Keywords :
Patient Fury, Patient Satisfaction, Shop Window, Patient Safety, Work Place Violence.

ABSTRACT

Background:

Over recent years there has been an increasing prevalence of verbal and physical violence in the Hospital settings. Aggrieved patients and their relatives in developed countries may sue their doctors but in India they perhaps verbally, physically attack and burn the hospital. There are limited studies published on understanding the infuriating factors for patient fury in public and private hospitals in India. This study was done to understand the aggravating factors of Patient Fury in public and private hospitals and suggestions provided in prevention of those factors by hospital administrators in Andhra Pradesh.

Methods:

Fifteen multispecialty hospitals with more than 100 beds in Hyderabad and Secunderabad, Andhra Pradesh were selected, stratification was based on Public hospitals (state government hospitals, public sector undertaking hospitals (e.g., Railways, ESI) and Private hospitals (Corporate hospital , Trust /non- profit hospitals and Andhra Pradesh Private Hospitals and Nursing Homes Association). Three hospitals under each category were selected randomly. Thirty hospital administrators (two top level managers/hospital) were given self administered questionnaire with quantitative and qualitative questions using Likert scale.
 
Results:

According to hospital administrators (N= 12) the major aggravating factors for patients’ fury in public hospitals include improper counseling by a doctor/consultant (90%), involvement or interference of local leaders (union/political) (83%), related to medico legal cases (77%), nursing services ( 77%), behavior of class four employees/house keeping staff (75%), print and electronic media ( 73%), security personnel or visiting hours ( 73%), lab services (70%) and other factors. The major factors aggravating the patient fury in private hospitals is related to billing related issues (either difference in the billing amount or actual bill is more than estimated amount) ( 93%), involvement of local leaders (political/union) (92%), delayed billing/discharge process (88%), inadequate counseling of doctor/ consultant (86%), front office or OPD services (82%), electronic and print media (80%), behavior of class IV/house keeping staff (80%), security personnel and visiting hours, (78%) diagnostic and lab services, (74%), parking, government health insurance availing patients and medical records (70%).

Conclusion: The aggravating factors for patient fury may lead to violence. According to World Health Organization, violence is preventable and is not inevitable. Hospital administrators have a major role to play in understanding the factors leading to patient fury and plan to prevent those. Frequent assessments by hospital will help the hospital administrators in understanding aggravating factors and new challenges in planning appropriately and in prevention of patient fury violence resulting in increased patient satisfaction.