What do Maltese psychiatric patients think of their outpatient care? A preliminary study

Abstract

Aims and Objectives: Patient views are increasingly being used as part of service improvement methodology. This study explores psychiatric patient perceptions regarding outpatient care including accessibility, responsiveness, and whether it meets their needs. It assesses patient satisfaction with current service, respect for their dignity and well-being. Methodology: review of literature and National Policy on Mental Health Service (Ministry for Home Affairs and Social Development,1995); parameters identified included referral, treatment, information, emergency care, provision of care by healthcare professionals, standards; support, discrimination within the rest of the service. Other aspects included primary/secondary interface, and general outpatient service domains. Qualitative study using focus group methodology was used to obtain patient perspectives. Results: Content analysis revealed general satisfaction with professional care; staff were perceived to do their best in spite of pressure of workload, frequent interruptions, and missing notes. Dissatisfaction was expressed with: lack of properly timed appointments; lack of information (treatment, side effects, illness, prognosis); access to care and communication with outpatients were difficult in crisis situations; lack of interaction with Social Services Department; little community support; lack of ‘joined-up’ care. There was no perception of discrimination within the rest of the service. Privacy and dignity are an issue in the waiting and common areas-though not in the consultation areas. Findings are being used to refine semi-structured interviews with individuals. A qualitative approach is very suitable for psychiatric patient survey and is being used as part of a quality improvement project currently under way using feedback. Recommendations: A number of areas identified can be solved easily (e.g. providing locks on toilet doors and publicizing Richmond Foundation information in the outpatient waiting area), others will require more planning and new resources (e.g. better coordination for social services and community care, better information provision, clerk receptionist to coordinate appointments and control telephone interruptions). There emerges a general need to make patients and caregivers more aware that they can register their concerns with outpatient staff or with customer care services, with a view to improving services.