Developing a conceptual model to improve patient experience as a strategy to engage public health sector reform in South Africa.
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Date
2018
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Abstract
Patient Experience is well recognized in health quality improvement initiatives within developed countries due to the reforms that result thereof. Developing a conceptual model to improve patient experience in South Africa is undertaken in this study. The study consists of a qualitative (nine nursing service managers participated in semi-structured interviews) and quantitative component (three hundred patients were included in a survey). A one hundred percent response rate was noted for the qualitative interviews and a 93.3 percent response rate was noted for the surveys that were conducted. Data for the quantitative study was analyzed using the Statistical Package for Social Sciences and a thematic analysis using NVIVO was applied to the qualitative data.
The results from the qualitative component highlight the need for patient experience to be incorporated in the drive for quality improvement and stress the value of a patient experience model. Nursing managers support that the patient experience is positive in the primary health clinic but the survey findings reveal that the majority of respondents reported a negative patient experience. The overall patient experience satisfaction variable indicates that more than 50% of the respondents are dissatisfied with the overall patient experience. The Kruskal-Wallis analysis reveals a significant association with age and race on the overall patient experience satisfaction. Older patients are more accepting of health service delivery as compared to younger patients who are more critical. Patients show agreement with more than 50% of respondents indicating that the fifteen domains as per the Conceptual Framework are influencers of their patient experience. Nursing managers showed support for all fifteen domains. A latent factor analysis revealed that Information, Communication, Management Effectiveness towards Producing Positive Outcomes and Patient Centered Care were not statistically significant towards influencing the patient experience.
The conceptual model was developed by incorporating the remaining eleven domains that influence the patient experience and the positive reforms that result thereof. Given the changing landscape in SA, it was necessary to develop a model to improve patient experience in order to improve the quality of service delivery thus engaging sustainable positive reform.
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Doctoral Degree. University of KwaZulu-Natal, Durban.