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Background: There are a number of different anesthetic techniques used in same-day surgery. The aim of the present study was to try to describe the postoperative clinical course and to identify factors that may be associated with the delay time from the surgical procedure was completed until discharge from hospital when intravenous anesthesia was used. Methods: A Quantitative Cross- sectional designed was used by using a self-designed questionnaire. Results: Total of 289 patients were enrolled in the study. The mean age was 40 years and 63% were women and 37% men. Of the 289 patients’ only one required unanticipated admission over night at the hospital. The median delay from completed surgery until discharge from hospital was 2 hours and 5 minutes and the maximum delay was 5 hours and 55 minutes. All patients received general anesthesia with an intravenous as maintenance anesthesia. Important risk factors for increasing postoperative delay were the severity of the postoperative pain and thereby the requirement of opioids in the postoperative phase Conclusion: Then undergoing daytime surgery the median delay from completed surgery until hospital discharge was about two hours. Problems with postoperative pain was associated with a prolonged delay. Thus, in order to shorten the delay to hospital discharge even further the pain-relieving treatment needs to be enhanced.

No / OBJECTIVE: To develop, validate and apply a scale to measure patient satisfaction in a randomised controlled trial of community pharmacy service. METHODS: Published scales were reviewed to inform development of the patient satisfaction scale. Questionnaires were sent to patients in the control (n=500) and intervention (n=941) groups of a randomised controlled trial of community pharmacy-led management of coronary heart disease at baseline and 12-month follow-up. Any underlying main factors were assessed with exploratory factor analysis. Reliability and construct validity were tested. The 15-item scale was used to compare patient satisfaction across arms with their most recent pharmacy visit. RESULTS: Response rates were 92% (461/500) for control and 96% (903/941) for intervention groups at baseline and 85% control (399/472) and intervention (810/941) at follow-up. At baseline satisfaction was very similar in the intervention and control groups (median scores of 42). At follow-up mean satisfaction had significantly improved for the intervention compared with the control (median scores of 46 compared with 43; P<0.01); intervention females were more likely to be satisfied with the service than males (49 compared with 44; P<0.01). Three main factors explained the majority of the data variance. Cronbach's alpha was 0.7-0.9 for both groups over time for all factors and total scale. An increase in the overall satisfaction corresponding to a decrease in subjects wanting that particular service to be provided during their next visit indicated construct validity of the scale. CONCLUSION: A new scale of patient satisfaction with community pharmacy services was developed and shown to be reliable and valid. Its application showed increased satisfaction in the intervention group receiving a new pharmacy service.

No / Aims and objectives; We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient satisfaction and in linking qualitative findings with trial results are explored. Design A sample of 13 patients randomized to the community hospital arm of the RCT joined the qualitative study. Official documentation from the hospital were accessed and six staff interviewed to identify assumptions underlying practice. Results Analysis of interviews identified a complex picture concerning expectations These could be classified as ideal, realistic, normative and unformed. The hospital philosophy and staff views about service delivery were closely in harmony, they delivered rehabilitation in a home-based atmosphere. The formal, or 'hard', process of rehabilitation was not well understood by patients. They were primarily concerned with 'soft' or process issues ¿ where and how care was delivered. Conclusions We identify a model of community hospital care that incorporates technical aspects of rehabilitation within a human approach that is welcomed by patients. If patients are to be able to participate in making informed decisions about care, the rationale for the activities of staff need to be more clearly explained. Recommendations are made about the appropriate scope of qualitative findings in the context of trials and about techniques to access patient views in areas where they have difficulty in expressing critical impressions.

No / Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. STUDY OBJECTIVES: This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? METHOD: 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. RESULTS: 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. DISCUSSION: Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.

This study aimed to explore existing quality improvement activities in primary health care setting in South Africa. Two sets of questionnaires were used to collect data from both patients and nurse managers. Findings indicated that clinics were generally acceptable and affordable to patients, but should operate for longer time-periods, that sorting of patients and long waiting times, coupled with short consultation time-periods, warranted immediate remedial actions. Only five of the fourteen listed quality initiatives were satisfactorily practised. It was concluded that despite many obstacles and difficulties as mentioned by respondents, the issue of quality-improvement in primary health care is receiving attention, but should still be improved to a greater extent. / Health Studies / M.A. (Advanced Nursing Sciences)