Evaluation of the Perception of Quality of Care of Patients Admitted to a Medical-Surgical ICU

The objective of this prospective observational cohort study is to describe the perception of quality of care of patients or reference companions admitted to a medical-surgical ICU.

Study Overview

• Status: Not yet recruiting
• Conditions: Critically Ill
• Intervention / Treatment: Behavioral: Serqual tool

Detailed Description

Background: Quality assessment in health systems is essential for the improvement and development of services. Assessments using the structure, process and outcomes model are the most widespread, however understanding the health system as a business model makes assessment essential. how much the service is able to meet the expectations of the patient and the market.

The Institute for Healthcare Improvement (IHI) highlights three domains (Triple aim) in which health systems must develop. Among them is "Improving the patient experience". One of the 6 domains of quality of care is patient-centeredness. Several funding institutions and scientific authorities have, in recent years, encouraged patient-centered clinical research with the use of outcomes that are also patient-centered.

The perception of the quality of the service provided to the critically ill patient or even is an uncommon outcome in the literature, especially evaluated with an objective and effective tool.

The SERVQUAL tool proposed by Parasuraman et al. It aims to compare the expectations and perceptions of the patient/companion regarding the quality of care provided.

In the literature, data on patient-centered perspectives and demands are scarce.

Purpose: To identify the difference between expectation and perception of care quality during the stay in the general ICU of a tertiary hospital. Objectives: To evaluate the perception of quality of care of patients admitted to a general ICU through the SERVQUAL tool translated and culturally adapted to the portuguese idiom.

Methods: A prospective, observational cohort study involving adult patients admitted to the general ICU (53 beds) of a tertiary hospital from July 1 to September 30, 2023. The SERVQUAL tool questionnaire of expectations will be applied in the first 24 hours after admission to the ICU and the perception questionnaire applied in the first 24 hours after discharge from the unit.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: JOSE AZEVEDO, MD, PhD; Phone Number: +559832168110; Email: jrazevedo47@gmail.com
• Study Contact Backup: Name: LUIS TUPINAMBA JR, MD; Phone Number: +559832168110; Email: francatupinamba@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

All adult patients admitted to the 53 beds general ICU during the study period. The SERVQUAL scale will be applied with the questionnaire of expectations in the first 24 hours of admission and perception questionnaire within the first 24 hours after discharge.

Description

Inclusion Criteria:

• Patients ≥ 18 years old
• consent form signed by the patient or a family member.

Exclusion Criteria:

• Patients unable to respond and who do not have reference companions
• Patients readmitted to the ICU during the study period.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Servqual tool	The questionnaire consists of 5 domains with 22 questions graded from 1 to 7 according to perceived quality and expected in each sphere of care delivery. Domains are: Tangibles. Equipment, physical structure, presentation of professionals and materials.; Reliability. Ability to resolve problems and resolve them within the deadline, and record without errors.; Availability and responsiveness. Ability to inform about the therapeutic plan, to execute on time, availability of professionals to help clients and degree of occupation of professionals to meet demands.; Security / Trust. Ability to inspire security, education of professionals and knowledge of processes by professionals.; Empathy. To provide individual attention, standard opening hours, sincere interest in resolving demands and ability to meet demands individually. The result is analyzed with the calculation: Average result of reality - Average result of expectation = Gap of perception of quality of care.	30 days

Collaborators and Investigators

• Sponsor: Hospital Sao Domingos

Publications and helpful links

General Publications

• Burstin H, Leatherman S, Goldmann D. The evolution of healthcare quality measurement in the United States. J Intern Med. 2016 Feb;279(2):154-9. doi: 10.1111/joim.12471.
• Sixma HJ, Kerssens JJ, Campen CV, Peters L. Quality of care from the patients' perspective: from theoretical concept to a new measuring instrument. Health Expect. 1998 Nov;1(2):82-95. doi: 10.1046/j.1369-6513.1998.00004.x.
• Jonkisz A, Karniej P, Krasowska D. The Servqual Method as an Assessment Tool of the Quality of Medical Services in Selected Asian Countries. Int J Environ Res Public Health. 2022 Jun 26;19(13):7831. doi: 10.3390/ijerph19137831.
• Malathi A, Jasim KM. Validating the relationship between service quality, patient sensitivity and experience towards medical applications using SERVQUAL. Int J Med Inform. 2022 Dec;168:104883. doi: 10.1016/j.ijmedinf.2022.104883. Epub 2022 Oct 5.
• Regaira Martinez E, Sola Iriarte M, Goni Viguria R, Del Barrio Linares M, Margall Coscojuela MA, Asiain Erro MC. [Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL)]. Enferm Intensiva. 2010 Jan-Mar;21(1):3-10. doi: 10.1016/j.enfi.2009.10.001. Epub 2010 Feb 1. Spanish.
• Lu SJ, Kao HO, Chang BL, Gong SI, Liu SM, Ku SC, Jerng JS. Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan. BMC Health Serv Res. 2020 Sep 29;20(1):908. doi: 10.1186/s12913-020-05764-8.
• Fan LH, Gao L, Liu X, Zhao SH, Mu HT, Li Z, Shi L, Wang LL, Jia XL, Ha M, Lou FG. Patients' perceptions of service quality in China: An investigation using the SERVQUAL model. PLoS One. 2017 Dec 22;12(12):e0190123. doi: 10.1371/journal.pone.0190123. eCollection 2017.

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2023
• Primary Completion (Estimated): September 30, 2023
• Study Completion (Estimated): November 1, 2023

Study Registration Dates

• First Submitted: June 17, 2023
• First Submitted That Met QC Criteria: July 1, 2023
• First Posted (Actual): July 5, 2023

Study Record Updates

• Last Update Posted (Actual): July 5, 2023
• Last Update Submitted That Met QC Criteria: July 1, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Expectations; Critically ill patients; Quality of care; Perceptions; Servqual tool
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: HSD 2023 2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No