Assessment of Service Quality Provided at Al Naser Ophthalmic Hospital
Amani Akram Habib
اماني اكرم حبيب
Performance assessment is just the starting point for quality improvement, inspire raising questions, improving data collection procedures, understanding results, and identifying actions for improvement. It should be embedded in a comprehensive quality improvement strategy and used as a quality management tool for the evaluation and improvement of hospital services. This is the first study aims to assess the current service quality provided at Al Naser Ophthalmic Hospital (NOH). The study appraises service quality from staff, patients and managers perspectives, explores quality performance standards at NOH and assess quality of provided services using Performance Assessment Tool for Quality Improvement in Hospitals (PATH). Moreover it identifies strengths and weaknesses areas in the light of quality performance indicators, and provide NOH with a flexible and comprehensive framework for the assessment of hospital performance. The study is a quantitative and qualitative cross sectional analytical descriptive one. The target populations was the working staff, discharged patients, key managers, and medical records at the hospital. Main study's tool was PATH with sub dimensional modifications. Different sub-tools were used. Self administered questionnaire, designed for staff where instrument reliability test (Cronbach’s Alpha) was high; ranged from (0.924) to (0.848), with 85.83% response rate (103 employee). Questionnaire designed for discharged patients' interviews where instrument reliability was moderate and ranged from (0.705) to (0.611), with 92% response rate (230 patients). Questions for mangers discussion group(5 key managers). Final tool was records review for hospital statistics and annual reports and 3checklists for (350) patients' files (inpatients' files and outpatient's files). Statistical Package for the Social Sciences Program (SPSS) has been used for data analysis. The study revealed different strengths and weakness areas regarding sub dimensional indicators. Clinical effectiveness and safety showed strengths areas regarding good effective visual outcome of cataract surgeries and low 30 day readmission rate (0.96%), while indicators flagged with inadequate effectiveness was reported in ECCE to Phaco rate, rate of intraoperative acquired infections (acute endophthalmitis rate), low day surgery rate (8.92%). Documentation indicator showed good results regarding cataract surgical file, while moderate results regarding files for patients whom admitted for medical treatment were reported. Moreover outpatient glaucoma files showed weaknesses regarding documentation of essential measures and parameters. Efficiency dimensions showed inefficient service in respect to rate of attendance to appointments (63.31%), while surgical cancellation rate was accepted (16.14%), and high efficient care regarding low length of stay (2.25 days). Responsive governance dimension showed that quality improvement was included at NOH's structure, but performance indicators and measurements were inadequate, while good responsive quality activities was reported regarding patients and provided service and less responsiveness for staff needs. V Staff orientation dimension showed many weakness areas regarding lack of training expenditure, inadequate work conditions regarding (enabling healthcare/work circumstances managerial practices, and training) from staff perspectives, while (72.4%) exposed to work related injuries and safety related practices was not fair enough to keep staff safe during care delivery. Moreover high burnout status was reported among about half of NOH's staff regarding emotional exhaustion domain and depersonalization. Strength areas reported regarding low rate of excessive working hours, low turnover rate, and low absenteeism rate among the majority of staff members . Patient centerednes dimension reported strengthens areas where patient perspectives showed adequate access to care and adequate meeting of expectations. The status of service quality at NOH is acceptable, but it still needs efforts to enhance the situation through developing a culture of measurements and using of performance indicators, monitoring, and continuous quality improvement. In addition NOH management has to enhance responsiveness regarding staff as well as for the patients to provide high quality care.