Methods: We conducted a mixed-methods analysis of descriptive statistics using R, (Version 3.5.0) and qualitative analysis of interview data using ATLAS.ti (Version 8.3.1) to categorize common themes reported by staff on their perspectives of patient satisfaction, patient-centered care and recommendations for improvement.
Results: Mean age of survey participants was 40 years, and 72% female. Analysis of time data showed the average wait from arrival at the clinic to seeing a provider was 2h, 10min. The longest wait interval was from arrival to registration which took an average of 1h 14min. The patient-reported average wait time to provider was 1h, 45min, which was considerably less than the actual wait. For patients, the areas of least satisfaction were the service hours, time waiting for providers, and cost of treatment. Patients were most satisfied because they received their medication and many felt they were provided good and quick service. Results from in-depth interviews with staff showed that staff shortage, service fees, and lack of staff salary for 4 months are causes for decreased patient satisfaction. Staff suggested that more staff be hired, the patient service fee should be removed, staff should be paid promptly, and staff should receive continuing education on counseling and appropriate patient treatment.
Conclusion: Patients reported good satisfaction regarding their services and care in relation to their previous experiences of HIV care, which historically included limited medication availability and all day clinic appointments. There was potential issues with Hawthorne Effect as patients stated services were better or faster on this particular day compared to other days. Extended waiting time due to staff shortage was a major source of patient dissatisfaction. Both patients and staff had similar insights regarding areas of dissatisfaction and recommendations for improvement.