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Abstract(s)
A qualidade dos serviços e das organizações é uma característica que se mostra
necessária para o sucesso e crescimento dos mesmos. É um conceito subjetivo e a gestão
da qualidade tem-se mostrado ser complexa, resultado das características específicas de
cada serviço ou organização. Ao longo dos últimos anos várias têm sido as investigações
nesta temática, quer na conceptualização da qualidade, quer no desenvolvimento de
métricas e escalas de medida de qualidade. Algumas destas escalas baseiam-se na
medição e avaliação da satisfação dos clientes em relação ao serviço prestado ou em
relação à própria organização, das quais se destacam os modelos SERVQUAL e
SERVPERF. A satisfação dos utentes é cada vez mais utilizada como medida para avaliar
a qualidade dos serviços, mas também para avaliar a eficácia de medidas de melhoria
implementadas.
Os cuidados de saúde constituem por si um serviço, e à semelhança de outras
organizações de setores diferentes, têm potencial de melhoria e devem ter como foco
apresentar um nível mínimo de qualidade. Para cumprirem este pressuposto, devem
preocupar-se em avaliar a perceção da qualidade que os seus clientes têm e devem
desenvolver estratégias de melhoria contínua dos seus serviços.
Dentro dos serviços de saúde, um que tem tido especial foco em Portugal, tem sido
a especialidade de GO no Serviço Nacional de Saúde (SNS), que pelas suas características
e pela sua importância tem sido alvo de queixas e notícias constantes sobre o fecho de
maternidades, falta de recursos humanos, fecho de algumas urgências, entre outros. Esta
é uma das especialidades médicas que mais contribui para o índice sociodemográfico do
país (pela sua ligação direta à taxa de mortalidade materna e infantil) e deve ser
periodicamente avaliada para que se possam implementar medidas de melhoria para ir
de encontro às expectativas das utentes e assim melhorar a qualidade e experiência das
mesmas com os serviços prestados.
Assim e de forma a avaliar a satisfação das utentes em relação a um serviço de GO
do SNS é utilizado neste estudo a escala SERVPERF, já anteriormente validada e
utilizada quer em serviços de saúde, quer especificamente em serviços de Ginecologia e
Obstetrícia. Pretende-se com este estudo aferir a qualidade do serviço pela avaliação da
satisfação das utentes internadas no serviço de GO da ULS Cova da Beira, bem como
analisar quais os pontos que carecem de maior melhoria para ir de encontro às
expectativas das utentes e poder melhorar o serviço nas experiências futuras.
Os resultados obtidos demonstraram que na generalidade, as utentes avaliam o
serviço de forma positiva com uma média de 5,96 em 7 e um desvio padrão de 0,774 para a qualidade global percecionada. Em termos das dimensões, as utentes deram uma
avaliação média de 5,57 para a tangibilidade, de 6,11 para fiabilidade, de 5,92 para a
capacidade de resposta, de 6,21 para a confiança e de 5,95 para a empatia, sendo por isso
a dimensão confiança a que foi mais bem avaliada.
Os itens com piores classificações são referentes aos equipamentos e à aparência
das instalações, à capacidade de o serviço realizar as suas funções nos tempos
prometidos, à disponibilidade dos funcionários para responderem de forma imediata aos
pedidos dos utentes e aos horários do serviço.
De uma forma geral também se consegui cruzar dados e analisar os resultados em
função das variáveis demográficas e foi possível verificar que utentes na faixa etária dos
26-40 anos avaliam de pior forma o serviço com uma avaliação global média de 5.8, atrás
das utentes com menos de 26 ou com mais de 40 anos; utentes com o ensino básico
avaliam o serviço de melhor forma que as utentes com ensino secundário ou curso
superior, com uma avaliação média de 6.13 e utentes que habitam em cidades avaliam o
serviço com 6.03 pontos, sendo mais positiva que as utentes que habitam em aldeias ou
vilas.
The quality of services and organizations is a characteristic that plays an important role on their growth and success. However, quality is an attribute of subjective nature, and quality management has proven to be complex, as it heavily depends on the details of each service or organization. Over the last few years, there have been several investigations into this topic, both in the conceptualization of quality and in the development of metrics and measurement scales. Some of these scales are based on measuring and evaluating customer satisfaction in relation to the service provided or with the organization itself, of which the SERVQUAL and SERVPERF models stand out. Customer satisfaction is increasingly used not only as a measure to assess the quality of services, but also to evaluate the effectiveness of improvement measures that are already in-place. Healthcare in itself constitutes a service, and like other organizations from distinct sectors, it has potential for improvement and must focus on providing acceptable levels of quality. In order to fulfill this assumption, healthcare services shall audit themselves through their patients – understanding their expectations and perception of quality – and shall develop continuous improvement strategies for their services. Within the Portuguese National Healthcare Service (SNS), the Gynecology/Obstetrics (Gyn/Ob) specialty service has recently been under the spotlight, due to several unfortunate patient cases that echoed through the media. Besides, this service had received several patient complaints across the country, which are believed to be related with the lack of human resources, closure of maternity wards and hospital emergency services, amongst others. This is one of the medical specialties that contributes the most to the sociodemographic index, given its direct link to maternal and infant mortality rates. Thus, Gyn/Ob services shall be continuously evaluated and improved, in order to better fit and address their patients’ expectations, needs and overall experience, in order to improve the perceived (and actual) service quality. This work aims to assess the quality and improvement areas of the Gyn/Ob inpatient service of the ULS Cova of Beira hospital center through a satisfaction questionnaire posed to cooperant inpatients. This questionnaire is leveraged by using the SERVPERF model, previously validated and used in health services, and more specifically in Gyn/Ob services as well. The acquired results show that, in general, these patients evaluated the service positively regarding perveiced quality, with an average of 5.96 out of 7 and standard deviation of 0.774. Looking at the dimensions, patients scored an average (out of 7) of 5.57 for tangibles, 6.11 for reliability, 5.92 for responsiveness, 6.21 for assurance and 5.95 for empathy, being assurance the dimension that was perceived as better. In contrast, the worst evaluated items are related with the available equipment and appearance of the physical facilities (on tangibles), service duties completed within acceptable time windows (reliability) and employee availability to answer to patients' requests (responsiveness). By analyzing the available data through demographic scopes, it was also possible to verify that patients ranging from 26 up to 40 years old evaluated the service more negatively than other patients, with an average perceived quality of 5.8 out of 7. Also, patients whose education level is primary education rated the quality higher (6.13 out of 7) than patients with higher levels of education, and patients inhabiting in cities also rated the service higher (6.03 out of 7) than patients living in towns or villages.
The quality of services and organizations is a characteristic that plays an important role on their growth and success. However, quality is an attribute of subjective nature, and quality management has proven to be complex, as it heavily depends on the details of each service or organization. Over the last few years, there have been several investigations into this topic, both in the conceptualization of quality and in the development of metrics and measurement scales. Some of these scales are based on measuring and evaluating customer satisfaction in relation to the service provided or with the organization itself, of which the SERVQUAL and SERVPERF models stand out. Customer satisfaction is increasingly used not only as a measure to assess the quality of services, but also to evaluate the effectiveness of improvement measures that are already in-place. Healthcare in itself constitutes a service, and like other organizations from distinct sectors, it has potential for improvement and must focus on providing acceptable levels of quality. In order to fulfill this assumption, healthcare services shall audit themselves through their patients – understanding their expectations and perception of quality – and shall develop continuous improvement strategies for their services. Within the Portuguese National Healthcare Service (SNS), the Gynecology/Obstetrics (Gyn/Ob) specialty service has recently been under the spotlight, due to several unfortunate patient cases that echoed through the media. Besides, this service had received several patient complaints across the country, which are believed to be related with the lack of human resources, closure of maternity wards and hospital emergency services, amongst others. This is one of the medical specialties that contributes the most to the sociodemographic index, given its direct link to maternal and infant mortality rates. Thus, Gyn/Ob services shall be continuously evaluated and improved, in order to better fit and address their patients’ expectations, needs and overall experience, in order to improve the perceived (and actual) service quality. This work aims to assess the quality and improvement areas of the Gyn/Ob inpatient service of the ULS Cova of Beira hospital center through a satisfaction questionnaire posed to cooperant inpatients. This questionnaire is leveraged by using the SERVPERF model, previously validated and used in health services, and more specifically in Gyn/Ob services as well. The acquired results show that, in general, these patients evaluated the service positively regarding perveiced quality, with an average of 5.96 out of 7 and standard deviation of 0.774. Looking at the dimensions, patients scored an average (out of 7) of 5.57 for tangibles, 6.11 for reliability, 5.92 for responsiveness, 6.21 for assurance and 5.95 for empathy, being assurance the dimension that was perceived as better. In contrast, the worst evaluated items are related with the available equipment and appearance of the physical facilities (on tangibles), service duties completed within acceptable time windows (reliability) and employee availability to answer to patients' requests (responsiveness). By analyzing the available data through demographic scopes, it was also possible to verify that patients ranging from 26 up to 40 years old evaluated the service more negatively than other patients, with an average perceived quality of 5.8 out of 7. Also, patients whose education level is primary education rated the quality higher (6.13 out of 7) than patients with higher levels of education, and patients inhabiting in cities also rated the service higher (6.03 out of 7) than patients living in towns or villages.
Description
Keywords
Ginecologia e Obstetrícia Qualidade de Serviço Satisfação dos Utentes Servperf