BACKGROUND: Patient satisfaction is a function of several variables addressing reasons why it is important to use methods in which these different factors can be isolated and their importance analysed. OBJECTIVE: In this project, two methods using this approach were used: the 'Quality from the Patient's Perspective' and the 'Quality, Satisfaction, Performance' models. The aim of the present study is to evaluate these two different methods with respect to application, strengths and weaknesses. DESIGN: In the Quality from the Patient's Perspective model, the patient judges the different domains in two dimensions: perceived reality and subjective importance. The Quality, Satisfaction, Performance model uses a multivariate analysis to capture the patient's priorities. Four hundred and sixty forms for each model were distributed to a random sample of patients at the Department of Obstetrics and Gynecology at Karolinska Hospital. MAIN MEASURES: The quality factors 'treatment by the nurse', 'participation', 'information', 'environment' and 'accessibility' were measured. RESULTS: On both forms, 'medical care', 'treatment by the doctor' and 'access to nursing treatment' received high scores in perceived reality' while 'accessibility' and 'participation' received low scores. 'Subjective importance' measured directly and indirectly, respectively, in the two models showed high values for 'medical care' and 'treatment by the doctor'. CONCLUSION: The advantages of the Quality from the Patient's Perspective model are that it has a comprehensive and solid question bank. The Quality, Satisfaction, Performance model's advantage is its immediate usefulness and its clear graphic presentation. An integration and further development of these two approaches may prove useful.
Discussions of quality assurance mechanisms for health professions are increasing in Canada. In their roles of protecting the public from incompetent or unsafe health care, and enhancing the quality of care provided by practitioners, provincial licensing organizations are taking an interest in quality assurance programmes. The paper reports the results from a national survey of five self-regulating health professions (dentistry, medicine, nursing, optometry and pharmacy) in Canada. The study found two types of activities in place--a complaints programme and a routine audit programme. Both programmes use a similar approach to identifying poor performers within a health profession. The paper discusses the results of the study, the advantages and disadvantages of the approach used, and suggests a second approach to quality assurance which could be used in conjunction with current activities.
While the public health benefits of supervised injection facilities (SIFs) have been well documented, there is a lack of research examining the views of injection drug users (IDU) regarding the operation of these facilities. This study used 50 semistructured qualitative interviews to explore IDU perspectives on the design and operation of an SIF in Vancouver, Canada. Although the environment and operation of the SIF are well accepted, long wait times and limited operating hours, as well as regulations that prohibit sharing drugs and assisted injections, pose barriers to using the SIF. Modifying operating procedures and expanding the capacity of the current facility could address these barriers.