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Sharon A. Bentley, Kellie L. Michel, Betty Tellis, Jill E. Keeffe, Caroline F. Clarke; Improving Patient-Centred Care: Perceptions and Experiences of Patients Attending an Australian Eye and Ear Hospital. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1437.
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To investigate the perceptions and experiences of patients attending a major Eye and Ear Hospital and use the findings to inform the development of an intervention for medical staff on patient-centred care.
We conducted a mixed-methods cross-sectional observational study of 51 representative patients who were selectively targeted from 28 eye, ear and ENT outpatient clinics at the Royal Victorian Eye and Ear Hospital. Patient care was observed from arrival through to departure by one researcher, according to a semi-structured checklist. Additionally, a patient satisfaction survey (constructed from the Victorian Patient Satisfaction Monitor Survey and the Outpatients Core Questionnaire) was interviewer-administered, which comprised 65 questions rated on a five-level scale (with 5 being very satisfied) and four open-ended questions requiring free-text responses. Data were interpreted using descriptive statistics and inductive thematic analysis.
The mean age of patients was 52 years (SD 25 years). Consistent with data for similar hospitals in the State, mean overall satisfaction was high, 4.34 (SD 0.72). Areas of highest patient satisfaction were: courtesy of the doctors (mean 4.27); how well cultural/religious needs were respected (mean 4.22); respect for privacy (mean 4.18); how well staff responded to health care problems (mean 4.17); and confidence and trust in hospital staff (mean 4.14). Areas of lowest satisfaction were: actually being helped by the visit to the hospital (mean 3.62); not having to wait too long (mean 3.71); communication between staff about treatment (mean 3.73); how well possible side effects of treatment/medicines were explained (mean 3.77); and helpfulness of the hospital staff in general (mean 3.83). The key themes that emerged on what might improve patient-centred care were: good doctor-patient communication; provision of information; professionalism; delivery of news; and management of fear/anxiety. Best things about the visit included, "Caring and friendly staff," and "The doctor explaining what was happening." Worst things about the visit included, "Waiting", "The doctor was rushed", and "Seeing staff arguing in public."
Based on patient perceptions and experiences we have identified areas of low patient satisfaction and key themes that can be used by clinicians, researchers, managers and policy makers to develop interventions to improve patient-centred care in an Eye and Ear Hospital.
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