Title: ‘Patient Satisfaction towards United Arab Emirates Healthcare: Research Survey of UAE Patients’
Introduction
There has been increasing emphasis on the use of patient satisfaction survey to assess elements of quality care at UAE hospital institutions and health care providers of the country however, how the patient satisfaction surveys are used to change service policies has received in less attention. UAE hospitals that compete for paying customers have reasons for achieving feedback about the satisfaction as the surveys provide information that can inform development and policy into the UAE context, assess effectiveness of the satisfaction for adapting in to patient needs and at the UAE hospital level, focused benchmarking with other care institutions can prompt action to improve services. Furthermore, the need for patient satisfaction is imperative within the UAE health care as there has been notion that patient satisfaction has long been considered an important componentwhen measuring health outcomes and quality of care (Donabedian, 1966; Ware, Davies-Avery and Stewart, 1978). Thus, rising strength of consumerism in society highlights the centralrole patients’ attitudes play in health planning and delivery (Baker, 1990; Williams and Calnan, 1991). Furthermore, satisfied patient is more likely to developa deeper and longer lasting relationship with their medicalprovider, leading to improved compliance, continuity of care,and ultimately better health outcomes (Larsen, 1976; Fitzpatrick, 1991). Henceforth, health care recipients in developing and newly developed nationsare particularly sensitive to perceptions of the quality oftheir health care delivery systems when compared with thosein advanced economies (Haddad, Fournier and Potvin, 1998). This is importantissue in UAE as well as other Arab Gulf countries, having in sufficientresources to provide clinical care model similar in Western countries. However, UAE from union of seven sovereign sheikhdomsin the Arabian Gulf assume health development that were negligible until 1950s. The UAE constitution states that health care is the right ofevery individual and that the state is responsible for providinghealth care facilities for keeping in effective prevention and treatment ways integrating patient satisfaction (Bener, Abdullah and Murdoch, 1993).
Table of Content
Abstract__________________________________________ p. 3
Research Statement____________________________ pp. 4-7
Introduction___________________________________ pp. 8-13
Research Aims/Objectives
Research Questions
Literature Review____________________________ pp. 14-20
Patient Satisfaction
Patient Satisfaction Survey
Research on UAE Context
Integration of Patient Satisfaction
Aspects of Patient Satisfaction Survey at UAE hospital institutions
Patient Satisfaction Survey Development
Research Methodology______________________________ pp. 24-32
Research Design and Data Collection
Patient Satisfaction Survey Organization
Results, Analysis and Presentation__________________________ pp. 44-50
Summary, Conclusion and Recommendation__________________ pp. 51-54
References/Bibliography_________________________________ pp. 55-60
Overview, preliminary topic analysis with reference to gaps in literature
The research will be centering on patient satisfaction and its patient satisfaction survey methodology. Several health care providers have launched patient satisfaction surveys without realizing research approach complexities, as the research will be executing patient satisfaction survey from within the UAE context, as such revival of interestin patient satisfaction as various perspectivesand definitions from within components of UAE centered satisfaction will be explored from within comprehensive survey method model will need to be considered, from the issues involved in order to design surveys towards patient satisfaction at UAE health care. The effectiveness of qualitative technique will be recognized and knowing in s how health care managementsystems do absorb research evidence as well as findings towards patient satisfaction surveys. Much of patient satisfaction research relies on patients’ perception of satisfaction on what is observed, such as array of services, and physician’s comforting bedside manner (Friedman, 1995). This, however, may not accurately reflect the quality of care they receive, since the technical aspect of the quality of care is not assessed. However, patients as noted by Morgan and Murgatroyd (1994) are passive receivers of treatment determined by professionals and thus, not in a position to understand the technical and medical aspects of care. Thus, the inability of patients to make judgments on the technical competency of the hospital and its staff have limited most patient satisfaction research to the functional quality of care, that is, the manner in which medical care is delivered to them (Tomes and Ng, 1995). Healthcare consumers are demanding excellence in care and services from care providers, and payers are following in their expectations. Demonstration of quality outcomes and consumer satisfaction with services are now a priority and the primary competitive edge in healthcare. Hospitals and healthcare systems that invest in programs to determine how patients evaluate their experiences will have valuable information to make transformational changes in care delivery and services. The purpose is to present an overview of consumer/patient satisfaction instruments, satisfaction measurement issues, research instruments, and commonly used vendor patient satisfaction survey programs. The introductory section discusses the setting and measurement of patient satisfaction within a desirable context of changes in UAE health service delivery. The need to examine several determinants of satisfaction in relation to research literature and some theoretical as well as conceptual variables from within the aspects of patient care also with breadth of literature in the focused research, existence of which is often not acknowledged by researchers presenting literature research as well as findings of studies. For such gaps in research literature, there seeks to bridge the gap between patient satisfaction and the success of the surveys as collaborated and integrated in forming in a valid and reliable research outcomes and research analysis from within the areas of patient satisfaction and care as there will address certain notions of:
· Integrative research of patient satisfaction and survey from within UAE concepts and ideas
· Patient satisfaction research method issues such as in measuring effectiveness of patient surveys to attain enough satisfaction level of UAE patients
The research will indicate empirical study and analysis of patients as subjects in focus of the study coming out from certain United Arab Emirates health care services such as those within UAE hospitals and health care centers, the acceptability of satisfaction as quality indicator is qualified by such known patient survey measurement issues or problems. The study will need to examine variability in satisfaction evaluations related to different measurement methods and the effect of response biases on reported UAE patient satisfaction to be obtained from a desired sample of respondents as the measures will be on global measure of satisfaction using visual scale; multidimensional measure of satisfaction based on patient satisfaction questionnaire; measuring of attitude of the satisfaction using five-point Likert agree-disagree response format. Surveys of patient experience need to undertake with precise objectives with a strong research focus on patient satisfaction research for UAE application domain.
Objectives in research questions format
Research questions are essential part of the research process, as this will imply a solid connection towards secondary knowledge composed of peer reviewed studies such as from academic centered journals and articles, also from documented information and facts from books having contents about leadership and change. The research questions serve as the initial organization flow of the study’s review of the literature which leads to the creation of research methods and techniques and the questions were the following:
· What is patient satisfaction about? Patient satisfaction survey? Discuss research studies from within UAE formative context
· How effective is patient satisfaction survey in comparison to other satisfaction techniques? Explain and assume analysis
· How to promote patient satisfaction effectiveness towards UAE health care patients?
· How to develop uniform patient satisfaction questionnaire for use throughout the UAE context?, allowing in comparative base against which UAE hospitals could equate performance success from other institutions
· How research approach will provide success on patient satisfaction surveys at UAE hospitals and or health care centers?
· How valid and reliable are patient satisfaction data for UAE health care team? Give analysis
Research methodology and Analysis
Research is the systematic and rigorous process of enquiry which aims to describe phenomena and to develop and test explanatory concepts and theories. Ultimately it aims to contribute to a scientific body of knowledge. More specifically, in relation to the focus of this book, it aims to improve health, health outcomes and health services. Research on health and health services ranges from descriptive investigations of patient satisfaction in relation to research appropriateness, effectiveness and costs (Lugon and Secker Walker, 1999). Thus, it is often necessary to measure structure and process in order to interpret the outcome of the care. For example, the collection of qualitative and quantitative descriptive data about process and structure is essential if the investigator wishes to address the question of whether and how the outcome was caused by variations in the structure, or the way it was organized or delivered. The patient satisfaction survey questionnaire will be used as the core method of this research as well as case study approach of several related studies known from the UAE health care institution and hospital care settings. Indeed, research methods can be classified as either quantitative or qualitative in nature. Thus, qualitative method is designed to help researchers understand people and the social and cultural contexts which they live. Kaplan and Maxwell (1994) argue that the goal of understanding of phenomenon from viewpoints of participants and its particular social and institutional context is largely lost when textual date is quantified. The questions will be reasonably objective and thus, to assume desirable patient satisfaction survey from within variations among the questionnaire adaptation (Paton, 2002) from within the UAE health care delivery functions. The need to examine case analysis and case analysis method, patient satisfaction survey will transcribe and comment needs to be clustered together with given conceptualization. Questions are needed to be examined for reliability and validity. In order to avoid the case when the respondent will be forced to give an inaccurate response when his real attitude towards the statements ranging from 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree, to be enclosed at. Data will be collected and analyzed through using qualitative techniques such as pointing towards document analysis, patient satisfaction centered survey and questionnaire. To be specific, the development of a self administered survey questionnaire engaging to patient satisfaction will be a pilot part of this research, wherein survey will include questions concerning perceived patient satisfaction regarding some health care issues to characterize patients’ functional means in UAE standard care settings. To include a telephone survey from the institutions based on the health care field, those patients on discharge approach at UAE hospital are to be undertaken to identify possible dimensions of patient satisfaction survey as well as aspects of the patient satisfaction. The questionnaire will then be about, measures of patient satisfaction with UAE hospital services, satisfaction with some aspects of service as well as patient expectations. Relatively high correlations indicate that the questionnaire can be shortened and dimensions are measured but, longer questionnaire would still be necessary to ascertain the relative values of measures, as the overall satisfaction with hospital care appear to be patient expectations and satisfaction within such nursing care however, there seems to hinge on satisfaction with services not under certain nurse’s control. The assessment of patient satisfaction has become an important concern in the evaluation of health services, as measures of satisfaction must be valid and reliable if they are to be used and that, the development of new survey questionnaire to assess patients’ satisfaction with consultations together with initial tests of the questionnaire’s reliability and validity, and the need to reveal patients’ assessments of care into principal components analysis from such factors of satisfaction as there may have ample role in healthy care research as well as in professional areas and health auditing. One study of patient satisfaction concluded that questionnaires with more episode specific content tend to produce more uniformly favorable responses from patients compared with somewhat more negative views elicited patients are asked for their views about health care in general terms, it is suggested that they draw on more negative stereotypes about health care facilities whereas in surveys focused on specific episodes they may have an optimistic bias to assume that their own experience is better than that of others. The more clearly focused each question, the easier it is to compare satisfaction with the different elements of care. Therefore most survey questionnaires now favor more than two alternative responses per question for example, respondents select from five possible answers in range from very satisfied through to very dissatisfied. The respondent is given a greater opportunity to express the precise nature of his or her view. Moreover, the reliability of items increases as the number of response alternatives increases. In practice the gain in precision or reliability of increasing the possible answers beyond seven is minimal, and generally five response categories are used. In particular, several different items may be asked about one issue in the form of a Likert scale of items, each of which typically has five responses from “strongly agree” to “strongly disagree,” which are given numerical score. The summed score of all the items is taken to represent the person’s underlying view or attitude. The assumption that several items all contribute to the measurement of a single underlying view or attitude is something that has to be checked statistically on a pilot sample before it can be properly used in a scale. If the patient survey is for self completion the questionnaire needs to be easy to follow and attractively set out. It is most important to include clear statement of the purpose and use of the questionnaire and explanations of why the person has been selected, how the questionnaire is to be completed, and what the person is to do with it after the completion.
The primary data is to be collected from the respondents in patient satisfaction survey and the secondary data is to be composed of useful resources concerning the research focus and subject. There is top confidentiality of the respondents. There will be a total of one hundred UAE found patients to answer the patient satisfaction survey as those respondents coming in from a maximum of five UAE hospital institutions and health care centers. The basis of this research will be to analyze the level of patient satisfaction in UAE hospitals, for both inpatient and outpatient services and the possibility to explore that patient satisfaction is also influenced by factors such as waiting time in the outpatient clinics. Two sets of surveys will be carried out. The outpatient survey gathers in respondents’ perception of the cleanliness and comfort of the physical surroundings, as well as the waiting time, treatment and medication received, tests carried out and the services of the doctors and nurses. The inpatient survey gather similar information, but also elucidated information on the patients’ satisfaction with respect to the food provided the level of noise in the wards and the management of visitors to the wards.
Some facts towards methodology of patient satisfaction surveys
· There has been a shift in thinking about the role of the consumer as patient. It is more likely now that researchers want to know what consumers think; that they accept that what the patient tells them is an accurate reflection of what happened; and that this information can be used to improve the quality of care
· Coinciding with the shift, is a serious questioning of the conception of satisfaction as a unitary concept whose causal variables can be measured
· Researchers now are more in favor of using several research methods, drawn from qualitative and quantitative research, to inform their survey instruments, and gather data
· Certain groups of people, whose social position or state of health may make them vulnerable to poorer quality care as difficult to reach via the conventional questionnaire
Patient satisfaction and patient perceptions of outcomes have become valuable and important components in the assessment of the quality of health care (AHCPR, Consumer Assessment of Health Plans). Thus, UAE patients maybe uniquely able to provide information about their ease or difficulty of obtaining care, the interpersonal dimensions of the patient-physician relationship, the patient’s view of the technical quality of care provided, and the patient’s functional status and perceived wellbeing.
Research plan including a timetable and resource requirements
The research plan will have to presented in hard and soft copies as to be written in word document file, and organized into several research chapters comprising of introduction section, preliminary literature section, methodology section, discussion, results and analysis section, summary, conclusion and recommendation section, references and bibliography section as well as appendices, as to be comprised of six study chapters respectively.
The resource requirements will be presented from within academic accepted resources coming from several respected authors or respondents creating in peer reviewed articles and journal resources and some books as necessary. The resources will be from Google scholar linked materials, Jstor, emerald insight and several databases as possible. There is a need to develop appropriate infrastructure for undertaking patient satisfaction work, to develop the level of expertise, and to consider the role which independent organizations based on a consumer perspective might play in undertaking consumer appraisal activities and research in joint activities with hospitals and purchasers.
Research Timetable
TASK
Week/Month (May to July, 2009)
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
Select topic
Undertake preliminary literature search
Write-up aims and objectives
Select appropriate methodology and locate sources of information. Confirm access.
Write-up Dissertation Plan
Undertake and write-up draft critical literature review.
Secondary and Primary Data Detailed
Research Findings:
- Analysed
- Evaluated
- Written-up
Discussion:
Research findings evaluated and discussed in relation to the literature review
Methodology written-up
(including limitations and constraints)
Main body of the report written-up and checked for logical structure
Conclusions drawn
Recommendations made
Introduction and Executive Summary written-up
Finalization
Printing
References
Baker R. Development of a questionnaire to assess patients’ satisfaction with consultations in general practice. Br J Gen Pract 1990; 40: 487–490.
Bener A, Abdullah S, Murdoch JC. Primary health care in the United Arab Emirates. Fam Pract 1993; 10: 444–448.
Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q 1966; 44 (suppl.): 166–206.
Fitzpatrick R. Surveys of patient satisfaction. II. Designing a questionnaire and conducting a survey. Br Med J 1991; 302: 1129–1132.
Friedman, M.A. (1995), “Issues in measuring and improving health care quality”, Health Care Financing Review, vol. 16, no. 4, pp. 1-13
Haddad S, Fournier P, Potvin L. Measuring lay people’s perceptions of the quality of primary health care services in developing countries. Validation of a 20-item scale. Int J Qual Health Care 1998; 10: 93–104
Kaplan B & Maxwell, J.A (1994): Qualitative Research Methods for Evaluation Computer Information Systems. In Anderson J G, C E Aydin and S J Jay (eds) (1994): Evaluating Health Care Information System: Methods and Applications. Sage. Thousand Oaks, CA, pp 45-68
Larsen DE, Rootman I. Physician role performance and patient satisfaction. Soc Sci Med 1976; 10: 29–32.
Lugon, M., Secker-Walker, J. (1999), Clinical Governance: Making it happen, The Royal Society of Medicine Press Ltd, London,
Morgan, C. and Murgatroyd, S. (1994), Total quality management in the public sector: An international perspective, Open University Press, Buckingham.
Paton, M.Q. (2002), Qualitative evaluation and research methods (2nd ed.). Newbury Park: Sage Publications.
Tomes, A.E. and Ng, S.P.C. (1995), “Service quality in hospital care: The development of an inpatient questionnaire”, International Journal of Health Care Quality Assurance, vol. 8, no. 3, pp. 25-33.
Ware JE Jr, Davies-Avery A, Stewart AL. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev 1978; 1: 3–15.
Williams SJ, Calnan M. Key determinants of consumer satisfaction with general practice. Fam Pract 1991; 8: 237–242
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