Implementing quality management to assess patient satisfaction with whole body vibration therapy using the Galileo® 2000 vibration plate together with physical therapy delivered in daily routine of a university setting.

Abstract

Since 2009, it has been a requirement for practising doctors and dentists to implement quality management (QM) in their surgeries. It was William Edwards Deming who originally laid the most significant foundation for quality management in business and economics with the Plan-Do-Check-Act (PDCA) cycle. A cycle similar to this was implemented in order to improve QM in the urogynaecology department of the gynaecological clinic at the Georg-August University Hospital in Göttingen, Germany where Galileo® vibration therapy (GVT) was used as a model. The research question was whether or not GVT, which had already shown to be effective in two studies conducted by the urogynecological department of the university, could be a valuable conservative treatment for female stress urinary incontinence in daily routine setting of the same department. With the help of an adapted PDCA cycle, GVT was established and the workflow between doctors, nursing staff, physiotherapy and the management in the urogynaecology department of the Göttingen gynaecological clinic was modified. GVT and QM were monitored by means of a complaint management system tailored to patients and by repeatedly measuring patient satisfaction using questionnaires. In order to compare the quality of the treatment under study, which are expected to offer optimum conditions for patients’ satisfaction and daily routine conditions, the participants from both of the aforementioned Galileo® studies were also interviewed. Research was conducted at the urogynaecology ward of the Göttingen gynaecological clinic over a period of two years. During this time, 46 women were given Galileo® vibration therapy in daily routine setting. When quality management was first introduced, the level of patient satisfaction was lower than had been initially expected. The findings revealed weaknesses in areas such as the transfer of medical results from initial examinations to physiotherapy, the transfer of information following GVT from physiotherapy to the doctor for the final clinical examination, and the transfer of examination details to the management for the purposes of billing clients for services not included in their health insurance. In response to these findings, the decision was taken to optimise the interfaces between the departments (management/medical examination, nursing staff/doctors, doctors/physiotherapy, physiotherapy/management, management/nursing staff). This led to a clinically relevant increase in the number of patients who felt the treatment had met their expectations from 45% to 88%. These results surpass those achieved under study conditions (73% and 82%). Another indicator of patient satisfaction in relation to the effectiveness of the treatment was burden of suffering. At the beginning, only 14% experienced no burden of suffering. Upon completing GVT, the number of women with no burden of suffering increased to 67%. Overall, by developing our QM, patients’ satisfaction with the GVT increased in the daily routine of the university setting. It was possible to bring the satisfaction levels in patients receiving treatment under daily routine conditions markedly closer to those receiving treatment under study conditions.2013-07-0