Patient Satisfaction Feedback Research Articles

Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy

Background: Long wait times for prescription services at the Outpatient Pharmacy of the Dr. OEN SOLO BARU Hospital in Indonesia have led to high numbers of complaints. In response, to decrease these wait times, the hospital undertook an intervention to determine wait time targets and provide feedback on patient satisfaction to personnel in the Outpatient Pharmacy. Objective: To measure the impact of providing wait time targets and patient satisfaction feedback to pharmacists in terms of decreasing wait times for prescription services at the Outpatient Pharmacy. Methods: This quasi-experimental research study had a single-group interrupted time-series design. Data on wait times and patient satisfaction were collected from “waiting patients”. The study participants were 35 employees (6 pharmacists and 29 technicians), and the intervention entailed provision of wait time targets and patient satisfaction feedback to the participants every week for 5 consecutive weeks. Results: The wait times for prescription services decreased by 11.13 minutes (17%) for compounded prescriptions and by 12.70 minutes (37%) for noncompounded prescriptions. There was a significant change in average wait time for both compounded and noncompounded prescription services from week 0 to week 4 (p < 0.001). There was also a significant change in patient satisfaction from week 0 to week 4 (p < 0.001). Patient satisfaction increased significantly in conjunction with the decrease in wait times for prescription services. Conclusions: The intervention of providing wait time targets and feedback on patient satisfaction to pharmacists helped to reduce wait times for prescription services. RÉSUMÉ Contexte : Les longs délais d’attente pour les services de délivrance de médicaments sur ordonnance à la pharmacie ambulatoire de l’Hôpital Dr. OEN SOLO BARU en Indonésie ont donné lieu à un nombre élevé de plaintes. En réponse, afin de réduire ces temps d’attente, l’hôpital a cherché à déterminer des objectifs de temps d’attente et à fournir des commentaires sur la satisfaction des patients au personnel de la pharmacie ambulatoire. Objectif : Mesurer l’incidence, sur le temps d’attente pour la délivrance de médicaments sur ordonnance à la pharmacie ambulatoire, de la remise aux pharmaciens d’objectifs de temps d’attente et de commentaires sur la satisfaction des patients. Méthodes : Cette étude de recherche quasi-expérimentale était conçue selon une série temporelle interrompue à groupe unique. Les données sur les temps d’attente et sur la satisfaction des patients ont été recueillies auprès des « patients en attente ». Au total, 35 employés (6 pharmaciens et 29 techniciens) ont participé à l’étude, et l’intervention consistait à remettre aux pharmaciens des objectifs de temps d’attente et des commentaires sur la satisfaction des patients chaque semaine pendant 5 semaines consécutives. Résultats : Les temps d’attente pour les services de délivrance de médicaments sur ordonnance ont diminué de 11,13 minutes (17 %) pour les ordonnances relatives aux préparations magistrales et de 12,70 minutes (37 %) pour les ordonnances relatives aux préparations non magistrales. Une différence significative a été observée entre les semaines 0 et 4 (p < 0,001) concernant le temps d’attente moyen pour les services de délivrance de médicaments sur ordonnance relatifs aux préparations magistrales et ceux relatifs aux préparations non magistrales. Une différence significative a également été observée dans la satisfaction des patients entre les semaines 0 et 4 (p < 0,001). La satisfaction des patients a augmenté de manière significative parallèlement à la diminution du temps d’attente pour les services de délivrance de médicaments sur ordonnance. Conclusions : La remise aux pharmaciens d’objectifs en matière de temps d’attente ainsi que de commentaires sur la satisfaction des patients a permis de réduire les temps d’attente des services de délivrance de médicaments sur ordonnance.

Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy.

Long wait times for prescription services at the Outpatient Pharmacy of the Dr. OEN SOLO BARU Hospital in Indonesia have led to high numbers of complaints. In response, to decrease these wait times, the hospital undertook an intervention to determine wait time targets and provide feedback on patient satisfaction to personnel in the Outpatient Pharmacy. To measure the impact of providing wait time targets and patient satisfaction feedback to pharmacists in terms of decreasing wait times for prescription services at the Outpatient Pharmacy. This quasi-experimental research study had a single-group interrupted time-series design. Data on wait times and patient satisfaction were collected from "waiting patients". The study participants were 35 employees (6 pharmacists and 29 technicians), and the intervention entailed provision of wait time targets and patient satisfaction feedback to the participants every week for 5 consecutive weeks. The wait times for prescription services decreased by 11.13 minutes (17%) for compounded prescriptions and by 12.70 minutes (37%) for noncompounded prescriptions. There was a significant change in average wait time for both compounded and noncompounded prescription services from week 0 to week 4 (p < 0.001). There was also a significant change in patient satisfaction from week 0 to week 4 (p < 0.001). Patient satisfaction increased significantly in conjunction with the decrease in wait times for prescription services. The intervention of providing wait time targets and feedback on patient satisfaction to pharmacists helped to reduce wait times for prescription services.

Neuromodulation of spinal reflex pathway for the treatment of detrusor overactivity by medial plantar nerve stimulation at surface of sole of foot in patients with spinal cord injury.

Suprasacral spinal cord lesions are prone to have neurogenic detrusor overactivity leading to urinary incontinence. Current medical management has known side-effects and often surgical managements are irreversible. Electrical stimulation to modulate spinal reflex pathway having same nerve root as urinary bladder is reported in the literature. This study aimed to reduce detrusor overactivity in patients with spinal cord injury (SCI) using surface electrical stimulation of medial plantar nerve at the sole of foot. Twenty adults with SCI having episode of at least 1 leak/day due to detrusor overactivity as diagnosed by cystometrogram (CMG), were on clean intermittent catheterization and ankle jerk was present consented for the study. Participants were asked to maintain bladder diary a week before and during 2 weeks of treatment. CMG was done on day-0 and day-14. cmcUroModul@tor®, an inhouse developed electrical stimulator was used for ½ h daily for period of 2 weeks. Patient satisfaction feedback questionnaire was taken on completion of treatment. CMG data were analyzed using Wilcoxon signed-ranked test while bladder diary was analyzed using binomial distribution. P < 0.05 was considered as statistically significant. Institutional Review Board (IRB) and ethics committee of Christian Medical College, Vellore, approved the study (CMC/IRB/11061). Statistical significant improvement in maximum detrusor pressure (P = 0.03) and cystometric capacity (P = 0.04) was observed. Of 20 subjects, 18 showed improvement in bladder diary. Neuromodulation of medial plantar nerve at sole of foot by surface electrical stimulation is non-invasive, cost-effective, and alternative simple treatment modality for urinary incontinence due to detrusor overactivity.

Physician Perceptions of Performance Feedback and Impact on Personal Well-Being: A Qualitative Exploration of Patient Satisfaction Feedback in Neurology.

To understand neurologists' experiences and perspectives on patient satisfaction feedback and its impact on personal well-being and behavior. From May to June 2021, the researchers conducted 19 semistructured interviews with neurologists from a large academic medical center. Clinical Performance Feedback Intervention Theory informed a combined inductive and deductive thematic analysis of the qualitative data, which focused on perceptions of current feedback practices, its impact on physician behavior, and recommendations for improvement. Participants tended to be female (n = 12/19, 63.2%), aged 30-39 (n = 8/19, 42.1%), white (n = 9/19, 47.4%), and were 10+ years into clinical practice (n = 18/19, 94.7%). Physicians were receptive to feedback overall, but perceptions varied by feedback type. Physicians preferred informal feedback (delivered unprompted directly by patients), given its tendency toward actionability. They disliked formal feedback (derived from anonymous surveys) due to low actionability, bias and validity issues, lack of contextual considerations, delivery through public reports, and links to financial incentives. Nearly all physicians reported formal feedback programs had the potential to negatively affect well-being and were not beneficial to their practice; a few reported adjusting their clinical practice to improve patient satisfaction performance. Five recommendations to improve patient satisfaction feedback programs emerged: Align on feedback intent, acknowledge survey limitations during program administration, increase actionability of feedback through specificity and control, support direct patient-physician feedback and problem resolution, and support empathetic integration of feedback. Understanding physician perceptions of current approaches to patient satisfaction feedback offers the opportunity to shape subsequent collection and distribution methods to improve physician performance and optimize professional fulfillment.

Ankle dorsiflexion assist using a single sensor-based FES: Results from clinical study on patients with stroke.

Ankle foot orthosis (AFO) commonly prescribed to manage foot-drop following stroke restricts ankle mobility. Commercially available functional electrical stimulation (FES) is an expensive alternative to achieve desired dorsiflexion during swing phase of the gait cycle. An in-house cost-effective innovative solution was designed and developed to address this problem.The aim of the study was to compare spatiotemporal gait characteristics of patients with foot-drop following stroke using commercially available FES against in-house developed versatile single sensor-based FES. Ten patients with cerebrovascular accident of at least 3 months duration and ambulant with/without AFO were recruited prospectively. They were trained with Device-1 (Commercial Device) and Device-2 (In-house developed, Re-Lift) for 7 h over 3 consecutive days with each device. Outcome measures included timed-up-and-go-test (TUG), six-minute-walk-test (6MWT), ten-meter-walk-test (10MWT), physiological cost index (PCI), instrumented gait analysis derived spatiotemporal parameters, and patient satisfaction feedback questionnaire. We calculated intraclass correlation between devices and median interquartile range. Statistical analysis included Wilcoxon-signed-rank-test and F-test (P < 0.05 was considered statistically significant). Bland Altman and scatter plots were plotted for both devices. Intraclass correlation coefficient for 6MWT (0.96), 10MWT (0.97), TUG test (0.99), and PCI (0.88) reflected high agreement between the two devices. Scatter plot and Bland Altman plots for the outcome parameters showed good correlation between two FES devices. Patient satisfaction scores were equal for both Device-1 and Device-2. There was statistically significant change in swing phase ankle dorsiflexion. The study demonstrated good correlation between commercial FES and Re-Lift suggestive of the utility of low-cost FES device in clinical setting.

Quality Improvement Project to Improve Patient Satisfaction and Opportunity to Attend Clinical Team Meetings

AimsClinical Team Meetings (CTM) are weekly multidisciplinary (MDT) meetings to review and discuss patients’ clinical care at Reaside Clinic, a medium secure inpatient forensic unit. Last year, there were significant difficulties in releasing nurses from ward duties to attend CTM, with effects on CTM efficiency and patients’ involvement and satisfaction in care. Furthermore, a hospital ‘protected mealtimes’ deadline commencing at 1230 meant additional pressure and further impacted patient attendance when meetings overran. The MDT (comprising doctors, nurses, psychologists, occupational therapists, pharmacists and admin staff) worked together to generate solutions, formulating a QI project to try to make improvements. Three primer drivers were: increasing patient satisfaction, increasing staff participation and increasing CTM efficiency.MethodsThe MDT generated multiple change ideas to test to improve CTM experience and outcomes. Actions implemented included review of timetabling of patients to ensure adequate timekeeping and ensuring availability of attending ward staff, defining patient expectations from CTM through increased communication, and seeking patient feedback on satisfaction or engagement after each CTM through anonymous questionnaires. Data were collected at CTMs from February to April 2022, retrospectively compared to reference data collected before QI actions were implemented. A Microsoft OneDrive document was shared between the MDT to ensure accurate data collection, with information collected on CTM finish time, number of patients offered to attend, number of patients who did attend and anonymous patient satisfaction feedback from questionnaires.ResultsEarly indications show improvement in meeting timelines and increased staff satisfaction with the CTM process, with data collection ongoing. Baseline results from September 2021 show an average of only 2 of between 13–15 patients attending weekly, in addition to finishing beyond the 1230 target on almost all occasions. Anecdotal evidence from the MDT showed poor patient satisfaction and engagement with the process before QI changes were implemented. Full results will be available by the time of presentation; currently, an average of 4 patients have attended CTM each week with all sessions finishing on time since implementation of changes.ConclusionPatient involvement in care and person-centred care are key to improving engagement and satisfaction with inpatient psychiatric management in forensic settings. Targeted multiple change ideas implemented by the MDT through this QI aim to improve patient satisfaction through enabling increased opportunity to attend weekly CTM, with modifications to the CTM process from key staff. Preliminary results show increased opportunity of patients to attend CTM, increased staff and patient satisfaction, and increased CTM efficiency.

How Feedback Is Given Matters: A Cross-Sectional Survey of Patient Satisfaction Feedback Delivery and Physician Well-being

ObjectiveTo evaluate how variation in the way patient satisfaction feedback is delivered relates to physician well-being and perceptions of its impact on patient care, job satisfaction, and clinical decision making. Participants and MethodsA cross-sectional electronic survey was sent to faculty physicians from a large academic medical center in March 29, 2019. Physicians reported their exposure to feedback (timing, performance relative to peers, or channel) and related perceptions. The Professional Fulfillment Index captured burnout and professional fulfillment. Associations between feedback characteristics and well-being or perceived impact were tested using analysis of variance or logistic regression adjusted for covariates. ResultsOf 1016 survey respondents, 569 (56.0%) reported receiving patient satisfaction feedback. Among those receiving feedback, 303 (53.2%) did not believe that this feedback improved patient care. Compared with physicians who never received feedback, those who received any type of feedback had higher professional fulfillment scores (mean, 6.6±2.1 vs 6.3±2.0; P=.03) but also reported an unfavorable impact on clinical decision making (odds ratio [OR], 2.9; 95% CI, 1.8 to 4.7; P<.001). Physicians who received feedback that included one-on-one discussions (as opposed to feedback without this channel) held more positive perceptions of the feedback’s impact on patient care (OR, 2.0; 95% CI, 1.3 to 3.0; P=.003), whereas perceptions were less positive in physicians whose feedback included comparisons to named colleagues (OR, 0.5; 95% CI, 0.3 to 0.8; P=.003). ConclusionProviding patient satisfaction feedback to physicians was associated with mixed results, and physician perceptions of the impact of feedback depended on the characteristics of feedback delivery. Our findings suggest that feedback is viewed most constructively by physicians when delivered through one-on-one discussions and without comparison to peers.

Adaptations and Evolution during COVID-19 in a Pediatric Satellite Setting

Background InformationThe global Covid-19 pandemic has required the rapid development and implementation of processes that support safety and quality of care. Prior to this unprecedented challenge, our satellite pediatric ambulatory surgical center consisted of four units: a preoperative unit (Preop), six operating rooms, a Post Anesthesia Care Unit (PACU), and an Inpatient Short Stay unit. Although the Preop and PACU nurses were cross-trained to cover both areas, Inpatient nurses maintained a distinct skill set and were a standalone unit. In effort to support virus containment, including social distancing, a flexible staffing model required the integration of Preop, PACU, and Inpatient nurses into one cohesive team.Objectives of ProjectDevelopment and implementation of changes to perioperative processes that support quality care and safety during Covid-19.Process of ImplementationInpatient areas were converted to support the preop care of patients/families and facilitate the adoption of COVID safety regulations. Inpatient nurses were oriented to the Preop nurse role, Preop Covid test screening, and Visitor/Employee lobby screening. This cross-training educational program included in-services on Preop documentation and procedures and one to one orientation with a Preop nurse. Presently, nurses may care for the same patient/families preoperatively and during their inpatient stay which promotes quality care and an improved surgical experience. Changes to staffing models were evaluated through staff survey, analysis of Press Ganey patient satisfaction feedback and surgical throughput data.Statement of Successful PracticeA majority (83.3%) of nurses agreed or strongly agreed that the new flexible staffing model promoted team cohesion and ensured safety and quality throughout the surgical experience. Between May and September 2020, our integrated perianesthesia team cared for 1206 perioperative patients. Press Ganey scores were overwhelmingly positive. One family stated “Before surgery the nurse kept us calm, engaged, & informed. After surgery that nurse did the same thing & was also a great teacher regarding home care”.Implications for Advancing the Practice of Perianesthesia NursingAs ambulatory surgical centers, continue to adapt during the pandemic, it is imperative that perianesthesia nurses design and implement flexible staffing models that promote team cohesion and ensure safety and quality during surgery.

Defining the treatment strategy for uncomplicated appendicitis based on patient satisfaction feedback: A cross-sectional study

BackgroundTwo surgical strategies are available for appendicitis: emergency laparoscopic appendectomy and interval laparoscopic appendectomy. However, timing of surgical intervention remains debatable. This study aimed to compare the surgical outcomes of emergency laparoscopic appendectomy and interval laparoscopic appendectomy and conduct a questionnaire survey to investigate the use of emergency laparoscopic appendectomy and patient satisfaction with regard to treatment. MethodsWe included 162 patients who underwent laparoscopic appendectomy at our hospital. Outcomes were assessed by operation time, blood loss, postoperative fasting time, length of hospital stay, and complication rate. Patient satisfaction was measured by questionnaire addressing degree of satisfaction, presurgery anxiety, and length of hospital stay. ResultsOf 162 patients, 74 (46%) and 88 (54%) received emergency and interval laparoscopic appendectomy, respectively. No significant difference was observed in the operation time, blood loss, length of hospital stay, or complication rate. Among 66 patients who responded to the questionnaire (28 emergency, 38 interval), a significant difference was observed only in the degree of satisfaction regarding the timing of the surgical intervention (p = 0.04). ConclusionSurgical outcomes of emergency and interval appendectomy were equivalent; however, patient satisfaction favored emergency appendectomy, suggesting it is a preferable approach for the treatment of uncomplicated appendicitis.

Patient Satisfaction and Their Willingness to Pay for a Pharmacist Counseling Session in Hospital and Community Pharmacies in Saudi Healthcare Settings.

ObjectivePatient satisfaction is an indicator for quality of healthcare service and is sometimes linked to patients’ willingness to pay. Willingness to pay is an economic method for estimating patient’s inclination for a service in monetary terms. This study assessed satisfaction of patients from pharmacist counseling service and estimated their willing to pay for the same.MethodsA month-long survey was conducted in community and hospital pharmacies located in Khobar, Dammam, and Qatif cities of Saudi Arabia, using Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction with counseling as well as willingness-to-pay. Convenient sampling method was used, and sample size was calculated based on power analysis. Data was analyzed through SPSS version 23. Chi-square (χ2) test and logistic regression analyses were conducted to report associations between variables and, determinants of satisfaction as well as willingness to pay respectively. The study was approved by concerned ethical committee (IRB-2019-05-020).ResultsPatients (n = 531) with previous counseling experience were more likely to be satisfied [adjusted odds ratio (AOR) 5.2, p < 0.05]. Patients were more willing to pay if, they had an income above SAR 10,000 i.e., USD 2666.5 (AOR 1.78, p < 0.05), were satisfied with counseling time duration (AOR 4.5) and, were able to get counseling without difficulty (AOR 2.1, p < 0.05). Patients were more likely to be satisfied and were willing to pay if, they received required knowledge/information completely (AOR 2.5, 3.7, and p < 0.05) and found pharmacist helpful (AOR 1, 4.5, and p < 0.05). Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10.ConclusionPatients considered counseling as an important service and were satisfied from it. Less than a third of patients were willing to pay for the service. Knowledge and helpfulness of pharmacist were identified as two major determinants that could not only satisfy and but also promote willingness to pay for the service. A pharmacist with skills in pharmaceutical care and counseling could be useful in promoting the service and making it profitable for pharmacy business.

Assessment of patient satisfaction following pharmacist counselling session by a novel patient satisfaction feedback on counselling questionnaire

Assessment of patient satisfaction following pharmacist counselling session by a novel patient satisfaction feedback on counselling questionnaire

Transvaginal treatment of anterior and apical genital prolapses using an Ultra lightweight mesh: Restorelle® Direct Fix™. A retrospective study on feasibility and morbidity

BackgroundVaginal mesh safety information is limited, especially concerning single incision techniques using ultra lightweight meshes for the treatment of anterior pelvic organ prolapse (POP). ObjectiveTo determine the intraoperative and postoperative complication rates after anterior POP repair involving an ultralight mesh (19g/m2): Restorelle® Direct Fix™. MethodsA case series of 218 consecutive patients, operated on between January 2013 and December 2016 in ten tertiary and secondary care centres, was retrospectively analyzed. Eligible patients had POP vaginal repair (recurrent or not) planned with anterior Restorelle® Direct Fix™ mesh (with or without posterior mesh). Surgical complications were graded using the Clavien-Dindo classification. ResultsIntraoperative complications were bladder wound (0.5%), rectal wound (0.5%), ureteral injuries (0.9%). 98.2% of the patient did not have per operative complications. We observed one fail of procedure. Early complications mainly included urinary retention (8.7%) urinary tract infections (5.5%) and haematoma (2.7%). One haematoma required surgical treatment and another, embolization. 80.7% of the patient did not have complications during hospitalization and 80.3% did not have complication at the follow up visit. None of the analyzed factors (age, body mass index, surgical history, grade of prolapse or concomitant procedure) was significantly associated with the risk of perioperative complications. A total of 2.8% patients had grade III complications according Clavien Dindo. None had grade IV or V. ConclusionsThis multicentre case-series on the early experience of the use of anterior Restorelle® Direct Fix™ mesh showed a satisfactory technical feasibility and a low rate of grade III complications according Clavien Dindo. Long term studies are necessary to assess anterior Restorelle® Direct Fix™ mesh performances and to appraise patient satisfaction feedback.

Evaluation of Dental Care through Patient Satisfaction Feedback – A Cross Sectional Study at Dental Institute of OJHA Hospital, Karachi, Pakistan

Evaluation of Dental Care through Patient Satisfaction Feedback – A Cross Sectional Study at Dental Institute of OJHA Hospital, Karachi, Pakistan

Current Practices and Priority Issues Regarding Nutritional Assessment and Patient Satisfaction with Hospital Menus.

Patient satisfaction with hospital food enhances consumption and adequate intake of nutrients required for recovery from illness/injury and maintenance of health; accordingly, the nutrient content of the menu must balance patient preferences. This study of Ontario hospital foodservice departments collected data on current practices of analyzing the nutritional adequacy and assessing patient satisfaction with menus, and it explored perceptions of priority issues. Foodservice managers/directors from 57 of 140 (41%) hospitals responded to cross-sectional in-depth telephone interviews. Deductive analysis of responses to open-ended questions supplemented quantitative data from closed-ended questions. The hospitals without long-term care facilities (LTCFs) assessed regular (58%), therapeutic (53%), and texture-modified (47%) menus for nutritional adequacy. This differed from hospitals governing LTCFs where there was a higher frequency of assessment of regular (75%), therapeutic (75%), and textured-modified (66%) menus. Most departments (86%-94%) obtained patient satisfaction feedback at the departmental/corporate levels. Many identified budget and labour issues as priorities rather than assessing menus for nutritional adequacy and patient satisfaction. Hospital menus were not consistently assessed for nutritional adequacy and patient satisfaction; common assessment methodologies and standards were absent. Compliance standards seem to increase the frequency of menu assessment as demonstrated by hospitals governing LTCFs.

Opinions of Intensive Care Nurses: Traditional or Disposable Wipes Bed Bath? A Quasi-Qualitative and Cost Analysis Study

Background: This study is to compare the traditional basin with the disposable washcloths bed bath in terms of two outcomes: ICU nurses’ satisfaction/preference and cost analysis. Methods: This is a quasi-qualitative and descriptive study was performed in three ICUs (orthopaedic, neurosurgery, and general surgical) at a university hospital. The sample consisted of 41 ICU nurses agreed to participate in the study. The ICU nurses used a visual analogue scale to respond to the questions about the two types of bed-baths. The researchers conducted interviews with ICU nurses about the two bedbath practices based on open-ended questions. The interview, lasting for 20-30 minutes, was administered during a rest period. A cost analysis was calculated by researchers based on equipment and workload. Results: The application time, workload of nurses, and cost analysis scores favoured the disposable bedbath method (p≤0.05). The traditional bed-bath application scored higher than the disposable washcloth application in parameters (performing, providing communication to the patient, patient feedback, cleanliness, integrity, and softness of skin) (p≤0.01). ICU nurses reported that the three most important parameters that affect the preference for the traditional bed-bath application are communication with patients, patient satisfaction feedback, and the cleanness and integrity of skin. Conclusion: Disposable bed-bath method was performed less time, less workload of nurses, and cost effective than traditional method. Furthermore the ICU nurses preferred the traditional bed bath application. Researchers determined that a bridge between cultural habits and nursing science should be established.

Day Case Bilateral Sagittal Split Osteotomies (BSSO): an audit and review of clinical practice at the Royal Gwent Hospital, Newport

Introduction: The role of Bilateral Sagittal Split Osteotomies (BSSOs) in Orthognathic surgery in the UK has been generally regarded as a surgical procedure requiring in-patient admission and hospital stay. Following the introduction of the national standards on day case surgery in the UK in 2011, BSSOs undertaken at the Royal Gwent Hospital have been performed as a day case procedures as it was felt that the procedure conformed to national guidelines in terms of safety and feasibility demonstrating excellent patient satisfaction feedback.

The impact of introducing a satellite dispensary service at an outpatient HIV clinic

BackgroundStudies have demonstrated the potential impact of pharmaceutical services in HIV care [1]. We sought to extend HIV pharmacy services at the Dean Street outpatient HIV/GUM clinic to improve efficiency and enhance client satisfaction. The pharmacy team was expanded and a satellite dispensary was opened in the clinic. This project compares the new dispensary service with the previous one offered.MethodComparisons were made between the pre‐ and post‐change period across a range of pharmaceutical services provided and patient satisfaction feedback. Medicine‐related interventions, repeat prescription requests, waiting and dispensing times were recorded. Service satisfaction questionnaires were designed for patients to quantify aspects of service provision.ResultsTypes of interventions remain broadly similar (p=0.353), with an increase in the daily number of interventions (p=0.0038) and a decrease in time spent per intervention (p=0.006) in the new service delivery model. A greater dispensing time (p=0.035, p=0.001) and time per item (p=0.043, p=0.002) for prescriptions with related queries was seen across both periods. However, the time taken to dispense prescriptions remained similar pre‐ and post change (p=0.8). The patient satisfaction survey had a series of statements relating to pharmacy services; there was a stronger association with patient satisfaction seen for the provided services during the post‐change period. The number and types of repeat prescription requests remain unchanged (p=0.342); however, patient prescription requests were completed more efficiently post‐change (mean time 5.4 minutes) as compared to pre‐change (mean 12.6 minutes; p = 0.001). There was also a significantly lower rate of FP10 prescriptions issued in the post‐change period due to a greater choice of available medications.ConclusionThe care contributions of HIV pharmacists to a multidisciplinary HIV clinic providing patient‐centred care were measured before and after the introduction of a satellite dispensary service. The expanded pharmacy service has increased efficiency by completing more tasks in less time and increased access to medications for patients. Its focus is dealing with patient‐related queries and providing support for the patients seen at the clinic.

Facial soft tissue augmentation with Artecoll®: A review of eight years of clinical experience in 153 patients

Artecoll (Canderm Pharma Inc, Canada) is a semipermanent, injectable, soft tissue filler composed of uniform polymethylmethacrylate microspheres in a bovine collagen gel, which has been used in Europe over the past decade. The authors review their experience using Artecoll as an injectable material for the correction of deep static folds of the face, improvement of nasal asymmetries following rhinoplasty, depressed acne scars and augmentation of the lip. A retrospective chart review, subjective patient satisfaction feedback and objective findings noted by the senior author were performed over an eight-year period. A total of 153 patients were treated with Artecoll injections; 74 underwent lip augmentation, 21 underwent deep nasolabial fold augmentation, eight underwent glabellar fold augmentation, 26 were treated for minor nasal dorsal irregularities and 24 were treated for depressed acne scars. No early or delayed allergic responses were reported. Complications occurred most commonly with lip augmentation, in which 13.5% of patients noted significant noticeable bruising postinjection that resolved completely within one week, 51.3% had detectable implant on palpation, and 13.1% required further intervention with massage, steroid injection and/or local excision to correct for lumpiness. Sixty per cent of patients requiring further intervention responded successfully, while local excision was performed on the two patients who failed to respond after six months of massage and steroid therapy. Overall, a total of 11 patients (14.9%) had minor asymmetries or less than optimal results within the lip augmentation study group. Among other sites, the most common complaint was undercorrection of the fold or wrinkle. Based on the authors' experience, Artecoll is a safe, viable option for long-term treatment of deep facial wrinkles, nasal asymmetry, hypoplastic or atrophic lips, and depressed acne scars, and the results have been accompanied by a high degree of patient satisfaction. Although the implant is often palpable, rarely does it cause significant visible lumps. Its use and applications as a semipermanent injectable agent certainly warrant further investigation.

Measuring Satisfaction with Social Work Services

For various reasons, the role of the medical social worker is often unclear to persons seeking medical treatment. Allied health professionals, such as nursing staff, tend to have a better understanding of the medical social worker's role and of whether services are being provided to best meet each patient's needs. We aimed to illustrate the abilities of nursing staff to provide patient satisfaction feedback to medical social workers in such areas as responsiveness to patient requests and the satisfaction of patients and their family members with the social services provided. Use of this satisfaction measurement technique will hopefully resolve any confusion that patients, and others not familiar with the role of the medical social worker, may have. This method provides accurate measurement of patients' evaluation of medical social work services.

Continuous quality improvement through team supervision supported by continuous self-monitoring of work and systematic patient feedback.

Evaluation of clinical supervision (CS) and exploration of its effects on the quality of care is a timely topic for research. The current emphasis in nursing is shifting towards continuous quality improvement (CQI), and the integration of this with CS seems to be an interesting challenge. So far the studies have relied mainly on supervisees' self-report data and patients have rarely been involved in research. However, the perspective of CQI requires that patients are involved in the quality improving efforts. The aim of this study is to describe how CQI was implemented through team supervision and supported by continuous self-monitoring of work and systematic patient feedback. The team supervision intervention was organized on five wards between 1995 and 1998. The methods of statistical process control and control charts were applied in the study as part of the intervention. Improvements in both patient satisfaction and the staff's self-monitoring of work were evidenced. A slow and minor upward trend was detected in the control charts and the variation decreased in the assessments. The patients' high and the staff's critical ratings drew nearer towards the end of the study. However, significant differences were found between the wards and not all wards showed improvements. Staff found it difficult to discern the effects of continuous patient satisfaction feedback and self-monitoring. The findings of the study show that CQI integrated with team supervision improves patient satisfaction and the overall quality of care.