Professional Documents
Culture Documents
Semester: 5th
Department: Marketing.
(OPD)”
2. EXECUTIVE SUMMARY
3. INTRODUCTION.
4. OBJECTIVE.
5. METHODOLOGY.
6. LITERATURE REVIEW
8. PROBLEM IDENTIFICATION
9. RECOMMENDATION
10.CONCLUSION
11.BIBLIOGRAPHY
Acknowledgement
Ebrahim Khan
Executive Summary
Venue:
Calcutta Medical Research Institute,
7/2, Diamond Harbour Road, Kolkata – 700 027
LITERATURE REVIEW
Concept of Satisfaction:
1. Expectations: The seeds of patient satisfaction are sowed during the pre-
purchase phase when consumers develop expectations or beliefs about what
they expect to receive from the product. These expectations are carried
forward and again activated at the time of reusing.
2. Performance: During the usage of services the patients experience the actual
product in use and perceive its performance on the dimensions that are
important to us.
3. Comparison: It will be done after usage with pre-usage expectations.
4. Confirmation/Disconfirmation: Comparison of expectations with actual
performance results in satisfaction or dissatisfaction.
5. Discrepancy: If the performance levels are not equal,discrepancy results.
Every human being carries a particular set of thoughts, feelings and needs. The
wishing list might be of value for those who want to know the real person within
the patient. One must admit that there are a lot of things which could be altered. By
getting to know the patients a little more to get their views on the care one ought to
come closer to what the patients consider as a good care.
It can be said that there are five determinants of patient satisfaction, they are
1. Top service hospitals are patient obsessed. They have a clear sense of their
target customers and their needs.
2. The best service hospitals set high service quality standards. The standards
must be set appropriately high, which leads to patient satisfaction.
3. Culture, subculture and social classes are important in determining the
satisfaction levels. Culture is the fundamental determinant of an individual's
wants and behaviour. It refers to a set of feelings of the patient or his
relatives. Social class reflects sex, income, occupation, education, area of
residence and recreational preferences, etc. which are important in
determining the satisfaction levels.
4. The patient's behaviour is greatly influenced by social factors like reference
groups, ideas, beliefs. Reference groups here refer to peers, relatives,
neighbours and friends. The family members are the important persons in
influencing the patient.
5. The person's satisfaction is influenced by the psychological factors such as
perception, learning and attitudes.
Apart from the above, other factors that influences the patient satisfaction
include availability of adequate staff, availability of physical facilities and
equipment, design of the ward, cleanliness, environment, availability of clinical
services, work load of the staff, behaviour of the doctors, nursing staff,
paramedical staff, effectiveness of management functions, the leadership styles
of administrators, communication channels, policies and procedures etc.
They also have to manage both patient & patient parties & to handle difficult
situations. Staffing should be done accurately so that both patient & patient party
does not suffer any problem & above all is directing & controlling all the staffs of
the floors & wards in a right direction so that the organization gains profit & can
reach its ultimate goal
There are a growing number of efforts to compare the service quality of health care
organizations on the basis of patient sssatisfaction data. Such efforts inevitably
raise questions about the fairness of the comparisons. Fair comparisons presumably
should not penalize (or reward) health care organizations for factors that influence
satisfaction scores but are not within the control of managers or clinicians. On the
basis of previous research, these factors might include the demographic
characteristics of patients (e.g.-age) and the institutional characteristics (e.g.-size)
of the health care organizations where care was received. The goal of this study
was to examine the extent to which a patient's satisfaction scores are related to both
his/her demographic characteristics and the institutional characteristics of the
health care organization where care was received. Conducted an analysis of
secondary data from the Veterans Health Administration (VHA), US Department
of Veterans Affairs. The database contained patient responses to self-administered
satisfaction questionnaires and information about demographic institutional
characteristics of the hospitals where patients received their care. Among
demographic characteristics, age, health status, and race consistently had a
statistically significant effect on satisfaction scores. Among the institutional
characteristics, hospital size consistently had a significant effect on patient
satisfaction scores. Study results can be interpreted as justifying the need to adjust
patient satisfaction scores for differences in patient population among health care
organizations. However, from a policy perspective, such adjustments may
ultimately create a disincentive for health care organizations to customize their
care.
Developed and responses collected from the patients of long stay directly.
Data thus collected was scrutinized, analyzed and inferences were drawn:
In the outcome related to quality care, the credit points are “number
out to elicit the patient’s opinion about the quality of services at SMHS Hospital
and to analyze the various factors which influence patient’s satisfaction or
dissatisfaction with the hospital services.
The SMHS Hospital is 710 bedded teaching hospitals which are spread in a large
share. It has many
Well reputed associated hospitals like Bone & Joint Surgery Hospital, Gynecology
Hospital (Lalla Ded) Pediatric Hospital, Psychiatry Hospital and Chest Diseases
Hospital. It has a good laboratory back up. It has facilities of C.T. Scan and MRI. It
has got well established laundry
Department, CSSD Depts. and Blood Bank etc. The opinions of 100 patients were
studied using the patient satisfaction questionnaire schedule. Patient’s response
was categorized as poor, average, good and excellent.
The hospital administrators should be aware of the needs and expectations of the
public as per the
Feedback of the public relations department and accordingly take policy decisions.
These measures play a significant role in patient’s satisfaction.
A good communication between the patient and provider of health care is vital
factor for patient satisfaction. There should not develop any communication bridge
between the Doctor and the patient.
This study examined the relationships of nurse burnout, intention to quit, and
meaningfulness of work as assessed on a staff survey with patient satisfaction with
nursing care, physician care, information provided and coordination of care, and
outcomes of the hospital stay assessed post-discharge. Sixteen inpatient units from
two hospital sites formed the data base and included 605 patients and 711 nurses.
Patients' perceptions of the quality of each of the four care dimensions
corresponded to the relationships nurses had with their work. Patients on units
where nurses found their work meaningful were more satisfied with all aspects of
their hospital stay. Patients who stayed on units where nursing staff felt more
exhausted or more frequently expressed the intention to quit were less satisfied
with the various components of their care. Although nurse cynicism was reflected
in lower patient satisfaction with interactions with nursing staff, the correlations
between cynicism and other aspects of care fell below statistical significance. No
significant correlations were found between nurse professional efficacy and any of
the patient satisfaction components measured. The implications of the relationship
between patient satisfaction and nurses’ perception of their work are discussed.
Jeffrey L. Jackson, Judith Chamberlin and Kurt Kroenke,
Infact, he built a strong platform for a self-reliant India, The Calcutta Medical
Research Institute (CMRI) was set up in 1969. An ISO 9001: 2000 certified
institution, CMRI today is one of the most advanced multi-specialty and research
centers in India.
A landmark medical institution with more than 400 beds, CMRI has tie up
with Cleveland Clinic Foundation, the No. 1 Heart Hospital in America for 10
years in a row, to provide international healthcare
MISSION: To offer the highest standards of medical treatments with utmost care
compassion & commitment to all sections of the society at best value-for-money
costs.
OBJECTIVES OF CMRI:
Top management has established the following objectives, which are measureable
and consistent with the quality policy. The objectives are as follows:
OUTPATIENT DEPARTMENT(OPD):
OPD is the First point of contact between patient and hospital staff . It is a
part of the hospital with allotted physical facilities and medical and other staff in
sufficient numbers, with regularly scheduled hours to provide care for patients who
are not registered as inpatients. It is visited by large section of community .The
human relation skill/ Public relation functions are of utmost importance in the OPD
of a hospital, it is necessary the OPD staff should always be polite, cheerful,
cooperative & efficient. OPD is a very important wing of hospital serving as a
mirror.
FUNCTIONS OF OPD
Outpatient Department is one of the department of the hospital which cares
for the ambulatory patient who come for diagnosis, treatment and follow up.
GENERAL OPD
General OPD is the place where patients come for consultation of doctors of
different fields. Around 350 patients are coming for consultation with the doctors
daily. Both “First come First serve” and Appointment systems are served over
here. Patients both directly come and take the appointment and appointments are
given over phone in the front office receptions.
In General OPD the patients will get the particular service that they are needed.
Such as an orthopedic patient will get an orthopedic doctor, general medicine
patients will get medicine doctors and so on. All the different types of treatments
are done in there respective departments.
Registration module is the first entry point for a patient to get the treatment in a
hospital. It encompasses various activities related to registration, appointment and
scheduling, payment collection and verification, recording out patient’s
consultation, treatment details, referral details, reporting, issuing lab requests and
storing the patient’s history.
The system generates patient’s id numbers (PUKA) for the out patient’s. The
(PUKA) is issued for future identification of the patients and recording their
essential data. Registration is also essential for the delivery of lab reports.
The system also generates referrals for clinical investigations. The investigations
which are to be carried for the patients would be accessed on-line by labs. The
system would help to schedule the visit of the patients by fixing the appointments
with the doctors as per their availability dates.
BILLING:
Billing is the system where bills are generated and payments are collected against
them. The system has options of both Centralized Billing and Decentralized
Billing.
In centralized billing, the patient clears all monetary dues to the hospital at one
central payment counter.
In decentralized billing the bills are generated at one place and payments are
collected at the respective service counters of the department where the services
are rendered.
Collection of payments
Corporate life might bring home big bucks and glamorous lifestyle, but sometimes-
endless hours of work and high streets levels leave little time to think about one’s
health.
That’s where our speciality clinic steps into make the lives of corporate executives
simpler and healthy by addressing problems that are official to professionals in
today’s stressful scenario.
CMRI’s specialty clinic offers the convenience of finding all related speciality and
services under one roof. With our professional nursing staff and doctors on site 24
hours a day we have the ability to cope with any level of infirmity or dependency.
Our patients fest reassured by the promise that they will receive the highest
standards of care and attention. Along with which a favorable staff-to-patient ratio
ensure personalized care. A majority of programs at our speciality clinic include
consultation, investigation and regular follow-ups with specialties.
SPECIALITY CLINIC
Speciality Clinic –is a place where patients come for consultation of doctors of
different fields. Around 350 patients are coming for consultation with the doctors
daily. Both “First come First serve” and Appointment systems are served over
here. Patients both directly come and take the appointment and appointments are
given over phone in the front office receptions. Speciality Clinic is located in the
1st floor of the South block building of the hospital.
In this clinic the patients will get the particular service that they are needed. Such
as an orthopedic patient will get an orthopedic doctor, general medicine patients
will get medicine doctors and so on. All the different types of treatments are done
in there respective departments. Even physiotherapy and pathology are also
available here. This clinic offers the special facilities which are not available in
general OPDs that is why we call it speciality clinic.
Uncounted number of doctors visit this clinic in a schedule way. Each doctor has a
particular days/dates to visit and each of them has been allocated with a particular
chambers with the name plates been given on the doors. There are two receptions,
one main reception one orthopedic and one ENT reception. There are also two
other receptions one in Cosmetic Clinic and another in Eye department. The billing
and requisition, different types of patient queries and information are helped over
here. To visit doctor’s chambers a computerized system has situated following
which patients will visit as per their serial number by the help of machine named Q
MANAGEMENT SYSTEM. Uncounted services are found at Speciality Clinic in
relation to the Out Patient Department.
REGISTRATION:
Registration module is the first entry point for a patient to get the treatment in a
hospital. It encompasses various activities related to registration, appointment and
scheduling, payment collection and verification, recording out patient’s
consultation, treatment details, referral details, reporting, issuing lab requests and
storing the patient’s history.
The system generates patient’s id numbers (PUKA) for the out patient’s. The
(PUKA) is issued for future identification of the patients and recording their
essential data. Registration is also essential for the delivery of lab reports.
The system also generates referrals for clinical investigations. The investigations
which are to be carried for the patients would be accessed on-line by labs. The
system would help to schedule the visit of the patients by fixing the appointments
with the doctors as per their availability dates.
BILLING:
Billing is the system where bills are generated and payments are collected against
them. The system has options of both Centralized Billing and Decentralized
Billing.
In centralized billing, the patient clears all monetary dues to the hospital at one
central payment counter.
In decentralized billing the bills are generated at one place and payments are
collected at the respective service counters of the department where the services
are rendered.
Collection of payments
Invoice generation
VARIOUS DEPARTMENTS OF SPECIALITY CLINIC WITH
THERE REEPECTIVE ROOMS
Patient survey and direct observation - Patient survey is very important as it helps
to know how satisfied patients are with the quality of catering and physical
amenities provided for inpatients or the accessibility of health care facilities.
Sample:- A randomly selected part of the population constitute the sample and the
methodology of selecting the sample is called sampling. A characteristic of a
sample is called a statistic.
My project is based on stratified sampling; I have selected the feedback form and
the questionnaire on this basis for analysis.
FIGURE:1
As shown in the PIE CHART among the responding outpatients 17% of the
patients came to the hospital for the first time.
46% of the patients came to the hospital for occasionally for some specific illness.
37% of the patients came to the hospital frequently for any problem.
The above data reveals that the visit of patient to the hospital is more to a
specific illness because of the famous of hospital’s specific departments.
Did you take appointment before
reaching to the hospital
22%
yes
No
78%
FIGURE: 2
Figure 2, shows the nubmer of patients who took appointment efore reaching
to the hospital. Figure shows the number of patients who took appoinment and who
did not take appointment before reaching to the hospital:
22% of the customers took the appoinment before reaching to the hospital while
78% of the customers did not take appointment before reaching to the hospitals. It
indicates that first come first serve is obeying in OPD only a few Consultants have
the appointment system. Figure shows the number of patients who took
appoinment and who did not take appointment before reaching to the hospital
Reason to choose the hospital
35
30
No. of patient
25
20
15
10
5
0
Near to Reputatio Reffered Availibity Sent by
the house n of the by the of relatives/
hospital family physical friends
doctor facilities
Series1
Series2 25 30 9 33 13
FIGURE : 3
It is quite clear from the bar diagram that 25% of the customers came to the
OPD because of near the house to the hospital.
Because of the Reputation of the hospital 30% of the customers visit to the
hospital.
33% of the customers were visited to the hospital because of the availability of
physical facilities.
13% of the customers were sent by relatives/friends to the OPD of the hospital.
From the above diagram it can be identified that majority of the customers choose
the hospital of the availability of the physical facilities
Response and courtesy shown y the
OPD staffs
40
35
no. of customers
30
25
20
15
10
5
0
Excellent Good Fair Poor
Series1 22 40 20 18
FIGURE: 4
Figure 4 shows feelings of the customers over the response and courtesy
shown by the OPD staffs
22% of the customers felt Excellent over the response and courtesy shown by OPD
staffs
40% of the customers felt Good over the response and courtesy shown by OPD
staffs
20% of the customers felt Fair over the response and courtesy shown by OPD
staffs
18% of the customers felt Poor over the response and courtesy shown by OPD
staffs
It indicates that most of the patient felt Good to the response and courtesy of the
OPD staffs.
Are you satisfied with the hospital
outpatient physical facilities?
100
No. of patient
80
60
40
20
0
Sitting Drinking Toilet facility Trolley ,
Arrangemen water stretcher
t
Yes 88 85 46 90
No 12 15 54 10
FIGURE: 5
Sitting arrangement and Drinking water of the OPD are satisfied by 88% and
85% respectively of the customer and less no patient i.e only 12% and 10% are not
satisfying with them. It shows that most of the customers satisfy with sitting
arrangement and drinking water facility.
More than half (54%) of the customers were not satisfied with toilet facility of the
hospital.
Trolley and stretcher facilities were almost (90%) satisfied by the customers.
What do you feel about the quality
service of opd?
80
no. of respondents
70
60
50
40
30
20
10
0
Reception help desk cleanliness waiting time
good 45 30 68 32
average 43 42 30 50
bad 22 28 2 18
FIGURE: 6
The Figure 6 shows the respondents feelings about the quality services of
OPD
The bar diagram shows that the OPD Reception is feeling good by the 45% of the
customers, 43% of the customers felt average, and 22% felt bad.
It indicates that the services of the Reception of the OPD is good but needs to
improve in to satisfy all the customers.
The above bar diagram shows 30% of customers felt good about the Help Desk of
the OPD, 42% of the customers felt average and 28% of the customers felt bad.
It reveals the services of the Help desk is average, nearly half of the customers
have the desire to improve the help desk of the OPD.
68% of the customers felt good about the cleanliness 30% of the opd, 30% of the
customers felt average, only 2% felt bad.
The above bar diagram shows 32% of the customers felt good about the waiting
time, 50% felt average and 18% felt bad. Half of the customers felt average about
the waiting time of registeration as well as consultants.
what do you think about the area of
OPD?
Very congested Reasonably spacious Quite spacious
16%
36%
48%
FIGURE: 7
The bar graph clearly indicates that 16% of customers are felt the area of
OPD is very congested, 48% of the customers felt Reasonably Spacious, 36% of
the customers felt Quite Spacious.
It reveals that most of the customer felt the OPD as reasonably spacious.
Ease of access to the medical
specialists in the hospital
Excellent Good Poor Bad
16% 12%
20%
52%
FIGURE: 8
12% of the customers felt Excellent about the ease of access of Medical Specialists
52% of the customers felt Good about the ease of access of Medical Specialists
20% of the customers felt Poor about the ease of access of Medical Specialists
16% of the customers felt Bad about the ease of access of Medical Specialists
It reveals that most of the customers felt Good about the ease of access of Medical
Specialists
Will you refer CMRI to your friends or
relatives?
45
40
no. of respondents
35
30
25
20
15
10
5
0
Yes May be No Never
Series1 42 40 10 8
FIGURE: 9
Figure 9 shows customers response about the referring of this hospital to the
friends or relatives.
42% of the customers response YES and they were ready to refer the hospital to
the friends or relatives.
40% of the customers response May Be, it reveals that they were neither satisfied
nor dissatisfied to the OPD service .
10% of the customers response No, it shows the dissatifaction level of the OPD
services.
8% of the customers response Never, it shows the highly dissatifaction level of the
OPD services.
Problem identification:
1. Lack of effective and efficient manpower.
2. Lack of appointment system.
3. Lack of coordination among the OPD staffs.
4. Lack of trolley and stretcher.
5. Toilet facility inside the hospital premises.
RECOMMENDATIONS:
Taking into consideration the problem faced by the customers, some actions are
suggested for enhancing the patient satisfaction and improving the service quality
of the OPD. These are discussed below:
1. Efficiency of the staffs: Most of the customers said that the information
given by Help Desk and Enquiry Desk are not adequate and the behavior of
the Receptionist is not good. The customers wants the staffs to be impartial,
friendly, sympathetic and courteous under all cicumstances. To make this
happen staffs should be given training in dealing with the customers. Taking
into consideration the low satisfaction of customers with regards to the
information given by the Help Desk and Enquiry Desk staffs, it is suggestd
that some type of orientation course on facilities and services available in the
hospital be given to them. This will help the mentioned staffs can render the
information adequately to the needy customers.
2. Long Waiting Time: Most of the patients were suffering from the long queue
in the registration counter as well as long waiting time to meet with the
Doctors . In order to reduce this problem appoinment system should be
adopted instead of existing first come first serve method for all the
consultants.
4. Doctor’s list: Most of the customers have the high demand of doctor’s list in
the Help desk as well as Registration counter, so it is highly required to
supply the doctor’s list from these two with the addition of Enquiry Desk.
5. Toilet facility: As the OPD toilet is outside the hospital premises, most of
the visitors facing a lots uncomfortable, so it is suggested to keep the toilet
facility inside the hospital premises for the OPD Visitors.
6. OPD Staffs: Comparing with the visitors and OPD staffs ratio , there is lack
of manpower. In order have a smooth workflow in the OPD more staffs
should be posted to the OPD of the hospital.
CONCLUSION:
Hospital is a service industry. The service of the customer
( patient) in a hospital is to be individualized( customerisation) to satisfy the
individual patients unlike the case of industries.
From the study it can be concluded that in the OPD, physical facilities, OPD staffs’
service and courtesy have assumed more for importance today as they contriute a
crucial role to increase the satisfaction level of the customers in Outpatient
Department
The study also identified some of the factors which are responsible for the
dissatisfaction of the patients, so effort must be made to reduce the level of
dissatifaction that patient may have with the services of OPD and thereby to
improve the functioning, public image and overall service of the hospital.
ANNEXURES
VISITORS SATISFACTION
AGE: ADDRESS:
a) Yes ( ) b) No ( )
a) Near to house ( )
Reception / Registration ( ) ( ) (
)
Help desk ( ) ( )
( )
Security services ( ) ( ) (
)
Waiting/Queuing system ( ) ( ) (
)
Quite spacious ( )
Date: Signature:
Thank you for your kind co-operation, valuable suggestion and options.