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Journal ArticleDOI

Patient Satisfaction in a One‐Stop Haematuria clinic and Urology Outpatients: A Comparison of Clinics

01 Nov 2016-International Journal of Urological Nursing (Blackwell Publishing Ltd)-Vol. 10, Iss: 3, pp 127-136
TL;DR: Whether or not one-stop haematuria clinics improve patient satisfaction is discussed and practical recommendations for related service improvements are offered.
Abstract: One-stop clinics have shown to improve the patient experience in early diagnosis of potentially life threatening conditions, although this service is less evident in Urology, where morbidity and mortality resulting from bladder cancers are increasing. This study will discuss whether or not one-stop haematuria clinics improve patient satisfaction. A survey analysis comparing patient satisfaction for a one-stop haematuria clinic and a traditional outpatient service was developed, based around the ‘Determinants and Components’ theory. A convenience sample of 102 haematuria patients attending either the one-stop clinic (Route A) or an outpatient clinic within the Urology service (Route B), at an assigned National Health Service hospital, were invited to complete a ‘patient satisfaction’ questionnaire. Data were compared between clinic routes according to the patient satisfaction themes of: Time and Availability, Quality of Care, Environment, Accessibility and Convenience and Global Satisfaction. Response rate was 51%; with overall positive patient satisfaction levels for both clinics. Route A patients were most satisfied with Quality of Care; however, reported problems relating to prior information provision and appointment co-ordination. For Route B, Availability and Time was a primary source of both satisfaction and dissatisfaction, receiving contradictory qualitative and quantitative responses respectively. Both groups rated Environment and Accessibility and Convenience highly overall, yet these were not a primary determinant of satisfaction. The majority of haematuria patients (82%), expressed a preference to attend a one-stop clinic over several outpatient appointments. Practical recommendations for related service improvements are offered.

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Figure 1: An Investigatory Flowchart for patients with at least one positive Haematuria Screening
test
History, examination, urinalysis, bloods
Ultrasound scan
Flexible
cystoscopy (if
required)
(Reference: Local protocol).
Figure 2: Patient Satisfaction Characteristics based upon the “Taxonomy of Dimensions” (Ware et
al, 1984)
Normal 1st line
1st line abnormality
Dipstick positive
Dipstick negative
2
nd
line investigation as
indicated (biopsy, bladder
resection)
Discharge
Intravenous urogram
Patient
Satisfaction
Technical
Quality
Efficacy /
outcomes
Finances
Accessibility /
convenience
Continuity
Physical
environment
Affability
Availability

Figure 3: Comparison of GP Referral Periods for “One-stop” Haematuria patients versus Urology
Outpatients
0
2
4
6
8
10
12
< 10 days 10 -14 days 15 - 20 days 21+ days
Frequency of Patients
Time period from GP referral
"Route A" - One-stop clinic
"Route B" - Urology Outpatients

Figure 4: Clinic preference for patients attending Haematuria clinic ‘Route A’

Figure 5: Clinic preference for patients attending Haematuria clinic ‘Route B’
Citations
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References
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Journal ArticleDOI
TL;DR: Form II of the Patient Satisfaction Questionnaire (PSQ), a self-administered survey instrument designed for use in general population studies, well represents the content of characteristics of providers and services described most often in the literature and in response to open-ended questions.

1,249 citations


"Patient Satisfaction in a One‐Stop ..." refers background in this paper

  • ...Sufficient periods enable patients to get between appointments and aid staffing and clinic scheduling; facilitating continuity for all (Ware et al. 1983)....

    [...]

Journal ArticleDOI
TL;DR: The burden of UBC will increase in less developed areas of the world, and changes can be attributed to global changes in exposure to risk factors for UBC and growth and aging of the World population.
Abstract: Urinary bladder cancer (UBC) is a common disease worldwide. At any point in time 2.7 million people have a history of UBC. The incidence of UBC varies over the world with highest rates in developed communities. But the burden of UBC will increase in less developed areas of the world. These changes can be attributed to global changes in exposure to risk factors for UBC and growth and aging of the world population.

824 citations


"Patient Satisfaction in a One‐Stop ..." refers background in this paper

  • ...…haematuria patient has changed; an increased median age, attributable to rising numbers of newly diagnosed bladder cancer patients above 85 years and cancer survivors requiring long-term follow-up (Ploeg et al. 2009), leading to extended waiting times and outdated, overcrowded, outpatient clinics....

    [...]

Journal ArticleDOI
TL;DR: In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.
Abstract: Background Patient satisfaction is a widely used health care quality metric. However, the relationship between patient satisfaction and health care utilization, expenditures, and outcomes remains ill defined. Methods We conducted a prospective cohort study of adult respondents (N = 51 946) to the 2000 through 2007 national Medical Expenditure Panel Survey, including 2 years of panel data for each patient and mortality follow-up data through December 31, 2006, for the 2000 through 2005 subsample (n = 36 428). Year 1 patient satisfaction was assessed using 5 items from the Consumer Assessment of Health Plans Survey. We estimated the adjusted associations between year 1 patient satisfaction and year 2 health care utilization (any emergency department visits and any inpatient admissions), year 2 health care expenditures (total and for prescription drugs), and mortality during a mean follow-up duration of 3.9 years. Results Adjusting for sociodemographics, insurance status, availability of a usual source of care, chronic disease burden, health status, and year 1 utilization and expenditures, respondents in the highest patient satisfaction quartile (relative to the lowest patient satisfaction quartile) had lower odds of any emergency department visit (adjusted odds ratio [aOR], 0.92; 95% CI, 0.84-1.00), higher odds of any inpatient admission (aOR, 1.12; 95% CI, 1.02-1.23), 8.8% (95% CI, 1.6%-16.6%) greater total expenditures, 9.1% (95% CI, 2.3%-16.4%) greater prescription drug expenditures, and higher mortality (adjusted hazard ratio, 1.26; 95% CI, 1.05-1.53). Conclusion In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.

812 citations


"Patient Satisfaction in a One‐Stop ..." refers background in this paper

  • ...…as The White Paper, Improving Outcomes: A Strategy for Cancer (DoH, 2011), and the ‘Cancer Patient Experience Survey’ (DoH, 2012), illustrating how service-user views can promote and improve patients’ experiences; systematic, critical measurement of PS, remains ill defined (Fenton et al. 2012)....

    [...]

Journal ArticleDOI
TL;DR: In both studies, the E5 scales showed greater response variability and better predicted whether patients intended to return to the same doctor in the future, recommend the doctor to a friend, and comply with the medical regimen.
Abstract: This paper presents the results of two studies that compared methods for measuring patient satisfaction with specific medical encounters. One form used six-point response scales ranging from “very satisfied” to “very dissatisfied” (S6 scale); the other used five-point scales ranging from “excellent”

611 citations