The origin of the patient-centered interdisciplinary collaborative round, which involves health care members of all levels at a time, is an effective and emerging approach to offer inpatient healthcare. Traditionally, post-partum rounds at teaching hospitals consisted of separate visits from all members of the obstetric team that resulted in patient inconvenience, care insufficiencies, and communication gaps. The main objective of this study was to assess the patient\u27s satisfaction level from the traditional post-partum round versus the patient-centered collaborative care (PCCC) round. This study showed that in the traditional round, the patient\u27s satisfaction with the treatment was 95.1%; whereas, in PCCC rounds it was 96.9%. Patients were more satisfied with the treatment options discussed with them and the results of the medical tests explained to them. In conclusion, the survey showed that the implementation of the PCCC round improved patient satisfaction

Javed, Arshia

Qadir, Nida

Sheikh, Irfan

Sohaila, Arjumand

English

eCommons@AKU

eCommons@AKU Department of Obstetrics & Gynaecology Division of Woman and Child Health 7-1-2021 Improved clinical competence and patients satisfaction: Comparison of patient-centered, interdisciplinary collaborative round versus traditional post-partum round Arshia Javed Arjumand Sohaila Irfan Sheikh Nida Qadir Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_obstet_gynaecol  Part of the Obstetrics and Gynecology Commons, and the Pediatrics Commons SHORT COMMUNICATIONJournal  of  the College of  Physicians and Surgeons Pakistan 2021,  Vol.  31(07):  868-870868Improved Clinical Competence and Patients Satisfaction:Comparison of Patient-centered, InterdisciplinaryCollaborative Round versus Traditional Post-partumRoundArshia Javed1, Arjumand Sohaila2, Irfan Sheikh1 and Nida Qadir11Department of Obstetrics and Gynecology, The Aga Khan University Hospital, Karachi, Pakistan2Department of Pediatrics, The Aga Khan University Hospital, Karachi, PakistanABSTRACTThe origin of the patient-centered interdisciplinary collaborative round, which involves health care members of all levels at atime, is an effective and emerging approach to offer inpatient healthcare. Traditionally, post-partum rounds at teaching hospi-tals consisted of separate visits from all members of the obstetric team that resulted in patient inconvenience, care insufficien-cies, and communication gaps. The main objective of this study was to assess the patient’s satisfaction level from the traditionalpost-partum round versus the patient-centered collaborative care (PCCC) round. This study showed that in the traditional round,the patient’s satisfaction with the treatment was 95.1%; whereas, in PCCC rounds it was 96.9%. Patients were more satisfiedwith the treatment options discussed with them and the results of the medical tests explained to them. In conclusion, thesurvey showed that the implementation of the PCCC round improved patient satisfaction.Key Words: Interdisciplinary collaborative  round, Traditional postpartum round, Patients satisfaction, Clinical competence.How to cite this article: Javed A, Sohaila A, Sheikh I, Qadir N. Improved Clinical Competence and Patients Satisfaction: Comparison ofPatient-centered,  Interdisciplinary  Collaborative  Round  versus  Traditional  Post-partum  Round.  J  Coll  Physicians  Surg  Pak  2021;31(07):868-870.An important indicator to assess the standard of healthcare ispatient’s  satisfaction,  which  can  also  be  used  as  qualityimprovement tool for healthcare institutions.1 Reports like ‘ToErr is Human—Building a Safer Health Care System’ empha-sised the need for innovations in delivery of high-quality carethat is patient-centered.2 Among such innovations, origin ofinterdisciplinary collaborative rounds, which involves nurses,physicians, quality officers, admin representatives as well aslearners of all levels at a time, is an effective and emergingapproach to offer inpatient healthcare.3Traditionally,  post-partum  rounds  at  teaching  hospitalsconsisted of separate visits from all members of the obstetricteam  individually  including  nurses,  medical  students,  resi-dents, attending physicians, quality improvement and patientsafety officers (QIPS). This resulted in patient inconvenience,dissatisfaction, care insufficiencies and communication gaps.3Correspondence  to:  Dr.  Irfan  Sheikh,  Department  ofObstetrics  and  Gynecology,  The  Aga  Khan  UniversityHospital,  Karachi,  PakistanE-mail:  sheikh.irfan@aku.edu.....................................................Received: March 06, 2020;  Revised: February 10, 2021;Accepted:  February  25,  2021DOI:  https://doi.org/10.29271/jcpsp.2021.07.868The majority of the literature on this matter is from United Statesand other high-income countries (HICs). Much remains unknownin low- and middle-income countries (LMICs), including Pakistan.Few earlier studies were conducted regarding patient’s satisfac-tion, but efficiency of patient-centered collaborative care (PCCC)in health delivery system was not evaluated locally, resulting in adearth of local literature regarding this important topic.Thus, to improve the culture of teamwork in a local teachinghospital, a quality improvement (QI) project was designed andevaluated in a local secondary care hospital that included notonly  physicians  and  doctors  but  also  nurses,  pharmacists,paramedical staff and QIPS officers, into daily bedsides morningrounds.  Pre-intervention  and  post-intervention  surveys  wereconducted to assess patient’s satisfaction level in order to assesswhether a paradigm shift from traditional post-partum round toPCCC round would improve clinical efficiency and patient’s satis-faction.This study is first of its type that examines the PCCC approach inlocal healthcare settings. The main objective of this study was toassess  the  patient’s  satisfaction  level  from  traditional  post--partum round versus PCCC round.This was a cross-sectional study, conducted from June 2017 toFebruary 2018, at one of the secondary care settings of the AgaKhan University Hospital for Women, Garden, Karachi.Arshia Javed,  Arjumand Sohaila,  Irfan Sheikh and Nida QadirJournal  of  the College of  Physicians and Surgeons Pakistan 2021,  Vol.  31(07):  868-870 869Table I: Responses by patients (N=145).Questions askedNumbers of patients who agreed to thequestions askedp-valueTraditional RoundN = 81 (%)PCCC RoundN= 64(%)  Team greeted me 80 (98.8) 64 (100) 0.999I was called by my name 79 (97.5) 63 (98.4) 0.999Team showed interest in my problem 76 (93.8) 64 (100) 0.129I was explained about my condition 76 (93.8) 63 (98.4)  0.229Treatment options were discussed 75 (92.6) 64 (100)  0.034*Reasons for medical tests were explained 66 (81.5) 61 (95.3) 0.026*Team communicated with me in understandable language 76 (93.8) 62 (96.9) 0.537I was given adequate time by team 75 (92.6) 63 (98.4) 0.128I feel treated with respect 76 (93.8) 62 (96.9) 0.089I am satisfied with my treatment 77 (95.1) 62 (96.9) 0.292I am satisfied with nursing care 65 (80.2) 62 (96.9) 0.007*I would like to visit this hospital again 72 (88.9) 62 (96.9) 0.099I will recommend this hospital to others 68 (84.0) 64 (100) 0.001*A p-value of ≤ 0.05 statistically significant denoted as *The  data  was  collected  on  a  structured  questionnaireadapted  from  previously  used  survey  tools.3  The  studyincluded all the patients admitted in post-natal ward for atleast two days after delivery from 20th June to 19th July 2017(pre-intervention  survey)  and  for  one  month  from  1stFebruary to 28th February 2018 (post-intervention survey)after PCCC rounds that has been placed for 6 months fromAugust 2017 to January 2018. A total of 145 women wereincluded in this analysis; 81 of them participated in tradi-tional  post-partum  rounds  and  64  participated  in  PCCCrounds.  The  survey  form was  given  to  consented  post--partum patients at the time of discharge, who were admittedduring study course. The obtained information from pre-inter-vention  survey  was  then  compared  with  the  informationcollected from post-intervention survey.Descriptive statistics was carried out to analyse the data bycalculating the frequencies and percentages for the categor-ical  variables.  Chi-square  and  Fisher’s  Exact  test  werefurther applied to evaluate the responses of survey ques-tions for those patients included in the traditional rounds,compared to those included in the PCCC rounds. A p-value of≤ 0.05 was considered statistically significant. The data wasanalysed using Statistical Package for the Social Sciences(SPSS) version 19 (SPSS Inc., Chicago, IL). The study wasapproved by the Ethics Committee of the Aga Khan Univer-sity Hospital.A  total  of  145  women  were  included  in  this  analysis;81(55.9%) of  them participated in traditional  post-partumrounds  and  64  (44.1%)  participated  in  PCCC  rounds.Maternal  age,  parity,  literacy  and  occupation  werecomparable  between  patients  included  in  traditional  andPCCC rounds.  The demographic data of  patients in tradi-tional round showed that majority of the respondents wereof age <31(76.5 %) years followed by >30 (23.5 %) years.About  1.2%  respondents  were  uneducated  followed  byprimary level (6.2%), secondary level (48.1%) and gradua-tion (44.4%). In the study, 91.4% of the respondents werehousewives, 95.1% had parity of less than four, while (4.9%)had  parity  of  more  than  four.  Whereas,  in  PCCC  round,majority  of  respondents  were  of  age  <  31(67.1%)  and>30(32.8%)  years.  About  7.8% respondents  were  unedu-cated  followed  by  primary  level  (3.1%),  secondary  level(40.6%) and graduation (48.4%). In all, 82.8% of the respon-dents were housewives, 96.9% of patients had parity of lessthan four, while 3.1% had parity of more than four.Table I shows that in traditional round the patient’s satisfac-tion with the treatment was 95.1%; whereas, in PCCC roundsit  was  96.6%.  A  difference of  1.6% was observed,  althoughhigher level  of  satisfaction was reported in the study byQadri;4  and   89.1% of  the patients were satisfied with PCCCrounds.  In  traditional  round,  80.2% of  the  patients  weresatisfied  with  the  nursing  care;  whereas,  with  PCCC  roundthe  satisfaction  level  raised  to  96.9%.  These  findings  aresimilar with the study conducted by Bitew.5 In PCCC round,100%  respondents  were  satisfied  with  the  interest  showedby the team in their problems; whereas, in traditional round93.8% respondents were satisfied.In  traditional  round,  93.8%  of  the  patients  were  satisfiedwith the disease explanation given to them, 92.6% reportedthat alternate treatment options were given to them, and81.5%  were  explained  about  rationale  of  medical  tests.While  for  PCCC  round,  98.4%  patients  were  satisfied  withdisease explanation, 100% of the patients with the alternatetreatment options and 95.3% with the reasoning of medicaltests. These finding are also similar to the study by Bitew,5 inwhich  satisfaction  with  explanation  about  treatment  wasreported in 92.3%.In traditional round, 88.9% patients provided the preferenceto visit  the same hospital again and 84% suggested thatthey would like to recommend this to others; while in PCCCround 96.9% patient exhibited their willingness to visit sameComparison of  patient-centered,  interdisciplinary collaborative round versus traditional  post-partum roundJournal  of  the College of  Physicians and Surgeons Pakistan 2021,  Vol.  31(07):  868-870870hospital  again  and majority  recommended this  facility  toothers. This is comparable to the study by Nisa,6 where 98%patients recommended same facility to others.Patient satisfaction is an important factor in the patient careand management.  The assessment of  patient  satisfactionthrough surveys and their outcome data help in monitoringquality of care and planning and implementing strategies toimprove patient care. This survey showed that implementa-tion of PCCC round improved patient satisfaction. Patientswere  more  satisfied  with  the  treatment  options  discussedwith  them and results  of  the  medical  tests  explained tothem, they showed more satisfaction with the nursing careand provided their  preference to  visit  the  same hospitalagain and to recommend it to others.Hence, this study specifies that PCCC round improves clinicalefficiencies with team work as well as effective communica-tion between team members. PCCC round brought the oppor-tunity of actively and mutually evaluating the patient andmedical  team member’s  interactions  in  such  a  way thatnecessary clinical, academic and administrative adjustmentsin the best interest of patient and hospital are made withsecure coordination and competency among team members.ACKNOWLEDGEMENT:The authors  acknowledge Ms.  Ghulam Kubra  Rind  (SeniorResearch Assistant, Department of OBGYN, Aga Khan Univer-sity Hospital) for her support in editing of this manuscript.ETHICAL APPROVAL:The  ethical  approval  was  obtained  by  the  Ethics  ReviewCommittee of the Aga Khan University Hospital prior to initia-tion of the research work.PATIENTS’ CONSENT:Written informed consents were taken from the participantsprior to data collection.CONFLICT OF INTEREST:The authors declared no conflict of interest.AUTHORS’ CONTRIBUTION:AJ:  Conceptualisation  of  topic,  designed,  literature  search,manuscript writing, and editing of manuscript.AS: Literature search, data collection and manuscript writing.IS:  Statistical  analysis,  proofreading,  review  and  finalapproval of manuscript. responsible and accountable for theaccuracy or integrity of the work.NQ: Data collection and interpretation of results.REFERENCESKanwal  K,  Rafi  Y,  and  Sarwar  ZM.  Patient  experiences1.and satisfaction at tertiary care setting in Public Hospitalin Pakistan. PJMHS 2019; 13(1):115-7.Markova T, Mateo M, Linda M.  Implementing teams in a2.patient-centered  medical  home  residency  practice:Lessons  learned.  J  AM  board  Fam Med  2012;  25(2):224-31. doi: 10.3122/jabfm.2012.02.110181.Segel S, Hashima J , Gregury TW, Edelman AA , Li H . A3.new approach to  postpartum rounds:  Patient-centeredcollaborative  care  improves  efficiency.  J  Grad  Med  Educ2010; 21(1):67-72. DOI: 10.4300/JGME-D-09-00060.1Qadri SS, Pathak R, Singh M. An Assessment of patient’s4.satisfaction with services obtained from a tertiary carehospital  in  rural  Haryana.  Int  J  Collab Res Intern MedPublic Health 2012; 4(8):1524-37.Bitew K , Ayichiluhm M, Yimam K. Maternal satisfaction5.on delivery services and its  associated factors amongmothers  who  gave  birth  in  public  health  facilities  ofDebre Markos Town , Northwest Ethiopia. BioMed Res Int2015; 2015:1-6.  doi: 10.1155/2015/460767.Nisa M, Sadaf R, Zahid M. Patient satisfaction survey in6.an obstetrics  and gynecology ward  of  a  tertiary  carehospital. J Med Sci 2012; 20(3):142-5.••••••••••

Improved clinical competence and patients satisfaction: Comparison of patient-centered, interdisciplinary collaborative round versus traditional post-partum round

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Improved clinical competence and patients satisfaction: Comparison of patient-centered, interdisciplinary collaborative round versus traditional post-partum round

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