Hemanga Bhattacharjee, Pritam Mandal, Virinder Bansal, Anu Sachdeva, Mamta Sood, Ashok Deorari. All India Institute of Medical Sciences
Introduction: Adequate and relevant preoperative information is pertinent for patient satisfaction, thus for quality of care. The spectrum of information patients desire may vary according to their socio-economic or cultural background. Hence, patients’ participation in the development of a preoperative information module is important in quality improvement initiative.
Plan-Do- Check-Act (PDCA) cycles and Focussed Group Discussion (FGD) are important aspects of Quality Improvement (QI) initiative. Herein, we have described the development of a module for preoperative information and a randomised controlled trial to evaluate the effectiveness of this module.
Materials and Methods: The study was conducted in a public funded teaching hospital catering to a population of middle and low socio economic strata. Institute’s ethics committee approved the study protocol. The study was conducted in two phases i.e. Phase 1: Development of the QI module and Phase 2: Evaluation of the module by a randomized study. Patients undergoing laparoscopic cholecystectomy and laparoscopic groin hernia surgery were enrolled.
Phase 1: Researchers did the root cause analysis, interviewed thirty patients and prepared the first draft of the QI module as a leaflet. Module was then implemented in 30 patients. Patients’ satisfaction score (PSS) was recorded on a standardized validated proforma. Six randomly selected patients from this group were then called for FGD. QI module was then improvised based on patients’ feedback during FGD. PDCA cycles were repeated and additional information was added to the QI module based on FGD feedback. Post 3rd PDCA, PSS reached more than 90% and the QI module, comprising scientific, social and logistical information on the disease and the treatment process, was standardized.
Phase 2: Sixty patients were randomized. Control group (n=30) received spoken information, as done in conventional protocol; study group (n=30) received spoken and written information in the form of QI module (leaflet) in addition to conventional protocol. WHOQOL BREF questionnaire was used for assessment of quality of life. Patients’ satisfaction was analyzed using PSS.
Results: The demographic profile and preoperativeWHOQOL BREF scores were identical between the two groups.In post-operative period, all domains of WHOQOL BREF showed improvement, however, the improvement in psychological health and overall domain was statistically significant in study group as compared to control group (p=0.002 and 0.01 respectively). The overall quality of life, satisfaction with health and Patients Satisfaction Score (PSS) were significantly more in study group (p=0.02,0.005 and 0.001 respectively).
Conclusion: Patients' satisfaction and perception of care can be improved by preoperative QI module.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94957
Program Number: P627
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster