Measuring service quality at a university health clinic

Describes research undertaken to assess the quality of service provided by a public university health clinic. The SERVQUAL instrument was administered to patients of the University of Houston Health Center in order to evaluate customer perceptions of service quality. The results of this study are currently being incorporated into the clinic's strategic planning process, specifically with respect to future resource allocation towards quality improvement projects.     

Factors influencing default at a hospital colposcopy clinic.

OBJECTIVE--To identify factors reducing compliance at diagnosis, treatment, and review stages among women referred with abnormal cervical smears to a hospital colposcopy clinic. DESIGN--Retrospective analysis of sociodemographic data from hospital notes of the attenders and defaulters during one year (1989-90) and prospective collection of information by structured interviews of a sample of defaulters and attenders during five months (May-September 1990). SETTING--One hospital colposcopy clinic. PATIENTS--238 women defaulting on two consecutive occasions and 188 attending regularly (retrospective analysis) and a subset of 40 defaulters and 24 attenders (interview sample). MAIN MEASURES--Sociodemographic data and interview responses about attitudes, behaviour, choice, accessibility cultural understanding, communications, and emotional response. RESULTS--22 (12%) women defaulted at diagnosis, 24(13%) at treatment, 39(21%) at the first check up after treatment, and 84(45%) at the review stage; 19(10%) defaulted from the first check up after diagnostic examination revealed no need for treatment. Age and social class differed between the two groups. 181(76%) defaulters were under 30 compared with 91(48%) attenders; 14(6%) compared with 41(23%) were over 40(p < 0.001). The proportion of women in social classes 4 and 5 was 33%(20/60) for defaulters and 21%(25/120) for attenders (p < 0.05) and unemployed was 66%(158/238) and 36%(68/188) respectively. 63(28%) defaulters were pregnant compared with 11(6%) attenders (p < 0.001). More defaulters came from gynaecology or antenatal clinics. Most defaulters (93%) had child care responsibilities and they knew and understood less about colposcopy. Their explicit reasons for defaulting included child care commitments and fear and their implicit reasons lack of understanding, inaccessibility of information, and staff attitudes. CONCLUSIONS--Compliance may be improved by promoting women's understanding of treatment and encouraging health professionals to develop a service more sensitive to the various needs of women in different socioeconomic groups.     

Logistical function and quality control in a hospital service

The characteristics of Logistical Function are studied, and are applied to controlling the quality of attention in a Medical service of a Hospital. Three variables were studied: number of annual admissions, average stay and DRG coefficients. The unit of time employed was the period of one year. Within the parameters that define this Function, the value K denotes the maximum capacity of yield of the Service in relation to the studied variable. The exponential factor b is the indicator of the ascending or descending course of the variable, which is qualified by the absolute value of the same, as much in one sense as in the other. It is essential, to be able to apply this procedure, that the human and material resources of the service under study do not vary during the entire period of observation.     

Emotional reactions in women attending a UK colposcopy clinic.

STUDY OBJECTIVE--To assess the emotional responses of women attending a colposcopy clinic for investigation of an abnormal cervical smear, and to elicit the women's views on the screening service and colposcopy clinic. DESIGN--Over 12 months all new attenders at a colposcopy clinic were invited to join the study. They were assessed psychiatrically four weeks before their first clinic appointment, and four weeks and 32 weeks after their first clinic appointment. SETTING--Colposcopy clinic, John Radcliffe Hospital, Oxford. PATIENTS--Of 114 women attending the colposcopy clinic for investigation of an abnormal cervical smear, 102 agreed to enter the study. MEASUREMENTS--Psychiatric symptoms were assessed with a standardised psychiatric interview, the present state examination; and with four self rated mood scales:--the general health questionnaire, the Beck depression inventory, the Leeds depression scale, and the Leeds anxiety scale. MAIN RESULTS--On all these measures, in the whole patient group, psychiatric morbidity was found to be transient and relatively minor. Thus ratings on the present state examination were not significantly higher than the rate found in a community sample of 520 women in Oxford, while on the four self rated mood scales, mean total scores were lower than the cut off value used to distinguished cases. Patient satisfaction with the colposcopy services was generally high but there was some dissatisfaction with delays. CONCLUSIONS--After an abnormal cervical smear, further investigation by colposcopy is generally associated with low levels of anxiety and depression.     

Hemosorption service in a clinic

The validation of the advisability of establishing an emergency detoxication service in Minsk is provided. It is demonstrated that the establishment of such a service made it possible to significantly improve the outcomes of treatment in patients with severe endotoxicosis of different genesis.     

实施ISO9000质量管理体系提升医院服务质量

建立医院质量管理体系是实现质量现代化管理的必由之路,是贯彻执行法律法规的保障。通过规范内部管理,对涉及医院质量管理的每一个细节都进行有效监督,并以预防为主,达到满足顾客需求和持续改进的目的。     

Measuring the quality of junior hospital doctors in general medicine

During the course of a larger study aimed at relating staffing levels of junior doctors in general medicine to the safety of the care provided, it became clear that consultant doctors considered the quality of their junior staff as being at least as important as the quantity. This paper describes several attempts to develop a feasible and valid method of measuring the quality of senior house officers (SHOs) and registrars using routinely available data. Having rejected three methods and had difficulties with three other methods, a modified Delphi survey was used to explore the extent to which consultants agreed on the key attributes of a high quality SHO or registrar. Sixty-seven (60%) of all consultants in the South-West Thames and Trent regions responded to two rounds of questionnaires which revealed communication skills as being consistently the most significant factor. This was confirmed in a second, anonymous survey of 198 (78%) SHO and registrar posts in the North-West Thames region. It also became clear that consultants viewed the quality of their own SHOs and registrars as generally high. This being so it is argued that the requirement to adjust for quality, when comparing SHO and registrar levels between hospitals, is of minor importance. These results also suggest that the explicit teaching of communication skills should have a high priority in undergraduate and postgraduate education.     

Measuring service quality provision within an eating disorders context

Traditionally, research concerning quality measurement and improvement has centred on manufacturing and industrial sectors. In the last decade, however, the focus has turned to the measurement of quality in services and more recently to healthcare. In today's progressively competitive health-care environment hospitals increasingly realise the need service quality as a means to improve their competitive position. The aim of this study is to assess the service quality provision of a leading UK-based eating disorder service provider, achieved through the development and application of the SERVQUAL research instrument for measuring service quality. Following thematic analysis of service user feedback, six dimensions of service quality were identified and mapped on to the P-C-P attributes model. The approach adopted for this case study research may usefully inform service assessment programmes for similarly positioned health-care service providers.     

Measuring hospital output: a review of the service mix and case mix approaches

This paper presents a survey of the literature on the definition and measurement of hospital output concentrating on those studies that have used either 'service-mix' or 'case-mix' as their basic output measure. The service-mix approach is described as a supply side analysis in which the nature of a hospital's output is determined by the character and range of its facilities and services. In contrast, the case-mix approach is essentially a demand side analysis which regards each hospital's case load as being determined by the needs and demands of the population served, with facilities and services the dependent variables. It is also argued that hospital output measurement has rarely been tackled directly. Typically such work has been secondary to the principle research objectives which have related to the study of hospital cost structure and economies of scale. The units developed have been, for the most part, partial measures which satisfy the requirements of their particular investigators but which, until recently, have had little potential for wider application. The call for more effective cost control in health care through reimbursement systems and review procedures, particularly in the United States, has led to an upsurge of interest in hospital output measurement and to a consequent improvement in techniques.     

优质护理服务在医院感染控制中的作用

目的探讨优质护理服务在医院感染控制中的作用。方法 2010年3月在全院开展以加强组织领导,更新服务理念,落实制度职责,强化基础护理为重点内容的"优质护理服务示范工程"活动;对2009年3-9月及2010年3-9月医院感染管理各项监测记录进行分析,比较活动前后医院感染控制质量。结果活动后医院感染率下降3.28%,医务人员手卫生执行率上升了29.88%,环境卫生学监测合格率上升了3.37%。结论开展优质护理服务对医院感染控制工作有很好的促进作用。     

The operation, quality and costs of a district hospital laboratory service in Malawi

Laboratory services are run down in many low-income countries, severely constraining their input to patient care and disease surveillance. There are few data about the quality and cost of individual components of the laboratory service in poorer countries, yet this information is essential if optimal use is to be made of scarce resources. Staff time, range of tests, workload, and safety procedures were monitored over 12 months (1997-98) in a typical district hospital laboratory in Malawi. Data were collected to calculate the total economic cost of these services. Of the 31203 tests performed, 84% were to support blood transfusion and diagnosis of malaria and tuberculosis (TB). Test quality was reasonable for malaria and TB microscopy and blood transfusion, but poor for haemoglobin estimation. The cost per test ranged from US dollars 0.35 for haemoglobin to US dollars 11.7 per unit of blood issued and the total annual cost of the laboratory service was US dollars 32618. Blood transfusion and microscopy for malaria and TB comprised the majority of tests. Ensuring that these tests are of the highest quality will therefore have the most impact in reducing wastage of laboratory resources. Inadequate quality of haemoglobin estimations is a particular problem. The findings of this study are likely to be relevant to other low-income countries with similar disease burdens.     

试论医院服务质量的评价与保障

作者就医疗服务质量评价进行分类阐述；(1)疗效与副作用；（2）生存质量；（3）质量调整生存年；（4）成本效果比；（5）医疗措施的适宜性；（6）病人满意度。随后就从抓行业作风等来职工医疗服务质量进行了分述。一是认真东实各项纠风措施；二是保持医院信息的的真实可靠；三是落实以病人为中心的理念；四是服务质量与行业作风同步评价；五是形成行风建设与质量与评价的良性机制。     

医院分质供水设备方案设计

论述了医院分质供水设备设计方案的设备功能定位及应遵循的各类水质标准。为实现速一目标。采用多种当代膜技术集成的制水工艺，并通过合理的分段取水，实现分质供水，满足不同的用水质量标准。医院分质供水设备有利于节能、节水，并便于管理。