Service quality of hospital outpatient

departments: patients’ perspective

ABSTRACT
Purpose
– Assessment of patient perceptions of health service quality as an important element in quality
assessments has attracted much attention in recent years. The purpose of this paper is to assess the
service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical
Sciences from the patients’ perspective.

Design/methodology/approach
– This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500
patients who were selected by multi-stage random sampling from four hospitals. The data collection
instrument was a questionnaire consisting of 50 items, and the validity and reliability of the
questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman
test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications.

Findings
– Eight significant factors were extracted for outpatient service quality, which explained about 67 per
cent of the total variance. Physician consultation, information provided to the patient, and the physical
environment of the clinic were the three determining factors of the quality of outpatient services. The
highest and lowest perceptions were related to physician consultation and perceived waiting time
dimension, respectively. The mean score of patients’ perception of outpatient service quality was 3.89
(±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per
cent as moderate, and 2.3 per cent as poor.

Practical implications
– The instrument developed for this study is valid and reliable, and it can help hospital managers to
identify the areas needing improvement and correction.

Originality/value
– According to the findings of this study, the majority of patients had a positive experience with
outpatient departments of teaching hospitals, and the services provided in these centres were of
adequate quality, based on patient assessments.

Reference:
Ehsan Zarei, (2015) "Service quality of hospital outpatient departments: patients’ perspective",
International Journal of Health Care Quality Assurance, Vol. 28 Issue: 8, pp.778-790,
https://doi.org/10.1108/IJHCQA-09-2014-0097
Diagnosis and Management of Acute Coronary
Syndrome: An Evidence-Based Update
Abstract
Acute coronary syndrome (ACS) describes the range of myocardial ischemic states that includes
unstable angina, non-ST elevated myocardial infarction (MI), or ST-elevated MI. ACS is
associated with substantial morbidity and mortality and places a large financial burden on the
health care system. The diagnosis of ACS begins with a thorough clinical assessment of a
patient's presenting symptoms, electrocardiogram, and cardiac troponin levels as well as a review
of past medical history. Early risk stratification can assist clinicians in determining whether an
early invasive management strategy or an initial conservative strategy should be pursued and can
help determine appropriate pharmacologic therapies. Key components in the management of
ACS include coronary revascularization when indicated; prompt initiation of dual antiplatelet
therapy and anticoagulation; and consideration of adjuvant agents including β blockers,
inhibitors of the renin angiotensin system, and HmG–coenzyme A reductase inhibitors. It is
essential for clinicians to take an individualized approach to treatment and consider long-term
safety and efficacy when managing patients with a history of ACS after hospital discharge.

Reference
Smith, J; Negrelli, J; Manek, M; Hawes, E. and Viera A. (2015) Diagnosis and Management of
Acute Coronary Syndrome: An Evidence-Based Update, Journal of American Board of Family
Medicine, 28(2) 283-293, DOI: https://doi.org/10.3122/jabfm.2015.02.140189