Physicians’ satisfaction with clinical referral laboratories in Rwanda

Abstract

Background: The quality of laboratory services is crucial for quality of patient care. Clinical services and physicians' decisions depend largely on laboratory test results for appropriate patients' management. Therefore, physicians' satisfaction with laboratory services is a key measurement of the quality service that stresses impactful laboratory service improvement to benefit patients. Objective: To assess physicians' satisfaction and perspectives on the quality of services in clinical referral laboratories in Rwanda. Methods: A cross-sectional survey among physicians from four referral hospitals with closedended questionnaire and one general open-ended question. A five-point Likert scale rating was used to measure satisfaction. Descriptive, ordered logistic regression, and thematic analysis were used. Results: In total, 462 of 507 physicians (91% response rate) participated in the study. Overall mean satisfaction was 3.2 out of 5, and 36.2% of physicians were satisfied (satisfied and strongly satisfied) with laboratory services. In four service categories out of 17, the physicians' satisfaction was over 50%. The categories were: reliability of results (69.9%), adequacy of test reports (61.9%), laboratory staff availability (58.4%), and laboratory leadership responsiveness (51.3%). Lowest satisfaction was seen for routine test turnaround time (TAT) (19.3%), inpatient stat (urgent) test TAT (27%), communication of changes such as reagent stock out, new test (29%), and missing outpatient results (31%). Eighty-four percent answered that test TAT was not communicated, and 73.4% lacked virology diagnostics. Pediatricians, internists, and more experienced physicians were less satisfied. While ineffective communication, result delays, and service interruption were perceived as dissatisfying patterns, external audits were appreciated for improving laboratory services. Conclusion: Availing continuously laboratory tests, timely result reporting, and effective communication between laboratories and clinicians would increase physicians' satisfaction and likely improve the quality of health care. Laboratory staff participation in clinical meetings and ward rounds with physicians may address most of the physicians' concerns.

Clinicians’ perceived quality of laboratory services provided at public hospitals and primary health centres in northeast Ethiopia

“…In this study, the third lowest-rated area was the adequacy of available test menu (3.8), with 33.3% dissatisfaction, and 42.5% of clinicians lacked a backup/specimen referral system. A study conducted in public hospitals in Ethiopia also showed that most physicians were dissatis ed with the existing test menu (67.3%) and lacked a backup/specimen referral system (62.0%) [14], similar to other ndings [3,13,15,16,27,30]. The clinicians' poor rating of test availability also corroborates our observation that the laboratories were capable of providing only 54.0% of the test menu expected from them.…”

“…The percentage of satis ed clinicians was lower for the larger hospitals compared to primary health centres (56.0% vs. 76.8%, p = 0.003), in line with ndings from southern Ethiopia [26], Rwanda [13], and South Korea [33]. The difference could be explained by the possible higher expectations of customers from more advanced facilities or by the differences observed in speci c areas of clinicians' experiences or technical practices of the laboratories.…”

“…The nding also corroborates the fact that targets of TAT were set but not regularly monitored in most of the laboratories we assessed. Achieving sustainable improvement requires regular monitoring of TAT to continuously identify wastages and optimize work ows throughout the testing process [6,13]. All laboratory staff should also be more sensitive to panic values and STAT requests that often need urgent results for the management of emergency or critically ill patients [2,6].…”

“…However, the quality performance improvements achieved thus far remain inconsistent, and the actual impact on users' outcomes largely remain unclear [11,12]. Customers' satisfaction survey enables managers to link the current status of laboratory quality improvement with real customers' expectations [6,13].…”

Health care services satisfaction and associated factors among people living with HIV/AIDS at Kibuye referral hospital, Rwanda

“…9 A few studies have however revealed that there are differences in satisfaction and use of health care services in Rwanda. 13,14 These studies found there was low use of these services, the provided reasons included poor infrastructure, insufficient resources human, staff reliability issues, limited range of existing services, lack of technical skills by staff, drug shortages and inadequate counseling and empathy from service providers. Although the findings were useful, they focused on total patient's access to healthcare and satisfaction and not those that are specific to chronic or sensitive diseases such as HIV/AIDS.…”