Improving the Quality of Health Care in the Public Sector

Abstract

The research aimed to demonstrate how transparency in the health sector can improve the efficiency of budget allocations and result in improved overall care.

TI Jordan conducted a survey in eight government hospitals in central Jordan (three in the north and two in the south) to assess the efficiency and effectiveness of secondary health care services. The number of respondents inside the hospital and in the outpatient clinics was 800, of which 505 were women. Survey results were made public and shared with the hospitals.

Methodology

This research project included five phases:

1. Evaluating the integrity and quality of secondary health care services and the degree of satisfaction of patients in hospitals.
2. Conducting focus group discussions.
3. Conducting round-table discussions.
4. Building the capacity of Civil Society Organisations to implement patient satisfaction studies.
5. Building the capacity of Civil Society Organisations in the field of health insurance and comprehensive health coverage.

Findings

1. 270 persons (33.75%) felt that the doctors and nurses treated others better than they felt treated.
2. When looking at the levels of satisfaction among those who expressed being treated wrongly by hospital staff, it was found that the satisfaction rate related to the nursing staff was only 55.1%, while it reached 69.39% with doctors and 59.18% with non-medical staff.
3. While studying the satisfaction of patients with different physical disabilities, it was found that satisfaction among those with motor disabilities was 69.57%, among those with hearing impairments was 62.5% and that all those nine with visual disabilities were satisfied with the level of services provided to them. It is noted that the general satisfaction rate of all respondents with disabilities reached 74.5%, which is less than the overall satisfaction rate of all respondents in the study (80.38%).

Recommendations

1. Implement an independent financial and administrative system. Further delegating authority to hospital directors to improve service provision, in addition to empowering managers through intensive training.
2. Addressing the lack of commitments towards hospital accreditation by some of the hospital staff.
3. Introduce accreditation learning to school and university curricula to create a generation acquainted with the accreditation.
4. Motivate, either with material or moral incentives, those accredited hospitals to improve the quality of services provided to patients.
5. Link the Ministry of Health doctors’ incentive system to staff performance (in the form of additional points based on merit according to the the nature of work).

Impact

We were able to improve the quality of health care services in the public sector through a study of the satisfaction of beneficiaries with the services provided in the hospitals of the Ministry of Health. We reached a deeper and more comprehensive understanding of the provided services, and managed to identify, analyse and narrow the gap between the current service delivery and the required level through a sound application.

Lessons Learnt

1. The importance of networking with civil society organizations working in the health field
2. The necessity of conducting awareness campaigns that include informing patients of their rights, as we found out through the meetings that were held that patients and even medical staff lack knowledge on their rights and duties
3. Increasing awareness amongst medical staff for the importance of accreditation, and that commitment to accreditation stems from the employee's awareness and conviction and their desire to improve the quality of the provided services.
4. The necessity of including the subject of accreditation in the university curricula in order to be able to create a medical generation keen on continuous improvement in the medical sector
5. Increasing the size of the study sample to include a larger number of hospitals across all governorates