A STUDY ON PATIENT SATISFACTION IN RADIOLOGY DEPARTMENT AT AMRI HOSPITALS (MUKUNDAPUR)

CARRIED OUT AT

AMRI HOSPITALS, MUKUNDAPUR

FOR THE PARTIAL FULFILLMENT OF THE DEGREE OF

BACHELOR IN HOSPITAL MANAGEMENT

UNDER

MAULANA ABUL KALAM AZAD UNIVERSITY OF TECHNOLOGY & MANAGEMENT

FROM

DINABANDHU ANDREWS INSTITUTE OF TECHNOLOGY AND MANAGEMENT

UNDER THE GUIDANCE OF

NAME OF THE EXTERNAL GUIDE NAME OF THE INTERNAL GUIDE

MR. SHAKTIPADA DAS MS. MOUMITA ROY AKULI

BY DEBDYUTI DAS

ROLL NO. :- 15403315009

REGN. NO. :- 151541310009

SEMESTER :- 6TH SEM

STREAM :- BACHELOR IN HOSPITAL MANAGEMENT

BATCH :- 2015 -2018

ACKNOWLEDGEMENT I am using this opportunity to express my gratitude to everyone who supported me throughout the course of this training. I am thankful for their aspiring guidance, invaluably constructive criticism and friendly advice during my training and the project work. I am sincerely grateful to them for sharing their truthful and illuminating views on a number of issues related to the project.

I express my warm thanks to Mrs. Sanjukta Nandy (Principle of our college), Mr. Surajit Das (HOD), Mrs. Moumita Roy Akuli (Guide of the project) and Mr. Shaktipada Das, (HOD of the Radiology Department) of AMRI Hospital for their support and guidance and all the people who provided me with the facilities being required and conductive conditions for my project.

Ms. Jayanti Chatterjee (UNIT-HEAD)

Mr Sounok Sen Gupta (Head- HR)

Mr. Prithwish Das (Sr. Manager, Patient Service)

Mrs. Mousmi Ganguly (Sr. Manager, Patient Service)

Ms . Poulami Saha (Executive Patient-Service)

& all the staff of CT-MRI Department, who not only guided me as a supervisor but also provided all possible help and support in spite of their extremely busy schedule.

I would like to thank the entire team of AMRI Vision Care Hospital, Kolkata for their help and co-ordination during the training period.

Thank you,

DEBDYUTI DAS

BHM 6th SEMESTER

Dinabandhu Andrews Institute of Technology And Management

DECLERATION FORM

I declare and inform you that this project entitled “A STUDY ON PATIENT STATISFACION IN RADIOLOGY DEPARTMENT IN AMRI HOSPITAL ,MUKUNDAPUR” has been submitted by me for the partial fulfillment for the requirement of the degree of Bachelor in Hospital management from Dinabandhu Andrews Institute of Technology & Management under Maulana Abul Kalam Azad University Of Technology & Management under the guidance of Mr. Surajit Das (HOD ) , MS. Moumita Roy Akuli (Faculty) , Mr. Shaktipada Das (Radiology -Manager) of AMRI Hospital, MUKUNDAPUR during the academic year of 2018-2019.

NAME :- DEBDYUTI DAS

ROLLNO. :- 15403315009

REGN. NO. :- 151541310009 OF 2015 - 2016

DURATION OF TRAINING:- 8TH JANUARY TO 14TH APRIL (3 MONTHS)

(Signature of the student ) :-

For office use only :-

The project has been approve / not

...………….…………………………. …………………………………………

( Signature of the HOD ) (Signature of the Internal GUIDE)

EXECUTIVE SUMMARY PATIENT SATISFACTION IN RADIOLOGY DEPARTMENT .

An extension study has been performed by me (DEBDYUTI Das), a student of Hospital Management 6th Semester, Dinabandhu Andrews Institute Of Technology & Management ,PATULI campus . It is a summarized idea of Marketing Function, Work Flow, Staffing Pattern and proper functional survey. The methodology of my assignment was purely based on primary and secondary data , the primary data has been collected through the personal observation along with the Departmental help . The secondary data has been collected from the hospital information system.

The hospital has been created keeping in mind that those needing treatment should find this unit as an end point of their search for excellence in clinical services , ambience , staff behavior , and at prices so slated so as to be affordable to all . It is a sincere attempt to stop patients from having to travel to north or south for treatment . We strive to build in transparency in our actions and develop strong doctor – patient communication .

The project here is a study of work flow , staffing pattern , functions of the department and patient satisfaction survey.

I have observed the different aspect in this Hospital through out of my project survey.

The object of the study has been to know present patient satisfaction and develop the strategy to attract , satisfy , and retain more customer for future .

CONTENT :- (a) INTRODUCTION (b) HOSPITAL PROFILE (c) OBJECTIVE (d) REVIEW OF LITERATURE (e) INTRODUCTION ABOUT THE SPECIALIZED DEPARTMENT (f) BROAD OVERVIEW (g) METHODOLOGY (h) DATA COLLECTION & INTERPRETATION (i) SUMMARY OF FINDINGS (j) CONCLUSION (k) REFERENCE (l) BIBLIOGRAPHY

INTRODUCTION Healthcare services, especially, the standard of medical care has always been of prime concern in every society and in every country. As a result, the healthcare providers who have been hitherto insensitive have started paying attention to the quality aspect of healthcare. The quality can be defined in the simplest words as the “Degree of Excellence”. The quality is a dynamic phenomenon; it keeps on changing. It changes with time, with place and varies from person to person. The level of knowledge, awareness and perception, which determines quality.

Radiology is the medical specialty directing medical imaging technologies to diagnose and sometimes treat diseases. , a subspecialty developed from Diagnostic Radiology, made relentless progress in last few decades. Today its impact can be felt in every field when patients need to be treated minimally or less invasively. Even Interventional Radiology having subspecialties or superspecialities under its belt like neuro, GI, vascular etc. Today IR can help in almost every aspect from diagnosis to treatment, from palliation to cure.

In following paragraphs, I am Trying to give a brief overview what all possible today and the major indications which can come handy during daily practice, some alternative approaches and in some lifesaving situations where an Interventional Radiologist can be engaged for a better outcome although awareness about these procedures are very low.

A variety of imaging techniques such as X-ray radiography, ultrasound, computed tomography (CT), nuclear medicine including positron emission tomography (PET), and magnetic resonance imaging (MRI) are used to diagnose and/or treat diseases. ... This report is then transmitted to the Clinician who requested the imaging.

HISTORY OF THE HOSPITAL :-

AMRI Hospitals is a private hospital chain which is headquartered at the city of Kolkata, . It was co-founded by the Emami and Shrachi Groups in 1996, two of Kolkata’s developing groups, in a partnership with the Government of West Bengal to expand health coverage options for consumers. The company’s head office is in Kolkata with 6 branches in West Bengal, 1 at . HOSPITAL PROFILE :- AMRI Hospital Mukundapur started as the first boutique multi super specialty healthcare facility in Eastern India. AMRI Mukundapur is a comprehensive healthcare treatment facility equipped with the state-of-the-art international standard equipment. The unit is currently functioning as a 175 bedded multi super specialty hospital. The best aspect about the hospital is the soothing ambience at par International Standards and highly professional staffs who manage the latest technology. Having being geographically located at the heart of south and in Kolkata surrounded by landmarks like Satyajit Ray Film Institute, Metro Cash and Carry it is not only very easy to reach but easy transit is availed by the Eastern Metropolitan Bypass which touches the hospital premises. Internationally acclaimed consultants are attached on full time basis with the unit hence highest standards of clinical service is always maintained. The facility has advanced infrastructure and expert team of dedicated full time doctors to take care of any clinical situation for women and child-

besides offering very specialized services like CO2 Laser Therapy and Bariatric Surgery for child obesity.

THE BACKGROUND In early 1990s the Government of West Bengal handed over the charge of ‘Niramoy’a Government owned Polyclinic at , to Mr. Shravan Todi of Shrachi Group. He inducted Emami and another promoter, to build Advanced Medicare & Research Institute Ltd., a super specialty hospital with sizeable investment to offer quality healthcare. The name was finally changed to AMRI Hospitals Limited in 2009. The most visible value that the Emami Group brought to the institution was a spirit of passionate entrepreneurship.

AMRI Hospitals Mukundapur started as a boutique multi super specialty healthcare facility in Eastern India.

AMRI Mukundapur is a comprehensive healthcare treatment facility equipped with state-of-the art International standard equipment. The unit is currently functioning as a 175 bedded multi super specialty hospital. The best aspect about the hospital is the soothing ambience at par International Standards and highly professional staff who manage the latest technology.

Board of Directors:

o Mr. Rupak Barua , Group CEO o Mr. Om Prakash Saxena, Director o Mr. Om Prakash Jhunjhunwala, Director o Mr. Rajesh Parekh, Director o Mr. Anil Malawat, Director o Mr. Ashish Goenka, Director

AMRI HOSPITALS VISION, MISSION & Quality Policy Vision

Be cherished as the best place to come for care and the best place to work.

Mission

To provide healthcare services maintaining accountability in a responsible manner which contribute to the physical, psychological, social and spiritual well-being of the patients and community, which we serve. To participate in the creation of healthier lives within the community conforming to the requirements of our patients and customers round the clock and constantly measuring and striving to improve the outcomes of our care and service. To create and sustain a work environment in which all participants are empowered and committed to continual quality improvements; confirming the values of participation, acknowledgement, accountability, teamwork, integrity and respect. Create the national model of care through relentless pursuit of unparalleled quality & value to the entire satisfaction of patient, customer and staff. To carry on educational and research activities related to the provision of care to the sick and injured or related to the promotion of health and continually rethink, reshape and redefine solutions to healthcare challenges.

Quality Policy

We at AMRI are committed to provide quality health care to our beneficiaries. We shall achieve this by

Identifying and meeting their needs and expectation. Complying with the benchmark of national and global level of practices through continual development, improvement and training. Remaining committed to ensure that a transparent quality system, as per the requirement of accreditation authority and appropriate to the purpose of the organization is understood and implemented at all levels.

GOALS OF “THE AMRI HOSPITAL”  Continuously improve all our service through quality management.  Focus on our patient and deliver high quality service.  Use training team work and open communication to enable all employees to achieve their full potential.  Take all responsible steps to ensure that patients, visitors, staff of the hospitals are afforded the safest possible environment.  Measure the effectiveness of our activities and monitor progress towards achieving our vision. AMRI is the First:

 Full-fledged geriatric department- the first hospital in Eastern India with a full-fledged r treatment and rehabilitation of senior citizens.  CO2 Laser- introduced treatment with CO2 Laser for the first time in Eastern India.  EECP for Cardiac patients- Eastern India’s first hospital to introduce EECP for Cardiac patients who cannot undergo bypass.  Bariatric Surgery: the first Bariatric Surgery performed in Eastern India.  CUSA- introduced CUSA for the first time in Eastern India.  Inclusive Approach- AMRI offers a rare and unique facility to support the less privileged patients. AMRI Patient Welfare Cell is exclusively committed to arrange donations and sanction.

LOCATION:-

AMRI Hospitals Mukundapur in collaboration with Vision Care Hospital

LOCATION- 230, Barakhola Lane, Purba Jadavpur, Behind Metro Cash and Carry, Mukundapur, Kolkata- 700099.

Tel: +91-33-6606-0606 /1000

Email: [email protected]

FACILITY LAYOUT Area Facilities Service Available

Basement Administration MRD, HR, IT, Biomedical Engineering, Linen Storage Area, RO Plant, IBMS Room, Mortuary, Medical Air Plant, End Feed Room, Call center, Car parking area.

Ground Emergency, Laboratory Services, Radiology and Imaging, Registration, Admission and Discharge desk, TPA desk, Floor Inside Administration, Waiting Lounge.

Ground Floor Outside Pharmacy, Manifold Room, LT Panel, Children Play Area.

Annex Area LMO plant, HT plant, Generator room, Ambulance Bay, Car Parking Area, LPG Bank, Assembly Area 1 & 2.

First Floor Registration, Billing, Report dispatch, OPD Clinics, Mammography, USG, Uroflowmetry, Sample Collection, Eye, Cardiology, Play area, Feeding Room, Electrophysiology, Dental procedure, Toilet.

Second Floor Labour room, NICU, Operation Theatre Complex, Cath lab.

Third Floor Stroke Unit, Bone Marrow Transplant, ICU, Neuro ICU, PICU, CTVS ICU.

Fourth Floor Dialysis Unit, Male Ward, Pediatric Ward, Twin Sharing Rooms.

Fifth Floor Gastroenterology Unit, Single Room, General Ward, Physiotherapy Unit.

Sixth Floor Executive Room, Nursery

Area Facility Services Available

Seventh Floor Kitchen, Cafeteria, Dietician Work Station, AC panel room.

Terrace Water tank, Lift machine room.

Service Floor Training room.

OBJECTIVES OF THE STUDY

1. Focus on the patient care .To measure the level of satisfaction among the patients . 2. To examine the status of patients satisfaction in the hospital . 3. To determine the awareness level among the staff involved in the hospital . 4. To identify the problem areas of the hospital . 5. To learn the activity of each & every department of the hospital. 6. To study the patient turnover in the departments and draw suitable cause & effect relation with suitable suggestions. 7. To Know the level of hygiene & cleanliness in the hospital. To aware people about harmful effect of hospital acquired infections & germs brought into the environment . 8. To understand the role played by the various departments in the delivery of ultimate quality health care services .

REVIEW OF LITERATURE

J Cutan Aesthet Surg. 2010 Sep-Dec; 3(3): 151–155 Bhanu Prakash

Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

Oman Med J. 2014 Jan; 29(1): 3–7.Rashid Al-Abri* and Amina Al-Balushi

Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings. This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.

Berkowitz, B. (January 31, 2016) Bobbie Berkowitz, PhD, RN, NEA-BC, FAAN The concept of patient experience is surprisingly complex and generally linked with patient satisfaction. As reimbursement and performance policies have become more normative within healthcare, the patient experience has become a metric to measure payment systems for quality. However, we still have much to learn about the concept of patient experience and its influence on how patients report satisfaction with their care. This article discusses challenges for measurement of the patient experience, such as lack of consistent terminology and multiple contributing factors, by reviewing a brief selection of selected literature to help readers appreciate the complexity of measurement. Several examples from clinical practice will consider regulation, organizational environments, and research that can offer clarity around important factors that impact a patient’s experience and subsequent satisfaction with the provision of care.

Koichiro Otani, Patrick A Herrmann, Richard S Kurz November 1, 2011

Health-care managers have to address many aspects of the organization, and patient satisfaction is clearly one of the critical aspects for managers. To respond to the need of health-care managers, there have been many patient satisfaction studies. However, these studies focus on which attributes (factors such as nursing care and physician care) are more influential; they do not provide specific aspects for each attribute. In order to develop an effective intervention programme to improve patient satisfaction, more specific research outcomes are needed. This study utilized data collected between January 2007 and June 2008 from 32 hospitals representing a large, national private not-for-profit hospital system. The patient satisfaction survey included the Consumer Assessment of Healthcare Providers and Systems, Hospital version questionnaire items, and there are 31,471 cases. Two-stage multiple linear regression analyses were conducted with control variables (age, gender, perceived health, education and race). It was found that patients' highest priority is to be treated with courtesy and respect by nurses and physicians. An effective intervention programme to improve patient satisfaction would include a training programme, where care providers understand that patients want them to show courtesy and respect. Then, well- trained and empathetic nurses and staff members can comfort patients, and consequently improve patient satisfaction.

J Gen Intern Med. 1998 Apr; 13(4): 280–282Richard Kravitz,

Measuring and reporting on patient satisfaction with health care has become a major industry. The number of MEDLINE articles featuring “patient satisfaction” as a key word has increased more than 10-fold over the past two decades, from 761 in the period 1975 through 1979 to 8,505 in 1993 through 1997. Patient satisfaction measures have been incorporated into reports of hospital and health plan quality,1, 2 and armies of consultants make a good living selling software packages to health care providers eager to assess their customers' reactions by telephone, fax, and modem. Unless my own academic hospital is aberrant, reams of patient satisfaction reports sit on the desk of every health care administrator in America. Amidst this flurry of activity, three fundamental questions emerge: Is patient satisfaction worth measuring? How can it best be measured? And how are we to use the results? These three questions—one philosophical, one empirical, and one practical—form a framework for evaluating the place of patient satisfaction in the patient outcomes movement as a whole.

INTRODUCTION ABOUT THE SPECIALIZED DEPARTMENT

 What is the Radiology Department?

The imaging department at university hospital and medical center is staffed by Board Certified Radiologists, trained to perform and interpret diagnostic and interventional procedures. The center provides a complete range of medical imaging procedures in general radiography and subspecialty areas. Radiologists use a variety of imaging techniques such as X-ray, Ultra sound , Computed tomography (CT), Magnetic Resonance Imaging (MRI) to diagnose and/or treat diseases . The radiology department may also be called the X-ray or Radiology Imaging department.

STAFFING :-

I. RADIOLOGIST :- a. Head of the department :- 1 b. Consultant and Head of units :- 4 to 5 c. Junior consultants :- 8 to 10 d. Residents depending upon the size and work load of the department :- 2 II. TECHNICIANS :- a. technician in charge :- 1 b. senior technician :- 8 to 10 c. Junior technician :- 10 to 12 d. Nurse :- 2

III. OTHER STAFF :- a. Receptionist :- 1 b. Store keeper :- 1 c. Clerk :- 1 d. Attendants :- 1 e. Security staff rotational basis :- 3 f. PRO :- 1

EQUIPMENTS :-

I. Stretchers II. Work tables III. Physician’s desks IV. Wall mounted cabinets V. X- ray view box VI. Chairs VII. Examination couch VIII. Wash basin IX. Instrument’s trolley X. Equipment’s for resuscitation XI. Portable x-ray Machine XII. Ultrasonography Machine XIII. Wheel chairs XIV. Digital X-ray Machine XV. CT Machine XVI. MRI Machine XVII. Mammography Machine

FUNCTION :- 1. The main function of this department is to assist the physician in the diagnosis and treatment of a patient’s disease through the use of Radiography , Fluoroscopy a radioisotopes and high voltage acceleration. 2. The primary function is to provide reliable radiological services to the patients. 3. Secondary function is to engage in essential research for medical advancement. 4. Participate in educational program for hospital resident and in service program for the medical staff. 5. Follow up treatment of discharged patients.

DEPARTMENT LAYOUT

BILLING PROCEDURE: -

Every patient who visits the hospital has to get registered prior to getting any consultation, treatment or investigations done. Registration of patients involves accepting certain general & demographic information about the patient. A complete report of patient right from the registration to discharge are organized which are viewed for a look in total bill summary, free consumption, and general information, patient relation with the other patient, account details & admission details of the patient.

Patient Registration

 Patient Admission

Patient Discharge

 Baby Registration

OPD BILLING: -

• People with CGHS & WBHS facilities get a special benefit of service. Both pensioners and working people get the facility

• Senior citizens also get concessions.

• Other than the bills for pathological tests and radiology investigations are made here.

BROAD OVERVIEW

What is patient satisfaction ? Hospital is for the patient where all activities are patient focused and consumer oriented. The patient is a number of the society under influence and care of a health care organization .

The word patient is derived from the Latin “ Paitor to suffer” . In many cases the character of the patient’s demand for hospital care is both medical and socio psychological.

Respect and dignity is one of the most basic rights and needs of the patient. In spite of that most hospitals provide less than a minimum of normal privacy for the patient. The medical staff should not regard the patient as a passive object who would be given all possible information. Delivering and receiving medical information is a delicate procedure.

Hospitalization is a period of strain for patients , whose emotional needs probably vary as much as their physical emotions.

.

Definition :-Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider. . Meaning :-The word patient is derived from the Latin “ Paitor to suffer” . In many cases the character of the patient’s demand for hospital care is both medical and socio psychological. Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. ... It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals.

Tools of measurement: - The databases utilized were Google Scholar, Medline, Emerald, Pub-Med and Science Direct, while the main keywords used were: patient satisfaction surveys, quality improvement, patient feedback, hospitals and patient satisfaction measurement.

BACKGROUND: Surveys used for health plan quality reporting are generally administered annually to health plan enrollees to assess satisfaction with both the health plan and health care services. Therefore, surveys may lack sensitivity to measure the effects of patient-focused, quality improvement initiatives that could demonstrate results in a shorter time period. OBJECTIVES: We describe the development and testing of a multidimensional, visit-specific measure of satisfaction with primary care that may be used in quality improvement. METHODS: Conducted in five adult and pediatric primary care sites serving a commercial, largely managed-care population, the survey includes the Medical Outcomes Study Visit-Specific Questionnaire, the American Board of Internal Medicine Patient Satisfaction Questionnaire, and locally developed items. We assessed the instrument's reliability, validity, and utility for quality improvement. RESULTS: For both adult and pediatric samples, three factors emerged: satisfaction with the provider, satisfaction with access, and satisfaction with the office. Satisfaction with the provider and with the office were independently correlated with overall satisfaction in both samples; satisfaction with access was significantly correlated with overall satisfaction only for adults. For adults, patients who disembroiled from the health plan were less satisfied with the office compared with patients who remained with the health plan. Finally, for adults, we detected significant differences across practice sites in terms of satisfaction with office and access; for children, there were interstice differences in terms of satisfaction with provider, office, and access. CONCLUSIONS: We have support for the reliability and validity of this instrument that has identified differences in satisfaction between practice sites that may be used for quality improvement. FUNCTION : -

1. The main function of this department is to assist the physician in the diagnosis and treatment of a patient’s disease through the use of Radiography, Fluoroscopy a radioisotopes and high voltage acceleration. 2. The primary function is to provide reliable radiological services to the patients. 3. Secondary function is to engage in essential research for medical advancement. 4. Participate in educational program for hospital resident and in service program for the medical staff. 5. Follow up treatment of discharged patients.

Importance : - 1. Satisfied patients will share their positive experience with five others, on average, and dissatisfied patients complain to nine (or more) other people. The Internet promotes rapid and wide dissemination of these opinions. This word-of mouth marketing is powerful, especially as consumers grow more savvy about their health care choices.

2. Because the cost of obtaining a patient is high, losing a patient is a substantial loss of investment. You may have attracted a patient through advertising or an insurance contract. And for each new patient, you must establish a patient record and gather payment information. Every interaction with the patient (e.g., reminder and follow-up calls), payer (confirming coverage, etc.), physician’s office (obtaining files, results of physical, etc.), pharmacy (ordering or refilling a prescription), or laboratory (following up on test results) represents a portion of your investment in that patient.

3. There is evidence of a reciprocal relationship between patient satisfaction and continuity of care (which is associated with better patient outcomes). Conversely, dissatisfaction and complaints can mean not only loss of business/investment, but also increased risk of malpractice lawsuits.

PATIENT RIGHTS & RESPONSIBILITIES

Patient Rights :- 1. Receive considerate , compassionate and respectful care in a safe and secure environment free from all forms of abuse , harassment , neglect and mistreatment. 2. Be treated with respect and regard for privacy, individuality, personal values , beliefs, spiritual and cultural traditions. 3. Be informed of your rights and the policies regarding them both verbally and in writing in a manner in which you or your representative understands. 4. Personal privacy and confidentiality. Consultation ,examination, treatment and case discussion are confidential and will be conducted discreetly. 5. Receive timely and qualified care in a setting appropriate to healthcare needs. 6. Receive referrals to staff and services in timely manner consistent with quality professional practice. 7. Access protective and advocacy services in case of abuse or neglect. 8. Know the professional status of the person (s) directing and /or providing care and those giving medical advice after hours . 9. Participate in decisions affecting your care and treatment according to your desires , needs , and understanding including the choice to have family & friends participate in the process. 10. Receive information regarding your health status , diagnosis, prognosis , the course of treatment , the benefits and risks of treatment , and the prospects for good health in terms you can understand . 11. Refuse care , treatment and services to the extent permitted by the law. You will be fully informed of possible consequences of such refusal. 12. Submit an advanced directive and appoint someone to make healthcare decisions for you if you are unable to. If you do not have and advance directive , we can provide you with information and help you complete one . 13. Express satisfaction regarding services rendered and comment and make suggestions for improvement of the quality of care and services . 14. File a complaint and to receive a response in a timely manner without fear of discrimination . 15. Access your medical records , approve and refuse the release of your medical records . Records are maintained private and confidential in a safe and secure environment . 16. Know , I advance of services , the cost of services and any applicable payment policy. 17. Agree or refuse to participate in research / departmental activities . 18. Change your primary care or dental providers if other qualified practitioners are available.

Patient Responsibilities :-

1. Ask question s and actively participate in discussions and decisions regarding your healthcare. 2. Provide complete information about your health and medical history , including present condition , past illnesses , hospitalizations and medications. 3. Discuss your health care problems , concerns and personal needs with your provider in an honest manner and to inform the health care provider of any changes occurring in your health. 4. Come to all appointments drug and alcohol free . Patient believed to be under the influences will be asked to leave. 5. Cooperate with all health care personnel involved in your care and to conduct yourself in a polite and respectful manner . 6. Respect the rights of your healthcare provider and to exchange information in a non abusive manner either physically and verbally while receiving one. 7. Follow your provider’s health care instructions or inform provider if you cannot or will not follow treatment plan. 8. Accept consequences for refusing care or not following treatment plan. 9. Show consideration and respect the rights and property of all health care professionals , employees and other patients. 10. Make and keep all scheduled appointments . to assure that all patients are served in a timely manner , patients are responsible for calling and changing appointments 24 hours in advance. 11. Pay for services at the time service is provided and to provide the patient registration ,office with accurate, complete and current information pertaining to insurance coverage , home address ,and telephone number .you have a right to receive detailed information regarding your bill. 12. Advice your provider of all changes in decisions concerning advance directives and / or persons designated by you to make healthcare decisions.

METHODOLOGY

STUDY VENUE:-This study has been carried out in the Out-patient department & investigation department of AMRI Hospital MUKUNDAPUR . DURATION : - 8TH January TO 14TH April ( 3 months)

SAMPLING METHOD:- In the present study of customer satisfaction, the samples have been drawn by Simple Random Sampling, from the various investigation departments of the hospital.

SAMPLE SIZE :- 100 PERSONS

TYPES OF DATA :- 1.Primary data

2. Secondary data

METHOD OF DATA COLLECTION:- Two types of data sources have been used in the study :

1.Primary data:-

o Direct observation o Personal interview o Questionnaire for patient

2. Secondary data :- o Data analysis of past records (patient feedback forms) o Information through various booklets , registers etc.

DATA COLLECTION & INTERPRETATION

Keeping in mind the objectives of the study, the surveys were being done & following interpretation were being drawn: Evaluation:-

Keeping this point in view and to fulfill the evaluation variants of which may form the basis for objectives of the studies an attempt has been made to segment the various respondents on the basis of some aspects collected from them through questionnaire. There are depicted through tables and graphs.

The copy of questionnaire administered is enclosed and the sample size was 100 respondents are enclosed at the end of this project. All the calculations and numerical interpretations are for 100% .

FINDINGS :-

DATA COLLECTION

Patient Satisfaction: - Table :- Patient Satisfaction

CRITERIA NO. OF PATIENT PERCENTAGE Registration & billing 70 70% Behavior of staff 82 82% levels of cleanliness 65 65% information service 85 85% radiology investigation 75 75% internal department communication 36 36%

Graph: - Patient Satisfaction

NO. OF PATIENT

internal department communication

radiology investigation

information service

levels of cleanliness

Behavior of staff

Registration & billing

0 10 20 30 40 50 60 70 80 90

NO. OF PATIENT

Patient Dissatisfaction: -

Table :- Patient Dissatisfaction

CRITERIA NO. OF PATIENT PERCENTAGE DISSATISFIED Registration & billing 30 30%

Behavior of staff 18 18% levels of cleanliness 35 35% information service 15 15% radiology investigation 25 25% internal department communication 64 64%

Graph:- Patient Dissatisfaction

NO. OF PATIENT DISSATISFIED

internal department communication

radiology investigation

information service

levels of cleanliness

Behavior of staff

Registration & billing

0 10 20 30 40 50 60 70

NO. OF PATIENT DISSATISFIED

1. Percentage of Patient Satisfied /Dissatisfied

I. Time taken for registration & billing Table 1.i: Average time for registration & billing

Criteria NO. OF PATIENT PERCENTAGE Total patient 100 100 SATISFIED 70 70% DISSATISFIED 30 30%

Graph 1.i: Average time for registration & billing.

PERCENTAGE

SATISFIED DISSATISFIED

As per shown in the above graph on average time for registration &billing in patients. Satisfied patient 70% and dissatisfied patient 30%.

II. STAFF BEHAVIOUR

Table 1.ii: Behavior of staff

Criteria NO. OF PATIENT Percentage Total patient 100 100 Satisfied 82 82% Dissatisfied 18 18%

Graph 1.ii: Behavior of staff

Percentage

Satisfied Dissatisfied

As per shown in the above graph on behavior of staff. Satisfied patient 82% and dissatisfied patient 18%.

III. Hygiene Maintain

Table 1.iii: levels of cleanliness

Criteria NO. OF percentage PATIENT Total patient 100 100 Satisfied 65 65% Dissatisfied 35 35%

Graph 1.iii: levels of cleanliness

percentage

Satisfied Dissatisfied

As per shown in the above graph on maintain the hygiene. Satisfied patient 65% and dissatisfied patient 35%.

IV. Availability of information

Table 1.IV: Satisfactory of information service

Criteria NO. OF PATIENT percentage Total patient 100 100 Satisfied 85 85% Dissatisfied 15 15%

Graph 1.IV: Satisfactory of information service

percentage

Satisfied Dissatisfied

As per shown in the above graph on Satisfactory of information service. Satisfied patient 85 % and dissatisfied patient 15%.

V. Time taken for radiology investigation.

Table 1.V: Average time for radiology investigation

CRITERIA NO. OF PATIENT PERCENTAGE

Total patient 100 100 SATISFIED 75 75% DISSATISFIED 25 25%

Graph 1.V: Average time for radiology investigation

PERCENTAGE

SATISFIED

DISSATISFIED

As per shown in the above graph on average time for consultation in patients. Satisfied patient 75% and dissatisfied patient 25%.

Vi. INTERNAL DEPARTMENT COMMUNICATION

Table 1.vi: internal department communication CRITERIA NO. OF PERCENTAG PATIENT E Total patient 100 100 SATISFIED 36 36% DISSATISFIED 64 64%

Graph 1.vi: internal department communication

PERCENTAGE

Satisfied Dissatisfied

As per shown in the above graph on internal department communication. Satisfied patient 36% and dissatisfied patient 64%.

SUMMARY OF FINDINGS

PROBLEM IDENTIFICATION o There is lack of housekeeping staff in radiology department. o There is lack of nurse in radiology department. o Internal communication gap. o Study revealed that billing and cash payment consumes 25-30 min which itself serves as dissatisfaction for the patients. o Collection of reports consumes time i.e. 40-45min. o The study shows that maximum no. of patients is dissatisfied with the punctuality of the staffs in attending to their needs. o Internal department co -ordination problem. o Radiologists when do not come on time it causes the waiting time to go up at the Report dispatch counter as well as in the investigations. o There is lack of Senior radiology technician. o Sometimes the technicians and nurses are not punctual for this reason there is a delay of work. o Radiology department through IPD department, Emergency department communication gap.

RECOMMENDATIONS: -

Some suggestion to improve the OPD facilities are as follows: - o Number of counters and staffs in pharmacy must be increased to avoid long waiting time for the patients. o Number of staffs should be increased in the depts., with large no. of patients. o Number of registration counters should be increased because during the peak hours it may result in the negative image of the hospital in the mind of the patients. o The waiting area should be more spacious. o Hospital should give separate outpatient feedback form. o Regarding the design of the OPD, the registration counter and enquiry desk should be open and near to the entrance of OPD and emergency dep., all the diagnostic dept. should be near to the consultancy rooms. o Hospital authorities should appoint more qualified and senior staff in OPD. o Reception personnel should be well informed about the visiting time of each & every investigation charges; rather it will misguide patient party. o While coming to any hospital patient & parties are distressed. So the reception personal has to behave calmly & politely to make them little bit satisfied &relaxed.

o Proper signboard should be given (what is where) so that patient and parties is not get harassed.

o Nurses should be polite while taking care of the patient.

o Toilet should be regular cleaned as various persons use it. So it should be cleaned regular to avoid infection.

o Parking of vehicles should be free of cost for the patients and their attainders.

CONCLUSION It should be remembered that patient care includes elements that may be examined objectively or subjectively or both. The objective elements can be measured by statistical documentation & analysis to serve as a point of departure from which qualitative judgment can be made, whereas the subjective elements require qualitative judgment through clinical evaluation. Continuous evaluation provides stimulation for improvement of clinical services, professional education, hospital administration & better patient care. Medical audit, when practiced can go long way in improving the quality of patient care in our hospitals, which at present is far below the expectation of the community. Patients attending each hospital are responsible for spreading the good image of the hospital and therefore satisfaction of patients attending the hospital is equally important for hospital management. Various studies about outpatient service have elicited problems like overcrowding, delay in consultation, proper behavior of the staff etc. It is a big hospital with enough resources, still it has a good prospect because it is giving quality service to people. The duration of training was 3 months. It is very difficult to cover the whole hospital’s scenario within this span of period.

REFERENCE: -

1. J Cutan Aesthet Surg. 2010 Sep-Dec; 3(3): 151–155 Bhanu Prakash 2. Oman Med J. 2014 Jan; 29(1): 3–7.Rashid Al-Abri* and Amina Al-Balushi 3. Berkowitz, B. (January 31, 2016) Bobbie Berkowitz, PhD, RN, NEA-BC, FAAN 4. Koichiro Otani, Patrick A Herrmann, Richard S Kurz November 1, 2011 5. J Gen Intern Med. 1998 Apr; 13(4): 280–282Richard Kravitz,

BIBLIOGRAPHY

Books:

To design, carrying out and understanding this project I have followed some e -books like –

i. Excellence in Diagnostic Care ii. Increasing Access to Diagnostics by World Health Organization. iii. Express health care management magazines. iv. Hospital administration - D.C Joshi & Mamta Joshi v. Principles of hospital administration & planning - BM Sakharkar

Websites:

There are some educational websites on medical diagnostic which helped me and are the source of important in-formations -

i. AMRI hospital Wikipedia .com. ii. Future learn. com. iii. healthline.com

ANNEXURE

PATIENT CHECKLIST:-

SL.NO. PATIENT NAME AGE BOOKING / FLYING 1. DHANESH SHARMA 42Y BOOKING 2. SURAVI SANYAL 23Y BOOKING 3. RITUPARNA SAHA 19Y BOOKING 4. RAMYA DEVI 57Y FLYING 5. SUDIPTO MONDAL 37Y FLYING 6. ISHA SAHA 27Y FLYING 7. ADRITA THAKUR 38Y BOOKING 8. ARUN BISWAS 85Y BOOKING 9. SAYAN BASU 35Y FLYING 10. SANJOY GANGULY 45Y FLYING 11. MOHINI CHOWDHURY 20Y FLYING 12. SASANKA CHATTERJEE 64Y BOOKING 13. NISHA SHAW 48Y BOOKING 14. ARUN PRAKASH DIXIT 62Y FLYING 15. BIJOY MAJI 37Y BOOKING 16. BANI MITRA 44Y BOOKING 17. SAYANTANI HORE 23Y BOOKING 18. RAI MARIK 27Y FLYING 19. SUPARNA MONDAL 34Y BOOKING 20. SAYANI KAR 22Y BOOKING 21. RAJA GOSWAMI 32Y BOOKING 22. PRABIR DAS 48Y BOOKING 23. PRIYANKA DEBNATH 26Y FLYING 24. KAMALA DAS 82Y FLYING 25. ALO BANERJEE 56Y FLYING 26. NANDINI ROY 48Y FLYING 27. SANCHARI PIPLAI 28Y BOOKING 28. MIRA PAL 41Y BOOKING 29. ANANDA ROY 47Y BOOKING 30. TANAY BANERJEE 48Y BOOKING 31. BANI PAJA 62Y FLYING 32. DEBANI LAHA 45Y FLYING 33. RAKHI BISWAS 35Y BOOKING 34. SUBHAMITA MITRA 38Y BOOKING 35. ANTARA KAR 45Y BOOKING 36. ESHA DAS 29Y FLYING 37. GANESH BAL 63Y FLYING 38. NITYA SARDAR 59Y FLYING 39. PARUL PAL 47Y BOOKING 40. BELA RANI DAS 54Y BOOKING 41. ALOK NASKAR 48Y FLYING 42. PAMPA BISWAS 32Y FLYING 43. ALO PAL 80Y BOOKING 44 BOBY BERA 44Y FLYING 45. SHYAM HORE 48Y FLYING 46. SUBHO SAHA 30Y FLYING 47. SOUMYA DEB 45Y FLYING 48. TANISHA MUKHERJEE 28Y BOOKING 49. MONIKA HALDER 37Y BOOKING 50. TANIA BOSE 18Y FLYING