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									International Journal of Management (IJM), ISSN
INTERNATIONAL JOURNAL 0976 – MANAGEMENT (IJM)      OF 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME


ISSN 0976-6502 (Print)
ISSN 0976-6510 (Online)
                                                                                  IJM
Volume 5, Issue 2, February (2014), pp. 01-09
© IAEME: www.iaeme.com/ijm.asp
                                                                            ©IAEME
Journal Impact Factor (2013): 6.9071 (Calculated by GISI)
www.jifactor.com




   SATISFACTION LEVEL OF IPD PATIENTS WITH MEDICAL SERVICES

                              Dr. Satpal Singh1,   Dr. Shipra Jain(PT)2
      1
          Assistant Professor, Department of Management Studies, D.C.R.U.S.T. Murthal, Sonepat
                    2
                      Masters of Hospital Administration, D.C.R.U.S.T. Murthal, Sonepat


 ABSTRACT

 SUBJECT
         This dissertation report presents the methodology and result of patient experiences and
 satisfaction about medical care in In-patient department of NKS Hospital.

 OBJECTIVES
        The objective of study was to determine the level of patient satisfaction about medical care
 services provided at NKS hospital through the use of patient satisfaction questionnaire.

 METHODOLOGY
         The Patient satisfaction questionnaire was allowed to fill up by the 50 randomly selected
 patients from the IPD at NKS Hospital.

 DATA COLLECTION
 Data were collected through patient satisfaction questionnaire.

 DATA ANALYSIS
 For the purpose of data analysis one has used the Microsoft Excel.

 RESULT
         Results are expressed through the findings of the tables and graphs. The result suggests that
 although patient level of satisfaction was different for different aspect of medical care services,
 mostly patients were satisfied with the service and service providers. We are able to determine how
 the level of satisfaction is an important indicator of patient’s experiences to medical services.

 RECOMMENDATIONS
         With these results, one can manifest the level of patient satisfaction for determining the
 quality of care given in IPD and develop strategies to improve the patient care. Since this study
 shows the satisfaction level slightly above the average in the IPD of NKS Hospital so in future a

                                                   1
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

study can be conducted on OPD to check the level of satisfaction and relate the satisfaction level
with the IPD.

INTRODUCTION

        The statement of problem identifies the gap in knowledge pertaining to the patient
satisfaction as it directly relates to perception of caring nursing behaviors. In addition, the problem
statement provides the researchers with a clear direction for the development of the research purpose.
In addition, the authors make a clear case that additional research is warranted, especially with the
extension of nursing in our country. In the literature review, the authors cite several studies
describing caring knowledge in nursing, but the lack of true evidence regarding caring consequences.
The purpose of this study was firstly to analyze the possibility of characterizing the patient’s
responses typologically, taking into account patient evaluations of medical care; and secondly, to
identify the particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction.
Understanding patient satisfaction with the healthcare provided by family doctors is, first and
foremost, essential for improving the quality of medical care.
        There are basically three reasons why patient satisfaction is viewed as an important tool for
measuring aspect of care. Firstly, there is convincing evidence that satisfaction is an important
outcome measure. It may be a predictor of whether patients follow their recommended treatments,
and is related to whether patients re-attend for treatment and change their provider of health care.
Secondly, patient satisfaction is an increasingly useful measure in assessing consultations and
patterns of communication. Thirdly, patient feedback is used systematically to choose between
alternative methods of organizing or providing health care.

PATIENT SATISFACTION AS MEASURE OF HEALTHCARE

           An important outcome measure.
           Useful in assessing consultations and patterns of communication.
           Used systematically, feedback enables choice between alternatives in
           Organising or providing healthcare.

REVIEW OF LITERATURE

        Doris C. Vahey (2004 February) studied that high levels of nurse burnout could adversely
affect patient satisfaction. This study examines the effect of the nurse work environment on nurse
burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction
with their nursing care. They conducted cross-sectional surveys of nurses (N = 820) and patients (N
= 621) from 40 units in 20 urban hospitals across the United States. Nurse surveys included measures
of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse
outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were
interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient
Satisfaction Scale (LOPSS).
        This research concluded that improvements in nurses' work environments in hospitals have
the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and
increase patients' satisfaction with their care.
        Mair F, Whitten P.( 2000 June) did a research into patient satisfaction with teleconsultation,
specifically clinical consultations between healthcare providers and patients involving real time
interactive video.Methodological deficiencies (low sample sizes, context, and study designs) of the
published research limit the generalisability of the findings. The studies suggest that teleconsultation

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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction
require further exploration from the perspective of both clients and providers.
         Sitzia J. (1999 Aug) did this study to assess the properties of validity and reliability of
instruments used to assess satisfaction in a broad sample of health service user satisfaction studies,
and to assess the level of awareness of these issues among study authors.
With few exceptions, the study instruments in this sample demonstrated little evidence of reliability
or validity. Moreover, study authors exhibited a poor understanding of the importance of these
properties in the assessment of satisfaction. Researchers must be aware that this is poor research
practice, and that lack of a reliable and valid assessment instrument casts doubt on the credibility of
satisfaction findings.
         Sitzia J, Wood N.( 1998 Aug) conducted the research to examine the quality of response rate
reporting and to identify methodological factors influencing response rates in published patient
satisfaction studies.Patient satisfaction studies generally show poor awareness of the importance of
methodological issues relevant to response rate. Far more attention to this aspect is needed if findings
in this field are to be accepted as valid and useful.
         Khayat K, Salter B.(1994 May) A survey was undertaken to investigate the use of a patient
satisfaction survey and whether aspects of patient satisfaction varied according to sociodemographic
characteristics such as age, sex, social class, housing tenure and length of time in education.Surveys
and analyses of this kind, if conducted for a single practice, can form the basis of a marketing
strategy aimed at optimizing list size, list composition, and service quality. Satisfaction surveys can
be readily incorporated into medical audit and financial management.
         Ann Kutney-Lee, Matthew D. McHugh (2009 June)Patient satisfaction is receiving greater
attention as a result of the rise in pay-for-performance (P4P) and the public release of data from the
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This paper
examines the relationship between nursing and patient satisfaction across 430 hospitals. The nurse
work environment was significantly related to all HCAHPS patient satisfaction measures.
Additionally, patient-to-nurse workloads were significantly associated with patients’ ratings and
recommendation of the hospital to others, and with their satisfaction with the receipt of discharge
information. Improving nurses’ work environments, including nurse staffing, may improve the
patient experience and quality of care.
         R Baker and M Whitfield(1992 June) conducted the researchto establish the validity of two
patient satisfaction questionnaires (surgery satisfaction questionnaire and consultation satisfaction
questionnaire developed for use in general practice. Both questionnaires classified patients in groups
1 and 2 according to the construct of satisfaction; thus the difference in median scores for every
component of satisfaction in each questionnaire was significant and occurred in the direction
predicted by the construct. Each questionnaire also discriminated between patients grouped
according to their assessed level of continuity of care. They concluded that SSQ and CSQ are valid
measures of satisfaction for these types of patients.
         D C Morrell and M O Roland(1986 March) An experiment was carried out in which patients
who were seeking appointments for a consultation in a general practice in south London attended
consulting sessions booked at 5, 7.5, or 10 minute intervals. The particular session that the patient
attended was determined non-systematically. The clinical content of the consultation was recorded
on an encounter sheet and on audio-tape. At the end of each consultation patients were invited to
complete a questionnaire designed to measure satisfaction with the consultation. The stress
engendered in doctors carrying out surgery sessions booked at different intervals of time was also
measured. At surgery sessions booked at 5 minute intervals, compared with 7.5 and 10 minute
intervals, the doctors spent less time with the patients and identified fewer problems, and the patients
were less satisfied with the consultation. Blood pressure was recorded twice as often in surgery
sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals.

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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

         There was no evidence that patients who attended sessions booked at shorter intervals
received more prescriptions, were investigated or referred more often to hospital specialists, or
returned more often for further consultations within four weeks. There was no evidence that the
doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals
than at consultations booked at 7.5 and 10 minute intervals, though they complained of shortage of
time more often in surgery sessions that were booked at shorter intervals.
         Vinagre, M. H. and Neves, J. (2008)."The influence of service quality and patients' emotions
on satisfaction." International Journal of Health Care Quality Assurance 21(1): 87-103. PURPOSE:
The purpose of this research is to develop and empirically test a model to examine the major factors
affecting patients' satisfaction that depict and estimate the relationships between service quality,
patient's emotions, expectations and involvement. DESIGN/METHODOLOGY/APPROACH: The
approach was tested using structural equation modeling, with a sample of 317 patients from six
Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality
evaluation and an adapted DESII scale for assessing patient emotions. FINDINGS: The scales used
to evaluate service quality and emotional experience appears valid. The results support process
complexity that leads to health service satisfaction, which involves diverse phenomena within the
cognitive and emotional domain, revealing that all the predictors have a significant effect on
satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS: The emotions inventory, although
showing good internal consistency, might be enlarged to other typologies in further research--needed
to confirm these findings. PRACTICAL IMPLICATIONS: Patient's satisfaction mechanisms are
important for improving service quality. ORIGINALITY/VALUE: The research shows empirical
evidence about the effect of both patient's emotions and service quality on satisfaction with
healthcare services. Findings also provide a model that includes valid and reliable measures
         Watrous, J. and Hobson, A. (1994)."A systems approach to gathering and analyzing patient
and family complaints and suggestions." Journal for Healthcare Quality 16(6): 14-6.
         Most medical facilities' leaders are concerned with satisfying the patients who use their
healthcare organization. Whereas many facilities have identified specific individuals whose job it is
to hear patient complaints, the authors promote the view that all staff members play important roles
in patient advocacy. Management's role is to determine how to collect and analyze the complaints
and suggestions voiced by patients throughout their healthcare experience. This article presents one
method.
         Wensing, M. and Elwyn, G. (2002)."Research on patients' views in the evaluation and
improvement of quality of care." Quality & Safety in Health Care 11(2): 153-7.
         The identification of methods for assessing the views of patients on health care has only
developed over the last decade or so. The use of patients' views to improve healthcare delivery
requires valid and reliable measurement methods. Four approaches are recognised: inclusion of
patients' views in the information to those seeking health care, identification of patient preferences in
episodes of care, patient feedback on delivery of health care, and patients' views in decision making
on healthcare systems. Outcome measures for the evaluation of the use of patients' views should
reflect the aims in terms of processes or outcomes of care, including possible negative consequences.
Rigorous methodologies for the evaluation of methods have yet to be implemented.
         VanderVeen, L. and Ritz, M. (1996). "Customer satisfaction: a practical approach for
hospitals." Journal for Healthcare Quality 18(2): 10-5. A California hospital developed a program to
better serve and satisfy its customers. This article details the hospital's plan to implement the
program with the collection and use of data to measure success, promote
staff accountability, and, ultimately, demonstrate improved customer satisfaction as measured by
fewer complaints. The various activities initiated to promote staff education and recognize
employees also are briefly addressed.


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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

        Turnbull, J. E. and Luther, K. M. (1996). "Patient satisfaction report paves way to improved
care." QRC Advisor 13(1): 1-7. In this article, the second in a two-part series, we show how a data-
driven clinical model was implemented to improve care using patient satisfaction reports. Last
month, we outlined the essential components of a data-driven clinical model and summarized two
research paradigms that provide the theoretical foundation
for such a model.
        Trumble, S. C., O'Brien, M. L., O'Brien, M. and Hartwig, B. (2006). "Communication skills
training for doctors increases patient satisfaction." Clinical Governance 11(4): 299-307.
Purpose - The purpose of this paper is to examine changes in patients' satisfaction after their doctor
has participated in a brief educational intervention on medico legal risk management.
Design/methodology/approach - Questionnaire completed by ambulatory patients, measuring
satisfaction with their doctor's communication skills before and three months after the doctor
participated in a three hour workshop on medico legal risk management. 75 obstetrician/
gynecologists (O&Gs) and 99 general practitioners (GPs) were each rated by 60 of their patients
following a consultation in their clinical rooms. Findings - Patient satisfaction as evidenced by
change to "complete satisfaction" with doctor's communication skills and overall satisfaction with
the clinical encounter. Practical implications - Participants had high initial patient satisfaction ratings
and these were found to have improved across all parameters three months after the educational
intervention. Originality/value - The educational intervention was successful in improving doctors'
communication skills as evidenced by enhanced patient satisfaction in all key areas, including those
most frequently associated with patient complaint, litigation and adverse outcome.
        Triolo, P. K., Hansen, P., Kazzaz, Y., Chung, H. and Dobbs, S. (2002). "Improving patient
satisfaction through multidisciplinary performance improvement teams" Journal of Nursing
Administration 32(9): 448-54. Hospitals today are challenged by high patient census, rising acuity,
and workforce issues that can result in a serious decline in overall patient satisfaction. This article
discusses how one hospital tackled the issue of declining patient satisfaction scores on five
"troubled" patient care units through a performance improvement strategy that included MD-RN
partnerships, co-mentoring, and unit staff development and involvement in the problem-solving
process. The result was a steady improvement in patient satisfaction over a 6-month period.

METHODOLOGY

STUDY DESIGN
        A survey was conducted on 50 randomly selected populations in the In-Patient Department of
NKS Hospital. Patient Satisfaction Questionnaire was used as tool for collecting data from the
randomly selected sample. The questionnaire was allowed to be filled up by individual subject in
order to prevent any kind of bias.

SAMPLE DESIGN
        Fifty patients were randomly selected from the Indoor Department of NKS hospital. All were
receiving treatment for their underlying medical condition.

DATA COLLECTION
        For present study, primary data are collected by personal interviews, observation and a set of
questionnaire to be filled by Patients/Attendants. A number of questions concerning to various
factors associated with Medical Care in I.P.D. Department are framed with a view to assess the
level of satisfaction in admitted patients and these questions are in proper sequence. Most of the
questions are of multiple choices and close ended type and filled by using survey method


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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

PROCEDURE
        Each subject was allowed to fill the Patient Satisfaction Questionnaire in the standard way.
Prior to filling of questionnaire clear instruction was given regarding the allocation of answers.

OBJECTIVE OF STUDY
     To determine the level of patient satisfaction in the IPD of NKS Hospital. Its purpose is to
     analyze the level of patient satisfaction about the medical services.
     To determine what factors are most likely to influence satisfaction with inpatient medical
     care.
     To explore the extent to which satisfaction is a meaningful indicator of patients’ experience
     of healthcare services.

DATA ANALYSIS & INTERPRETATION

        Among 50 randomly selected patients, all completed the questionnaire with a response rate of
100%. All the results were analysed by using Patients Satisfaction Questionnaire through the use of
tables, graphs

                                                   TABLE NO.1
 SR.                QUESTION ASKED FROM PATIENTS                             S.A   A.   N.O.   D.   S.D.   TOTAL
 NO.                                                                                                        PTS.
  1    Doctor’s explain the reasons for medical tests                         2    9    22     13    4       50

  2    Doctor’s consultation room is well equipped to provide                 5    16   11     15    3      50
       comprehensive medical care….
  3    Perfectness of medical care                                            9    19    8     8     6      50

  4    Sometimes doctors make me wonder if their diagnosis is correct         0    9    22     13    6      50

  5    Cost of medical care is affordable financially                        15    17    9     7     2      50

  6    Doctor’s examine patients carefully to check everything when           3    9    28     6     4      50
       treating
  7    Patients have to pay more for medical care than they can afford        2    5    17     17    9      50

  8    Availability of medical specialists on patient’s need                 15    23    2     6     4      50

  9    Waiting time is too long for emergency treatment                       0    5     6     23   16      50

  10   Doctors act too businesslike and impersonal toward patients            0    6     9     22   13      50

  11   Doctors are friendly and courteous towards patients                   17    24    7     2     0      50

  12   Sometimes healthcare professionals hurry too much when they treat     13    6     5     19   17      50
       patients.
  13   Is it hard to get an appointment for medical care on patient’s need    0    0     3     28   19      50
       and right away
  14   dissatisfaction with some things & departments while getting the       9    8    10     14    9      50
       medical care
  15   Patients get medical care & immediate attention of healthcare         11    27    5     7     0      50
       professionals whenever patients need it

S.D. - STRONGLY DISAGREE, D - DISAGREE, N.O. - NO OPINION, A - AGREE, S.A. -
STRONGLY AGREE


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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

Graph 1: SHOWING THE SATISFACTION LEVEL AMONG PATIENTS IN I.P.D.
DEPARTMENT


               PATIENT SATISFACTION IN I.P.D. DEPARTMENT
             STRONGLY AGREE      AGREE     NO OPINION        DISAGREE       STRONGLY DISAGREE




                                2                                       0
                                                                        2                       0
         4     3                      4          4
                    6     6                                                                     7
                                7           9                           7               9
                                      6          6             13
                                                        16                  17
        13    15    8                                                             19            5
                                                 2
                          13    9
                                                                                       14
                    8                      17
                                                                    24
              11                     28          23            22
                                17                                          19                  27
        22                                              23                             10
                          22
                    19
                                                                                  28
                                           17
              16                                                                        8
                                                               9             5
                                      9                 6
         9                                                                   6
                          9                 5
                                                        5      6
                                                                                  3
                                                                                  0
         1     2    3     4     5     6     7    8      9      10   11      12    13   14       15

                                             GRAPH 1

                                                                           concluded:
From the data analysis from above table and graph, the following result is concluded

       The level of patient satisfaction is low in doctor’s explanations for medical test in NKS
       hospital.
            evel
       The level of satisfaction is average for the availability of medical facilities.
       The level of satisfaction is high for perfectness of medical care in NKS Hospital.
       The level of patient satisfaction is below average in NKS Hospital.
       The level of satisfaction for the cost of medical services is high in NKS Hospital.
       The level of patient satisfaction was average for alertness of medical practitioners in NKS
       Hospital.
       The patients level of satisfaction for affordability of treatment is average in NKS Hospital.
            evel
       The level of satisfaction is high for accessibility of medical services in NKS Hospital.
       The level of satisfaction is high for waiting time to get emergency medical services in NKS
       Hospital.
                                                                         high
       The level of satisfaction for attitude of medical professional is high for NKS hospital.
       The level of satisfaction is high for behaviour of medical professional towards them in NKS
       Hospital.
       The level of satisfaction is high for time spent with doctors in NKS Hospital.
                                                    convenience
       The level of patient satisfaction is low for convenience to get service in NKS Hospital.


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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

       The level of satisfaction is high for dissatisfaction related to some medical services in NKS
       Hospital.
       The level of satisfaction is high for opening hours in NKS Hospital.

CONCLUSION

        Initially, researchers focused on patient satisfaction as an intermediate condition in order to
reach desirable clinical outcomes such as patient compliance with recommended treatment.
Gradually, patient satisfaction was shifted to a final outcome for evaluating and improving health
and care services. So, the goal of the study was to conduct a patient’s satisfaction survey to
determine the patient’s level of satisfaction in different aspect of medical care & to explore the extent
to which satisfaction is meaningful indicator of patient’s experience of healthcare services. This
study was conducted by an analysis of primary data from the NKS Hospital, New Delhi, INDIA. The
database contained patient responses to self-administered satisfaction questionnaires and information
about medical care services characteristics. The result suggests that although patient level of
satisfaction was different for different aspect of medical care services, mostly patients were satisfied
with the service and service providers. We are able to determine how the level of satisfaction is an
important indicator of patient’s experiences to medical services.

RECOMMENDATIONS

        In comparable settings, if care providers wish to improve the quality of health services from a
patients’ perspective, they should give priority to provide reasons and explanation for the treatment
and medical test to the patients and family members. Further studies are recommended to discover
complementary predictors in formation of overall satisfaction. Since this study shows the satisfaction
level slightly above the average in the IPD of NKSHospital so in future a study can be conducted on
OPD to check the level of satisfaction and relate the satisfaction level with the IPD.

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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),
Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

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  19.   Dr. Satpal Singh and Dr. Sahil, “Study on Medical Tourism Global Competition in
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        Journal of Marketing & Human Resource Management (IJMHRM), Volume 5, Issue 1, 2014,
        pp. 9 - 21, ISSN Print: 0976 – 6421, ISSN Online: 0976- 643X.
  20.   Dr. Satpal Singh and Dr. Pankaj, “Health Care Quality Assurance: Emergency Department of
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        (IJARM), Volume 5, Issue 1, 2014, pp. 31 - 41”. ISSN Print: 0976 – 6324, ISSN Online:
        0976 – 6332.



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