Improvement of responsiveness at a clinic setting in secondary care Hospital in Sri Lank

Introduction Responsiveness is defined as “how well the health system meets the legitimate expectations of people for non-health aspect of health care. Improving the training of health care workers in health system responsiveness, improving the processes in a health setting,s and providing basic amenities are very important to achieve a high level of responsiveness. Aims To improve the level of responsiveness at the medical clinic in the base hospital, Balapitiya and to develop and implement strategies to improve the level of responsiveness Methodology This is an interventional research project conducted from December 2018 to June 2019 in the medical clinic at the base hospital Balapitiya. Patients who were treated for more than 3 months at MC in BHB were included in this project. Data was collected by using an interviewer-administered structured questionnaire, KII, and structured format to assess the waiting time in both pre and post-tests. A study was conducted in three components including pre-interventional assessment, intervention, and assessment of post-interventional improvement of health system responsiveness. The post-test sample was compared with the pre-test sample by using an independent t-test. Results The overall responsiveness had significantly improved in the post-test sample (p = 0.001). The specific domains like dignity (p = 0.00), communication (p = 0.00), confidentiality (p = 0.00) and prompt attention (p = 0.00) improved significantly. Although, three domains including autonomy (p = 0.130), choice of provider (p = 0.786) and basic amenities (p = 0.174) were not improved significantly. Conclusions Findings of this project indicate that improving the knowledge, attitudes of health care workers through comprehensive training programs in health system responsiveness improving the processes in health care settings, and providing basic amenities to the patients will improve responsiveness. It further recommended adopting the intervention in other units of the hospital to improve overall health system responsiveness. Keywords: Responsiveness, Medical clinic, Process improvement