Client Satisfaction Evaluations

1 1 Workbook 6 Clent Satisfaction EvaluationsWHO/MSD/MSB 6 ClientSatisfactionEvaluations2 evaluation of Psychoactive Substance Use Disorder TreatmentWHO/MSD/MSB Health OrganizationUNDCPU nited Nations International Drug Control Programme EMCDDA European Monitoring Center on Drugs and Drug AddictionWorld Health Organization, 2000cThis document is not a formal publication of the World Health Organization (WHO) and all rights are reserved by theOrganization. The document may, however, be freely reviewed, abstracted, reproduced and translated, in part or inwhole but not for sale nor for use in conjunction with commercial purposes.

2 The views expressed in documents bynamed authors are solely the responsibility of those 6 Clent Satisfaction EvaluationsWHO/MSD/MSB (Canada) edited the workbook se-ries in earlier stages. JoAnne Epping-Jordan (Switzerland) wrote furthertext modifications and edited theworkbook series in later Lalji (WHO, SubstanceAbuse Department) and JenniferHillebrand (WHO, Substance AbuseDepartment) also edited the work-book series in later stages. MaristelaMonteiro (WHO, Substance AbuseDepartment) provided editorial inputthroughout the development of World Health Organizationgratefully acknowledges the contri-butions of the numerous individualsinvolved in the preparation of thisworkbook series, including the ex-perts who provided useful com-ments throughout its preparation forthe Substance Abuse Department,directed by Dr.

3 Mary Jansen. Finan-cial assistance was provided byUNDCP/EMCDDA/Swiss FederalOffice of Public Health. Cam Wild(Canada) wrote the original text forthis workbook and Brian RushAcknowledgements4 evaluation of Psychoactive Substance Use Disorder TreatmentWHO/MSD/MSB 6 Clent Satisfaction EvaluationsWHO/MSD/MSB of contentsOverview of workbook series6 What is a Client Satisfaction evaluation ?7 Why do a Client Satisfaction evaluation ?7 How to do a Client Satisfaction evaluation ?8 Conclusion and practical recomendation17 Comments about case examples19 Case examples of Client Satisfaction evaluationPart A: An evaluation of Satisfaction with a statedrinker driver treatment program21 Part B: Client Satisfaction with residential substancetreatment programmes26 Part C.

4 The case of community methadonstreatment programs326 evaluation of Psychoactive Substance Use Disorder TreatmentWHO/MSD/MSB ofworkbook seriesThis workbook is part of a series in-tended to educate programme plan-ners, managers, staff and other deci-sion-makers about the evaluation ofservices and systems for the treatmentof psychoactive substance use disor-ders. The objective of the series is toenhance their capacity for carrying outevaluation activities. The broader goalof the workbooks is to enhance treat-ment efficiency and cost-effectivenessusing the information that comes fromthese evaluation workbook discusses the assess-ment of Client Satisfaction .

5 It focuseson:lreasons for assessing Client satis-factionlthe use of Client Satisfaction mea-sures for programme improvementlmeasures of Client satisfactionIntroductory WorkbookFramework WorkbookFoundation WorkbooksWorkbook 1: Planning EvaluationsWorkbook 2: Implementing EvaluationsSpecialised WorkbooksWorkbook 3: Needs Assessment EvaluationsWorkbook 4: Process EvaluationsWorkbook 5: Cost EvaluationsWorkbook 6: Client Satisfaction EvaluationsWorkbook 7: Outcome EvaluationsWorkbook 8: Economic Evaluations7 Workbook 6 Clent Satisfaction EvaluationsWHO/MSD/MSB is a clientsatisfaction evaluation ?

6 Client Satisfaction Evaluations arean excellent opportunity to involveclients or patients in the process ofevaluating your Satisfaction Evaluations can reliability of services , or the assur-ance that services are provided in aconsistent and dependable manner; responsiveness of services or thewillingness of providers to meet cli-ents/customer needs; courtesy of providers; security of services , including thesecurity of questions may assess clients views about :lthe physical setting of serviceslthe helpfulness of support stafflinformation resourceslthe competence of counsellorslthe costs of servicelthe relevance of services to their needslthe accessibility of serviceslwaiting times for service componentslfrequency of appointmentsltime spent with counsellorlthe humanness of serviceslthe effectiveness of services in ame-liorating their problemsClient Satisfaction occupies an interme-diate step in establishing a healthy cul-ture for evaluation within a

7 Programmeor a setting. It often follows processevaluation and cost analysis, and pre-cedes outcome and economic evalua-tions. Accordingly, measures of clientsatisfaction lie somewhere between pro-cess and outcome measures. When theconcern is with the extent to which cli-ents are satisfied with the context, pro-cesses, and perhaps the costs of a treat-ment service or network, the relevantmeasures of Satisfaction can be viewedas process measures. However, when theconcern is with the extent to which cli-ents view the programme as having beenhelpful in resolving their problems, cli-ent Satisfaction becomes a proxy out-come of Psychoactive Substance Use Disorder TreatmentWHO/MSD/MSB assessment of Client Satisfaction addsan important consumer perspective toevaluations of PSU treatment services andsystems.

8 Client Satisfaction evaluationscan be viewed as an opportunity to consult with clients about their experi-ences in your programme. Client satisfac-tion surveys may provide the only meansfor clients to express concerns about theservices received, and to express theirviews about new services that are Satisfaction ratings have beencriticised as indicators of the quality ofhuman services because they may reflectunrealistic expectations. While this criti-cism may be valid in some instances, re-Why do a clientsatisfaction evaluation ?

9 Clientsatisfactionsurveys mayprovide theonly means forclients toexpressconcernsabout theservicesreceived. search with clients of mental health ser-vices suggests that they can effectivelydiscriminate between services that aredifferent in quality (Lebour, 1983;Sheppard, 1993). It is, however, impor-tant to recognise that evidence of posi-tive Client Satisfaction is not, in itself,sufficient to establish the effectivenessor accessibility of treatment. clients withno base for comparison may be satisfiedwith services that are ineffective as de-termined by more objective outcomeevaluations.

10 On the other hand, clientsmay be displeased with services thatachieve the objective of reducing theirPSU but employ rigid or Satisfaction with treatment pro-cesses may both influence, and be influ-enced by, treatment outcomes. Clientswho are not satisfied with a service mayhave worse outcomes than others becausethey miss more appointments, leaveagainst advice or fail to follow throughon treatment plans. On the other hand, clients who do not do well after treatmentmay have less than favourable attitudestowards a treatment service, even if it wasof high quality by other criteria.