Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 87482

AbstractMaterial and MethodsResultsDiscussionConclusionAcknowledgementReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : June | Volume : 16 | Issue : 6 | Page : BC05 - BC11 Full Version

Patients and Clinicians Satisfaction with Clinical Laboratory Services at a Tertiary Care Hospital: A Cross-sectional Study


Published: June 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/56436.16416
Bi A Khadeja , Santhosh Viswan , A Kaviyathendral , Suganya Sasikumar

1. Associate Professor, Department of Biochemistry, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madurantakam, Chengalpattu, Tamil Nadu, India. 2. Professor and Head, Department of Biochemistry, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madurantakam, Chengalpattu, Tamil Nadu, India. 3. Undergraduate Student, Department of Biochemistry, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madurantakam, Chengalpattu, Tamil Nadu, India. 4. Assistant Professor, Department of Biochemistry, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madurantakam, Chengalpattu, Tamil Nadu, India.

Correspondence Address :
Dr. Bi A Khadeja,
GST Road, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, Chengalpattu, Tamil Nadu, India.
E-mail: akhadbi@gmail.com

Abstract

Introduction: Clinical laboratories are an essential part of the health care system providing vital information required for patient’s care. As the importance of monitoring the satisfaction status is becoming necessary and no data regarding the same is available in this region, so present study was designed to implement it in the institution.

Aim: To estimate the clinicians and patients satisfaction status with the services provided by the Central Clinical Laboratory, Karpaga Vinayaga Institute of Medical Sciences and Research Centre (CCL-KIMS and RC) in Kanchipuram District, Tamil Nadu, India.

Materials and Methods: A cross-sectional study was conducted in the Central Clinical laboratory, KIMS and RC between April 2019 to December 2019 in three phases including a total of 150 clinicians and 150 patients. The patient’s satisfaction status was assessed using questionnaires by the investigator. Self-administered structured questionnaire was used for the determining the clinician’s satisfaction status. Likert scale was used and the mean score of satisfaction for each, patients and clinician was calculated. Data entry and analysis was done using Statistical Package for the Social Sciences (SPSS) 25 V software. Chi-square test was used to find out the association between satisfaction status and the different attributes. Spearman’s correlation was performed to assess to relationship between the satisfaction status and the different phases of the study.

Results: In present study, the mean age of patients was 38.0±11.6 years and clinicians 42.9±8.7 years respectively. Majority of participants among patients were females n=82 (54.7%), and clinicians were males n=105 (70%). Among patients 63.3% were married (n=95), 90% came from the middle category of socio-economic status (n=135), while 81.3% resided in the semi-urban area n=122. 67.3% of the clinicians (n=101) had an experience of more than three years at KIMS and RC. Overall 87.3% (n=131) of the patients and n=106 (70.7%) of the clinicians were satisfied with the services provided by the central clinical laboratory at KIMS and RC. An improvement in the satisfaction status of the patients and clinicians from phase I to III was observed. Around n=19 (12.7%) and n=44 (29.3%) of the patients and clinicians were dissatisfied with the laboratory services.

Conclusion: In the present study, the overall level of patients and clinicians satisfaction status was high and satisfactory. An improvement in the observed satisfaction status from phase I to III was attributed to the trainings given to the laboratory staff on the international standards of laboratory management. Domains like the turn around time, interface of laboratory and hospital information system and waiting time for specimen collection required improvement.

Keywords

Attitude of health personnel, Clinical laboratory standards, Patient care, Quality assurance, Quality improvement tool

Clinical laboratories are an essential part of the healthcare system providing important information required for patient’s care [1-3]. Customer satisfaction with the services provided in a medical laboratory is one among the 12 quality essentials of Total Quality Management System (TQMS). It is emphasised by all the standards for quality assurance including ISO 17025, ISO 15189 and ISO 9001 (4). Customers’ satisfaction is an expression of the gap between the expected and perceived characteristics of a service. Customers reviewing a healthcare facility are patients, their relatives, physicians, para medical staff, health officials, communities and interested parties (4).

In developing countries services from the healthcare sectors have an overwhelming work load, due to which the focus on the concept of quality in the care provided is neglected, although it is the right of the beneficiary (5). Needs of patients should be taken in to account, as the assumption, of them to be uneducated with few options for healthcare services is invalid. They are well educated and aware of the health care choices. Recently, accreditation bodies for a hospital or a clinical laboratory emphasise on the beneficiaries’ role in the improvement of the services provided (6),(7). It is in contrast to the traditional assessment of health care which emphasised on technical improvements only (8),(9).

The customer is the king in medical laboratory services and their satisfaction is core in quality of health care delivered. Services provided are meaningless when it does not satisfy its users. Periodically analysing patients and clinicians satisfaction with the healthcare services provided has a vital role in prioritising the funds and implementing the essentials required for the laboratory in a timely manner (4).

Patients are referred as the main value of the clinical environment. They are the reason for all works and therefore work cannot be done without them. Patient’s satisfaction has a positive effect on their recovery from illness, patient’s willingness to follow-up in the same institution, appropriate clinical care by physicians and job satisfaction for all healthcare personnel (8),(10). Customer satisfaction gives an opportunity to identify the deficiencies between the expected versus received care. Comforting and reassuring the apprehensive patients prior to sample collection by a well trained phlebotomist who is the first person a patient meets in the laboratory was found to be an effective factor in ascertaining patient satisfaction (7).

The best way of measuring and improving the quality of laboratory service is to take into account the valuable suggestions by the test requesting clinician who is the prime user of the laboratory (11). The 70% of all medical decisions are based on laboratory results (1). The reports generated from the laboratory gives an added value to the clinical expertise for prompt decision making by the clinician and to minimise guess work.

Quality and improvement in healthcare without considering the medical laboratory service is incomplete. The quality improvement in healthcare is mainly proven by the high quality of medical laboratory results (9),(12). It also aids in providing better service, remain in competition with other hospitals, participating confidently in recognition and accreditation programs (5),(13). Poor infrastructure, shortage of supplies, lack of trained technical staff, ineffective equipment maintenance and material-man power mismanagement are some of the problems faced by the laboratories in rural locality (1). Satisfied services needs team work among all healthcare workers (14),(15),(16).

Patient and clinician satisfaction assists in the evaluation of health care services from the beneficiaries’ point of view. As the importance of monitoring the satisfaction status is becoming necessary and no data regarding the same is available in this region, hence, present study was designed to estimate the patients and clinicians satisfaction status with the services provided by CCL-KIMS and RC.

Material and Methods

A cross-sectional study was conducted in the Central Clinical laboratory, at Karpaga Vinayaga Institue of Medical Sciences and Research Centre (CCL-KIMS and RC), a tertiary care Medical college hospital in Kanchipuram district, Tamil Nadu between April 2019 to December 2019. The study was conducted with prior approval from the Institutional Ethics committee (IEC Ref No. KIMS/SUG/2019/05). The laboratory caters to the people from the surrounding 20 villages around it in the disciplines of clinical chemistry, pathology and microbiology. The laboratory functions 24*7 and on all days.

Inclusion criteria: All available clinicians in KIMS and RC who regularly required laboratory investigations to be performed for their patients and agreed to participate in the study were included. All patients above the age of 18 years who were willing to participate in the study were included randomly and interviewed after completing their laboratory examinations upon leaving the hospital. Patients availing laboratory services between 08.00 AM- 05.00 PM were only included in the study.

Exclusion criteria: Patients and clinicians not willing to participate in the study were excluded.

Sample size calculation: The required sample size for the participants was determined by using a single population formula considering the following assumptions: proportion of 87.6% level of significance =0.05, margin of error (d) =5% and a non respondent rate of 10%. The calculated sample size for the study was 150 patients and 150 clinicians (1).

Study Procedure

A written consent for participation in the study was obtained after the study objectives were explained to each participant. The study period of nine months was divided into three phases, phase I (April- June), phase II (July-September) and phase III (October-December) respectively to ensure guiding and addressing the issues requiring improvements then and there through out the study. Data collection and methodology employed was uniform during all the three phases of the study. ISO 15189:2012 is a standard available for quality and competence testing in a medical laboratory. ISO 15189: 2012 and feedbacks from the participants were used as a guide to identify the existing gaps and to implement the improvements during the study period. Training and implementation on all the different clauses was done based on ISO 15189: 2012 (17).

The (Table/Fig 1) depicts the number of participants enrolled during the three phases of the study. Modified patient and clinician satisfaction questionnaires were used for data collection. These questionnaires were developed after referring to a validated published survey tool from the CAP Q-Probes program (18). Adaptation to the questionnaire was done by the senior consultants from the department of biochemistry, KIMS and RC. The patient’s satisfaction questionnaire contained 15-items. Socio-demographic details of the patients (marital status, education, occupation, income, socio-economic status by Standard of Living Index (SLI) scale (19), residence, language, number of times patient has visited and availed the hospital services) were collected through face-to-face interviews by the investigator and the satisfaction survey was carried out using paper based questionnaires. A 12-items paper based clinician’s satisfaction questionnaire was distributed to the participating clinicians and was collected the same day (18). The questionnaire was standardized and validated by piloting on 10 patients and 10 clinicians. Details like number of years working in KIMS and RC and department to which the clinician belonged were collected as profile from the clinicians.

A 5-point and 3-point Likert scale was used for clinician’s and patient’s satisfaction questionnaires respectively. 1-Very satisfied, 2-Satisfied, 3-Neutral, 4-Dissatisfied, 5-Very dissatisfied was employed for clinicians and 1-satisfied, 2-neutral and 3-dissatisfied was employed for patients. The mean score of satisfaction for each patient and clinician was calculated as the average of all satisfaction domains. A mean score of less than 2 was taken as patient’s perceived satisfaction and a score of more than or equal to 2 was taken as patient’s perceived dissatisfaction. A mean score of less than 3 was taken as clinician’s perceived satisfaction and a score of more than or equal to 3 was taken as clinician’s perceived dissatisfaction.

Participants were informed to attend all the questions and tick the appropriate option mentioned in the questionnaire. Suggestions/ recommendation for improvement from the current laboratory practice from the participants were documented in the comments section of both the questionnaires.

Statistical Analysis

Data entry and analysis was done using SPSS software version 25.0. Socio-demographic variables were analysed as percentages. Association of the variables with the satisfaction status was checked with Chi-square test. The p-value <0.05 was considered to be statistically significant. Spearman’s correlation was performed to assess to relationship between the satisfaction status with the different phases of the study participation.

Results

In our study, the mean age of patients was 38.0±11.6 years (range: 19-66). Majority of participants among patients were females n=82 (54.7%) and n=68 (45.3%) of the patients were males.

In (Table/Fig 2) among patients n=95 (63.3%) were married and n=53 (35.3%) were graduated, n=17 (11.3%) of the patients were unemployed whereas n=54 (36%) were professionals and n=135 (90%) came from the middle category of socio-economic status while n=122 (81.3%) resided in the semi-urban area. It was observed that n=116 (77.3%) of patients spoke Tamil. The n=13 (8.7%) of patients said that they had visited the hospital services more than thrice. Around two thirds of the patients n=93 (62%) had visited the hospital services more than once.

According to the (Table/Fig 3) the clinician’s profile have mean age of clinicians was 42.9±8.7 years (range: 28-67). The clinicians were males with n=105 (70%) while n=45 (30%) were females.

The (Table/Fig 4) describes the association between the socio-demographic variables and satisfaction status of the patients and clinicians. Among the socio-demographic variables considered, marital status of patients (p-value 0.04) and gender of clinicians (p-value=0.002) was found to be significantly associated with the satisfaction status. This implied that married patients and male clinicians were more satisfied with the services provided. Patient variables such as age, gender, language, education, occupation, residence, socio-economic status and number of patient visits to the hospital services were not statistical significant.

The above (Table/Fig 5) depicts that overall n=131 (87.3%) of the patients and n=106 (71.3%) of the clinicians were satisfied with the services provided by the central clinical laboratory at KIMS and RC. The patients and clinicians were dissatisfied with the laboratory services were n=19 (12.7%) and n=44 (28.7%) respectively. Among the 150 patients and clinicians in each group, who participated in the study, n=36 (24%), n=60 (40%), n=54 (46%) of the patients and n=30 (20%), n=70 (46%), n=50 (34%) of the clinicians were enrolled during the phase I, II and III respectively. Progressive and a statistically significant improvement in the satisfaction status of the patients and clinicians from phase I to III is depicted in (Table/Fig 5). Conversely there is a reduction in dissatisfaction status from both the groups. As and when the levelstudy progressed, as an outcome of the training, the compliance of the employees of the laboratory improved which showed an improvement in the satisfaction levels of both the patients and the clinicians.

Spearman’s correlation was performed to assess to relationship between the satisfaction status and the different phases of the study. A statistically significant correlation indicating an improvement in the satisfaction status of the participants is observed in the present study. No significant response was observed for adequacy of test menu on the test request form and turn around time from the clinicians (Table/Fig 6).

Discussion

The study was intended to find out patients and clinicians satisfaction status at central clinical laboratory- KIMS and RC. The participants of the study were young, married women predominated as patients. Similar study done by Alelign et al also reported the same (10). Another study by Teklemariam Z et al., concluded that 50% of the population were females (1). Only 6.7% of our patients were illiterate and 11.3% were unemployed. 90% of our patients were from the middle category of socio-economic status and 81.3% resided in the semi-urban area. The study also concluded that 38% of patients were using the laboratory services for the first time. Among the clinicians 54% were above the age of 40 years and of the total clinicians 30% were females. The average experience of the clinicians at KIMS and RC was more than three years. However this relationship had no impact on the satisfaction status of the laboratory services.

There was an improvement in the patient and clinician’s satisfaction score as the study progressed from phase I to III. The study concluded that clinician’s satisfaction score was 70.7% which improved from 60% in phase I to 88.2% in phase III (p-value=0.01). This difference may be attributed to the study design with participation involving three phases and also to the sample size in different phases.


The initial clinician’s satisfaction score was similar to that observed from Pusan National University hospital in South Korea (58.1%), Millennium medical college (60%) and Nekemte referral hospital (65%) Ethiopia (20),(21),(22). The final satisfaction score from the clinicians was similar to the studies from hospitals in north eastern parts of Ethiopia (80%) and college of American Pathologist Q-probes study of 81 institutions (85.7%) (1),(23). Hailu L et al., (24) observed that 50% of the clinicians were satisfied with the general laboratory services, gender was not associated with satisfaction status, while specialisation was significantly correlated. In the present study gender of the clinicians was associated with satisfaction status while the departments to which they belonged was not associated with the satisfaction status.

Among the different domains assessed in our study, a significant improvement was observed from phase I to phase III by the clinicians for despatch services (Chi-square=64.28, p=0.0001), notification of the critical value (Chi-square=39.39, p=0.0001) and introduction of a new test (Chi-square=35.99, p=0.0001). They were also satisfied with the availability of lab staff during the working hours (Chi-square=33.92, p=0.0001), quality/ reliability of laboratory test results (Chi-square=29.26, p-0.0001), departmentalisation of hospital laboratory (Chi-square=29.23, p=0.0001), provision for emergency/urgent test (Chi-square=28.54, p=0.001). In our study dis-satisfaction was observed for Turn Around Time (TAT) and Laboratory Information System- Hospital Interface System (LIS- HIS) interface. Similar studies done by Almatrafi D et al., and Hailu HA et al., also concluded dis-satisfaction for TAT from the clinicians (9),(25).

The overall patient’s satisfaction status was 87.3% and it had improved from 72.2% in phase I to 96.3% during phase III (p-value=0.03). In our study the satisfaction was high among women, especially married women as they were the predominant population using our laboratory services.

Across the three phases a statistically significant improvement was observed predominantly in most of the domains from the patients. Doubts from patients were encouraged and addressed by lab staff (Chi-square=50.34, p=0.0001), crowd regulation in counters (Chi-square=46.49, p=0.0001), lab personnel availability during working hours (Chi-square=33.8, p=0.0001), seating availability in waiting area (Chi-square=32.84, p=0.0001), location of the laboratory (Chi-square=27.3, p=0.0001) were among the most satisfied domains over the three phases. Explanation of procedure by lab personnel before sample collection (Chi-square=23.3, p=0.0001) had improved over the three phases due to the effective trainings conducted to the lab technicians.

Patients in our study were satisfied with the available toilet facility for sample collection. However Qadri SS et al., has reported dis-satisfaction for the toilet facility in his study (2). Fondoh VN et al., observed a statistically significant reduction in the dis-satisfaction scores for waiting time (34.9% to 19.3%), issuing of results (22% to 8.1%), specimen collection (21.5% to 13.8%) and duty consciousness (21% to 4.7%) after addressing the feedbacks received from the customers (26). Similar to our study, they assessed the satisfaction scores for waiting area and explaining sample collection procedure before the sample collection. However, low satisfaction scores were reported from their study. Gupta A et al., reported that 70% of participants were satisfied with the phlebotomy services. However, sitting arrangements in waiting area and knowledge of universal precaution were poor (6). Dawar R et al., observed that comforting and reassuring the apprehensive patients prior to sample collection by a well trained phlebotomist who is the first person a patient meets in the laboratory was found to be an effective factor in ascertaining patient satisfaction (7). Factors like poor communication, long waiting periods and repeated pricks were considered as negative experience by the patients thereby decreasing their satisfaction (7). Service quality, short waiting period to receive test reports, availabilty of advised lab tests and clean and accesible washrooms and staff behaviour influences patients satisfaction for laboratory services, (11).

However at CCL-KIMS and RC, 12.7% of patients and 29.3% of clinicians were dissatisfied with the laboratory services. The main dissatisfaction was observed for HIS-LIS interface and turn around time from the clinicians and waiting time for specimen collection from the patients.

Limitation(s)

Participants were limited to patients availing services between 08.00 AM-5.00 PM only. Patients coming during the evenings and night could not be included as the services are 24*7.

Conclusion

The overall degree of patients and clinicians satisfaction status was 87.3% and 71.3%, although domains like the turn around time, interface of laboratory and hospital information system and waiting time for specimen collection required improvement. It is also concluded that there was an improvement with the satisfaction levels from phase I to III which was attributed to the trainings given to the laboratory staff on the international standards of laboratory management. There were also 12.7% of patients and 28.7% of clinicians who were dissatisfied. Root cause analysis was discussed with all the stakeholders of the laboratory. Corrective and preventive actions were planned for implementation to improve the overall percentage of satisfaction. Regular studies like this will improve good laboratory practices thereby ensuring quality health care system.

Acknowledgement

The authors acknowledge all the participants of the study. We also acknowledge the efforts from Mrs. Gladius Jennifer and Ms. Manjula Devi, statisticians at SRM Medical College Hospital and Research Centre and Karpaga Vinayaga Institute of Medical Sciences and Research for their aid in statistical analysis.

References

1.
Teklemariam Z, Mekonnen A, Kedir H, Kabew G. Clients and clinician satisfaction with laboratory services at selected government hospitals in eastern Ethiopia. BMC Res Notes. 2013;6:15. doi: 10.1186/1756-0500-6-15. PMID: 23324260; PMCID: PMC3556148. [crossref] [PubMed]
2.
Qadri SS, Pathak R, Singh M, Ahluwalia SK, Saini S, Garg PK. An assessment of patients satisfaction with services obtained from a tertiary care hospital in rural Haryana. InternJ Collabo Res Internal Med Pub Health. 2012;4(8):1524-37.
3.
Rusanganwa V, Gahutu JB, Hurtig AK and Evander M. Physicians’ satisfaction with clinical referral laboratories in Rwanda, Global action, 2020;13(1):1834965. DOI: 10.1080/16549716.2020.1834965. [crossref] [PubMed]
4.
Etukudoh N, Uchejeso MO. Patient’s (Client) satisfaction with medical laboratory services contributes to health and quality improvement. 2021. DOI: 10.5772/intechopen.99290 [crossref]
5.
Chattopadhyay A, Saha T, Karmakar P, Sengupta P, Boral K, Yasmin S. Patient satisfaction evaluation in CGHS dispensaries in Kolkata, India. J Dent Med Sci.2013;6(4):13–19. [crossref]
6.
Gupta A, Dwivedi T, Sadhana, Chaudhary R. Analysis of Patient's Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement. J Clin Diagn Res. 2017;11(9):EC05-EC08. doi: 10.7860/JCDR/2017/26190.10562. Epub 2017 Sep 1. PMID: 29207713; PMCID: PMC5713735.
7.
Dawar R. Patient satisfaction of phlebotomy services in a tertiary care hospital. Int J Curr Res Aca Rev. 2015;3(6):35-8.
8.
Obeta, Uchejeso M, Goyin, Longul P, Udenze, Chukwudike, Ojo, James. Assessment of job satisfaction indices among health professionals in Jos University teaching hospital: An analytical study. Journal of Business and management. 2019;21(2):38-50.
9.
Almatrafi D, Altaweel N, Abdelfattah M, Alqazlan M, Darrar H, Alomari A, et al. Assessment of Customer Satisfaction with the Clinical Laboratory Services Provided in King Abdullah Medical City, Makkah. The Egyptian Journal of Hospital Medicine 2018;70(11):2029-37. [crossref]
10.
Alelign A, Belay YA. Patient satisfaction with clinical laboratory services and associated factors among adult patients attending outpatient departments at Debe Markos referral hospital, Northwest Ethiopia, BMC Res Notes. 2019;12(1):517. [crossref] [PubMed]
11.
Zaini RG, Zaini RG. Physician’s satisfaction from laboratory services in maternity and children hospital in Makkah. Int J Lab Med Res. 2014;1:2-9. [crossref]
12.
Abera RG ,Abota BA, Legese MH, Negesso AE. Patient satisfaction with clinical laboratory services at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, Patient Prefer Adherence. 2017;11:1181-88. [crossref] [PubMed]
13.
Khan G. The impact of healthcare accreditation on patient’s satisfaction: A literature review. International Journal of health sciences and pharmacy. 2020;4(1):49-56. DOI: http://doi.org/10.5281/zenodo.3862791. [crossref]
14.
Obeta MU, Etukudoh NS, Chongs ME. and Ime DM. Challenges of Inter Professional Teamwork in Nigerian Healthcare. (2020). DOI:10.5772/intechopen.95414 [crossref]
15.
Obeta MU, Etukudoh NS, Udenze C, and Eze ME. Inter professional teamwork in public organisations, a paradigm shift to crisis in Nigerian hospitals. London journal of medical and health research. 2020;20(3):31-40.
16.
Ashdown LC. PATIENT: A tool to assist in creating a patient-Centered team approach to health-care delivery: Lessons from a physician patient. J Patient Exp. 2020;7(1):16-18. DOI:10.1177/2374373518812048 [crossref] [PubMed]
17.
ISO 15189:2012 Medical laboratories- requirements for quality and competence. 2012. Edition:3, No.of pages: 53.
18.
Laboratory general checklist. Laboratory accreditation program. North-field, Ill: College of American Pathologist: 2006. GEN.20368.
19.
Saif-Ur-Rahman KM, Anwar Iqbal, Hasan Md., Hossain Shahed, Shafique Sohana, Haseen Fariha, et al. Use of indices to measure socio-economic status (SES) in South-Asian urban health studies: A scoping review. Syst Rev. 2018;7:196. https://doi.org/10.1186/s13643-018-0867-6 [crossref]
20.
Koh YR, Kim SY, Kim IS, Chang CL, Lee EY, Son HC. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level. Ann Lab Med. 2014;34(5):380-85. [crossref] [PubMed]
21.
Yeshanew AG, Geremew RA, Temesgen MK. Assessment of patient and healthcare workers satisfaction on the laboratory services in St. Paul’s hospital millennium medical college, Addis Ababa, Ethopia. Int J Sci Rep. 2017;3(7):192-99. [crossref]
22.
Ejeta E, Tadele G, Desalegn M, Abere S, and Elias K. Health care provider satisfaction with laboratory service of Nekemte referral hospital. Int. J. Med. Sci. 2015;7(5):91-7. [crossref]
23.
McCall SJ, Souers RJ, Blond B, Massi L. Physician Satisfaction with clinical laboratory services. Arch Pathol Lab Med. 2016;140(10):1098-103. [crossref] [PubMed]
24.
Hailu L, Mihiretie H, Dabsu R, Demissie D, Hallu W. Clinician’s satisfaction and utilization of laboratory services in selected western Ethiopia hospitals Nekemte Ethiopia. SCIOL Biomed. 2019;3:136-42.
25.
Hailu HA, Yalew A, Desale A, Asrat H, Kebede S, Dejene D, et al. Physicians’ satisfaction with clinical laboratory services at public hospitals in Ethopia: A national survey. PLoS ONE. 2020;15(4):e0232178. [crossref] [PubMed]
26.
Fondoh VN, Awasom CN, Enow- Tanjong R, Fondoh RM, Njukeng P, Shang J et al. Evaluation of corrective actions of feedback from clinicians on clinical laboratory services at Bamenda Regional Hospital Laboratory, Cameroon. Afr J Lab Med. 2020;9(1):843. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/56436.16416

Date of Submission: Mar 17, 2022
Date of Peer Review: Apr 04, 2022
Date of Acceptance: May 05, 2022
Date of Publishing: Jun 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 25, 2022
• Manual Googling: Mar 30, 2022
• iThenticate Software: May 05, 2022 (6%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com