Reoperation Krampf]
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    Verletzung des Blutflusses während der Schwangerschaft verursacht Folgen

    Fiala; What Do Patients Want? Technical Quality Versus Functional Quality: While most surgeons are well aware of outcomes studies and quality assessment based on technical quality TQ measurements, there has been little attention given in reoperation Krampf plastic surgery literature to the discussion of functional quality FQ —the process by which a health care service is delivered, as opposed to the actual procedure itself.

    Most patients judge the quality of their hospital experience based on FQ issues. They use their assessment of FQ to secondarily reoperation Krampf a judgment of the TQ level of a surgeon or facility. Surgeons, conversely, reoperation Krampf, typically reoperation Krampf their own success with purely technical quality measures, reoperation Krampf, paying little attention to FQ. This article reviews the relevant service-quality medical literature and introduces plastic surgeons to the importance of differentiating between TQ and FQ.

    Important FQ assessment techniques are reviewed. Implications for the plastic surgeon are discussed. Despite a plethora of publications in the marketing and commerce literature about service excellence and strategies that can be implemented to help achieve it, there is relatively little in the surgical literature about methods to ensure or to enhance service excellence for plastic surgery patients.

    However, a review of both the relevant marketing and non—plastic surgery literature can provide a number of useful insights for aesthetic plastic surgeons. Previous research in this literature shows that physicians and patients display a surprising difference in terms of emphasis when making a judgment about the quality of the surgical experience. Understanding these differences will help plastic surgeons to provide an improved patient experience, leading to increased patient satisfaction and subsequent clinical success.

    Quality is a simple idea, reoperation Krampf, but it reoperation Krampf difficult for reoperation Krampf and experts alike to articulate a precise definition of quality.

    Here, reoperation Krampf, the definition tends to center on patient requirements, reoperation Krampf, and how well surgeons can meet their expectations, reoperation Krampf. Despite its intangible nature, we all instinctively know quality when we see it. Furthermore, reoperation Krampf, efforts to improve quality have real, reoperation Krampf, tangible results.

    Research in a wide variety of business models, including health care, has linked improved quality to improved market share, profitability and net revenue, reoperation Krampf, increased return on investment, reduced manufacturing costs, improved productivity, higher customer retention, positive word of mouth, and patient satisfaction.

    Consumer perceptions of service quality in health care are considered to be Produkt von Krampfadern important for the following reasons: Patients who rate services as being of higher quality tend to be more satisfied, more likely to return again in the future, reoperation Krampf, and more likely to comply with medical advice.

    Patients who rate services as being of higher quality are more likely to recommend a health care provider. Agencies such as The Joint Commission TJC; formerly the Joint Commission Kalanchoe von Krampfadern Bewertungen Accreditation of Healthcare Organizations are now requiring consumer feedback as a condition of accreditation of health care organizations.

    According to the service literature, reoperation Krampf, there are 2 distinct forms of quality: The difference between them is a concept worthy of some discussion. They are ill-equipped to make a rational TQ assessment of a health care provider or system. FQ, on the other hand, is the manner in which services are delivered to customers and represents how the customer experienced the human interactions that occurred during the process.

    It is the way the service is delivered, rather than the service itself. This reoperation Krampf is likely self-evident: During surgical residency, the educational emphasis is on achieving appropriate levels of TQ—performing an operation correctly, in a timely manner, with low rates of morbidity and mortality.

    These thought patterns generally continue after the completion of residency. Therefore, it is not at all surprising that even well-written articles reviewing operative procedures in the plastic surgery literature have traditionally been concerned with complications, reoperation rates, reoperation Krampf, and other TQ metrics, and do not Was ist ein Krampfbeckenvenen explore FQ issues other than in terms of basic questions related to patient satisfaction.

    However, this emphasis on TQ—surgical technique, procedural reoperation Krampf and refinement—is only one part of the total perceived-quality equation mentioned earlier. For excellence in overall service, we need to pay attention to both the TQ- and FQ-related issues. It is here that we as surgeons can learn from our colleagues in other service industries. Skills in customer service are not innately present; they require training and practice to develop.

    In other words, if FQ seems good to the patient, then the TQ of the reoperation Krampf, clinic, or hospital must also be good, reoperation Krampf. Furthermore, it has been previously shown that the TQ of care provided by reoperation Krampf clinician does not typically overcome for systemic shortcomings or reoperation Krampf that exist for the patient elsewhere in the office, reoperation Krampf, clinic, or hospital.

    FQ trumps TQ, for many patients. These are all FQ issues. To add a further element of complexity, reoperation Krampf, research shows that hospital administrators typically value different quality attributes than either surgeons or patients. According to Jun and associates, patients emphasize courtesy, reoperation Krampf, communication, and responsiveness; administrators focus reoperation Krampf competence, understanding the customer, and collaboration; and physicians value TQ issues of competence and patient outcomes, reoperation Krampf.

    If you are like most people, your selection is entirely based on FQ issues, reoperation Krampf, and TQ has little input into your decision. Aesthetic surgeons—members of one of the ultimate service industries—should be aware of and pay appropriate attention to FQ issues.

    They should fully understand the thought process of the prospective patient, and how FQ and TQ both play a role. Does this new awareness of the importance of FQ mean that surgeons should give up on their quest for higher levels of TQ? No—technical excellence is critical to the survival of our specialty. What you say, how and when you say it, and how you behave all matter.

    While patients clearly do appreciate technical excellence, in many areas of health care they actually seem to appreciate functional excellence at least as much, if not more, reoperation Krampf. While it is certainly possible that aesthetic surgery patients may value TQ more than other surgical patients, as of this writing little research has been published on this hypothesis.

    To assess the FQ of a process, there are a variety of qualitative methods that can be used: Expected service is a mixture of customer needs, word of mouth, and marketing communications, reoperation Krampf. The difference between these 2 gives the perceived service quality Figure 1. Grönroos model of perceived service quality. Perceived service quality is based on the difference between the expectations for the service and the actual experience.

    Created from information provided in Grönroos C. A service quality model and its marketing implications. View large Download slide Five-gap theory of customer service, showing the potential areas for service deficiencies at the managerial, marketing and customer service levels. A conceptual model of service quality and its implications for future research. Five-gap theory of customer service, showing the potential areas for service deficiencies at the managerial, marketing and customer service levels.

    The 5-gap model has been found to be applicable in the health care setting 38 and can be used to develop a questionnaire to evaluate physician service quality. SERVQUAL was conceived and reoperation Krampf to be a general-purpose survey instrument that Krampfadern Behandlung in Ryazan be applied across a variety of service industries.

    The 22 pairs of questions are scored on a 7-point Reoperation Krampf scale. Some investigators have developed their own modifications, with different questions and additional categories or dimensions of quality. Overall, while both methods are valid and acceptable, debate continues over the ideal assessment method in the reoperation Krampf care setting.

    The relative importance of the 5 dimensions of quality varies from industry to industry. For example, a study of service quality in information technology organizations showed that reliability and responsiveness were the most important dimensions, reoperation Krampf empathy was the least important. In multiple studies, regardless of the precise methodology, there is a common theme about which dimension matters most to patients, reoperation Krampf.

    Yoo reported that for outpatient medical clinics in Korea, the most important dimensions for customer satisfaction were tangibles and empathy. Commercially available methods used for measuring patient satisfaction include the Press-Ganey Survey, surveys from the Gallop organization, and others. A selection of survey results about key drivers of patient satisfaction is shown in Appendix B available at http: Patients were most satisfied by hospitals and clinics where their needs Walnüsse Varizen anticipated and where they were treated by a caring, sensitive, and compassionate staff.

    As mentioned previously, it remains to be shown whether or not aesthetic plastic surgery patients share this view—the data shown in Appendix B, admittedly, are from reoperation Krampf general hospital population. This is shown in the model proposed by Naidu Figure 3. Created from information provided in Naidu A. Factors affecting patient satisfaction and healthcare quality. Of note, not all experts in this area feel that a complex survey instrument must be used to assess the patient experience.

    Reichheld, who is well known for his work on customer loyalty, feels that only a single question needs to be asked: The research into service quality in plastic surgery is in its early stages. Chung and associates from the University of Michigan used a 9-item questionnaire, called the VSQ, to evaluate patient satisfaction in a general plastic surgery outpatient clinic.

    Interestingly, in their research the length of waiting time in the clinic was not found to be significant. Babakus and associates used a modified question SERVQUAL survey combined with open-ended questions to study attitudes among patients who had undergone either cosmetic or reconstructive breast surgery in a US metropolitan area during Finally, perhaps there is a self-serving reason for surgeons to take an interest in patient satisfaction and FQ: Other industries, notably tourism and hospitality, have long mastered the art of delivering first-class service.

    Prospective aesthetic surgery patients are increasingly knowledgeable, often as a result of online research. They shop for their elective plastic surgery services, comparing the options. They expect value for reoperation Krampf money, and they expect to be cared for well. Mayer and Cates 66 describe a continuum reoperation Krampf patient and customer status.

    Patients, in their analysis, tend to be acutely ill or injured, are more dependent on the physician, have less choice, and require technical expertise in a time-dependent manner. Customers, on the other hand, are less severely ill, are more independent, have more choice, and their treatments are much less time critical. They reoperation Krampf more service skills.

    Mayer and Cates summarize the situation as follows: The more vertical they are, the more they are a customer. Methodology for these assessment and improvement processes will be discussed in a future article. The total perceived quality of a service is made up of both TQ and FQ reoperation Krampf. Surgeons value the TQ of the procedure itself, while patients instead tend to make judgments based on the FQ of the service—their experience with the people and systems in the health care setting associated with the performance of the procedure.

    Thus, surgeons and patients rate quality in different ways. FQ is measureable and a number of useful survey instruments exist for this purpose. Overwhelmingly, these show that patients highly value was für Tabletten von Thrombophlebitis zu trinken, compassionate care, and communication. TQ, surprisingly, is not always the sole or most important determinant of patient satisfaction, reoperation Krampf.


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