Surgery Client’s Perception on the Healthcare Quality and its Relationship with Safety Culture and Nurse-Physician Inter-Professional Communications in Surgery Wards of Imam Reza Hospital of Tabriz, 2015

Abstract

Abstract: Introduction: Safety culture and professional communication between the health team members are important factors affecting the quality of services. The aim of this study was to determine the perception of surgical patients from the quality of services and its relationship with patient safety-culture and the professional communication between physicians and nurses in the surgical wards of Imam Reza (AS) Medical Educational Center in Tabriz. Method: In a descriptive-correlational study, 300 surgical patients in surgical wards of Imam Reza (AS) Hospital, Tabriz were sampled randomly and their 101 nurses were sampled through census. Data were collected through Iranian version of SERVQUAL questionnaire, Hospital Survey on Patient Safety Culture (HSOPSC), and a physician-nurse professional communication questionnaire were analyzed and analyzed in SPSSV22. Findings: The findings showed that in terms of patient perception of service quality, the highest mean score was for reliability (13.92 ± 3.55), the lowest score was for responsiveness dimensions (10.13 ± 2.71), and empathy score was (6.78 ± 1.88). In the dimensions of patient safety culture, the highest mean scores were related to organizational learning-continuous improvement (3.49), the lowest mean score was related to staffing (2.27), and non-punitive response to errors was (2.27). The results of regression analysis showed that the model of the relationship between patient's perception of service quality and safety culture with its dimensions was significant (P<0.001). From among the variables included in the model, the dimensions of frequency of events reported (P<0.05), handoffs & transitions, communication openness, and teamwork within units (p <0.01) have a significant effect on patient perception of service quality. Moreover, these three variables have explained 7% of the variance in patient's perceptions of quality of service. Furthermore, the results of linear regression of the relationship between quality of health care services and professional communication showed that respect and sharing information had a significant effect on patient perception of service quality (p<0.001), and this variable explained more than 5% of the variance of the scores of the patient's perception of the quality of services. The model of the relationship between patient safety culture and professional communication between physician and nurse is significant (P<0.001), and this variable has been able to explain 35/5% of the variance of the scores of the patient safety culture. Conclusion: Supplying adequate and available human resources and conducting workshops of patient communication skills can improve the quality of services from the perspective of patients. Physician-oriented systems in Iranian hospitals should be replaced with respect between physicians and nurses and sharing of information between them, so that its positive effects on the quality of care and treatment improve patients' perception of the quality of services. In addition, acculturation for safety and creating a climate where employees can express their opinions and mistakes without fear of blame and punishment will improve health care and increase the perception of patients about the quality of services.