الفهرس 
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Abstract
Diabetes mellitus is a chronic progressive medical condition in which the levels of glucose in the blood are too high. These elevated glucose levels are due to the failure of the pancreas to produce enough of the hormone insulin (which controls the levels of glucose) or the inability of the body to make use of the insulin available.
The simplest and perhaps the most comprehensive definition of quality is that used by advocates of total quality management (TQM) is ’’doing the right things right the first time and every time’’. What are the right things? How are the right things done right? To answer these questions standards were created, so that quality can be said to be, at least in part, compliance with standards.
The current study aimed to improve quality of health care services provided to diabetic patients attending to outpatient clinic in MUST hospital during the period from April 2010 to May 2011.
To detect patient satisfaction with the provided health care services 400 patient were included in the study and to detect the provider satisfaction 15 doctors were included in the study.
Also the adherence between the ADA standards of diabetes care and the performance of doctors in outpatient clinic was measured using a direct observation checklist.
Interview questionnaire used to assess the level of satisfaction of the included patients but a self administered questionnaire used to assess the level of satisfaction of the studied doctors.
Before start in collection of data a pilot study was done to detect the reliability of the used questionnaire.
Statistical analysis was carried out. In the current study most of the studied participants were in the age group less than 50yrs. Males represent 60.8% of the studied candidates, while females represent 39.2%. As regard marital status 62.5% of the samples were married. As regard educational level of the patients about 60% of the studied candidates were average educated. Officers represent 50% of the studied sample. 29% of the studied candidates live in Abo Rawash.
The results of the study revealed that 97.5% of studied sample were satisfied with the space of the waiting room and 57.75% of studied patients were satisfied with the cleanliness of waiting place. Lighting of waiting place. About 81.5% of studied patients were dissatisfied with waiting time before entry to doctor.
Concerning change of bed cover after each examination 73% of the studied candidates said that that it is not changed. But about 62 % of them stated that there is a useful water basin and a curtain beside the examination bed.
When asked about nursing srviseces in the clinic 85.75% of the studied patients were dissatisfied with help of nurse to doctors during examination.
As regards patients’ satisfaction with doctors’ services 89% of studied patients were dissatisfied with doctor listening to them also 75% of studied patients were dissatisfied with consultation time.
Regarding preventive advises to avoid compli-cations of diabetes about 71% of the studied patients were dissatisfied and 4.5% of them were completely dissatisfied.
The statistical analysis of the collected data revealed that 75% of studied sample were dissatisfied with clinic privacy during clinical examination. About 88 % of studied sample were dissatisfied with doctor accessibility, regarding follow-up system in outpatient’s clinic 88% of the studied patients were dissatisfied.
Regarding clinical practice in the clinic 92% of the studied patients reported that there blood pressure was measured every visit. As regard foot examination every visit, 51% of studied diabetic patients stated that it is not done. About 70% of studied patients reported that renal functions tests were not requested every 6 months.
Concerning requested investigations 76% of the sample stated that urine analysis not requested every year. 68.5% of the studied patients answered NO when asked if HBA1C (Glycosoliated hemoglobin) requested every 3 months and also 77.5% of them answered NO when asked if fundus examination requested every year but when asked about diet 61% of them answered Yes.
The statistical analysis of the collected data from provider satisfaction questionnaires revealed that 70% of studied doctors were dissatisfied with the money recourses of the clinic and also 65% of them were dissatisfied with manpower recourses of the clinic.
As regard specific objectives of the clinic 87% of studied doctors were dissatisfied. 55% of doctors were dissatisfied with the policies for work in clinic and 76% of them.
Concerning referral system 67% of doctors in the study were satisfied with the referral system.
In the current study 81% of doctors were satisfied with filing system and 80% of studied doctors were satisfied with the statistical reports system in the clinic.
Doctors (Providers) satisfaction regarding administrative issues revealed that about 78% of doctors in the study were dissatisfied with working in the clinic as a team and also about 85% of doctors were dissatisfied with the response of managers to their needs. As regards sharing with managers in decision-making 85% of doctors were dissatisfied.
Statistical analysis of data obtained by a direct observation checklist revealed that about 61% of doctors in the study asking patient about his name and 35% of doctors taking a verbal consent from patient before starting examination. Only 4.6 % of doctors welcoming their patients.
Regarding clinical examination 52% of doctors in the study examining food of their patients every visit and only 13% of doctors examine fundus of their diabetic patients.
Concerning requested investigations by direct observation checklist 68% of doctors in the study measuring blood pressure of their patients every visit and only 32% of doctors requesting measure of glycosylated hemoglobin of their diabetic patients, weight and diet assessment about 58% of doctors requesting.
The current study revealed that the average waiting time of patients before entering to doctor was 16 minutes and the average time of consultation was 9 minutes