Public Health Institutions (Primary and Secondary)

are under-utilized and have unequally distributed

patient footfall.

One of the main Reason:-

◦ Attitude of the healthcare professionals including

support staff, is more mechanical than

empathetic, towards providing services to the

patients.

Consequences:-

◦ Over-burden of Tertiary care and some selected health

facilities.

◦ Increased footfall in private organized and

unorganized sector.

◦ And the result is, increased Out-of-Pocket

Expenditure by the patients and unequal distribution

of the patients in the healthcare institutions.

Will the behavior and attitude change training

programme for the healthcare professionals

(including support staff) employed in the public

health institutions (5 PHCs in Chaksu- selected by

RCT) of Jaipur district leads to development of an

empathetic way of care rather than a mechanical

approach to create a culture of patient friendly

environment ?

Aim: To increase the retention of patients in the

public health institutions , by creating goodwill of

the concerned institution while improving the

communication and interaction strategies of

healthcare professionals.

Objective(s):

◦ To inculcate a culture of empathy in patient

care, by improving the behavior and attitude of

healthcare professionals including the support staff.

◦ To develop an intervention for providing training to

the healthcare professionals for behavioral and

attitudinal changes in the working environment.

Description of Intervention:◦ Process of intervention:

Base-line study of patient satisfaction with

respect to behavior and attitude of healthcare

professionals.

Target Group Intervention

Pre-testing the Intervention

Final Intervention

End-line study of patient satisfaction with respect

to behavior and attitude of healthcare

professionals.

◦ Modes of Intervention:

Stage 1: Power-point Presentation in all the 5 PHCs of Chaksu to all the healthcare professionals Objective: Importance of intervention, how to

communicate in different situations like emergencies, epidemics, peak hours, etc.

Stage 2: Focused Group Discussions and Coping strategies

Stage 3: Group Activities (Mock activities)

Stage 4: Special Training to understand the psyche of the patient Objective: How to interact with patients to develop trust

and faith

Stage 5: Awarding the best performing healthcare professional at the end of the month.

Phases of Intervention:

◦ Pre-Intervention Phase:

Base-line Study

Stakeholder Analysis

Healthcare Professionals

Government

Patients and patient attendants

◦ Implementation Phase:

Experimental study (RCT)

Training to healthcare professionals with different means

◦ Evaluation Phase:

Indicator: Parameter to judge the change of Behavior and

attitude of healthcare professionals before and after

provision of Trainings.

Monitoring Framework:

Phase 1 Monitoring- Monitor the base-line study

Phase 2 Monitoring- Monitor the stage 1 intervention

Phase 3 Monitoring- Monitor the stage 2 intervention

Phase 4 Monitoring- Monitor the stage 3 intervention

Phase 5 Monitoring- Monitor the stage 4 intervention

Phase 6 Monitoring- Monitor the stage 5 intervention

Phase 7 Monitoring- Monitor the end-line intervention

Mechanical culture of patient care

Patient friendly empathetic culture of patient care

Challenges

Special StrategiesOf Intervention

The training moderators should not blame the health care professionals in any way.

The self esteem of each participating individual should be kept in mind.

Their willingness for undergoing trainings should be considered.

The objectives of the intervention should be clearly conveyed to all the trainees beforehand.

Ethical committee should be there for providing guidance.

Sr. No. Event Duration in days

Immediate predecessor

Phase 1: preparatory

phase

35

1. Selection of the study area 7 -

2. Permission from the higher authority

7 1

3. Preparation of the training material and training the master trainers

7 1

4. Preparation of the questionnaire

7 1

5. Pre test 3 2,3,4

6 Finalized the schedule 4 5

Sr. No. Event Duration in days

Phase 2: Baseline

study(all 5 PHC)

14

7. Data collection 14 6

Phase-3:Intervenation 52

8.Stage-1: Power point presentation at all 5 PHCs

10 5

9.Stage-2: FGD 14 8

10.Stage-3: Group Activities 14 9

11.Stage-3: Special training session 14 10

12. End line evaluation 7 11

13. Analysis and report writing with dissemination

7 12, 7

Activity time Early Start Early Finish Late Start Late Finish Slack

Project 83

1 7 0 7 0 7 0

2 7 7 14 7 14 0

3 7 7 14 7 14 0

4 7 7 14 7 14 0

5 3 14 17 14 17 0

6 4 17 21 58 62 41

7 14 21 35 62 76 41

8 10 17 27 17 27 0

9 14 27 41 27 41 0

10 14 41 55 41 55 0

11 14 55 69 55 69 0

12 7 69 76 69 76 0

13 7 76 83 76 83 0

GANTT CHART

BACKGROUND LITERATURE REVIEW

A Contribution to the Philosophy of medicine The Basic Models

of the Doctor-Patient Relationship ;THOMAS S. SZASZ, M.D.;

MARC H. HOLLENDER, M.D. ; Arch Intern Med. 1956;97(5):585-

592.

GAPS IN DOCTOR-PATIENT COMMUNICATION: Doctor-

Patient Interaction and Patient Satisfaction ; Barbara M.

Korsch, Ethel K. Gozzi, Vida Francisempathy

Patient-Physician Communication: Why and How :John M.

Travaline, MD; Robert Ruchinskas, PsyD; Gilbert E. D'Alonzo Jr,

DO

Effective Patient - Doctor Communications ; Trisha Torrey