Assessing Service Quality Dimensions and Their Effect on Patients Satisfaction in Bahrain Primary Healthcare Using a Modified Version of the General Practice Assessment Questionnaire.

OBJECTIVE: This study aimed to have an instrument for assessing Bahrain healthcare. For such purpose, we used the General Practice Assessment Questionnaire (GPAQ-R2) and a modified shorter version of it, GPAQ-R2-BDF. The GPAQ-R2-BDF was modified based on the healthcare system and the cultural behavior in Bahrain. SUBJECTS AND METHODS: This cross-sectional study was conducted at the general practice (GP) of the Bahrain Defense Force (BDF) Hospital from March 2018 to April 2018. Five hundred and twenty patients visiting the clinics completed the original GPAQ-R2 questionnaire. A validity, reliability, and rotated factor analysis were performed on the original and modified questionnaire. Patients' characteristics such as age, gender, long-standing health conditions, and employment status were recorded. The score responses of the questionnaire were analyzed, and areas of weakness were identified. RESULTS: The validity, reliability, and correlation matrix values of the original GPAQ-R2 in the GP access and GP practice components were unsatisfactory in BDF hospital assessment. However, the modified GPAQ-R2-BDF revealed higher overall validity, reliability, and correlation matrix, and the rotated factor analysis showed values between 0.704 and 0.928. Furthermore, the reliability values ranged from 0.77 to 0.936. As for patients' satisfaction scores were highest (~90%) in confidence and enablement, and doctor care but lowest in GP access, and GP practice (~77%) (P<0.001). On the other hand, patients with long-standing health conditions were less satisfied with doctor care, confidence and enablement, and GP access (p<0.05-0.01). CONCLUSION: The present findings demonstrated high reliability and validity for the GPAQ-R2-BDF, which supports its use to assess Bahrain's GP healthcare system. Furthermore, such an instrument should be adapted in a longitudinal research design to assess Bahrain's healthcare system better. Lastly, BDF hospital healthcare clinics showed concerns in GP access, GP practice, and quality services for patients with long-standing health conditions requiring strategic interventions to reach better quality services.

Outpatient parenteral antimicrobial therapy with ceftriaxone for acute tonsillopharyngitis: efficacy, patient satisfaction, cost effectiveness, and safety.

BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) is the administration of intravenous antimicrobial therapy to patients in an outpatient setting. It may be used for patients who have infections that require parenteral treatment but who are otherwise stable enough to not require admission as inpatients. OBJECTIVE: We aimed to review the treatment of patients with acute tonsillopharyngitis at the OPAT health care clinic in the Bahrain Defense Force Royal Medical Services (BDF-RMS), with regard to efficacy, patient satisfaction, cost effectiveness, and safety. METHODS: A retrospective case notes review was conducted for all patients admitted to the OPAT clinic in the BDF-RMS with acute tonsillopharyngitis treated with ceftriaxone, between March 2012 and March 2014. RESULTS: In the period between March 2012 and March 2014, 97 patients with acute tonsillopharyngitis were treated with ceftriaxone for a minimum of 3 days at the OPAT clinic. In total, 94.8% of patients completed the prescribed course of ceftriaxone. Total cure was achieved in 89.7% of patients. Usage of the OPAT clinic led to cost savings of 10,693 BD, while total bed days saved were 301 over the 2-year period examined by this study. Participants in the program expressed high satisfaction rates, and the average (± standard deviation) score on a patient satisfaction survey was 4.41 (± 0.31) out of a total of 5. This study highlights the efficacy, patient satisfaction, cost effectiveness, and safety of the OPAT clinic service for the treatment of acute tonsillopharyngitis with ceftriaxone. We found a 45.5% drop in admission rate for acute tonsillopharyngitis after starting the OPAT service clinic and that 301 bed days were saved through this treatment. CONCLUSION: This study showed that the management of acute tonsillopharyngitis with ceftriaxone in the OPAT clinic is safe, clinically effective, and cost effective, with low rates of complications/readmissions and high levels of patient satisfaction.

The reliability, validity, and feasibility of multisource feedback physician assessment: a systematic review.

PURPOSE: The use of multisource feedback (MSF) or 360-degree evaluation has become a recognized method of assessing physician performance in practice. The purpose of the present systematic review was to investigate the reliability, generalizability, validity, and feasibility of MSF for the assessment of physicians. METHOD: The authors searched the EMBASE, PsycINFO, MEDLINE, PubMed, and CINAHL databases for peer-reviewed, English-language articles published from 1975 to January, 2013. Studies were included if they met the follow ing inclusion criteria: used one or more MSF instruments to assess physician performance in practice; reported psychometric evidence of the instrument(s) in the form of reliability, generalizability coefficients, and construct or criterion-related validity; and provided information regarding the administration or feasibility of the process in collecting the feedback data. RESULTS: Of the 96 full-text articles assessed for eligibility, 43 articles were included. The use of MSF has been shown to be an effective method for providing feedback to physicians from a multitude of specialties about their clinical and nonclinical (i.e., professionalism, communication, interpersonal relationship, management) performance. In general, assessment of physician performance was based on the completion of the MSF instruments by 8 medical colleagues, 8 coworkers, and 25 patients to achieve adequate reliability and generalizability coefficients of α ≥ 0.90 and Ep ≥ 0.80, respectively. CONCLUSIONS: The use of MSF employing medical colleagues, coworkers, and patients as a method to assess physicians in practice has been shown to have high reliability, validity, and feasibility.

Multisource feedback to assess pediatric practice: a systematic review.

INTRODUCTION: The assessment and maintenance of competence for pediatricians has recently received increased attention. The aim of the present study was to investigate further the use of multisource feedback for assessing pediatricians in practice. METHODS: A systematic literature review was conducted using the electronic databases EMBASE, PsycINFO, MEDLINE, PUBMED, and CINAHL for English-language articles. RESULTS: 762 articles were identified with the initial search and 756 articles were excluded for a total of six studies that met the inclusion criteria for this systematic review. Internal consistency reliability was reported in five studies with α ≥ 0.95 for both subscales and full scales. Generalizability was also reported in two studies with Ep (2) generally ≥ 0.78. These adequate Ep (2) coefficients were achieved with different numbers of raters. Evidence for content, criterion-related (e.g., Pearson's r) and construct validity (e.g., principal component factor analysis) was reported in all 6 studies. CONCLUSION: Multisource feedback is a feasible, reliable, and valid method to assess pediatricians in practice. The results indicate that multisource feedback system can be used to assess key competencies such as communication skills, interpersonal skills, collegiality, and medical expertise. Further implementation of multisource feedback is desirable.