Hospital Functions and Services (EDL 340)
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MODULE I : HOSPITAL FUNCTIONS AND SERVICES
“The mortality rate for patients treated at teaching hospitals is 25 percent lower than that of patients in regular hospitals,” reports an extensive study published in the New England Journal of Medicine. Likewise, the American Journal of Obstetrics & Gynecology states in one of its studies that there is no increased risk for negative outcomes in surgeries performed by residents, except for a slightly prolonged operative time. According to a data analysis published in the Journal of Maternal-Fetal and Neonatal Medicine, the risk of rectal injuries was present following labor and delivery regardless of operator status. This study, involving over 17,000 women, showed that the complications of labor and delivery did not increase if the patient was treated by a resident instead of an attending physician. The findings published in Surgical Laparoscopy & Endoscopy have drawn similar conclusions, noting that resident surgeons did not pose a threat to safety of patients. While most patients consider resident involvement a risk to surgery at teaching hospitals, many medical professionals claim residents to be extremely beneficial. Vascular Surgeon, Jon Schellack has been working with surgical residents for 25 years. According to him, a better environment is created for patients and doctors through the residency program. “The medical students and the residents are very inquisitive, always looking up the patient’s problem, diagnosing, researching, challenging me and asking me questions,” he says. Stephen Yang, a professor of surgery and oncology at the Johns Hopkins University School of Medicine, in his paper published in 2008, states that the mortality rates were low and complications were lesser at teaching hospitals. Jarret Brashear, a third-year general surgery resident, says he has never had a patient reject his care because he was a resident. He adds that the residents are always supervised when performing procedures, and patient safety is the priority. Philip Young, a gynecologic surgeon and clinical professor of reproductive medicine at the University of California-San Diego School of Medicine says that a good private hospital will provide the same care as a good teaching hospital, except a teaching hospital has more resources and is better at taking care of oddball things. As per the US New Best Hospitals 2014-15, the top five hospitals in the U.S. were Mayo Clinic, Massachusetts General Hospital, Johns Hopkins, Cleveland Clinic and UCLA Medical Center. All of these hospitals were the ones that had surgical residency programs. In a study that evaluated over 1.5 million patients, a 10 percent reduced risk of mortality was seen in teaching hospitals for the three most common health problems like heart attack, heart failure and pneumonia. Professor of surgery at Harvard Medical School and vice president of the Massachusetts General Hospital for Quality and Safety, David Shahian, who evaluated the outcomes of these 1.5 million patients says, “Residents are qualified medical doctors and every teaching hospital has professional doctors constantly available.” Through the studies conducted globally, it can be noted that teaching hospitals have better care facilities and services. It is evident through these studies that resident surgeons pay close attention to patient safety and are effective at their procedures of patient handling. Talking about the quality of care in teaching hospitals, Shahian says “training of residents is much more closely supervised than it was decades ago.” Resident involvement always adds to the quality of care, he adds.
Question 1: “According to the article, what is less at teaching hospitals?”
Select one:
a. Patient care
b. Mortality and complications
c. Facilities and equipment
d. Resident doctor performance
Question 2
“In a hospital, the highest risk of martality of patients is due to:”
Select one:
a. hospital acquired infections
b. incomepetence of doctors
c. “heart attack, heart failure and pneumonia”
d. All of the above
Question 3
“While performing any medical procedure, the highest priority is:”
Select one:
a. Teaching the procedure to resident doctors
b. Reducing the time and money involved in the procedure
c. Patient safety
d. All of the above
Question 4
How is patient safety ensured in a teaching hospital?
Select one:
a. “Resident doctors are always supervised, so scope of errors is reduced”
b. “Medical students and residents are very inquisitive, and so thoroughly understand the patient’s problems to provide the best care”
c. “Teaching hospital has more resources available, so issues can be taken care of quickly”
d. All of the above
Question 5
Many studies conducted across the globe have shown that teaching hospitals
Select one:
a. are not fulfilling the need they were designed for.
b. have higher rates of patient mortality.
c. have more doctors than requiured.
d. have better care facilities and services
Question 6
Supervision of resident doctors in a teaching hospital:
Select one:
a. is not required.
b. is more closely supervised that a few years ago.
c. is done by the peer group
d. is a rule.
Question 7
The top rated 5 hospitals in the USA are all:
Select one:
a. teaching hospitals.
b. private hospitals.
c. inaccessible to common man.
d. ones with t he best equipment and resources
Question 8
What advantages does a teaching hospital provide to resident doctors?
Select one:
a. “Resident doctors are able to take care of several patients with different complaints, and thus are prepared to handle any disease condition effectively”
b. Resident doctors are allowed to handle all complicated and emergency cases
c. Resident doctors are available 24/7 in a teaching hospital
d. There are no specific advantages
Question 9
Why is it beneficial to have resident doctors present during a surgery?
Select one:
a. They will be able to learn effectively
b. Patient priority is taken care of
c. resident surgeons pay close attention to patient safety and are effective at procedures of patient handling.
d. All of the above
Question 10
Why would a patient refuse to get treated by a specific doctor?
Select one:
a. “If the patients feel that the doctor is not competent enough, they may refuse to allow that doctor to treat them”
b. Patients cannot refuse the services of any doctor
c. Patients prefer to go to doctors referred by their family and friends.
d. None of the above
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MODULE II : CLINICAL SERVICES
Emergency services, across the globe, play a significant role in saving lives of patients who need urgent medical assistance. Emergency Medical Services (EMS) took off in India in the year 2005, before which ad-hoc emergency providers were the hospitals and their respective taxis. This service, otherwise known as the “108 Ambulance Service Project” is aimed to ensure emergency care to the rural as well as urban India. Starting then, there has been much effort in building various services to minimize life risk during accidents. Various policies have been coming up, ideas kept pouring in and strategies are being laid by the government as well as the private healthcare providers to attend to emergencies and save lives.
In one such effort, the Tamil Nadu government has installed an app-based system in ambulances to reach any emergency within a set time of 3 minutes. This feature announced by the Tamil Nadu Health Systems Project (TNHSP) officials, will work like the app-centered system used by cab aggregators like Ola and Uber. With the help of this app, the ambulances can track the accident spot in no time and thereby reduce the average response time.
In a similar approach, Telangana Chief Minister K. Chandrasekhar Rao launched a unique Bike Ambulance Service in early 2018. This service is aimed at providing services at the accident spot itself. Mr. Rao flagged off 50 bike ambulances, in an effort to allow services to reach the victims faster through narrow routes. The Telangana government is also ready to increase the budget for the medical and health in its next budget session. “Apart from giving better education and good health services to the poor, there is no other priority,” said the CM as he talked of the plans and priorities for the state.
In another advancement brought across by a startup company in Vishakapatnam, an Internet of Things (IoT) device is all set to be installed in some of the major traffic junctions across the city. This device is a first of its kind system that creates geo-fencing to identify any ambulance within 500 meters radius from the traffic signals and triggers an alert in the traffic junction box to turn the lights green to allow the ambulance to pass through. Greenline Labs of Visakhapatnam, the startup that brought across this idea, has created a technology called Emergency Response Automation (ERA) to create the geo-fencing.
With many such efforts being made to make emergency services quickly available for victims of accidents, there is surely going to be an improvement in emergency care in India. Traffic has so far been identified as the major setback in making ambulance and emergency services reach within the stipulated time, leading to loss of many lives. Such approaches to minimize the reach-time of ambulances are sure to bring emergency services within closer reach for accident victims and aid in saving lives, given that the quality of treatment is maintained.
Question 1: “In case of an accident occurring, what should the onlookers do?”
Select one:
a. Call a taxi or autorickshaw and transport victim to the nearest hospital
b. Call 108 or alternate number for an ambulance
c. Call the police and let them handle everything
d. Do nothing
Question 2
“Recently, a bike-ambulance service was launched. In which state was this launched?”
Select one:
a. Telangana
b. Tamilnadu
c. Karnataka
d. Delhi
Question 3
Emergency Medical Services (EMS) is otherwise known as ______ in India.
Select one:
a. Bike Ambulance Service
b. Emergency Response Automation (ERA)
c. 108-Ambulance Service
d. Geo-Fencing Services
Question 4
How can digital technology help in EMS?
Select one:
a. Several apps can be developed to help in emergency medical services
b. Technology helps the government in tracking the services
c. Tracking of patients is easier using technology
d. Technology has no role to play in emergency services
Question 5
What challenges does an emergency medical service provider face?
Select one:
a. “Locating the patient becomes a challenge, due to haphazard city planning”
b. “Coverage of area for ambulance services is limited, keeping in mind the size of India”
c. Bad road conditions and traffic slow down the ambulances.
d. All of the above
Question 6
What is the importance of ambulance services?
Select one:
a. Ambulances are used to transport patients from one place to another
b. Hospitals can get more number of patients when they run an ambulance service
c. “Ambulance has medically trained personnel who can immediately start treatment of patients in emergency situations, while transporting them to hospitals”
d. Ambulance services are not necessary
Question 7
What is the logic in fitting ambulances with app-based systems?
Select one:
a. Apps are not required to be installed for ambulances
b. Apps can help the ambulance to be located by the hospital
c. It sounds hi-tech
d. App-based systems help the ambulances navigate the routes better and reach the patient quickly
Question 8
Which of the given statements is false?
Select one:
a. “The Emergency Medical Services in India run under the name “”108″” in most Indian cities.”
b. Rural areas do not require provisions for emergency medical care
c. The Indian government and some provate firms are making efforts to improve emergency medical services in the country.
d. Several digital technologies are being used to improve the emergency medical services provided to patients
Question 9
Which of the given statements is true?
Select one:
a. Emergency Medical Services can be a substitute for providing first aid to accident victims
b. Ambulance services are only run by corporate hospitals
c. Emergency medical services provide first aid to patients in emergency situations and ensure they get appropriate medical treatment at the earliest
d. Emergency medical services work only in urban areas
Question 10
Why is speed a necessity for an ambulance?
Select one:
a. “Ambulances have to typically travel long distances, thusm they need to be fast”
b. There is no deendancy on speed in operating an ambulance
c. “Due to bad road conditions and traffic, ambulances cannot travel fast.”
d. “Am ambulance needs to reach the patient in time, so that treatment can start immediately”
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MODULE III: CLINICAL SUPPORT SERVICES
Established in the year 1983, Apollo Hospitals is Asia’s largest healthcare group and India’s first corporate hospital. Ever since its entry into the private healthcare sector, Apollo Hospitals has ventured into diverse platforms of the healthcare ecosystem, which includes hospitals, pharmacies, primary care, and diagnostics. Besides these mainline services, Apollo Hospitals has its significant presence in health insurance services, medical colleges, e-learning, nursing, hospital management, and research foundation, among others.Apollo Pharmacy, a part of Apollo Hospitals, is the first and the largest branded pharmacy network in India. The company had about 2,742 outlets by the end of September 30, 2017, and has accelerated its expansions to reach the target of 3,000 stores by mid-2018. Its International Quality Certification, the genuineness of medicines, round-the-clock operations, 24×7 customer support and over 400 self-branded products are a few of its notable qualities. The online portal of Apollo Pharmacy, www.apollopharmacy.in, has more than 4000 products in widespread categories like OTC medicines, baby care, personal care, health foods, vitamins and supplements, etc. The retail outlets are well-stocked with medicines, OTC drugs, and FMCG products. The outlets are equipped with computerized systems and competent pharmacists. Providing the ease of shopping to its customers, Apollo Pharmacy features online ordering and home delivery options for a wide range of OTC and FMCG products. It also features an option to upload prescriptions to order prescription medicines.The nationwide distributors of Patanjali Ayurved, the Pittie Group, recently announced its distribution arrangement with Apollo Pharmacy. With this move, the latter group will ensure the availability of the Patanjali products across all the Apollo Pharmacy stores in the country. “This tie-up with Apollo pharmacy will enhance the reach of Patanjali. It is another step towards our mission of providing high-quality products to every Indian consumer,” said Aditya Pittie, CEO of Pittie Group.The logistics unit of Flipkart, called Ekart, has also tied-up with over 300 outlets of Apollo Pharmacy. Ekart will use these outlets to drop-off shipments to be picked up by the customers. These pick-up points will be displayed to the customer while he places the order. The ordered products will be delivered to the Apollo Pharmacy outlet by the Ekart delivery personnel, after which the customer is alerted with a four-digit pin to pick up the product. The receiving store of Apollo Pharmacy keeps the shipment for five days, after which it returns the product upon pick-up failure. An undisclosed amount will be paid to Apollo by Ekart for keeping these shipments.With healthcare being the need of the hour, Apollo is sure to take its services ahead to match the rising demands and improve its reach further.
Question 1: ABC VED matrix helps a pharmacy to:
Select one:
a. Categorize the drugs in the pharmacy
b. Have a proper control over its supplies
c. Meet the drug requirements of the hospital
d. Monitor the exact usage of the drugs and quantities
Question 2
Apollo Pharmacy provides which of the following features to its customers?
Select one:
a. Online ordering of medicines
b. Home delivery of medicines
c. 24/7 operations
d. All of the above
Question 3
Apollo Pharmacy sells What type of products?
Select one:
a. Critical drugs
b. General and medical supplies
c. “OTC drugs, medicines and FMCG personal care products”
d. All of the above
Question 4
Inventory control in the pharmacy is very important because:
Select one:
a. It is a major portion of the hospital’s annual budget
b. Hospitals need to keep a tight control on the pharmacy
c. Hospitals need to monitor each and every drug usage
d. None of the above
Question 5
Non-availability of which of the following would immediately affect the operation of a hospital?
Select one:
a. Essential items
b. Vital drugs
c. Desirable items
d. Emergency drugs
Question 6
Pittie Group is the nationwide distributors of:
Select one:
a. Patanjali Ayurved
b. Flipkart
c. Apollo Pharmacy
d. FMCG Products
Question 7
Products sold by Patanjali can be classified under which category?
Select one:
a. Essential items
b. Vital drugs
c. Desirable items
d. Emergency drugs
Question 8
The largest branded pharmacy in India is:
Select one:
a. Patanjali Ayurved
b. Pittie Group
c. Apollo Pharmacy
d. Apollo group
Question 9
Why is a good pharmacy important for a hospital?
Select one:
a. “A pharmacy purchases, stores, and distributes drugs, medicinal preparations and chemicals to patients”
b. Tracking of all medications is possible
c. It is possible to investigate pharmaceutical problems arising in the use of medications
d. All of the above
Question 10
Why is Apollo Pharmacy is tying up with other distributors like Patanjali?
Select one:
a. To improve its market presence
b. To reach a greater number of customers and improve its brand identity
c. To gain goodwill in the market
d. To avoid competition
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MODULE IV : ANCILLARY SUPPORT SERVICES
The World Health Organization states that 85% of hospital wastes are non-hazardous, 10% are infectious and 5% are non-infectious (but included in hazardous wastes). About 15% to 35% of the total hospital waste generated is considered as infectious waste. These wastes threaten the public since hospitals are situated in the heart of the city. Therefore, medical waste must be disposed of properly. Waste generated in the process of healthcare includes scalpels, blades, hypodermic needles, gloves, clothes, bandages, discarded body fluids, human tissues and organs, PVC products, chemicals and radioactive wastes. Inadequate management of such biomedical waste can be associated with risks to patients, healthcare workers, sanitation workers, communities, the general public and the environment.
The Indian government has recently updated the regulations regarding biomedical waste management in the country, to bring in better processes to manage the various types of biomedical waste generated.
A study was done to observe and assess the proportions and quantities of different constituents of wastes, their handling, storage, treatment and disposal methods in different health-care settings in two different cities: Pune and Bhopal. The study aimed to observe and assess the processing systems for biomedical waste disposal, including the hazards associated, the development of new waste management plans, policies, and protocols, establishing recommended training programs.
Pune is the second largest city in the state of Maharashtra and the eighth largest metropolis in India with a total population of 5,92,00,000 as per 2017 census. The total hospitals in the city are around 1000 that cater to around 3,500 patients daily. As per a study done in June 2011, Pune has a 19.58% share in BMW generated in the state of Maharashtra; a total of 5000-8000kg/day of bio-waste is generated in the city, and this includes corporation run hospitals that generate almost 2,000kg of bio-waste every day. The bio-medical waste is collected from all the hospitals and healthcare facilities in Pune and treated at the Kailas Crematorium plant.
As per the Medical Waste Rules, 1998 Amendment, it is obligatory for all the clinical establishments in the city to get an authorization from the Maharashtra Pollution Control Board (MPCB). Approximately about 1,200 kg biomedical waste is transported every day to towns located over 140 km from Pune. A survey was conducted at ten hospitals from Pune city revealed that more than 55% of the hospital employees are not aware of the adequate collection, handling, and treatment of the biomedical waste. About 45% of owners of the healthcare facility are found to be ignorant, and 62% of respondents do not consider biomedical waste management as a serious issue.
Bhopal: In a study conducted in Bhopal in 2011, of the approximately 245 hospitals in Bhopal city, 32 hospitals are governed by the State Govt., four by the Central Govt., while 209 are private hospitals. Bio-medical waste generated at Central Govt. hospitals is 556 kg/month, State Govt. hospitals is 7937 kg/month and in private hospitals it is 12,224 kg/month.
Safe and effective measures for biomedical waste management are not only a legal necessity but also a social responsibility. There is a need for education as to the hazards associated with improper waste disposal. Lack of concern, awareness, motivation, and high cost factors are some of the problems faced in proper biomedical waste management. A major stymie to the practice of waste disposal is apathy to the concept of waste management. Healthcare providers should always try to reduce the waste generation in their clinic or at the hospital on a day-to-day basis. Proper collection and segregation of bio-medical waste is very important.
Question 1: “As per the Medical Waste Rules, 1998 Amendment, is it necessary for all the clinical establishments in the city to get their authorization?”
Select one:
a. Authorization is not required
b. “Yes, it is obligatory to get the authorization “
c. Authorization is objected
d. None of the above
Question 2
“In cities with large population, the biomedical waste is commonly disposed: “
Select one:
a. To a common biomedical waste treatment plan
b. To a dump yard at the end of the city
c. In any of the open area/plot inside the city
d. In a waste bin within the hospital premises
Question 3
“The development of new waste management plans, policies and protocols helps in”
Select one:
a. Waste of time
b. Not helpful for disposal of wastes
c. Better biomedical waste disposal
d. None of the above
Question 4
About _________ of Hospital waste is considered as infectious waste in hospitals
Select one:
a. 60% to 70%
b. 40% to 50%
c. 15% to 35%
d. None of the above
Question 5
Bio-medical waste means
Select one:
a. “Any waste that is generated during the initial diagnosis, treatment, immunization of human beings or animals “
b. Waste produced during research activities during the production in hospitals and health camps
c. Waste produced at home
d. Both A and B
Question 6
Biomedical waste management rules are established because
Select one:
a. BMW poses a serious health hazard for people and the community
b. The quantity of waste generated is huge
c. There is a lack of concern regarding biomedical waste management
d. Hospitals are unsure of how to dispose of biomedical waste
Question 7
Important steps involved in the management of biomedical waste are:
Select one:
a. Handling
b. Segregation and collection
c. Disposal
d. All of the above
Question 8
Inadequate management of biomedical waste can be associated with
Select one:
a. No risk to healthcare workers
b. “Risk to patients, healthcare workers, sanitation workers, etc.”
c. Risk to the environment
d. Both B and C
Question 9
The problems that are faced in the proper management of hospital waste are:
Select one:
a. Cost factors
b. Lack of concern
c. Lack of motivation
d. All of the above
Question 10
Which of these are most important for safe biomedical waste disposal practices?
Select one:
a. Legal regulations
b. Education and training of healthcare workers regarding safe biomedical waste disposal practices
c. Availability of cost effective waste disposal methods
d. All of the above
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MODULE V : GENERAL SUPPORT SERVICES
In today’s technology-driven world, social media offers a great platform for building brands and marketing. Many industries take the support of Facebook, LinkedIn, Twitter, Pinterest, Google Plus, YouTube, Instagram, etc. Organizations are building a huge fan base on social media, thus leveraging the online platform to increase awareness about their products and services.
In recent years, the healthcare industry has evolved in terms of its marketing strategies. Digital marketing and online presence have become its new tools. Earlier, online marketing was not a media of choice for many healthcare marketers, as there was a gap in understanding how social media can be integrated into their marketing strategies. Also, their concern about patient privacy and compliance with HIPAA regulations, etc. restricted them from using social media as a marketing platform. However, in recent times healthcare organizations have realized that these obstacles can be conquered easily.
Let us look at a case study about how a hospital utilized social media marketing to its advantage.
Shrikhande Hospital and Research Center is a 20-year-old IVF & Surrogacy center in Nagpur. Well-equipped with the most advanced technology in reproductive medicine, the hospital has a team of experts in Gynecology, Urology, and Embryology. It has 10000 embryo transplants to its credit. The organization wanted to tap into social media marketing and hence approached an expert company ‘Digital Skills’ for the same.
The prime objectives were to enhance the brand reach to netizens across various social media platforms, engage the audience, provide the right information to patients on pages, and drive traffic to the hospital website via social media. However, there were certain challenges. Most physicians think that social media is a waste of time and for practicing doctors direct advertising to promote their services is not feasible. It was challenging to visualize how an IVF & surrogacy center can make use of social media. Also, being a local set-up, the target audience was limited.
Digital Skills then came up with a strategy for better brand presence– build a digital ecosystem and focus on creating brand awareness. The message of good health and various disease prevention measures were posted on the social media, thus creating the image of a health conscious ecosystem. Also, promotions with crisp and engaging content were done on special days, festivals, and events.
The execution included a well-planned calendar for promotions, split into daily and monthly basis for each social media platform. Appropriate messages were created considering the target audience. Engaging updates were posted daily on social media. Special series of updates, contests, etc., were run on select days.
The result was a whopping 446% increase in brand reach. In just four months, the number of likes increased from 400 to 4500. Direct messages were received on Facebook, twitter and LinkedIn pages from patients across the world. There was 300% increase in clinic footfall by driving social media traffic to the website. The hospital was able to establish a self-brand within their peer community.
Question 1: “Earlier, what was the concern of healthcare marketers in using social media”
Select one:
a. Brand reachability
b. Cost
c. Patient’s privacy
d. Ease of use
Question 2
Shrikhande hospital marketed_______________ to the consumers?
Select one:
a. Goods
b. Services
c. Experiences
d. Events
Question 3
Shrikhande hospital opted for ________________ type of media
Select one:
a. Print Media
b. Display marketing
c. Electronic Marketing
d. Direct Selling
Question 4
The content created by Digital Skills on social media was ______________________
Select one:
a. Lengthy
b. engaging
c. non-informative
d. falsified
Question 5
The social media campaign helped in increasing the ______________________
Select one:
a. Brand reach
b. brand visibility
c. both of the above
d. None of the above
Question 6
The ultimate result of the social marketing was _______________
Select one:
a. Increase in footfall
b. decrease in trust
c. less brand awareness
d. all of the above
Question 7
What could the hospital establish within their peer community
Select one:
a. brand association
b. Self-brand
c. both of the above
d. none of the above
Question 8
What did Digital Skills company decided to build ________________________
Select one:
a. hospital
b. digital ecosystem
c. display marketing
d. direct market
Question 9
What was the primary objective of social media marketing for Shrikhande hospital?
Select one:
a. Increasing sales
b. Brand awareness
c. Health education
d. Social service
Question 10
What were the challenges noticed in healthcare digital marketing for Shrikhande?
Select one:
a. Limited local audience
b. Well-equipped
c. Cost
d. no proper guidance
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ASSIGNMENT 2
A study sponsored by the Directorate of Health Services, Government of Madhya Pradesh was conducted at a representative sample of public health facilities in MP to measure patient satisfaction about various components of patient department (OPD) services. One district was identified from each of the 8 administrative divisions in the state. To select OPD patients from each district, a sample of OPD patients were drawn from the public health facilities, i.e., district hospital (DH), civil hospital (CH), community health center (CHC), and primary health center (PHC). One DH, one CH, one CHC and one PHC were identified from each district. Thus, 561 OPD patients (47% male, 53% females) were covered from 32 public health facilities of the state. Of these, 45% belonged to the 16-30 years age group and 6% to the 0-15 year age group.The questionnaire covered information related to patient’s choice of health facility, registration process, perception towards availability of basic amenities, behavior of doctors and other staff, facilities available in pharmacy and dressing room. Inexpensiveness and good infrastructure was one of the most cited reasons (83%) for choosing the public health facilities. The majority (81%) said that the main source of information about the hospital was family members/relatives. The time taken to reach the hospital was less than 15 minutes for more than half of the respondents (58%). Almost all the respondents did not find any problem in locating the hospital (93%) or locating different departments within the hospital (87%). One of the major reasons for choosing the public health facility was unavailability of other health facilities in the area.Registration counters were reported to be over-crowded by 64% OPD patients. This was observed more at the higher level health facilities (DCs) compared with lower level health facilities (PHCs). However, patients were happy with the behavior of registration clerks at all the facilities. It was found that respondents were more satisfied with the basic amenities such as seating arrangement for the patients and attendants, cleanliness, toilets, and drinking water at higher level facilities, i.e. district and civil hospitals as compared to community health centers and primary health centers. The main reason being the higher level facilities have better infrastructure than the lower health facilities.The sitting arrangements were found adequate by more than half of the respondents (54%) and 71% respondents found hospitals adequately cleaned. Regarding toilet facility, 44% respondents said it was available and clean, but 49% respondents said it was available but dirty. It was observed that the waiting time for OPD patients at the higher level health facilities is longer than the lower level health facilities, because of the high patient load at district and civil hospitals. Most of the patients (78%) at PHCs said that they have to wait less than 10 minutes for the doctor whereas in case of DH, CH and CHC; 54%, 52%, and 51% patients respectively said so. The majority of the patients (above 85%) have observed that doctor’s behavior was good at all the facilities and they also felt that the doctor has given adequate time to see the patients.Data revealed that the patients at lower level health facilities (CHC and PHC) were more satisfied with the queue system at the pharmacy than at the higher level health facilities (DH and CH). Most of the OPD patients also perceived that the behavior of the pharmacist was good particularly at the higher level facilities (DH and CH). Behavior of pharmacist was either good or satisfactory for all the OPD patients. Regarding the quality of drugs, OPD patients were happier at CHC and PHC as compared to DH and CH and the overall response to the quality of drugs was either good (64%) or satisfactory (33%) and only 3% considered it poor.
Question 1: Which of the following were the most cited reasons for which OPD patients chose a particular health facility?
Select one:
a. Inexpensiveness
b. Good infrastructure
c. Dressing room and pharmacy facilities
d. Good reviews
Question 2
Which of the following healthcare facilities comprise India s secondary healthcare?
Select one:
a. Community health center
b. Primary health center
c. District hospital and Civil hospitals
d. Only Civil hospitals
Question 3
Which of the following healthcare facilities comprise India s primary healthcare ecosystem?
Select one:
a. Community health center and primary health center
b. District hospital and Civil hospital
c. Only primary health centers
d. Corporate hospitals
Question 4
Which of the following has been seen to be the highest cause of decreased satisfaction with a hospital?
Select one:
a. Mismatch between patient s expectation and services received
b. Length of waiting list
c. Non-availability of medicines
d. Time given to the patient by doctor
Question 5
Which of the following factors influence choice of hospital?
Select one:
a. Proximity/time taken to reach the hospital
b. Word of mouth recommendations by family and friends
c. Unavailability of other health facilities in the area
d. All of the above
Question 6
The patients at higher level health facilities (DH and CH) were less satisfied on one aspect compared to the outpatients at lover level facilities. This was:
Select one:
a. Behavior of the pharmacist
b. Queue system at pharmacies
c. Quality of drugs
d. None of the above
Question 7
The higher waiting times at higher level facilities (district and civil hospitals) are attributable to?
Select one:
a. Non-availability of doctors
b. Inefficient registration processes
c. High patient load
d. Behavior of registration clerks
Question 8
Public health services can be improved by making them more responsive to people’s needs and expectations.
Select one:
a. TRUE
b. FALSE
c. True only in case of corporate hospitals
d. False in case of government hospitals
Question 9
Customer satisfaction with a hospital is most influenced by:
Select one:
a. Clinical outcomes
b. Non-clinical outcomes
c. Patient expectations
d. Both clinical and non-clinical outcomes
Question 10
“The main source of information about hospitals is through hospital staff, such as pharmacists and hospital clerks.”
Select one:
a. TRUE
b. FALSE
c. True in case of corporate hospitals
d. True in case of small hospitals of 50 beds or less
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