Baseline patient satisfaction survey in 266 clinics located in three health districts of the Eastern Cape: Amathole, OR Tambo and Chris Hani

Abstract

Background: The Eastern Cape Department of Health commissioned the Human Sciences Research Council (HSRC) to conduct Patient Satisfaction survey in order to assess patient perceptions, expectations and satisfaction with services.

Aim: To conduct patient satisfaction survey in 275 clinics located in 3 health districts i.e. Amathole Health District (87), Chris Hani (108) and O.R. Tambo (80 clinics) using the DHIS client satisfaction survey module to monitor the satisfaction levels of the customers and also to identify quality issues for continuous quality improvement initiatives.

Methods: A descriptive study was conducted involving a purposive sample of 19136 patients from 266 clinics based in Amathole, Chris Hani and OR Tambo District Municipalities. Data was collected by trained local fieldworkers using an adapted version of the Health System Trust (2004) Patient Satisfaction Survey questionnaire and a widely used and standardised 23-item EUROPEP instrument to tap information on the quality of primary care in the past 12 months (Grol & Wensing, 2000). Data was captured on Excel and exported to the DHIS and SPSS version 16 software and analysed.

Summary of Results:

Access to services: More than 30% of the respondents took longer than one hour to get to the clinic and paid >R10-00 to get to the clinic. More than 60% of the respondents agreed that: the clinic had convenient opening hours, they did not pay money to be treated, the nurse who treated them spoke in a language they could understand, the clinic was user friendly for disabled persons and that the nurse tried to get an appointment to suit them. More than 50% indicated that the health worker was neither accessible/did not speak to the health worker through the phone.

Empathy: More than 60% of respondents agreed that: the nurse or doctor who treated them introduced him or herself, they were also able to answer all the questions they had regarding their illness, gave permission to be examined and treated, their privacy was respected by all staff, the nurse or doctor who treated them was polite, nurses were very interested in their clients and their personal situations as well as made it easy for clients to tell them their problems.

Standards: More than three-quarters of the respondents agreed that the standards of service were good in as far as registration procedures, fast queues, health worker identification tag and the display of required documents on the walls are concerned. However, more than 30% did not know where and to whom to raise their concerns, did not write and put their complaints in the suggestion box provided, did not receive feedback when they complained, did not know the chairperson/member of the clinic committee of their facility. Almost 60% agreed that raising complaints improve services.

General Satisfaction: More than 90% indicated that they will come back next time, they were pleased with the way they were treated in the facility and they would tell their friends to come to the facility if they fell sick. About 80% - 89% indicated that they always get treatment when they visit the facility and staff was helpful. About 70% -79% indicated that their treatment is always better if they get an injection, staff informed clients of delays and changes in service from time to time. About 60% indicated that patients do not usually appreciate all that the staff in the clinic do for them.

Assurance: Respondents were generally assured as more than 80% reported that they were assured on the 21 items that were asked, e.g. involved in decision making, were listened to, their records were kept confidential, got quick relief of symptoms, helped to feel well, thoroughness and the rest of the assurance items, assurance, etc.

Tangibles: More that 70% agreed that the clinic was friendly to people with disabilities, building was in a good condition, the clinic and its surrounds were clean, there were toilets at the facility, which were clean and in a good condition, benches were available to patients to sit on whilst waiting to be seen by a health worker and that clean water was available to patients.

Conclusion: While clinics performed well on some of the domains, there is definitely a room for improvement. An intervention strategy that focuses on health workers, patients, health systems is being proposed in order to enhance effective and efficient service delivery.