A study using patient feedback to predict the effects of quality improvement initiatives in a tertiary care cancer hospital of India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20263186Keywords:
Patient satisfaction, Healthcare management, Oncology hospital, Patient feedback, Quality improvement, Service qualityAbstract
Background: Patient feedback is increasingly recognized as an important indicator of healthcare quality and quality improvement (QI), but evidence from tertiary cancer hospitals in India remains limited. Aim was to assess whether patient feedback predicts perceived QI effectiveness and identify key influencing factors.
Methods: A descriptive cross-sectional study was conducted among 872 patients at a tertiary care cancer hospital (March-August 2023). Data were collected using a standardised 21-item questionnaire and analysed using descriptive statistics, correlation, and regression analysis.
Results: Overall patient satisfaction was high (94%). Patient satisfaction showed a strong positive correlation with perceived QI effectiveness (r=0.701, p<0.001) and explained 49.2% of its variation. Service quality (β=0.730, p<0.001) and staff behaviour and communication (β=0.333, p<0.001) were significant positive predictors, while infrastructure satisfaction showed a negative association (β=–0.183, p<0.001). Together, predictors explained 73.7% of the variation in perceived QI effectiveness.
Conclusions: Patient feedback is a strong predictor of perceived QI effectiveness. Service quality and staff communication strongly influence patient perceptions, highlighting the value of integrating patient feedback into routine QI strategies.
References
Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570.
Parasuraman A, Zeithaml VA, Berry LL. SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality. J Retail. 1988;64(1):12-40.
Ganz PA, Hassett MJ, Miller DC. Challenges and opportunities in delivering high-quality cancer care: a 2016 update. J Clin Oncol Educ Book. 2016;36:e294-300.
Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475-83.
Pasaribu ES. Effects of Service Quality and Patient Satisfaction on Patient Adherence at The Outpatient Rehabilitation Unit of Fatmawati National Hospital, Jakarta. Makassar: Universitas Hasanuddin; 2022.
Divya D, Savita S, Kaur S. Unveiling excellence in Indian healthcare: a patient-centric PRISMA analysis of hospital service quality, patient satisfaction and loyalty. Int J Pharm Healthc Mark. 2025;19(3):874-914.
Kwateng KO, Lumor R, Acheampong FO. Service quality in public and private hospitals: a comparative study on patient satisfaction. Int J Healthcare Manag. 2019;12(4):251-8.
Gomez-Cano M, Lyratzopoulos G, Abel GA. Patient experience drivers of overall satisfaction with care in cancer patients: evidence from responders to the English Cancer Patient Experience Survey. J Patient Exp. 2020;7(5):758-65.
Al-Balushi S, Sohal AS, Singh PJ, Al Hajri A, Al Farsi YM, Al Abri R. Readiness factors for lean implementation in healthcare settings: a literature review. J Health Organ Manag. 2014;28(2):135-53.
Régis TKO, Gohr CF, Santos LC. Lean healthcare implementation: experiences and lessons learned from Brazilian hospitals. Rev Adm Empres. 2018;58:30-43.
Dodkins J, Zachou G, Rashid A, van der Meulen J, Nossiter J, Tree A, et al. Improving performance in radiation oncology: an international systematic review of quality improvement interventions. Radiother Oncol. 2025;206:110798.
Friedel AL, Siegel S, Kirstein CF, Gerigk M, Bingel U, Diehl A, et al. Measuring patient experience and patient satisfaction—how are we doing it and why does it matter? A comparison of European and US American approaches. Healthcare (Basel). 2023;11(6):797.
Bari V, Hirsch JS, Narvaez J, Sardinia R, Bock KR, Oppenheim MI, et al. An approach to predicting patient experience through machine learning and social network analysis. J Am Med Inform Assoc. 2020;27(12):1834-43.
Berger S, Saut AM, Berssaneti FT. Using patient feedback to drive quality improvement in hospitals: a qualitative study. BMJ Open. 2020;10(10):e037641.
Casaca P, Schäfer W, Nunes AB, Sousa P. Using patient-reported outcome measures and patient-reported experience measures to elevate the quality of healthcare. Int J Qual Health Care. 2023;35(4):mzad098.
Yang J, Liu F, Yang C, Wei J, Ma Y, Xu L, et al. Application of Donabedian three-dimensional model in outpatient care quality: a scoping review. J Nurs Manag. 2025;2025(1):6893336.
Epstein RM, Street RL Jr. The values and value of patient-centered care. Ann Fam Med. 2011;9(2):100-3.
Kesbakhi MS, Rohani C. Exploring oncology nurses' perception of the consequences of clinical empathy in patients and nurses: a qualitative study. Support Care Cancer. 2020;28(6):2985-93.
Pramesh CS, Badwe RA, Borthakur BB, Chandra M, Raj EH, Kannan T, et al. Delivery of affordable and equitable cancer care in India. Lancet Oncol. 2014;15(6):e223-e233.
Otani K, Waterman B, Faulkner KM, Boslaugh S, Burroughs TE, Dunagan CW. Patient satisfaction: focusing on "excellent". J Healthc Manag. 2009;54(2):93-102.
Etikan I, Musa SA, Alkassim RS. Comparison of convenience sampling and purposive sampling. Am J Theor Appl Stat. 2016;5(1):1-4.
Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.
Renedo A, Marston C. Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement. BMC Health Serv Res. 2015;15(1):122.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.
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