Faculty of Health Sciences
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Item A survey of patient satisfaction of the DUT Homoeopathic Community Health Centre (DUT HCHC)(2022-05-13) Adandé, Adhiéman Sihle; Couchman, Ingrid; Brijnath, ShraddhaBackground Patient satisfaction is a vital area of research concerning the quality of healthcare. Satisfied patients are more likely to benefit from their healthcare, keep their appointments and comply with medical regimes such as proper medication upon given instructions from their healthcare practitioner (Hills and Kitchen, 2007: 243). Herr (2008) conducted a similar study on patient satisfaction at the Homoeopathic Community Health Centre (HCHC) at Durban University of Technology (DUT). Although there has been renovation at the community health since then, more than five years have passed without any evaluation. Patient satisfaction is a patient-focused indicator of healthcare services. Therefore, evaluating patient satisfaction is a good criterion for analysing the quality and relationship between patients and healthcare practitioners. Therefore, patient dissatisfaction is a significant factor for changing healthcare services or complaints against a healthcare practitioner (Miri, Nejad and Soltani, 2016: 89). Thus, continuous improvement in healthcare quality is a daily goal for all healthcare services, such as clinics and professionals who work in healthcare. To thrive in a competitive marketplace, it is essential for healthcare organisations and their practitioners to recognise that viewing patients as customers and improving customer satisfaction has direct implications on healthcare quality (Harding and Taylor 2010: 928; Stavins 2006:29). This study evaluated patient’s feedback to create a patient satisfaction survey for use at the HCHC at DUT continually. Aim The aim of this study was to conduct a patient’s satisfaction of the service provided at the DUT HCHC, with the purpose to identify shortfalls/gaps such as to improve every aspect of patient satisfaction, which positively contributes to the overall treatment and service being provided at the DUT HCHC. Methodology The sample group of the first 70 patients that consulted at the DUT HCHC between July 2020 and March 2021, that voluntarily participated in this study were included in the study by means of convenience sampling. The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service provided at this facility and increase the degree of patient satisfaction experienced. Results In this study there was generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction were, Patient’s arrival at the community health centre where they were both promptly and politely greeted, as well as the overall interaction between the student Homoeopath, Administrative staff as well as the Clinician on duty and the patient. Areas that demonstrated lower degree of satisfaction were advertising by media and signage, signage, toilet accessibility for disabled patients and parking. Conclusion The feedback from the patient satisfaction survey will subsequently serve to improve the quality of the service provided at the DUT HCHC and increase the degree of patient satisfaction experience.Item Development and validation of a patient satisfaction monitoring tool for the Durban University of Technology Chiropractic Clinic(2018) Singh, Ashmindher; Varatharajullu, Desiree; Cruickshank, GillianBackground Patient perceptions of the value of services and care they obtain at healthcare practices offer healthcare providers and staff important information to effect improvements. Studies have shown a high rate of patient satisfaction of patients receiving chiropractic care. South Africa is distinguished as the only country in Africa to offer training in chiropractic. Currently, only two tertiary establishments in South Africa, the Durban University of Technology and the University of Johannesburg offer a master’s in Chiropractic degree. There is, however, no feedback system currently implemented at the Durban University of Technology Chiropractic day clinic for patients to indicate levels of satisfaction. Patient satisfaction surveys are considered as a means of gathering patients valued opinions on primary health care services that they have received. This study evaluated the patients’ feedback in creating a patient satisfaction survey for use at the DUT CDC on a continual basis. Aim The aim of this study was to develop a valid and reliable patient satisfaction questionnaire, which could easily be used on a routine basis in order to monitor patient satisfaction levels at the DUT CDC in terms of quality of care, accessibility and interpersonal factors. Method This study consisted of three phases. Phase one was a preliminary review of the literature on questionnaire design and conceptual frameworks. Phase two consisted of instrument development, expert group and pilot testing. The development of the instrument and its contents was informed by the review of the literature and questionnaire exemplars from phase one. In this phase, a second questionnaire was developed and trialled with the expert group, as it was used to rate the significance of the questions on the patient satisfaction questionnaire (PSQ); subsequently the PSQ was piloted. Phase three was the handing out of the PSQ and the rating patient satisfaction questionnaire (RPSQ) to patients attending at the DUT CDC. Results The PSQ and RPSQ questionnaires were completed by 400 patients. The patients gave their suggestions as to which statements should be included in the final PSQ. The statements with a majority agreement were included in the final PSQ. The final PSQ was shown to be reliable with Cronbach's Alpha score of 0.93. Conclusion The final PSQ could help to continually monitor patient satisfaction at the DUT CDC. The clinic committee could utilise the feedback to implement or build on quality improvement initiatives, which would assist in demonstrating a commitment to patient-centred care and improve the overall healthcare experience at the DUT CDC.Item A retrospective clinical audit of the Durban University of Technology homoeopathic satellite clinic in Redhill(2016) Pramlall, Pratisha; Couchman, Ingrid; Nienaber, SilvanaIntroduction The Durban University of Technology (DUT) homoeopathic satellite clinic in Redhill was established in 2005. It was started by private homoeopathic practitioners who wanted to provide healthcare services to members of the community. This satellite clinic is very distinct from other DUT homoeopathic satellite clinics as it occupies space in an eThekwini Municipality public health care clinic. The homoeopathic clinic offers free homoeopathic treatment to the local community, as it is a training facility for 5th year homoeopathy students of the DUT. Students consult at this clinic under the direct supervision of a qualified homoeopathic clinician. This descriptive and retrospective study aimed to determine the patient demographics, the disease prevalence, the forms of homoeopathic treatment modalities utilised and to assess the financial implications of operating the clinic. Data was collected by conducting an audit of new and follow up appointments at the Redhill clinic over a five year period from 2010 to 2014. Methodology This descriptive and investigative clinical audit was conducted retrospectively at the Redhill Clinic. A data collection sheet was completed for each patient file which included demographic data such as race, age and gender, the year of the consultation, the date of each visit, the number of visits, the diagnoses and treatment protocols, materials used, prices of medicines and the cost of the clinician. The researcher captured the relevant data of each patient file at the DUT premises under the direct supervision of the supervisor. Each patient file was examined individually. Any patient file that was found to have missing information was not included on the data collection sheet or entered into the Microsoft Excel® spread sheet. The results were then analysed by using various forms of descriptive statistics such as pivot tables, pivot charts, pie charts and bar-charts. Results The Redhill Clinic was open once a week from 2010 to 2012 thereafter it was open every second week until September 2014 due to unavailability of rooms. A total number of 841 patient files which met the inclusion criteria were investigated. There were a total number of 1573 visits over a five year period. The majority of patients who attended the Redhill clinic during the study period were Africans, females and between the age group 21 – 30 years old. The five most prevalent conditions that were seen at the Redhill clinic were respiratory, musculoskeletal, infections, dermatological and gastro-intestinal conditions. The operational expenditure of a homoeopathic satellite clinic included the cost of medicines and materials used. The total cost was calculated to be less than R130 000 over a five year period. Conclusion The patient numbers decreased from 2010 to 2014. The number of follow up visits increased from 2010 to 2012. The number of patient visits has been consistent with more than 50 new and follow up visits each year. This suggests that there has been patient satisfaction with homoeopathic treatment over the years. The homoeopathic satellite clinic is unique as it is enclosed within the Redhill municipality clinic where allopathic doctors also practice medicine. This setting is advantageous because the nursing sisters at the clinic often refer patients to the homoeopathic satellite clinic on a weekly basis and students are able to refer their patients to the municipal clinic as appropriate. Patients were treated with homoeopathic remedies, herbal tinctures and creams and tissue salts. The low operational expenditure of the homoeopathic satellite clinic shows that it is very cost effective and inexpensive to maintain such a clinic. The results that were obtained from this study imply that the inclusion of homoeopathic satellite clinics in disadvantaged communities such as Redhill is beneficial and viable. The practice of homoeopathy is viable especially because of the current challenges that the health system of South Africa is exposed to. One of the significant concerns is that there is a shortage of health care workers in the public health care system. This study did not aim to investigate the possibility of incorporating homoeopathy into public health care at present but results can serve as a model for the inclusion of homoeopathy into other public health care facilities. The disease profile and treatment protocols that were obtained from this study can be used in planning the establishment of other homoeopathic satellite clinics in the future.Item Case based learning in the undergraduate nursing programme at a University of Technology : a case study(2015-03) Sinqotho, Thembeka Maureen; Adam, Jamila KhatoonBackground The current health care system in South Africa and its diverse settings of health care delivery system require a nurse who can make decisions, think critically, solve problems and work effectively in a team. Traditional nursing education teaching strategies have over the years relied on didactic and often passive approaches to learning. In pursuit of quality, academics and students must be continually engaged in a process of finding opportunities for improving the teaching and learning process. Purpose of the study The purpose of this study was to evaluate the structure and the process in case based learning at the University of Technology. Methodology This study is qualitative in nature, governed by an interpretive paradigm. This is a case study, which enabled the researcher to merge student interview data with records in order to gain insight into the activities and details of case based learning as practised at the University of Technology under study. Most importantly, the case study method was deemed appropriate for the current study, since case-based learning as a pedagogical approach (and a case) cannot be abstracted from its context for the purposes of study. Case based learning is evaluated in its context namely, the undergraduate nursing programme, using the Donabedian framework of structure, process and product. Results The study recorded that students were positive towards case based learning though some identified dynamics of working in groups as demerits of case based learning. The structures that are in place in the programme and the CBL processes are adequate and support CBL. There are however areas that need attention such as the qualification of the programme coordinator, the size of the class-rooms and the service of the computer laboratory. Conclusion The study found that apart from a few minor discrepancies, case based learning is sufficiently implemented, and experienced as invaluable by students, at the University of Technology under study.Item A clinical audit of the implementation of the tuberculosis screening tool amongst clients who are on anti-retroviral therapy in the eThekwini local municipality clinics(2014-10-08) Munsamy, Michelle; Botha, IzelBackground : Tuberculosis (TB) is a global public health concern and is identified as the leading cause of morbidity and mortality in the population infected with Human Immune Deficiency Virus (HIV). South Africa (SA), particularly the KwaZulu-Natal Province, is burdened with persistently high rates of both TB and HIV infections. In an attempt to improve TB and HIV co-infection outcomes the South African health care system has adopted the World Health Organisation (WHO) guidelines for intensified TB case findings in all HIV positive individuals for regular screening of TB symptoms in order to promptly diagnose and treat active TB disease or to exclude TB for initiation Isoniazid Prophylactic Therapy (IPT). IPT has proven effective in preventing TB disease in People Living with HIV or AIDS (PLWHA). This critical first step of TB symptom screening is regarded as the intervention that could significantly reduce the challenge currently faced with TB-HIV co-infection. The study was conducted in selected eThekwini Municipality Primary Health Care (PHC) facilities with the focus on an investigation to determine the extent of the implementation of the TB symptom screening tool in HIV infected individuals, in addition to identifying treatment initiation or further investigations based on the tool implementation. It has been found during the literature review, that there is a lack of research in SA to show that this critical first step in TB identification has been investigated, yet one in six South African’s is HIV positive and the incidence of TB-HIV co-infection is not declining. Methodology : A quantitative, descriptive approach was utilised to conduct a retrospective patient chart review. A multistage cluster sampling technique comprising three stages was implemented to identify the sample. There was a random selection of clinics, and the required number of client records was obtained through convenience sampling from the selected clinics. Results : The findings of this study revealed there is inadequate implementation of the current national and provincial TB protocols. The study provides varied levels of information about TB symptom screening in HIV infected individuals in the PHC clinics of eThekwini Municipality. It was observed that Health Care Worker’s (HCW) in some facilities carried out TB symptom screening to an extent. However, the inconsistent and partial application of this screening tool warrants improvement to facilitate the broad success of TB-HIV care strategies.Item A clinical audit of the Durban University of Technology homoeopathic satellite clinic established at Ukuba Nesibindi(2010) Smillie, Tracey; Naude, David F.; Ngobese, Jabulile CresanciaIn collaboration with Lifeline, Durban University of Technology (DUT) established its first satellite homoeopathic community clinic; Ukuba Nesibindi Homoeopathic Clinic (UNHC). UNHC provides a free homoeopathic primary healthcare service on the third floor of the LifeLine building in Warwick junction, Durban, an area which is classified as being disadvantaged with high crime rates, prostitution, violence, small, informal business and low cost housing. The clinic is run by 4th and 5th year homoeopathic students under the supervision of a qualified homoeopathic practitioner and funded totally by the Department of Homoeopathy – DUT. The purpose of this retrospective clinical audit of UNHC was to determine a patient demographic and disease prevalence profile, as well as identify and describe the major medicines prescribed. Methodology The study used a retrospective, explanatory, and descriptive design method by means of a clinical audit, to determine a patient demographic and disease prevalence profile, as well as identify and describe the various homoeopathic treatment modalities. All the patient files from June 2004 – June 2008 were included for analysis and the data collection spreadsheet (Appendix D) was compiled respectively. IV The data collection form was divided into patient demographics, information on number of consultations and follow-ups, clinical diagnoses, urine dipstick analysis, patient referral information and medicines prescribed. The researcher captured the data, which was analysed and various means of descriptive statistics applied using Excel from Microsoft Office® 2007. Results UNHC opened in 2004 and initially only operated two afternoons per week; in order to cope with the demand for this service which grew rapidly in 2006 an additional consultation afternoon was added. A total number of 862 patients were seen between June 2004 and June 2008, 497 being new patients and 365 being follow up patients. On average 56% of patients came back for more than one follow up consultation during the study period. The majority of patients who attended UNHC during the study period were African females between 40 and 64 years of age who were unemployed and single. Of the 5 most prevalent systemic disorders encountered at UNHC infectious disorders were the most frequent along with cardiovascular, dermatological, psychological and musculoskeletal disorders. Conclusion The significant increase in patient numbers at UNHC and the relatively high percentage of patients who returned for more than one follow up consultation are positive trends and suggestive of UNHC’s success in providing homoeopathic primary healthcare as well as the positive impact it has had on the surrounding community. With additional funding UNHC can improve service provision further; dedicated translators as well as various equipment to facilitate administration will streamline the consultation process significantly and allow for more patients to be seen. Expansion of the scope of diagnostic services provided such as pregnancy and glucose testing will reduce the need for referral for such basic services. V Future studies should formally measure patient benefit in response to treatment in the form of a patient benefit survey; qualitative measures of patient satisfaction with the service provided by UNHC are also warranted.