% 0%
%

PRIVACY DURING 88 59
53% 0%
TEST % %

ADEQUACY OF 82 76
11% 0%
INFORMATION % %

BILLING 62 25
10% 1%
COUNTER % %

TARIFF 60 28
8% 2%
EXPLAINATION % %

This Information is presented using BAR GRAPH as shown below

60
 DEPARTMENTAL SERVICES
95%
85%
75%
65%
55%
45%
35%
25%
15%
Axis Title

5%
REGISTER- MAINTE- STAFF BE- PRIVACY ADEQUACY BILLING TARIFF EX-
ATION NANCE HAVIOR DURING OF IN- COUNTER PLAINA-
TEST FORMA- TION
TION

GOOD 0.91 0.84 0.95 0.88 0.82 0.62 0.6

AVER- 0.09 0.15 0.05 0.53 0.11 0.1 0.08
AGE
POOR 0 0.01 0.01 0 0 0.01 0.28
NA 0 0 0 0.59 0.76 0.25 0.02

INTERPRETATIONS:

This graph shows that Overall number of patients was most satisfied with Staff Behaviour which is 95%,
while they were least satisfied with tariff explanation.

TABLE: 8

8.1 SATISFACTORY RATE OF GENDER WITH CLINICAL SERVICES

CLINICA
L
GOOD AVERAGE POOR NA
SERVICE
S

MALE 52.67% 6.33% 0.08% 14.83%

FEMALE 30.99% 0.02% 0.01% 7.52%

This Information is presented using BAR GRAPH as shown below

61
 CLINICAL SERVICES
55.00%

45.00%

35.00%
Axis Title

25.00%

15.00%

5.00%

GOOD AVERAGE POOR NA

MALE 0.5267 0.0633 0.0008 0.1483
FEMALE 0.3099 0.0002 0.00012 0.0752

Interpretations: Males are having a higher satisfactory rate. Female’s needs should be individually
assessed and put into consideration so their satisfactory rate.

8.2 OVERALL SATISFACTIORAY RATE OF RESPONDENTS WITH CLINICAL SERVICES

CLINICAL GO AVER PO
NA
SERVICES OD AGE OR

CONSULTATIO
94% 5% 1% 0%
N

RADIOLOGY 81% 17% 1% 0%

PHYSIOTHERA
69% 6% 0% 24%
PY

PATHOLOGY 68% 8% 0 22%

62
DIETICIAN 60% 5% 0% 29%

PHARMACY
59% 9% 0% 13%
SERVICES

This Information is presented using BAR GRAPH as shown below

CLINICAL SERVICES
85%
65%
45%
25%
5%
CONSUL- RADIOL- PHYSIO- PATHOL- DIETICIAN PHARMACY
Axis Title

TATION OGY THERAPY OGY SERVICES

GOOD 0.94 0.81 0.69 0.68 0.6 0.59

AVER- 0.05 0.17 0.06 0.08 0.05 0.09
AGE
POOR 0.01 0.01 0.24 0 0 0
NA 0 0 0 0.22 0.29 0.13

Interpretations: This is generally good overall in all the departments. To increase the rate or
percentages, we could improve on the pharmacy services.

TABLE 9:

9.1 SATISFACTORY RATE OF WITH SUPPORT SERVICES

SUPPORT GOO AVERAG

POOR NA
SERVICES D E

CAFETERIA 68% 16% 4% 12%

63
HOUSEKEEPIN
80% 13% 2% 4%
G

ATTENDANT 85% 10% 0% 5%

This Information is presented using BAR GRAPH as shown below

SUPPORT SERVICES
85%
75%
65%
55%
45%
35%
Axis Title

25%
15%
5%
GOOD AVERAGE POOR NA
CAFETERIA 0.68 0.16 0.04 0.12
HOUSEKEEPING 0.8 0.13 0.02 0.04
ATTENDANT 0.85 0.1 0 0.05

Interpretations: Housekeeping is very good, mainly needs improvement on the café department.
Improving on the hygiene and making sure it is clean would be beneficial in the long run for dietary
requirements for everyone.

Table 10: OVERALL COUNT OF NPS

COUN
NPS T OF
NPS

AVERAGE( 4
7)

64
AVERAGE
25
(8)

BEST(9) 86

BEST(10) 51

NIL 2

OVERALL COUNT OF NPS

NIL

BEST(10)

BEST(9)

AVERAGE (8)

AVERAGE(7)
5 15 25 35 45 55 65 75 85 95
AVERAGE(7 AVERAGE BEST(9) BEST(10) NIL
) (8)
COUNT OF NPS 4 25 86 51 2

INTERPRETATIONS:

This graph shows that 86 respondents have rated the overall services with 9 NPS out of 10, while 4
respondents gave 4 NPS out of 10 and 2 respondent were not interested to rate it.

TABLE 10.1:

COMPARISON RATE OF GENDER WITH NET PROMOTER SCORE

NPS AVERAGE AVERAGE BES BES NIL

65
 T
(7) (8) T (9)
(10)

FEMA 5.29 14.12 0.59

2.35% 2.35%
LE % % %

24.71 36.47 0.59

MALE 0.59% 12.94%
% % %

This Information is presented using BAR GRAPH as shown below

COMPARISON RATE OF GENDER WITH

NET PROMOTER SCORE
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
AVERAGE(7) AVERAGE(8) BEST (9) BEST (10) NIL

FEMALE MALE

Interpretations: This graph results signifies likeliness of recomnedning services to friends and family.

PARETO CHART

SR REASONS FOR COUN CUMULATI CUMULATIVE %

. DISSATISFACTI T VE

66
NO
ON PATIENT
.

1 WAITING TIME 16 16 22

HOUSEKEEPING
2 11 27 38
SERVICES

3 MANAGEMENT 10 37 52

4 CAFETERIA 8 45 64

DIAGNOSTIC
5 7 52 74
SERVICES

BILLING
6 5 57 81
PROCESS

STAFF
7 5 62 88
BEHAVIOR

8 PROCESS FLOW 4 66 94

DOCTOR
9 3 69 98
INTERACTION

10 MAINTENACE 1 70 100

TOTAL 70

67
 120

100 98 100
94
88
80 81
74
64
60
52

40 38

20 22

0
E ES T A ES S CE
M IC EN RI IC ES I OR OW IO
N
TI V E V OC AV FL T EN
A
G R EM ET R AC
IN SE AG CA
F SE PR EH S S
ER NT
AI
T C G B CE T AI
NG AN ST
I IN AF
F O IN M
W PI M O ILL PR R
E B ST O
E KE
A GN CT
US DI DO
HO

Series1 Series2

INTERPRETATIONS:

This Pareto Chart shows that among all the reasons of dissatisfaction Waiting time, Housekeeping
services, and Management contribute to a lower satisfactory rate among respondents. 20% of the causes
contribute to high rate of dissatisfaction.

68
DISCUSSIONS:

The present study attempted to assess the satisfaction of the patients with regards to various aspects of
health care services provided in a multi speciality care hospital in Ahmedabad. The results of the study
indicate that most of the respondents interviewed were satisfied with the services they received. Very few
similar studies have been done and therefore there is lack of data for comparison. Measuring patient
satisfaction has many purposes. Such interviews help to evaluate health care services from the patient’s
point of view, facilitate the identification of problematic areas and help generate ideas towards resolving
these problems. Despite a good level of patient satisfaction, a small, but by no means insignificant,
proportion of patients expressed least satisfaction towards certain OPD services. The fact that patients
expressed least satisfaction with the services indicates that hospital administration needs to do more in the
drive towards improving services.

Total experiences of 170 patients were computed to determine their experiences regarding different
services provided by the OPD of Medicine department. The patient with good experience showed high
level of satisfaction as compared to those who had poor experience with satisfaction. The patients had the
highest level of experience from Medicine department OPD about helpfulness of staff, about
departmental, clinical and support services inside the OPD. The poor experience was from the waiting
time for taking housekeeping and management services in OPD and about the diagnostic place.

Component wise patients had good experience from all the components but for doctors services the
patients had the highest level of good satisfaction while highest level of poor satisfaction was from
pharmacy services.

Regarding departmental services, which includes Registration, Maintenance, Staff Behavior, Privacy
during test, Adequacy of information, Billing counter, Tariff explaination services majority of the patients
were mostly satisfied with it. According to the result of the study, 80% of patients had good accessibility
towards departmental services of OPD.

The higher the accessibility higher will be the satisfaction level of the patients. The support services of
hospital which are cafeteria, housekeeping, and attendant , patient were 77.67% satisfied with it. This
shows that 22.33% were dissatisfied with this services.

The least satisfaction was with clinical services of the hospital which is 71.83%. Here, individually
patient were mostly satisfied with consultation services and least with pharmacy sevices.

69
SUGGESTIONS AND RECOMMENDATIONS

70
SUGGESTIONS AND RECOMMENDATIONS:

Patient satisfaction depends upon many factors such as:

❖ Quality of Clinical Services Provided,

❖ Availability of Medicine,

❖ Attitude,

❖ Behavior of Doctors and Staff,

❖ Cost of Services,

❖ Hospital Infrastructure,

❖ Physical Comfort,

❖ Emotional Support and Respect for Patient Preferences.

Scope for Improvement and recommendations:

1. Internal environment plays very vital role in patients ‘satisfaction. Pleasant internal

environment helps to rejuvenate patients and their relative.

2. There should be proper signage system, name boards, direction signs of various Service areas.

Practical suggestion: For example, In Health checkup Department, the Directional Map should be made
of individual services so that the process of patient gets proper and easy and Departmental signanges in
Local Language.

3. OPD should have strong coordination between different departments of the hospital.

Practical suggestion: Healthy relationships between department heads can have a significant influence
on how well team members collaborate and it’s important to create a culture of collaboration within the
leadership team.

To initiate periodic meetings with each departments to understand their progress and challenges, while
helping each other brainstorm ideas and problem-solve.

To Encouraging feedback can help empower team members, thus contribute to streamlining and
improving processes and collaboration between departments.

4. Healthcare providers have to be very proficient and wise about their work to become a leader of the
team for quality improvement in healthcare organization.

71
5. Patient confidence in the doctor will increase if providers have the knowledge of work they are
performing.

Practical Suggestion: The executives must know the overall of the services of their individual OPDs
department. For that, weekly meetings with the consultation doctor to get to know the services and new
ideas of the individual services.

6. Healthcare providers must involve themselves in setting standards, monitoring and addressing
problems this should be done in an orchestrated manner incessantly and applied to all aspects of
healthcare.

Practical Suggestion: Get Involved In Other Departments Processes

- Unnecessary frustrations can be avoided if teams are involved in the other departments processes while
to ensure that the solution proposed by one team is in alignment with the overall strategic vision and can
be supported by the capability of other departments.

- To have collaboration between departments by scheduling formal team check-ins, interdepartmental

reviews as well as encouraging informal “touch base” among team members.

7. Leaders of healthcare team prepare guideline for improvement and supervise to ensure effective
implementation of quality and better healthcare services.

8. Healthcare providers show commitment in outpatient department hold meetings, to solve issues
regarding patients and staff for better quality and improve services of outpatient department.

9. The behavior of staff should instill confidence among the patients and their relatives. Full attention
should be given to the patients’ health and it should be monitored regularly. Patients should feel that they
are the most important and their health and well-being is the top most priority of the Hospital.

Practical Suggestion: Incorporate effective communication in your organization’s mandatory training

program.

- Schedule regular monthly meetings with your staff to discuss patient survey feedback and areas of
strength and weakness. This provides the opportunity for employees to share their thoughts and ideas for
improvement in a group setting, which encourages collaboration and open exchange of information.

10. Health care providers must also build a trusting relationship with the patients. The objective is to
provide goal the best option to the patients so they can go back into their pain free daily lives.

11. Patients’ feels that more time has been given to them and treatment should be much quicker than what
it was earlier. Waiting time at registration counter must be reduced.

Practical Suggestion: More focusing on doctor commitments to their appointments. Adjustment doctors
operations' time with his clinic to avoid the delay

-Keep Patients Informed of Wait Times

72
- Estimated wait times on a screen in the waiting room of the OPDs.

12. Doctor patient relationship is very important in delivering high quality of care to patients in all health
care settings it depends upon multiple factors like behavior of doctors, clinical services provided to
patients, physical comfort and cost of services.

13. Management should organize meetings and workshops with front desk staff to investigate the reasons
of resistance and bottlenecks and delays can be discussed. These discussions also highlight the areas
overlooked by management which will also lead to making improvement in an effective change system.

14. Outpatient department have to evaluate the healthcare providers’ participation in outpatient
department. Their services have to be measured and are taken into account to promote and improve
quality of patient. There is always a room for improvement in health care services which is provided by
the professionals.

The hospital outpatient facility amongst the medical services qualities is an important factor in Private
Hospitals and thus dissatisfying this requirement of patients will lead to patient dissatisfaction, but
achieving this process will lead to greater patient satisfaction. Patients visiting a particular hospital for the
first time are completely ignorant about the hospital infrastructure and working and hence are mislead due
to insufficient information on the formalities connected with the visit or admission to the hospital.
Hospitals must design patient oriented registration procedures and examination processes. Thus, hospitals
must establish schemes to simplify appointment, payment, and examination processes.

73
CONCLUSIONS:

The study on the patient satisfaction is an effective mean of evaluating the performance of the hospital
from the view of the patient. The information obtained through this type of study is valuable to overcome
the discrepancies so as to make this hospital and Medicine department OPD more attractive for patients.

A descriptive study was undertaken to assess Patient Satisfaction with Outpatient Department of the Multi
speciality Hospital. The study was conducted in feedback sample of 170 patients. Based on the findings
of the study the following conclusion were drawn. Study shows that the patients were least satisfied with
the Waiting time in the OPDs, Housekeeping Services and Management services. These least satisfied
services should be considered as point of improvement of overall satisfaction level. These findings can be
explained by the fact that increasing modern era demands and awareness of healthcare seekers push the
medical care providers to deliver quality hospitality and related facilities to succor them. Appropriate and
on-going data collection and analysis could be guide more efficient utilization of outpatient services to
achieve better outcomes.

74
REFERENCES:

1. (PDF) Patient's satisfaction with care in a government health facility in North East India: A cross-
sectional study ([Link])

2. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj-
iYbEt4fwAhVdyDgGHUiPDKoQFjAAegQIBhAD&url=https%3A%2F%[Link]
%2Fpmc%2Farticles%2FPMC3047732%2F&usg=AOvVaw3r6XLEmQ4aPuzTK-84lkzw

3. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiLyJjat4fwAhW0wTgGH
QyfDbsQFjAJegQICRAD&url=https%3A%2F%[Link]%2Farticle%2Fpmc
%2Fpmc3047732&usg=AOvVaw2-hMf_VhmMTV5PfXwlLzoL

4. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwisgYPtt4fwAhXs3jgGHdb
_B6YQFjABegQIAhAD&url=https%3A%2F%[Link]%2Fessay%2FDermatological-Practice-
Case-Study-FKRPPY36JE86&usg=AOvVaw1Jflm7m-tj2bS8fLSumT3N

5. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjCsJyHuIfwAhWXxDgG
HcyVCVYQFjACegQIBBAD&url=https%3A%2F%[Link]%2Fwp-content%2Fuploads
%2F2019%2F04%2FDALIA-SARKAR-PROJECT-SGCCRI-PATIENT-
[Link]&usg=AOvVaw1tNoZIdjw_v6PeWcBapEV4

6. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjNkI-
huIfwAhVMzzgGHSPDD2AQFjAAegQIBhAD&url=https%3A%2F%[Link]
%2Fvision_mission.html&usg=AOvVaw1c__Yf5MhLGxOep87U1HCt

7. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwifrIKwuIfwAhWZwzgGH
VU3Bl0QFjAAegQIBBAD&url=https%3A%2F%[Link]%[Link]%2Fijcmph
%2Farticle%2Fview%2F629&usg=AOvVaw1twm_i7h_IotX31rz0F4xJ

8. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiS9N_EuIfwAhWrILcAH
d6MBAUQFjABegQIBhAD&url=https%3A%2F%[Link]%2Fjournals%2Fijd
%2F2020%2F6621848%2F&usg=AOvVaw0w8ci8IVwUzow2dw1gbDnY

9. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiHhPPPuIfwAhXlmuYKH
Tb-AU4QFjABegQIBBAD&url=https%3A%2F%[Link]
%2F27004489%2F&usg=AOvVaw0vLwOYZ1tZPttnVmuIIDZw

75
10. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwimgOjYuIfwAhUdIbcAH
UCGDiwQFjABegQIBBAD&url=https%3A%2F%[Link]
%2F26187638%2F&usg=AOvVaw3v6Q8lnZgZhN8BZ_Wu7Wvg

11. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjkpZPkuIfwAhU183MBH
YQuArMQFjAAegQIBRAD&url=https%3A%2F%[Link]%2Fpmc%2Farticles
%2FPMC4213903%2F&usg=AOvVaw3tfm22B3xssEZ--PIonLyG&cshid=1618736894587351

12. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjclO_3uIfwAhUd8HMBH
crrAP0QFjABegQIAxAD&url=https%3A%2F%[Link]%2F2071-
1050%2F12%2F4%2F1612%2Fhtm&usg=AOvVaw2mrcxIK-xac6mxp4b3WWKe

13. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjYntGBuYfwAhUs6XMB
HcmBDw0QFjABegQIAhAD&url=http%3A%2F%[Link]%2Fuploads%2F5-2_199-
[Link]&usg=AOvVaw2Q9_9AoHTQYHOvTVw0JH8T

14. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiAwaqLuYfwAhUP73MB
HeB8Bv8QFjAAegQIAhAD&url=https%3A%2F%[Link]%2Fpublication
%2F260041460_Patient_satisfaction_OPD_services_in_a_tertiary_care_hospital_of_Lahore&usg=AOvV
aw30WFWDP_CX3eeDbOwJ2U5b

15. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj8y72WuYfwAhVI5nMB
HYKtDuYQFjAAegQIAxAD&url=https%3A%2F%[Link]
%2F21715557%2F&usg=AOvVaw1ncnSjOOlkTx3xPAyO8fQD

16. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj3ufafuYfwAhUUILcAHf
6yBkUQFjAAegQIAxAD&url=https%3A%2F%[Link]%2Fpublication
%2F327918760_Patient_Satisfaction_With_Health_Care_Services_In_Outpatient_Department_Of_A_D
ental_College_Hospital_In_Pakistan&usg=AOvVaw3_6msbehwO7MZSVcBi12B-

17. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwilj8WpuYfwAhUe8HMB
HZbpCgoQFjAAegQIAxAD&url=https%3A%2F%[Link]%2Fgradreports
%2F32%2F&usg=AOvVaw0tYOYY6Y3KT_8r6ye0KXXJ

18. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjf6MexuYfwAhXB7XMB
HeyIDSUQFjADegQIBBAD&url=https%3A%2F%[Link]%2Ffactors-of-patient-
satisfaction-in-adult-outpatient-departments-%2F17415772&usg=AOvVaw2wl34M3PCfFkSN04gbGdrY

76
19. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjd6568uYfwAhXyX3wK
HQg-CRoQFjABegQIBRAD&url=https%3A%2F%[Link]%2Fpaper
%2FPATIENT-SATISFACTION-ABOUT-HEALTH-CARE-SERVICES%253A-A-Joshi-Sochaliya
%2Fe24af31a557e8ee59ac4d07eb82eb3fe3fc507eb&usg=AOvVaw3PA2F1X3yhkD3Q8mMhJI7E

20. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj_xsnFuYfwAhWcgtgFHe
vZDlcQFjADegQIBRAD&url=https%3A%2F%[Link]%2Fpublication
%2F49610979_The_Mediating_Effect_of_Patient_Satisfaction_in_the_Patients
%27_Perceptions_of_Healthcare_Quality_-_Patient_Trust_Relationship%23%3A~%3Atext%3DFinding
%2520indicate%2520that%252C%2520while%2520patient%2Csignificant%2520impact%2520on
%2520patient%2520trust.&usg=AOvVaw1VJQnxxt653Uh1F7eQU7hb

21. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjm28bQuYfwAhXv7XMB
HcrhAXIQFjACegQIBBAD&url=http%3A%2F%[Link]%2Fbitstream
%2F10488%2F269%2F3%2FRAFTOPOULOS%2520GROUNDED%2520THEORY
%[Link]&usg=AOvVaw2ALyujcYnJItBqdn4CzLh4

22. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjy08jauYfwAhUkgtgFHR
ENA1QQFjAAegQIBRAD&url=https%3A%2F%[Link]
%2F7206846%2F&usg=AOvVaw3op2C59-zaUiFazPW3HYFE

23. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjSzJbiuYfwAhXN9nMBHegcBwUQFjACeg
QIBhAD&url=https%3A%2F%[Link]%[Link]%3Fissn%3D0970-0218%3Byear
%3D2009%3Bvolume%3D34%3Bissue%3D2%3Bspage%3D156%3Bepage%3D159%3Baulast
%3Dprasanna&usg=AOvVaw227FN5zVSmATyIr_cqUtZ3

24. [Link]

25. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiAy_T2uYfwAhXEumMGHcNwA2IQFjAB
egQIBhAD&url=https%3A%2F%[Link]%2Fbooks
%2FNBK99051%2F&usg=AOvVaw0__2YdpoNbXZix2Jlr1Kci

26. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiftZqBuofwAhWN4zgGH
eySDUkQFjABegQIBBAD&url=https%3A%2F%[Link]%2Fwp-content%2Fuploads
%2Fpapers%2Fv8i6%[Link]&usg=AOvVaw1rrtcT7jusjS4e9mkl_Ozg

27. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjlgMGJuofwAhVPzzgGH
WH7ClAQFjADegQIAhAD&url=https%3A%2F%[Link]%2Fpublication
%2F12970413_Patients

77
%27_perception_and_satisfaction_with_health_care_professionals_at_primary_care_facilities_in_Trinida
d_and_Tobago&usg=AOvVaw2E4snM_5vTcfvDqCQIG2WF

28. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj7-
66UuofwAhU2zTgGHeDADjMQFjABegQIBRAD&url=https%3A%2F%[Link]
%2Fpaper03_jul-[Link]%23%3A~%3Atext%3DA%2520Study%2520on%2520Out%2520Patient
%2520Satisfaction%2520at%2520a%2520Super%2520Specialty%2520Hospital%2520in%2520India
%26text%3DPatients%2520and%2520staff%2520satisfaction%2520is%2Cin%2520this
%2520competitive%2520modern%2520era.%26text%3DOut%2520of%2520200%2520patients
%2520surveyed%2Cservice%2520offered%2520in%2520the
%2520hospital.&usg=AOvVaw2eonN7x0X3WL_i-u6UPzxH

29. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjXkqScuofwAhWEzDgG
HYDlAw4QFjAQegQIExAD&url=https%3A%2F%[Link]%[Link]%3Fissn%3D2249-
4863%3Byear%3D2017%3Bvolume%3D6%3Bissue%3D3%3Bspage%3D538%3Bepage
%3D542%3Baulast%3DDharmasivam%3Btype%3D3&usg=AOvVaw0u-7LCA7aSkrG4bH1cf7h8

30. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjTsKqmuofwAhX5zTgGH
a-VAyYQFjAAegQIBhAD&url=https%3A%2F%[Link]%[Link]%3Fissn%3D0972-
4958%3Byear%3D2017%3Bvolume%3D31%3Bissue%3D2%3Bspage%3D94%3Bepage
%3D98%3Baulast%3DRajkumari&usg=AOvVaw1xOgGtaE3Dk0JPnHE_B3Dp

31. [Link]
sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjo1dmvuofwAhXWxzgG
HVRPBg4QFjAAegQIAxAD&url=https%3A%2F%[Link]
%2F19876453%2F&usg=AOvVaw3V05eDDu9srI3ynPwdtOAA

78