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|a Given the emphasis on patient satisfaction as a quality indicator in health care, it is considered an important outcome measure. How and when such a measure is undertaken influences how patients and their families respond. Some patients and families find it difficult to know how service decisions are made, when interventions should be undertaken and what they should expect regarding their care and discharge. Therefore, these factors present a challenge for gathering feedback in the form of a satisfaction survey, whether by self report, focus group, face-to-face or telephone interviews. The research literature suggests there is a need to review quality monitoring processes to ascertain how information is gathered and how the processes required are conveyed to patients in ways that they can readily respond to. The interest in gaining feedback from patients and families is generally driven by a desire to highlight the aspects of service that require change or improvement. However, any resulting service changes ought to be in the best interests of the patient and family, with a shared investment in ensuring the best outcomes for all including the institution and the health professional staff. Therefore, careful consideration needs to be given to what to measure and how to measure it. A first concern is the reliability and validity of the data gathering tool which affects the specificity and usefulness of the information gathered. Ware (1981, 1983) cautions that it is wrong to equate all patient survey information with satisfaction, as there are differences in expectations and time frames of care. Where the patients are at on their journey of recovery or care is also influential. Jenkinson et al (2002) agrees with Ware in that patient satisfaction scores are limited, and measuring patient's experiences can be more useful toward improving healthcare. Ovretveit (1998:244) believes that patients will only communicate their perceptions and experiences depending on: How easy it is for them to do so; Whether they think the staff really want to know; How strongly they feel; Their social background; Their personality; Their personal state at the time; and Their wish to make things better for other patients. Ovretveit (1992) emphasizes that healthcare quality has three dimensions: quality for clients, professional quality and management quality, and involves a set of methods with its own philosophy. However, when services are under more pressure than ever, it is extremely difficult to find development finance to invest in a quality programme, along with the time and energy of staff to apply these methods‖ (Ovretveit, 1992:7). The purpose of this literature review is to identify the involvement of older adults in service delivery quality monitoring processes.
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