Quantitative and qualitative assessment of women's experience of a one‐stop menstrual clinic in comparison with traditional gynaecology clinics

Abstract

f Objective A quantitative and qualitative evaluation of the views of patients attending two types of clinics for menstrual disorders. Methods Semi-structured qualitative interview and quantitative questionnaire.Setting Five traditional general gynaecology clinics and a one-stop menstrual clinic, where investigations are performed and results given to patients on the same day.Participants Two hundred and thirty-nine women (126 from the gynaecology clinic and 113 from the menstrual clinic) were recruited into the quantitative study; 18 and 26 patients from the gynaecology and the menstrual clinic, respectively, were interviewed for the qualitative study. Main outcome measures Women's views about their care and progress towards resolution of their problem.Results Following the initial consultation, 106 (84%) of the gynaecology clinic, and 98 (87%) of the menstrual clinic patients completed the ®rst part of the questionnaire. Of those, 75 (71%) and 79 (81%) patients from the two types of clinic, respectively, completed a follow up questionnaire one year later. There were statistically signi®cant differences in all the components of the ®rst part of the questionnaire (information, continuity, waiting, organisation, and limbo) in favour of the one-stop menstrual clinic. After one year, there was a statistically signi®cant difference in one of the components, patient centeredness, but not in overall process co-ordination. The interviews showed that patients attending the menstrual clinic appreciated getting the results of their investigations on the same day. They also found the organisation of the one-stop menstrual clinic more closely suited to their needs and as a result were more likely to feel they were making progress.Conclusion Women were consistently more positive about their experience in the one-stop clinic. One-stop clinics organised to meet the needs of patients might be appropriate for other clinical conditions. The combination of quantitative and qualitative methods is an effective method of assessing patients' views of health services.

Qualitative methods in research on healthcare quality

“…Qualitative methods have also been used to guide the design of a new "one stop" clinic for women with menstrual problems and to evaluate the service from the patient's perspective. 22 Box 3 The coding process (1) As the researcher comes across an idea or phenomenon, a label is attached. A fragment from adolescent girls' focus groups 9 : "I always talk to my mother because I can tell her everything.…”

An integrated care pathway for menorrhagia across the primary-secondary interface: patients' experience, clinical outcomes, and service utilisation

“…Using patient career diaries, assuming a mean score of 80 for the patients treated using the OSMC, 12 and an SD of 18 in each group, we calculated that 81 patients would be needed for each group to detect a clinically important change in score of 10% with 80% power and p,0.05. We aimed at recruiting 100 patients for each group to allow for dropouts.…”

“…Our results are significant as we compared the Bridges model with a one-stop clinic which was associated with considerable improvement compared with the traditional clinic. 12 Possibly, a randomised controlled trial would have yielded more robust conclusions, but this would not have been feasible in the current structures in primary care without a considerable risk of contamination. Although this model has the potential to be applied to areas other than menstrual problems, it is not possible to extrapolate directly from our findings to other areas, and there is a need for further research with different patient groups and disease conditions.…”

“…Although the results from the PCD suggest that the impact of the new pathway may blunt over time, this is not surprising and is consistent with our observation in the OSMC compared with the traditional gynaecology clinic. 12 Health status (SF-36) and menstrual status questionnaires demonstrated that both pathways produce comparable health outcomes. We remain uncertain of the clinical significance of the more favourable role-emotional score for patients attending the OSMC.…”

“…The clinic provides same day service for consultation, investigation, results (including histopathology) and initiation of treatment. 12 …”