Introducing an Enhanced Gynecology Service in Primary Healthcare Facilities in the UAE

Introduction

In the last four decades, the United Arab Emirates healthcare sector has expanded significantly. The current situation compared to 1971 when UAE was being established, the country only had 7 hospitals and 21 health centers. According to 2015 statistics, the UAE had 126 public and private hospitals with a total capacity of 12,000 beds (Al-Neyadi, 2016). Population growth is due to the expansion of the health sector. The steady growth of healthcare sector in the United Arab Emirates has posed significant challenges that include recruiting and education funding of adequate quality professionals and covering their costs. In the coming years, the UAE might require outsourcing of healthcare professionals to meet the rising demand for quality health services. The primary care experiences a small number of trained medical professionals, which is contributing to the lack of primary care in many countries. The primary purpose of this evaluation is to determine how effective the intervention to enhance gynecology services in UAE. To be able to evaluate the success of the response and propose improvements on the intervention, Ovretveit evaluation model will be utilized.

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Evaluation is an essential part of the assessment of intervention and plays a considerable role to ensure that informed decisions regarding the progress of a project. An assessment gives an entity a deeper understanding of the best alternatives to improve the implementation of a plan. This project aims to assess whether the desired improvements are realized by introducing an enhanced gynecology service in primary healthcare facilities in the UAE.

Objectives

Objective 1: To Improve Patient Satisfaction By 20%

Patient satisfaction directly relates to the state of the patient when they received service from gynecology to the time after discharge. The significant aspect tested is the test for casualty that a patient might have underwent in the process of receiving medication. Quality improvement in primary healthcare aimed at ensuring that patients receive the best possible healthcare services. The evaluation the satisfaction of a patient will involve a review of the quality healthcare they receive from the time of admission to the time they left the hospital. Although the level of care and diagnosis occasionally depends on the communication between the patient and the physician, the doctor is responsible to perform proper diagnosis to a patient. The patient has the responsibility to state what they feel as transparent as possible to enable the physician to diagnose them correctly. However, not all the physicians show responsiveness and compassion and offer their quality time to the patients (Philips, 2010). Therefore, while evaluating patient satisfaction, both aspects have to be tailored before concluding. On the part of the physician, it would be essential to elaborate more on the technical jargon that they might offer to make the patients understand more (Pineda & Pilar, 2010). In the gynecology services, based on the patient's culture, not all patients are willing to engage in revealing talks with the doctor. Moreover, the doctor's attitude towards the patient will determine the level of disclosure from the patient. In some extreme instances, patients end up lying about their conditions.

The assurance that a patient will receive the desired care solely depends on the professional commitment displayed by doctors and their staff skills. This offers the patients more time to communicate with doctors to create a favorable environment for the information disclosure. Considering the culture and background of the patient, they might feel uncomfortable to ask for an assurance from the staff regarding their health conditions (Steensma et al., 2014).

Based on the John Ovretveit's list of the evaluation method, the evaluation will follow the steps stipulated that involves showing the experience of the patients about their experiences compared with the new way. The financial incentives of the further intervention will be evaluated based on the value for money of the initiative. Is the intervention worth investing in? Activating the new way of working, monitoring and practicing the further response and feedback guidance. The final step of evaluation is showing the evidence of benefit compared to the way things were before the intervention and sharing with other professionals through journals, newspapers and other media.

The evaluation of the objective to improve patient satisfaction by 20% will consider the condition of a patient before admission and after their discharge. Precisely, data will be collected in UAE regarding improvements in gynecology in primary health care quality from discharge patients. The evaluation will focus on 16 fundamental dimensions, which define the vital aspects of both inpatient and outpatient healthcare services in the UAE. Respondents will be identified through permitted hospital patient records and response will be based on a voluntary basis with specific patients of the gynecology care. The respondents will be asked to state their level of satisfaction by requesting them to rate their level of comfort on a scale of one (very dissatisfied) to ten (very satisfied). Other conditions such as the patient's condition before admission and after admission will also be included to ascertain the level of improvement and the time relative to their stay at the hospital. Their status will also be rated on a scale of 1 (terrible) to 10 (very good).Various variables will be used to assess the quality of gynecology healthcare services offered at primary level.

To find out the improvements in the healthcare facilities, different variables will be put into consideration. Assessment will be based on the added amount of facilities to improve patient care in the gynecology department. Increased number of gynecology facilities such as laboratories will determine the quality of service greatly as improvement in the procedures impacts significantly on the quality of healthcare. Assessment of the outcome regarding increased facilities will also encompass the waiting time for both inpatient and outpatient and outpatient.

Instilling empathy among gynecologists pays off in patient care and improves the quality of service offered to the patients. Discharged patients will be asked the attentiveness and willingness of the doctors to listen to their issues. A comparison of the current state of empathy will be compared to the time of evaluation to determine if an improvement in quality service is evident. Patients will be asked yes/no question on whether the physician was patient and willing to listen to the problems they were undergoing. Physicians will also be assessed on whether they have attended any training and refresher courses concerning clinical empathy. Being a good doctor requires a good understanding of people and their needs and wants. Research has linked insight to better patient satisfaction and reduced physician burnout.

Professionalism and courtesy of gynecology physicians directly linked to the patient satisfaction. Both inpatient and outpatient will be asked on the way in which they communicate body language and appearance of the physician. Patients in the gynecology care need to feel comfortable with whom they are relating with and delegating their safety too. Assessment will be based on whether the patients handle better connecting with physicians that may intern help them heal faster psychologically. Patients will be required to fill out whether the gynecology healthcare staff are friendly and open to the patients or not.

Health-status before admittance and after discharge will be evaluated to ascertain the level of satisfaction of the services offered at the healthcare facility. Patient's records will assist to get information about the patient's status as well as the examination of the patient's condition and the condition that the patient left the hospital. The transition time incorporated to know how long the patient took to recover and release. The recovery time is associated with the availability of facilities and medication and the professionalism of gynecology physicians in a primary healthcare facility. Patients who considered satisfied are those that complete treatment successfully.

The value for money for the intervention in improving the quality of gynecology services is essential to establish whether it was worth initiating the response. This assessment will involve whether the project has resulted in improved patient satisfaction through improvement of facilities and the level of attaining its objective to improve patient satisfaction by 20%. The evaluation will be to ascertain whether there is value or loss of funds.

The results of the intervention will be shown that also involves the practice of the new behavior and new way of working. A follow-up programme will then be designed to establish the training and practicing of further action is adhered to. This will involve one on one or group discussion about the benefits (evidence) of the intervention compared to the previous handling of patients.

The Ovretveit's model on evaluation was favorable for assessment of this objective because it provides a comprehensive outlook on the improvement of the quality of patient satisfaction. The change between now and the time of evaluation. The model captures appropriately all the aspects needed to detect an increase in the healthcare sector. Often using the yes or no questions has more disadvantages than the benefits. Despite it being easy to answer, it is considered one of the most unpredictable valuations (Basarab &Dave, 2011).). True or false questions highly encourage guessing.

Objective 2: To Improve Follow-Up Protocol Not to Exceed 30 Days from Date of a Member's Request.

Outpatient resource provision and management has become an integral part of UAE to ensure that patients are given optimal treatment attention as they deserve. The evaluation will be conducted based on a questionnaire survey with outpatient patients. Assessment of the recommended follow-ups regarding the timetable for the check-ups, which provides the follow-ups and the routine testing, which is used on gynecological patients.

The evaluation questionnaire will ask gynecology physician whether they do routine observation tests in patient-initiated follow-ups. Outpatient patients that will be involved considering the type of treatment operations. This includes ovarian, cervical, and endometrial and vulvar surgeries and the tests conducted upon the follow-up. Follow-up tests were undertaken to be evaluated the number of ultrasound test, blood tests. The frequency of telephone follow-up calls for patients is determined to ascertain the improvement of the intervention to aftercare services.

The evaluation also included the number of recurrence of an infection due to lack of routine follow-ups (Ovretveit, 2014). Patients will be asked the frequency of the repetition of the illnesses because of a missed test or lack of consistent monitoring. The success of the intervention will be measured by improvement in the routine follow-up of patient-initiated follow-ups.

Critics

The ultimate time for advising a patient regarding the appropriate form of follow-up is unclear which might be after short modalities of treatment has been executed. Alternative strategies should be evaluated for gynecology patients follow-up since the dynamics might be dependent on economic factors. When the first few follow-ups are made without detection of a recurrence an illness, the physician might end up being a reactant or the patient may become tired and request for fewer tests.

The model gives a wide range of...