HOW CAN WE IMPROVE PATIENT CARE?

Improving patient care has become a priority for all healthcare professionals with the overall goal of achieving high levels of patient satisfaction. Increased public awareness, the growing need for better health care, increased competition, stricter regulation of health care, more legal proceedings for medical malpractices and fear of poor outcomes are all factors contributing to this change.

The quality of patient care is largely determined by the quality of infrastructure, the quality of training, the competence of staff and the efficiency of operating systems. The main prerequisite is the implementation of a "patient-centric" system. Existing problems in health care are related to both medical and non-medical factors, and a comprehensive system must be introduced to improve both aspects. Health systems in developing countries face even greater challenges, as quality and cost recovery must be combined with equitable patient care.

Non-medical aspects

The fact that the patient is the most important person in the health care system must be recognized by all who work in the system. This is the only factor that is essential to the care of patients in any hospital. In developing countries, financial constraints often lead to poor quality of care. This can be remedied by implementing cost-benefit-oriented management systems. Our experience shows that a system that attracts patients who can afford to pay for quality care must first be developed and then extended to insolvent patients. This system has the advantages of high quality care and a good return on expenses. Some of the issues that need to be addressed to improve patient care are listed below.

Access. Access and availability of both a hospital and a doctor should be guaranteed for all who need medical care.

I am waiting. Waiting times for all services should be as short as possible. In most developing countries this is often a serious problem due to the high demand for services. However, in order to effectively address this problem, patient responses and other data need to be constantly analysed and used to make necessary changes in systems.

Information. Patient information and instructions on all procedures, both medical and administrative, need to be very clear. Well-trained patient counsellors ensure effective communication between patient and hospital staff, making the patient's experience better and the doctor's task much easier.

Administration. Procedures for check-in and check-out should be "patient friendly". For inpatient patients, for example, we have introduced a system for discharging patients to their wards so that the patient or his family no longer have to go to another office or to a counter in the hospital and wait there for a long time. This was well received by the patients.

Communication. Communicating with the patient and family about possible delays is a factor that can avoid many disappointments and anxieties. Establishing a special "patient care unit" with a full-time administrator has greatly helped our institution and improved our interaction with patients and their families.

Support services. Other services, such as communication, meals, etc., should be available to both patients and their families.

Medical aspects

The medical aspects of patient care are much better understood by most health professionals. This depends on the quality of medical and technical expertise as well as the equipment and quality assurance systems in practice. The following factors contribute to improving patient care.

Trained staff. A well-trained "team of ophthalmologists" is necessary to provide high quality care with the desired results. Lack of adequate staff and lack of adequate training opportunities for existing staff are serious problems. The temptation to hire untrained or poorly trained staff should be resisted. Training programmes should be increased and existing ones improved. The provision of a common core curriculum for all training institutions/programmes should promote standardization.

High quality eye care. The results of cataract surgery and other common surgical interventions are of great concern. The inclusion of quality assurance systems in every aspect of patient care is crucial. For example, compliance with asepsis in operating theatres will help to reduce postoperative morbidity, and appropriate training of ophthalmologists in diagnostic techniques will help to achieve better control over visually threatening diseases.

Equipment. All necessary equipment should be available and properly maintained. This is crucial to the functioning of the medical system and makes a significant contribution to improving results. Acceptable standard ophthalmic equipment is available today at reasonable prices and must be accompanied by appropriate maintenance systems.

Use of appropriate tools. Good quality instruments are now available at a lower price. Costs can be reduced by developing appropriate stock management systems for a specific operation.

Use of appropriate medication. Access to affordable medicines is an absolute necessity to ensure adequate care.

Use of new technologies. It is important to continuously use new technologies that improve the quality of care. Of course, this must be done in terms of cost-effectiveness.

Improving patient care is a dynamic process and should be the focus of medical professionals. Developing and maintaining a patient-centred system is of paramount importance to achieving this goal. It is important to pay attention to quality in every aspect of patient care, both medical and non-medical.