title: Listening to patients: improving the outpatient service.
abstract: OBJECTIVE
  This paper assesses the patients' healthcare information needs and expectations when they attend a rheumatology outpatient clinic. It proposes that obtaining the patients' perspectives about the services they use is an essential service-development tool. The aim of this paper is to expand the current domains used to evaluate these perspectives.
  
  
  METHODS
  This paper is an exploratory study, looking at quality assessment and improvement based on Donabedian's quality model in a rheumatology outpatient setting. A structured interview schedule addressing care pathways was used and 70 consecutive patients were recruited.
  
  
  RESULTS
  The article provides insights about how relevant change can be brought about when service development is contemplated. It suggests that patients are important stakeholders in the ongoing service development process.
  
  
  CONCLUSIONS
  Because rheumatological conditions tend to be chronic and require long-term follow-up, the results may lack generalisability. Therefore, researchers are encouraged to test propositions in different clinical settings.
  
  
  CONCLUSIONS
  The article highlights healthcare delivery areas that are not meeting patient expectations. Some recommendations (such as informing waiting patients regularly about any delays) require minimal additional resources for successful implementation. Service providers need to obtain the patients' healthcare perspectives to ensure that services are built around their needs.
  
  
  CONCLUSIONS
  This article fulfils an identified need to study how patients perceive service quality.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Mercieca
authors.forename: Sara
authors.initials: S
authors.lastname: Cassar
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Borg
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000592:standards*; D001071:Appointments and Schedules; D003142:Communication; D005260:Female; D006272:Health Facility Environment / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D012216:Rheumatic Diseases / Q000523:psychology / Q000628:therapy*