The Patient Satisfaction Survey (PSS) conducted by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) aimed to evaluate the quality of healthcare services provided to Palestine refugees. The survey focused on four fields of operation (FO): Jordan, Lebanon, Syria, and the West Bank (including East Jerusalem). Due to the ongoing conflict beginning in October 2023, the Gaza FO was excluded from the survey. This article explores the findings, trends, and recommendations from the survey to enhance patient satisfaction and healthcare quality.
Enhancing Accessibility of Healthcare Services
Geographic and Social Accessibility
One of the primary findings from the Patient Satisfaction Survey indicated that geographic accessibility was generally high across the four fields of operation, with an average of 90% positive responses. Despite this success, substantial shortcomings were observed in the physical accessibility infrastructure, such as elevators and ramps, particularly in Lebanon and Syria. In Lebanon, only 23% of surveyed health centers had adequate physical accessibility options, while Syria lagged behind at 15%. Additionally, elevator functionality was notably scarce, with Lebanon reporting only 8% availability and none at all in Syria.
On the other hand, social accessibility was reported to be very strong, with 98% of respondents stating that there were no social barriers to accessing healthcare services. The operational hours were found to be convenient for a vast majority of respondents, and Saturday was highlighted as the preferred visiting day. These findings suggest that while patients can generally access healthcare services geographically and socially, there is a significant need for improvements in physical accessibility to ensure that facilities are fully inclusive and accessible to all.
Preference for Consultation Methods
When it comes to patient preferences for consultation methods, the survey revealed that in-person consultations were more popular, with 40% of respondents preferring them over telemedicine, which was favored by only 5%. Despite the clear preference for in-person consultations due to the comfort and perceived security they provided, a significant 55% of respondents indicated that they had no preference, showing an openness to either method of consultation. This highlights the potential for expanding telemedicine services to accommodate patient needs, especially in areas with limited physical accessibility.
Observational data from the survey further highlighted several challenges related to accessibility, including inadequate parking facilities for disabled persons, with only 24% of health centers across all fields of operation providing adequate parking. Additionally, issues such as the availability of ramps and slippery surfaces were noted, particularly in Lebanon and Syria. These challenges underscore the need for targeted infrastructure improvements to ensure that healthcare facilities are fully accessible and safe for all patients, including those with physical disabilities.
Improving Interpersonal Skills of Healthcare Providers
Communication and Listening Abilities
The survey results showed high levels of satisfaction regarding the communication skills and listening abilities of healthcare providers. In Lebanon and the West Bank (including East Jerusalem), 100% of respondents reported positive feedback for staff communication, while Jordan and Syria followed closely with 99%. This high satisfaction extended to language comprehension, with patients feeling understood during their interactions with healthcare providers. However, while overall satisfaction with patient expression time was high at 96%, it was slightly lower in Syria, where it dropped to 90%, indicating room for improvement in allowing patients sufficient time to express their health concerns.
Effective communication and empathetic listening are crucial components of patient-centered care, and these findings highlight the strong performance of UNRWA healthcare providers in these areas. Nevertheless, the slightly lower satisfaction in Syria suggests that additional training and resources may be needed to further enhance provider-patient interactions, particularly in conflict-affected settings where patients may have heightened needs for effective communication and emotional support.
Privacy and Confidentiality
Maintaining patient privacy and confidentiality during physical examinations and consultations is a fundamental aspect of healthcare quality. The survey found that 97% of respondents across the four fields of operation were satisfied with the privacy provided during their physical examinations. However, the availability of chaperones during examinations was a significant concern, with only 38% and 53% reporting adequate chaperone availability in Syria and Jordan, respectively. This underscores the importance of ensuring that gender-appropriate chaperones are available to accompany patients during examinations, particularly in cultures where this practice is critical to patient comfort and trust.
Observational data confirmed high levels of confidentiality and patient privacy, with 98% of treatment plan explanations and addressing of patient concerns meeting patients’ expectations. Despite these positive findings, challenges remain in addressing cultural differences, trauma impacts, overcrowding, and understaffing, particularly in conflict-affected areas like Syria. These factors can significantly impact the ability of healthcare providers to maintain privacy and confidentiality, and addressing them is crucial for ensuring high-quality, patient-centered care.
Ensuring Quality of Healthcare and Compliance
Administrative Quality and Referral Mechanisms
The survey highlighted varying levels of administrative quality across the four fields of operation. Lebanon stood out with higher ratings for timely appointments (60%) and personal information updates. In contrast, Syria had the lowest scores, with only 39% satisfaction in personal information updates and 65% for waiting times. Adherence to clinical guidelines was commendably high, especially in Syria, where it reached 99%. The West Bank led in effective referral mechanisms, with 97% satisfaction, while Syria had the highest referral rates to non-UNRWA services at 23%. These disparities in administrative quality and referral mechanisms underscore the need for tailored improvements in each region to enhance the efficiency and effectiveness of healthcare delivery.
Family Health Team (FHT) Approach and Other Medical Services
The Family Health Team (FHT) approach received an overwhelmingly positive response overall, with 88% of respondents expressing satisfaction. However, Jordan reported the lowest approval at 51%. Satisfaction with other medical services was also high, with pharmacy services receiving 94% positive feedback and laboratory services at 97%. Awareness of patient rights and engagement varied considerably, being highest in Lebanon (88%) and lowest in Syria (73%). These findings point to the importance of promoting the FHT approach and enhancing patient rights awareness to ensure a holistic and patient-centered care experience.
Compliance with Standards and Best Practices
General and Specialized Care Compliance
Compliance with healthcare standards and best practices varied across the surveyed regions. Jordan reported the lowest average compliance at 68%, grappling with deficiencies in radiology services and the use of outdated equipment. Lebanon and Syria faced similar challenges, with compliance rates at 72% and 77%, respectively. The West Bank performed the best with an 82% compliance rate. Specialized care compliance was notably high in obstetric documentation and follow-up, reaching 95%. However, areas like preconception care (16%) and oral health screening (44%) showed significant room for improvement.
Non-Communicable Diseases (NCDs) Management
Management of non-communicable diseases (NCDs) was another critical area evaluated in the survey. Lebanon achieved the highest compliance rate at 88%, demonstrating effective NCD management practices. Conversely, Syria reported the lowest compliance at 80%. Common challenges included inconsistent risk scoring methods and frequent medication stock-outs, particularly in Syria. Addressing these inconsistencies and ensuring a steady supply of essential medications are vital steps towards improving NCD management and overall healthcare quality in the region.
Enhancing Facility Management
Administrative Efficiency and Facility Maintenance
Administrative efficiency and facility maintenance showed considerable variation across the fields of operation. Jordan and Lebanon reported high standards, with average positive responses of 89% and 93%, respectively. However, Syria faced significant challenges, with only 79% satisfaction in areas like facility maintenance (66%), cleanliness (68%), and emergency preparedness (8%). The West Bank performed well overall, with a 92% satisfaction rate but highlighted areas for improvement, including patient feedback mechanisms, which received only 17%. These findings illustrate the need for focused improvements in facility management to ensure a safe and efficient healthcare environment.
Patient Flow Analysis
The survey’s patient flow analysis revealed longer average waiting times across the fields of operation, especially in Jordan, where patients reported an average wait time of 147 minutes. Lebanon followed with 96 minutes, while the West Bank and Syria reported 87 and 81 minutes, respectively. Consistent challenges included prolonged waits and scheduling issues, particularly affecting registration, reception, specialist services, and logistical processes. These delays highlight the need for enhanced operational efficiencies to streamline patient flow and reduce wait times, ultimately improving patient satisfaction.
Recommendations for Improvement
Operational and Administrative Enhancements
To enhance patient satisfaction and healthcare service quality, several operational and administrative recommendations were provided. These include upgrading infrastructure for accessibility, particularly in regions like Syria, Lebanon, and Jordan, which were noted for having significant physical accessibility challenges. Implementing robust referral mechanisms is essential for optimizing appointment scheduling and reducing overcrowding. Moreover, standardizing referral processes, especially in Lebanon, and conducting comprehensive studies when necessary, can further streamline patient flow and ensure efficient healthcare service delivery.
Increasing patient awareness and introducing online appointment scheduling systems can significantly improve administrative processes, particularly in Lebanon, where awareness and engagement showed room for improvement. Enhancing clinical practices and treatment plan explanations through provider training in Jordan stands as another critical recommendation. Additionally, campaigns to raise awareness and provide training sessions on the Family Health Team (FHT) approach and specialized services can help address the lower levels of satisfaction observed in some regions. Improving medication counseling, particularly in Jordan, and providing confidential spaces in Syria for pharmacist counseling are also recommended to ensure patient privacy and enhance the quality of care.
Enhancing Telemedicine and IT Systems
The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) conducted a Patient Satisfaction Survey (PSS) to evaluate the quality of healthcare services provided to Palestine refugees. This comprehensive survey aimed to gauge the level of satisfaction among patients in four fields of operation (FO): Jordan, Lebanon, Syria, and the West Bank, including East Jerusalem. However, due to the ongoing conflict that began in October 2023, the Gaza FO was excluded from this survey.
The objective of the survey was to identify areas for improvement by examining the findings, trends, and suggestions provided by patients. By focusing on these insights, UNRWA seeks to enhance the overall patient experience and the quality of healthcare services offered to Palestine refugees.
In this article, we delve into the survey’s findings, highlight notable trends, and discuss key recommendations aimed at improving healthcare services. The data collected provides valuable information that can help healthcare providers better understand patient needs and expectations, ultimately leading to more effective and satisfactory healthcare delivery. By implementing the recommendations derived from the survey, UNRWA aims to ensure that Palestine refugees receive the highest possible standard of care in its various fields of operation.
