https://www.um.edu.mt/library/oar/handle/123456789/63404 Thu, 16 Apr 2026 05:13:31 GMT 2026-04-16T05:13:31Z https://www.um.edu.mt/library/oar/handle/123456789/44640 Title: A comparison of the users' opinions of the services provided by Zammit Clapp Hospital. Abstract: Many geriatric hospitals, as is the case of Zammit Clapp Hospital, are specifically devoted to preventing life-long hospitalisation or institutionalisation. However, achieving this goal is no easy task. It requires much effort and a constant monitoring of the quality of medical, technical, inter-personal and supportive services provided by the hospital to its patients. An important part of this auditing exercise involves the securing of the users' opinion of the type and quality of services provided. Due to the difficulty in eliciting information from the elderly patient, it is not rare for this information to be obtained from the patients' relatives and taken to represent patient (users) opinion. This study attempted to investigate the use of relative opinion in lieu of patient opinion by verifying whether or not second user opinion (relative) accurately represents first user opinion (patient). Following this line of reasoning, the study identified four user groups - the able patient, and his relatives, the unable patient and his relatives. By definition, the unable patient could not be involved in this study. Thus, to each of the other three user groups, 2 questionnaires were given. The first was to be completed on admission and attempted to measure their expectations and weighted importance for a number of service attributes. The second questionnaire was completed just prior to discharge and primarily measured their perceptions of the same service attributes. The employed questionnaires drew their composition and design from the quoted SERVQUAL model and Donabedian's framework of hospital service quality. Extensive literature review provided extra support to serve the purposes outlined. Comparison of questionnaire results of all user groups showed that for all questions asked, no statistical significant differences between the groups were found. The first hypothesis "the relatives' expectations and perceptions of the services provided by Zammit Clapp Hospital will be different from those of the patients themselves" was not supported. The second hypothesis "there will be no difference between the expectations and perceptions of relatives of patients who can make their views known, than those of patients who are unable to do so" was supported. It would appear that using relative as proxies may be justified. This study does also show that in the opinion of the users of the service (both patients and relatives) the services provided at Zammit Clapp Hospital are highly regarded and generally match expectations. Furthermore, the management finding that the majority of patients are returning to the community is also supported by both patients' and relatives' views. However, some limitations and observations were made on the interpretation of these results. Patients and their relatives, have valuable information to give to the hospital for the improvement of its service product. Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 1997 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/44640 1997-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/43186 Title: Evaluating clinical outcomes on implementing and managing team midwifery in Malta. Abstract: This study explored the need of enhancing clinical documentation through the Total midwifery care is provided to pregnant women by small teams of midwives within a Team Midwifery System of Care. The purpose of this study was to change the fragmented care given in Traditional Systems of Care, into a Team Midwifery System of Care. This system was hypothesised to provide clients with continuity of care by known carers throughout the three phases of childbirth: antenatal, intrapartum, and postnatal care. This change was to result in a reduction in the use of analgesia in labour and in obstetric interventions. These same parameters were hypothesised as being beneficial to Team Midwifery clients when compared with Traditional Systems' clients. Lewin's (1951) Force-Field Change Model was utilised to implement and manage the change. A convenience sample of 294 women was divided into three groups: a Team Midwifery Group, run by midwives, private care and hospital care control groups, run by obstetricians and general practitioners. The control groups served as a comparison in this quasi-experimental design. Assignment of "Low Risk" women to the Team Midwifery System Group was voluntary. Matching criteria - parity, expected and actual dates of delivery - were used to form the control groups. Information was collected from the women's case notes and pregnancy co-operation cards. Group differences were analysed using Chi Square Tests. Of the four hypotheses tested in this study, only the one regarding known carers at delivery, yielded statistical significance for the Team Midwifery Group. Results addressing all other levels of care were similar in all three groups. This suggests that the Team Midwifery System of Care is a viable supplement to present day care. Further studies are needed to plan the integration of Team Midwifery and the concept of continuity of care into the present day system. Description: M.SC.HEALTH SERVICES MANGT. Wed, 01 Jan 1997 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/43186 1997-01-01T00:00:00Z