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Improving patient satisfaction during obstetretic preassessment clinics, using a photobook to enhance information delivery and closing the loop

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Visual aid to improve patient satisfaction with obstetric pre-assessment clinics


Patient satisfaction is an important and commonly used indicator for measuring quality in health care. The obstetric population are younger, information seeking and want choice. It is important to convey information in both verbal and visual forms to help with understanding in a population with varied education levels and language skills.

We run an anaesthetic pre-assessment clinic for women undergoing elective caesarean delivery. The anaesthetic plan is discussed with the patient and a written leaflet is given to reinforce this.


•To assess patient satisfaction of clinic attendees with the verbal and written anaesthetic information provided.
•To assess whether information provision in different formats can assist with understanding of the anaesthetic plan and relieve anxiety towards the procedure.



Patients completed a questionnaire at the end of their pre-assessment clinic appointment. Data was collected over 6 weeks (no exclusion criteria). Changes were implimented and a re-audit carried out over another 6 week peroid.

Changes implemented:

•An updated, more detailed written information leaflet
•This leaflet given at the start of the appointment, whilst the patient was in the waiting room
•Visual information via a photobook was provided in the waiting room, this depicted the patients journey from admission to post delivery care on the ward. This is also accessible on the trust intranet site.

Creation of photo-book

We used volunteers to play the part of patient and partner. Medical photography were used to produce professional images. The  photographs were  taken to outline a step-by-step process of what happens on the day of an elective section tailored to FPH. The images are accompanied by a description of the process. Women who had recently undergone an elective caesarean were shown the book in its development stage and their feedback used to refine the book further.


There is a high rate of satisfaction with the anaesthetic pre-assessment services provided at FPH. By auditing our practice we have improved our services and adopted a multi-modal approach to providing information for expectant mothers. There were no significant differences between the audits when looking at 'usefulness' of the information leaflet, despite changes made to improve it. The photobook was well received and favoured more than the information leaflet, especially by those having had previous caesarean sections, whereas those attending for the first time felt less anxious after their discussion with the anaesthetist.



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