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Arch Dis Child. 2007 July; 92(7): 653–654.
PMCID: PMC2083802

An immunisation clinic: care, comfort and convenience

Child immunisation is predominantly provided in primary care by health visitors, practice nurses and general practitioners. Immunisation queries are dealt with in several ways depending on local expertise, for example telephone advice (health protection unit or community paediatrician) or by a clinic visit (general paediatric or immunisation clinic).

In Stockport a referral service for immunisation has existed for over 15 years. Children are assessed, investigated and immunised as appropriate, either in the clinic or under observed conditions on the paediatric ward. The service has close links with clinical and laboratory immunology services.

Most children who attend the immunisation clinic are well. They may have an underlying medical condition that affects their immunisation schedule or have an immunisation problem causing parental anxiety.

We undertook a postal satisfaction survey of parents whose children attended the clinic between April 2005 and November 2005. A questionnaire was constructed to measure clinical quality1 and outpatient department satisfaction, and it was sent to parents 2 weeks after their child completed his/her episode of care. It assessed five domains using a 5‐point Likert scale rated from “poor” to “excellent”. Domains included “pre‐arrival” (information, convenience of appointment time and location), “on arrival” (directions to clinic, promptness of attention and waiting time), “amenities” (quality of refreshments, toys, toilet and disabled facilities), “consultant care” (privacy, listening, use of plain language and involvement in decision making) and “clinic care” (cleanliness, courtesy and understanding the child's needs).

Seventy nine of the 149 (53%) questionnaires were returned. Of the 79 children, 37 (47%) were male, 42 (53%) were female and 50 (63%) were less than 2 years of age.

Satisfaction with clinical care was high (satisfaction score 4.6). Comments by parents suggested that teamwork and having sufficient time to discuss immunisation were important factors. In England lack of time to discuss immunisation with a health care professional is one of the commonest causes of dissatisfaction with the immunisation visit.2

figure ac115600.f1
Figure 1 Satisfaction scores for the immunisation clinic.

The “amenities” domain was the lowest scoring (satisfaction score 3.9). Important factors included lack of refreshments (the clinic is located some distance from the canteen) and problems with car parking. Car parking is important for parents with young children and this problem has been reported previously.3 We suspect that it is an important issue in many paediatric outpatient departments.

Similar surveys4,5,6 have identified high levels of satisfaction with clinical care. This survey highlighted to us that non‐clinical factors are important for patient experience and that small changes within the clinic can lead to perceptible improvements for patients.

Footnotes

Competing interests: None

References

1. American Board of Internal Medicine Using patient satisfaction questionnaires (PSQs) for recertification. Philadelphia: ABIM, 2002, http://www.uthscsa.edu/gme/nsgeval.pdf (accessed 4 April 2007)
2. Yarwood J, Noakes K, Kennedy D. et al Tracking mothers' attitudes to childhood immunisation 1991–2001. Vaccine 2005. 235670–5687.5687 [PubMed]
3. Witchell L, Lester S. Ask the children – auditing children's services with PALS standards. Paediatr Nurs 2005. 1734–36.36 [PubMed]
4. De Bruin C, Howell F, Bedford D. et al Outpatient experiences in acute hospitals. Irish J Med Sci 2002. 17189–93.93 [PubMed]
5. Robinson R O, Edwards M, Madigan C. et al Audit of a children's epilepsy clinic. Dev Med Child Neurol 2000. 42387–391.391 [PubMed]
6. Sullivan P B, Burnett C A, Juszcak E. Parent satisfaction in a nurse led clinic compared with a paediatric gastroenterology clinic for the management of intractable, functional constipation. Arch Dis Child 2006. 91499–501.501 [PMC free article] [PubMed]

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