title: Assessing obstetric patient experience: a SERVQUAL questionnaire.
abstract: OBJECTIVE
  Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues.
  
  
  METHODS
  This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed.
  
  
  RESULTS
  Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services.
  
  
  CONCLUSIONS
  The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures--between locally responsive and externally comparable.
  
  
  CONCLUSIONS
  The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.
authors.affiliation: Obstetrics and Gynaecology, The Great Western Hospital, Swindon, UK.
authors.forename: Francesca
authors.initials: F
authors.lastname: Garrard
authors.forename: Harini
authors.initials: H
authors.lastname: Narayan
mesh_terms: D005260:Female; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D017060:Patient Satisfaction; D011295:Prenatal Care / Q000379:methods / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom