title: In the eyes of the beholder:assessment by clients on healthcare delivery in a large teaching hospital in Ghana.
abstract: BACKGROUND
  Improving quality of health care delivery is a primary goal of all health care institutions. Health care systems face challenges in providing quality health care to the citizenry due to rising health care cost and clients demanding higher standards of care.
  
  
  OBJECTIVE
  The study aimed at finding out clients' perceptions of the quality of health care delivery at the tertiary care level in Ghana, using the Central Outpatient Department (COPD) of the largest teaching hospital in Ghana as a case study.
  
  
  METHODS
  Overall 665 clients were selected through systematic random sampling procedure over a four-week period, between September and October 2010. Clients were interviewed after a visit to the COPD of the hospital during the survey period using a structured questionnaire.Two focus group discussions were held for clients during the period.
  
  
  RESULTS
  Majority of clients (56%) were females and most (84%) were clients coming for review. During the focus group discussion, clients'considered one hour as the mean maximum time they would like to wait while seeking medical help,however, more than half of clients (51.9%)waited for over an hour (after registration) to see a doctor. About 86% had their condition explained to them and 87% were physically examined. In all, 83% of clients were satisfied, and 6% very satisfied with care given at the COPD. Clients however, considered poor attitude of some health workers, long waiting times,late starting times of clinic, uncomfortable physical environment and inadequate staff as being detrimental to the effective delivery of quality healthcare.
  
  
  CONCLUSIONS
  Overall quality of health care as measured by the indicators used were generally perceived to be high except with client waiting time for services, lack of directional signs in the hospital and an uncomfortable waiting area at the COPD. There were concerns about attitude of some staff and late starting times of outpatient clinics. These when addressed would further improve quality.
authors.affiliation: Public Health Unit, Korle-Bu Teaching Hospital, P.O. Box KB 77, Korle-Bu, Accra, Ghana.
authors.forename: A E
authors.initials: AE
authors.lastname: Yawson
authors.forename: A J
authors.initials: AJ
authors.lastname: Hesse Afua
authors.forename: P K
authors.initials: PK
authors.lastname: Amoo
authors.forename: A C
authors.initials: AC
authors.lastname: Reindorf
authors.forename: H N
authors.initials: HN
authors.lastname: Seneadza
authors.forename: A N
authors.initials: AN
authors.lastname: Baddoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D005869:Ghana; D019538:Health Care Surveys; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult