Short Assessment Of Patient Satisfaction Research Articles

Service evaluation of an early pregnancy loss support clinic in an inner London early pregnancy unit

BackgroundEarly pregnancy loss (EPL) can have profound implications for physical and psychological health. In the UK, significant variation in service provision exists for women affected by EPL. There is very little guidance on what hospital-based follow-up support services should entail, and how these can be implemented and integrated into current care provision to meet the needs of women who experience EPL. This service evaluation (SE) reports on an Early Pregnancy Loss Support Clinic (EPLSC) in an inner-city Hospital Trust.MethodsThis SE gathered both quantitative and qualitative feedback from women to assess the value of a locally implemented Early Pregnancy Loss Support Clinic (EPLSC). Quantitative feedback was collected using the Short Assessment of Patient Satisfaction (SAPS) questionnaire and the Visual Anxiety Scale (VAS-A), both administered to women attending the EPLSC. Qualitative feedback was collected through semi-structured interviews and focused on four pre-determined themes based on EPL literature - physical health, mental health, role of the bereavement midwife and overall service user experience. Quantitative feedback was summarised using descriptive statistics, while qualitative feedback was analysed using framework analysis.ResultsA total of 127 women were invited to the EPLSC, with 110 (87%) attending, and 17 (13%) not attending their appointment. SAPS scores ranged from 21 to 28, indicating that women were either satisfied or very satisfied with the care they received at the EPLSC. Results from VAS-A scores showed that 76 (69%) women reported a decrease in anxiety immediately after attending the EPLSC, compared to 8 (7%) who reported no change or a small increase in anxiety. Qualitative findings highlighted women’s concerns around future fertility, the importance of emotional support and the value of connecting with the bereavement midwife.ConclusionAn EPLSC that focuses on providing emotional support and reassurance, particularly regarding future fertility, is important to women. Further rigorous evaluation of national disparities in EPL follow-up is urgently needed to assess the gaps in clinical care delivery.

Percutaneous treatment of type C distal radius fractures using dual-external fixator

BackgroundThis study aimed to introduce a potential alternative percutaneous treatment for AO types C1, C2, and C3 distal radius fractures using dual-external fixator (a no-bridging cemented-pin frame and a conventional wrist-bridging external fixator). Materials and methodsFrom January 2018 to January 2021, 52 patients (52 distal radius fractures) were treated with dual-external fixator. For comparison, 61 patients (61 distal radius fractures) were treated with a plate and screw system. Wrist function was assessed using the Mayo Wrist Score. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction. A P < 0.05 was considered statistically significant. ResultsFracture healing was achieved in all patients. At the final follow-up of 29 months (range, 24–34 months) vs 36 months (range, 26–39 months) (P > 0.05), the patients treated with dual-external fixator and a plate and screw system achieved mean ulnar deviations of 31° vs 29° (P < 0.05), mean Mayo Wrist Scores of 91.12 ± 5.98 vs 88.12 ± 7.54 (P < 0.05), and mean patient satisfaction scores of 23.42 ± 2.47 vs 23.04 ± 2.32 (P > 0.05). ConclusionsAO types C1, C2, and C3 distal radius fractures can be treated successfully using dual-external fixator. The technique is a potential alternative in addition to the conventional treatments. Level of evidenceLevel IIa.

Serial mediation of illness perception and beliefs about medicines in the relationship between patient satisfaction and medication adherence: An evaluation of self-regulatory model in rheumatoid arthritis and ankylosing spondylitis patients.

This study examined the effect of patient satisfaction on medication adherence through serial mediation of Self Regulatory Model (SRM) components which are illness perception and beliefs about medicines in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The 222 outpatients (nRA = 112; nAS = 110) were administered a sociodemographic form, the Medication Adherence Report Scale, the Brief Illness Perception Questionnaire, the Short Assessment of Patient Satisfaction, and the Beliefs about Medicines Questionnaire. The results showed that SRM components fully mediated the relationship between patient satisfaction and medication adherence. This proposed model had acceptable and better fit indices than the alternative model where patient satisfaction was introduced as a direct predictor. Furthermore, patient satisfaction, illness perception, and beliefs about medicines had an extremely good relationship, so these may be interpreted as variables of a latent construct of the illness experience which deserves further research in these group of patients.

Digging Deep: Medication Adherence in Chronic Diseases and Its Association With Patient Satisfaction and Stress in an Indian Metropolis.

Introduction Medication adherence is a critical aspect of managing chronic diseases. Poor medication adherence leads to therapeutic failures and increased health costs, and puts patients at potentially life-threatening risks.The impact is felt drastically by patients suffering from chronic diseases. Patient satisfaction is known to be strongly associated with medication adherence. Psychosocial factors such as depression have been proven to negatively affect medication adherence; however, to our best knowledge, the association of stress with adherence remains largely unexplored. Objectives The aim of this study is to explore or assess the relationship between medication adherence, patient satisfaction, and stress levels. Methods A cross-sectional observational study was conducted within an Indian metropolitan city (Mumbai) among adults diagnosed and treated for at least one chronic disease with a medication regimen spanning over three months. An online questionnaire was designed, incorporating validated scales such as the Adherence to Refills and Medications Scale, Short Assessment of Patient Satisfaction, and Perceived Stress Scale. Results In the study, 23.7% of participants (n=300) showed adherence to their prescribed treatment regimen. Adherence exhibited a positive association with age (p=0.009) and educational attainment (p=0.031). Additionally, a significant gender difference emerged, with males (28%) displaying higher adherence rates compared to females (16.7%) (p=0.036). Furthermore, participants reporting lower stress levels exhibited higher adherence (39.5%), while those experiencing moderate-to-high stress levels displayed reduced adherence rates (17-18.8%) (p<0.05). Patient satisfaction was also linked to adherence, as satisfied individuals demonstrated higher adherence levels (29.1%) in contrast to dissatisfied counterparts (15.7%) (p=0.011). Conclusion Level of medication adherence is much lower in India as compared to other developed nations. Various demographic factors such as age, sex, and education status influence adherence. Physician counselling plays an important role in adherence, and satisfied patients are far more adherent. Furthermore, a significant negative association was found between stress and adherence.

Acceptability, feasibility and preliminary effectiveness of Picopulse for the treatment of melasma among Malaysian women: A pilot quasi‐experimental

AbstractBackgroundWomen are greatly affected by melasma as compared to men and has a significant negative impact on their quality of life. Thus far, there are no well‐conducted trials for melasma in Malaysia.ObjectivesThis multicentre quasi‐experimental pilot study aims to determine the acceptability and feasibility of conducting a preliminary effectiveness trial for the Picopulse treatment effect on melasma severity and quality of life in Malaysian women.MethodsOutcome measures were collected from 32 participants aged 18–65 years old presenting dermal melasma with Fitzpatrick skin type III–V from OneDoc Skin Centres in Klang Valley, Malaysia at baseline, 2 weeks, and 4 weeks after intervention. All preliminary effectiveness analyses were performed under the terms of intention‐to‐treat.ResultsOverall, the average score of Short Assessment of Patient Satisfaction (SAPS) was 22.2 (SD = 4.8), this demonstrated that the treatment was satisfied and well‐accepted by all patients. The recruitment and retention rates were 48.48% and 71.88%, respectively. Twenty‐five out of 32 patients completed all 10 treatments (78.13%). There were significant mean differences in Melasma severity index (MSI) score reported with partial eta square at 0.79 (p &lt; 0.0001), physician global assessment (PGA) with partial eta square at 0.89 (p &lt; 0.0001), and melasma quality of life scale (MELASQoL) with partial eta square at 0.32 (p &lt; 0.05), from baseline measurement to 4 weeks postintervention. The three most common temporary side effects were pain (M = 0.2, SD = 0.46), redness (M = 0.12, SD = 0.24), and dryness (M = 0.11, SD = 0.17), however, all adverse effects were well‐tolerated and resolved without any treatments.ConclusionsThese findings provide promising data that support the acceptability and feasibility for future full‐scale clinical studies. This study was registered with ClinicalTrials.gov (NCT04834167).

Level of Satisfaction Towards Healthcare Services in Patients Attending Psychiatry Outpatient Department of a Tertiary Care Hospital in Eastern India.

Patients' satisfaction with healthcare services contributes to their compliance with the treatment and thus impacts their health. Therefore, patient satisfaction is increasingly being used as an indicator of health system performance in a country. Though several studies have been reported from different parts of India, most did not include psychiatric patients. This study assessed the level of satisfaction of psychiatric outpatients and its association with socio-demographic, hospital-related, and treatment-related variables. This cross-sectional study assessed 152 patients attending psychiatry outpatient department (OPD) of a tertiary care hospital. Treatment-related satisfaction was measured using the Short Assessment of Patient Satisfaction (SAPS) scale, and variables not related to treatment were assessed using Likert scales. Most participants were satisfied with the overall cleanliness of the hospital (82.9%), the useable condition of toilets (73%), and waiting time in the OPD ticket counter, doctor's room, and pharmacy. More than 80% were pleased with the OPD staff's behavior and working efficiency. In the seven dimensions of the SAPS scale, satisfaction level was variable. Overall satisfaction with the care received in the hospital was 60.5%. The level of patient satisfaction is good in psychiatry OPD services of our hospital, and it depends on treatment-independent variables also. So, liaison between the medical- and non-medical-management teams is crucial to augment patient satisfaction.

Patient satisfaction with quality of care of a multidisciplinary thrombosis service – a cross sectional survey

BackgroundIn October 2017 we opened a multidisciplinary Adult Outpatient Thrombosis Service (Thrombosis Service) in a regional health authority servicing over 300 000 people. The Thrombosis Service is a comprehensive thrombosis and anticoagulation management program with unique, interrelated clinics providing a broad spectrum of care for this patient group. Evaluation of patient satisfaction with this new model of patient care is an important quality measurement.MethodsWe conducted a cross-sectional survey of patients who attended the Thrombosis Service between October 2017 and May 2019. We measured patient satisfaction with the seven-item Short Assessment of Patient Satisfaction (SAPS) which uses a 5 point scale (0–4) for responses. The continuous score range for SAPS is 0 to 28. Categorical responses for SAPS are defined as 0–10 very dissatisfied, 11–18 dissatisfied, 19–26 satisfied, and 27–28 very satisfied. We used linear regression analysis to examine the associations between patients’ characteristics and their satisfaction with the Thrombosis Service.ResultsOf the 1058 surveys distributed, 563 were returned. The mean score for the SAPS was 22.1 (SD 4.1, range 8 to 28). For the categorical response, 85% were satisfied or very satisfied with the Thrombosis Service. The multivariate analysis showed patients with post-secondary education were more satisfied with the Thrombosis Service (β-coefficient 1.6153, p = 0.024), and patients taking warfarin were less likely to be satisfied with the Thrombosis Service (β-coefficient -1.5832, p = 0.0390).ConclusionsThe majority of survey participants (85%) who attended an appointment in one of the Thrombosis Service clinics were satisfied or very satisfied with the care they received. This information may benefit other centres who are interested in developing a program to manage thrombosis and anticoagulation.

Treatment of isolated fourth metacarpal neck fractures using the closed reduction and percutaneous intermetacarpal and external fixation

BackgroundThe isolated fourth metacarpal neck fracture is uncommon, and the appropriate management is still debatable. The aim of this retrospective study was to introduce a closed reduction and percutaneously intermetacarpal K-wire fixation external technique to treat the isolated fourth metacarpal neck fracture. MethodsFrom October 2013 to January 2018, 21 patients with closed-isolated fourth metacarpal neck fractures (angulation ≥35°, rotation ≥5°, or shortening ≥5 mm) were treated with the closed reduction and percutaneous intermetacarpal and external fixation technique. Total active motion, grip strength of the hand, dorsal prominence, and patient satisfaction were assessed. ResultsFollow-up lasted 28 months (range, 24–37 months). All patients obtained bone healing at a mean time of 5 weeks (range, 4–8 weeks). External fixation devices were removed when bone healing achieved. The mean total active motion reached 97.5% (range, 92.9%–100%) of opposite side. There were 18 excellent and 3 good results. The mean grip strength reached 98.4% (range, 96.2%–100%) of the opposite hands. Based on the 100-mm visual analogue scale, the mean dorsal prominence was 0 (range, 0 to 1). Based on the Short Assessment of Patient Satisfaction, the mean satisfaction score was 26 (range, 24 to 28). ConclusionsThe closed reduction and percutaneous intermetacarpal and external fixation technique is useful and reliable for treating the isolated fourth metacarpal neck fracture. The technique can effectively restore the fracture deformities and maintain the reduction stably, resulting in good hand function. Level of evidenceTherapeutic study, Level IV.

Implementation and evaluation of a university&#x2013;hospital partnership program for Type 2 diabetes.

Objective The aims of this study were to determine whether a university-hospital partnership program for Type 2 diabetes (T2D) would: be well attended; reduce the number of patients on the diabetes out-patient waiting list who have been waiting longer than the recommended; increase discharge from the hospital clinic; increase university health clinic (UHC) occasions of service; be sustainable; and be acceptable to participants. Method A prospective observational study was conducted between 2016 and 2019. Participants with T2D were referred to a UHC, initially from a hospital diabetes wait list. The final program consisted of 10 weeks: before and after individual assessments, as well as 8 weeks of exercise and education facilitated by health professionals and students. Participant demographic characteristics and data on attendance, discharge and follow-up requirements, the percentage of patients waiting longer than the recommended for a new hospital out-patient appointment, university activity and patient satisfaction were collected. Results In all, 130 participants commenced the program, 80% completed at least six of eight group sessions and 80% attended the final assessment. The percentage of people waiting longer than recommended decreased from 63% to 16%. The hospital discharged 87% and 59% of participants from the dietitian and endocrinologist respectively. The UHC recorded 2056 occasions of service and 2056 student experiences including dietetics, exercise physiology, psychology, nursing, optometry, social work and podiatry students relating to the program. Satisfaction was high, as measured by the Short Assessment of Patient Satisfaction, with a mean score of 23.9 from a possible score of 28.0 (n = 93). Conclusion The partnership resulted in a new model of care for patients with T2D and increased learning experiences for students. What is known about the topic? Diabetes is the fastest growing disease in Australia, placing unsustainable demands on the health system. Access to patient-centred care and self-management education is essential to optimise glycaemic control, prevent or delay complications and maintain quality of life. The increasing demand of diabetes on the health system affects access to timely care, with unacceptably long wait times reported, resulting in an increase in morbidity and mortality and poor patient satisfaction. A potential solution is the use of clinical students to contribute to service delivery. Student-assisted and student-led health clinics have increased access to care across the globe for many years. What does the paper add? Although group education has the potential to reduce the burden on clinical service delivery, it was unclear whether a partnership program using students and university and hospital resources would be acceptable to people with T2D and whether this model delivered at a UHC would be sustainable and of benefit to both the health service and university. The results of the evaluation suggest that a university-hospital partnership program is well accepted by participants, well attended, reduces the number of patients waiting for a hospital appointment longer than the acceptable waiting times, increases UHC activity and provides interdisciplinary student experiences. As such, this paper provides evidence that this model of care offers a potential solution to increasing demands for health services for diabetes and student clinical experience. What are the implications for practitioners? Partnerships between UHCs and hospitals offer a sustainable solution to increasing demand for diabetes services and student training requirements. The description of the development, implementation and evaluation processes can be used by practitioners and educators as a framework for the translation of similar models of care to meet demands in other areas where demand for health services exceeds capacity.

Percutaneous reduction and fixation technique for 4th metacarpal shaft fracture

The objective of this retrospective study was to introduce a percutaneous reduction and intermetacarpal K-wire fixation technique for the treatment of the 4th metacarpal shaft fracture. From January 2014 to February 2017, 25 patients with isolated closed 4th metacarpal shaft fracture (angulation > 30°, rotation > 5°, or shortening > 5 mm) were treated by percutaneous reduction and internal fixation. Assessment comprised total active motion, grip strength, dorsal prominence, and patient satisfaction. Bone healing was achieved in all patients. At a mean follow-up of 28 months (range, 25–32 months), total active range of motion averaged 98% of contralateral values (range, 88%–100%). There were 20 excellent and 5 good results. Grip strength averaged 97% of contralateral values (range, 88%–100%). Mean dorsal prominence on a 100-mm visual analogue scale was 0 (range, 0–1). Mean satisfaction rating on the Short Assessment of Patient Satisfaction 26 (range, 22–28). Percutaneous reduction and intermetacarpal K-wire fixation is a useful technique for treating 4th metacarpal shaft fracture, achieving stable and reliable fixation, with good hand function.

Steroids Versus Steroids With Dexmedetomidine In Ultrasound Guided Sacroiliac Joint Injection In Patients With Chronic Low Back Pain

The goal of this study is to evaluate the effect of adding dexmedetomidine as an adjuvant to steroid injection versus steroid alone in chronic low back pain caused by sacroiliac joint arthritis. Sixty patients of both sex, ASA grade 1 and 2, between the ages of 18-70 years, BMI less than 30 kg/m2, after diagnosis of sacroiliac joint dysfunction and failure of conservative management were randomly allocated into two groups (n=30). Group (1): patients received SI injection with 2ml of long-acting corticosteroid (14 mg Betamethasone) and 0.5 ml of normal saline and group (2): patients received SI injection with 2ml of long-acting corticosteroid (14 mg Betamethasone) and 0.5ml dexmedetomidine (50 mcg). Patients were observed for vital signs, pain intensity and possible side effects in the recovery room for 4 hours then discharged. The patient’s pain intensity using Numerical Rating Scale, or functional improvement using Oswestry Disability Index and Functional Rating Scale and complications were followed up at 2 weeks, 4 weeks and 12 weeks. While, short assessment of patient satisfaction was assessed 2 weeks after injection. The results revealed that addition of dexmedetomidine to steroids in sacroiliac joint injection is of low value. There was no statistically significant difference between the steroid group and the dexmedetomidine group regarding the changes in the NRS, ODI and FRI scores at 2 weeks, 4 weeks and 12 weeks after injection.

Newborn in Neonatal Intensive Care Unit: Parental Concerns

Background:Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents.Objectives:This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at dischargeStudy Design:Semiqualitative interview.Participants:Parents of 100 (56 M, 44 F) neonates.Intervention:We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ).Results:Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors.Conclusions:This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.

Patient Satisfaction with Quality of Care of a New Multidisciplinary Thrombosis Service

INTRODUCTION As patient centered healthcare is becoming increasingly popular, it is important to assess patient satisfaction with this approach. We started a new multidisciplinary Adult Outpatient Thrombosis Service (TS) in October 2017 in a Canadian health authority servicing over 300 000 people. The TS is a comprehensive thrombosis and anticoagulation management program with unique, interrelated clinics providing the spectrum of care required for this patient group. The TS includes an Emergency Thrombosis Clinic for care after an acute episode of venous thromboembolism; Thrombosis Clinics addressing non-urgent thrombosis questions and follow up; Anticoagulation Management Clinics for patients on extended duration anticoagulation; and a Perioperative Anticoagulation Management Clinic for patients on anticoagulation requiring surgery or procedures. The TS is staffed by Pharmacists, a Thrombosis Physician/Hematologist, and Clerical staff. The objective of this study was to assess patient satisfaction with the TS. METHODS We conducted a cross sectional survey of patients attending at least one appointment at the TS between October 2017 and May 2019 and who had a valid mailing address available in the hospital records. Eligible patients (n=1058) were mailed an anonymous survey with a cover letter and self-addressed, return stamped envelope. Patient satisfaction with the TS was measured using the seven item Short Assessment of Patient Satisfaction (SAPS), a validated, convenient satisfaction survey tool. The SAPS assesses the core satisfaction domains including treatment satisfaction, explanation of treatment results, clinician care, participation in decision-making, respect by the clinician, time with the clinician, and satisfaction with clinic care. The SAPS utilizes 5-point responses (0-4), with the continuous score range from 0 (extremely dissatisfied) to 28 (extremely satisfied), and categorical responses (0-10 very dissatisfied, 11-18 dissatisfied, 19-26 satisfied, and 27-28 very satisfied). Additionally, five patient characteristic questions were included. Patients were also given the opportunity to respond to an open-ended question regarding the care they received. Participant characteristics and responses are presented using descriptive statistics; linear regression was used to explore variations across characteristics. Qualitative content analysis of open-ended question comments was used to further our understanding of the patient experience and perceived quality of care. RESULTS A total of 563 surveys were returned for a response rate of 53%. Nine were excluded due to more than 2 missing SAPS item answers. Most respondents (87%, n=481) were 50 years of age or older, and 51% (n=285) were male. About two-thirds (67%, n=368) had post-secondary education. About half (54%, n=296) were taking a direct oral anticoagulant (DOAC), about one fifth taking warfarin (19%, n=102), or on no anticoagulant (19%, n=104) at the time of survey response. Almost half had taken the anticoagulant for 1 to 5 years at the time of survey response (47%, n=255), with the remainder split between less than 1 year (28%, n=152), and greater than 5 years (25%, n=137). The mean score for the SAPS was 22.1 (SD 4.1, range 8 to 28). Based on the categorical response, 85% were satisfied or very satisfied with the TS. Multivariate analysis showed that patients with post-secondary education were more satisfied with the TS (β=16.153, p=0.024), and patients taking warfarin were less satisfied with the TS (β= -15.832, p=0.039). The SAPS tool demonstrated a high internal consistency when assessed for reliability using Composite reliability tests (0.86). Forty percent (n=223) provided written responses to the open-ended question. The majority of responses described positive patient experiences and perceptions regarding the TS and quality of care received. Four major themes emerged: service organization and coordination of care, patient-provider relationship, pharmacist-led medication therapy management, and patient-centered delivery and communication of health information. CONCLUSION To our knowledge, this is the first survey to assess patient satisfaction with a multidisciplinary TS. We found a high proportion (85%) of respondents were satisfied with the care provided. Disclosures Young: Sanofi Canada: Honoraria, Research Funding; Bayer: Research Funding; Pfizer: Honoraria. Chitsike:Sanofi Canada: Honoraria, Research Funding; Bayer Canada: Research Funding.

Addressing Disparities in Prenatal Care via Telehealth During COVID-19: Prenatal Satisfaction Survey in East Harlem.

Objective In the setting of an inner city, safety net hospital, patient satisfaction with prenatal care conducted via telehealth was compared with in-person visits at the height of the novel coronavirus disease 2019 (COVID-19) pandemic. Study Design Through this cross-sectional study, patients were identified who received at least one televisit and one in-person visit during the COVID-19 pandemic. The Short Assessment of Patient Satisfaction (SAPS) survey was used to measure patient satisfaction. Surveys pertaining to in-person and televisits were conducted at the end of a telephone encounter, and overall satisfaction scores were documented. Patients were excluded if they received in-person or virtual care only and not both. The SAPS score correlated with the degree of patient satisfaction. Results A total of 140 patients were identified who received both virtual and in-person prenatal care from March 1, 2020 to May 1, 2020. One hundred and four patients (74%) agreed to be surveyed: 77 (74%) self-identified as Hispanic and 56 (54%) stated that their primary language was Spanish. The overall median satisfaction score for televisits and in-person visits was 20 (interquartile range [IQR]: 20, 25) and 24 (IQR: 22, 26) ( p = 0.008, Z score = 2.651). In patients who self-identified as Hispanic or identified their primary language as Spanish, there was no statistically significant difference in their satisfaction scores. Conclusion While there were lower scores in patient satisfaction for televisits in every category, there were no clinically significant differences since all medians were in the “satisfied” range. By lowering patient exposure to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), especially for those at risk for reduced access to care and higher COVID-19 cases by zip code, telehealth allowed for appropriate continuation of satisfactory prenatal care with no impact on patient perceived satisfaction of care. Key Points Telehealth allowed for continuation of satisfactory prenatal care in Hispanic patients.Hispanic patients are at risk for reduced access to care.Telehealth was a useful tool for achieving patient-perceived satisfactory care.

The role of demystifying anaesthesia in allaying anxiety and improving post-operative patient satisfaction in a tertiary care centre: A randomised control trial

Preoperative anxiety and stress are inevitable in patients awaiting surgery. However it is known that larger doses of anaesthetics, higher peri- and post-operative requirement of analgesia and longer hospital stay follow higher levels of anxiety. Studies have shown that pre-operative education reduces anxiety symptoms. This studywas undertaken to answer the question: “Does a structured educational intervention to demystify anaesthesia reduce fear and anxiety prior to surgery?” To assess the role of patient education in reducing pre-operative anxiety and fear and improving satisfaction in patients undergoing surgery using the Anesthesia- and Surgery-dependent Preoperative Anxiety Scale (ASPA)and the Visual Analog Scale for fear and the Short Assessment of Patient Satisfaction (SAPS) in patients who have received the structured educational intervention and those who have not.This is aparallel group, single blinded, randomised control trial in 56 consenting patients awaiting abdominal surgery under general anesthesia. The participants were randomized to the interventional and comparator groups and ASPA and VAS were administered. Participants in Group A were given the structured educational intervention to demystify anesthesia. The ASPA and VAS Scales were again administered by a blinded assessor to all participants. The student investigator administered SAPS on the third post-operative day or prior to discharge, whichever was earlier. There was significant reduction in median scores before and after intervention for anxiety (ASPA=2) and fear (VAS=20) in intervention group compared to the comparator group. (p value=&amp;#60;0.001). The median scores for patient satisfaction as measured by SAPS was also higher in the intervention group compared to the comparator group.(p value=0.042).There was a significant reduction of pre-operative fear and anxiety in the intervention group, while the patient satisfaction was also higher in the intervention group.

Comparison of pediatric sports fracture outcomes based on provider type

ABSTRACT Objective: Pediatric primary care sports medicine physicians and pediatric sports medicine orthopedic surgeons, in conjunction with physician assistants (PAs), often manage patients with fractures. We sought to determine if pediatric patients with fractures seen by primary care sports medicine physicians had similar outcomes and satisfaction as those seen by orthopedic surgeons. Methods: We performed a retrospective chart review of four to 18-year-old patients who were treated by a sports medicine provider (primary care or orthopedic surgeon/PA) for a fracture of the radius, ulna, tibia, or fibula. Patients or their parents completed a patient satisfaction survey (Short Assessment of Patient Satisfaction [SAPS]) and an injury location-specific patient-reported functional outcome tool: the Foot and Ankle Ability Measure (FAAM) or the Disabilities of the Arm, Shoulder, and Hand (DASH) Scale. Results: Fifty-seven (70%) of the 82 patients were treated by pediatric primary care sports medicine physicians and 25 (30%) were treated by a pediatric sports medicine orthopedic surgeon or surgical PA. The median time from injury to clinically confirmed healing was similar between the two groups (47 vs 60.5 days; p = 0.54), as was the patient satisfaction (SAPS median score = 26 [range = 19–28] vs 24 [range = 9–28]; p = 0.12). Patient-reported outcomes did not differ significantly between groups for the functional outcome tools. Conclusions: Patients seen by pediatric primary care sports medicine physicians and sports medicine orthopedic surgeons have similar patient-reported fracture outcomes and similar satisfaction with care. Pediatric patients with fractures will likely have favorable outcomes when cared for by either of these subspecialty providers.

Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study.

BackgroundGlobally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey.ObjectiveThis study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss.MethodsA nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic’s Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services.ResultsOf the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family.ConclusionsThis study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption.&#x0D; Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section.&#x0D; Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively.&#x0D; Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.&#x0D; Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

ASSESSING PATIENT OUTCOMES FOLLOWING A FRACTURE

Background: Both primary care sports medicine physicians and orthopedic surgeons, in conjunction with advanced practice providers, often manage young patients with fractures. To our knowledge, no investigations have evaluated patient outcomes based on the type of provider they see for fracture management. This study examined fracture management, patient outcomes, and patient satisfaction in pediatric and adolescent patients with fibula, tibia, radius and ulna fractures. Specifically, we sought to determine if there were differences between patients seen by a primary care sports medicine physician or orthopedic surgeon/physician assistant (PA) on measures of time to clearance from the injury, patient-reported functional outcomes, and patient satisfaction. Methods: A retrospective chart review was performed for 4-18 year-old patients who were treated by a sports medicine provider (primary care or orthopedic surgeon/PA) for a fracture of the radius, ulna, tibia or fibula over the course of three months. We contacted patients approximately 10 months post-injury. Patients or their parents completed a patient satisfaction survey (Short Assessment of Patient Satisfaction [SPAS]) and an injury location-specific patient reported functional outcome tool: the Foot and Ankle Ability Measure (FAAM) was used for patients with fibular or tibia fractures; the Disabilities of the Arm, Shoulder, and Hand (DASH) Scale was used for patients with radius or ulna fractures. The SPAS is scored from 0-28 with higher scores indicating higher satisfaction. The DASH is scored from 0-110, while the FAAM is scored from 0-140. For the DASH and FAAM, 0 indicates the least disability. Results: 83 of 139 (60%) of patients who were contacted completed the study. 58 (70%) of patients were treated by pediatric primary care sports medicine physicians and 25 (30%) were treated by a pediatric sports medicine orthopedic surgeon or the surgeon’s PA. Both patient groups (Table 1) were of similar age (10.3±3.1 vs. 8.9±3.9 years; p= 0.09), proportion of females (47% vs. 36%; p= 0.47), proportion of upper extremity injuries (67% vs. 80%; p= 0.30), and number of x-rays obtained (3.2±3.5 vs. 3.5±1.8; p= 0.60). The median time from injury to clinically-confirmed healing was similar between the two groups (47 vs 60.5 days; p=0.54), as was the overall patient satisfaction (Table 2) on the SPAS (median score = 26 [range = 19-28] vs 24 [range 9-28]; p = 0.11). In addition, the patient reported outcomes did not differ significantly between the two groups for the DASH (median score=0 [range= 0-11] vs. 0 [range= 0-43], p= 0.47), or the FAAM (median score= 0 [range= 0-47] vs. 0 [range= 0-0], p= 0.36). A greater proportion of patients that were treated by sports medicine primary care physicians reported they would prefer to see a sports medicine primary care physician for future care relative to the pediatric sports medicine surgeon group (Table 3; 74% vs. 20%; p&lt; 0.001). In contrast, those seen by a sports medicine surgeon or PA indicated they would prefer to see a pediatric PA or pediatric nurse practitioner in the future relative to the pediatric sports medicine primary care group (28% vs. 2%; p= 0.001). Conclusion/Significance: Pediatric primary care sports medicine physicians and pediatric sports medicine orthopedic surgeons, with their PAs, have similar outcomes when caring for young patients with fractures of the radius/ulna and tibia/fibula. Patients report equal satisfaction with their care. Patients will likely have favorable outcomes when they are cared for by any of these providers. Tables and Figures: [Table: see text]

Application of Path-Goal and Transformational Leadership Theory to Improve Patient and Provider Satisfaction with APP-Led Survivorship Care: A Quality Improvement Initiative

Introduction A limited number of survivorship models have been implemented following theoretical frameworks to promote patient and provider satisfaction. The purpose of this quality improvement (QI) initiative was to evaluate both parties' satisfaction with a newly implemented advanced practice provider (APP) led survivorship visit and apply theoretical principles of Path-Goal (PG) and Transformational Leadership (TL) to enhance outcomes. Methods We surveyed a convenience sample (n = 11) of adult cancer survivors ages 36-75 undergoing survivorship visits at day 100 (n = 5) and at 1 year (n = 6) post stem cell transplant (SCT) and APP's (n = 7) conducting the visits following an interrupted QI design. Satisfaction scores were obtained from both parties using a modified version of the validated Short Assessment of Patient Satisfaction (SAPS). Scores of > 19 were considered satisfying. Additionally, 10-point Likert scales, binary, and open-ended questions were used to assess satisfaction, self-management, and survivorship care plan (SCP) utility. We analyzed the data using descriptive statistics, reporting median scores and percentages for the most common results. For open-ended questions, qualitative analysis was used to identify themes. Results We found patients were satisfied with the visit (median SAPS 25, range 19-28). Additionally, 100% were very satisfied with the effect of their care, found the SCP useful and reported improved post-visit self-efficacy. Conversely, providers were overall dissatisfied (median SAPS 14, range 6-19). Only 28% were satisfied with care they provided and 42% were dissatisfied with their plans. We also found 42% of providers and 23% of patients were dissatisfied with explanations about post-SCT risks. Furthermore, 29% of providers and 36% of patients were dissatisfied with care planning decisions. Conclusion Our APP-led survivorship model was satisfying for patients. However, provider satisfaction was low. Both parties expressed dissatisfaction with education about post-SCT risks and decisions affecting care planning. Results of a theory based provider intervention to enhance satisfaction will be presented at the 2019 Transplant and Cellular Therapies Meeting in February 2019.