Using Quality Circles to Improve Comprehension and Satisfaction of Patients Undergone Nuclear Medicine Examinations-Experience of a Hospital of Middle Taiwan

Abstract

Background: In clinical practices, majority of people does not fully understand most of medical imaging examinations, especially in nuclear medicine. The resulting concerns and anxieties among these patients thus reduce their compliance in the procedure. To improve the quality of the NM care in our clinic, quality circles (QCs) approach was applied. It is a method widely used in medical services. Through QCs, one improves quality of care and provide better medical services. The aim of the study is to enhance the comprehension of patient information of NM examinations by QCs intervention and to ultimately improve the quality of nuclear medicine examination.Materials and methods: This study investigated comprehension and satisfaction questionnaires that were collected from patients or their family members visiting our NM Department from April to November, 2010. The questionnaires were collected before and after intervention of QCs, and were analyzed independently. For the pre-QCs study, the total of 123 copies of comprehension questionnaires and 101 copies of satisfaction ones were completed. After intervention of QCs using PDCA (Plan-Do-Check-Action) cycles, we collected 143 comprehension and 100 satisfaction questionnaires. The patients grouped to ”before QCs” and ”after QCs” were different persons, thus the unconditional logistic regression model and Chi-square test were used for analysis of data.Results: Before QCs intervention, the overall patients' comprehension was 51.7%. The understanding of the NM examination, the required examination time, patient preparation and safety were 62.2%, 30.9%, 47.2% and 39.8%, respectively. After intervention of QCs, the overall patients' comprehension was 79.5%, and the four parts of comprehension questionnaire were 84.3%, 76.2% ' 80.8% and 69.7%, respectively. There was a great satisfaction improvement by raising 13% of excellent satisfation (P ＜0.001) after QCs approach. Further analysis, patients' age or educational level all had significant impact on the comprehension. In addition, educated patients showed higher appreciation toward staffs due to their better understanding of the procedure.Conclusion: The QCs approach based on concept of patient-centered to identify the causes of the insufficient comprehension has significantly improved the patient general satisfaction. It has been achieved by reducing patients' nervousness and increasing their comprehension and satisfation of NM examinations. By choosing appropriate education tools, methods of communication and personalized patient education, we have been able to provide better service to patients referred to nuclear medicine.