Coskun Bakar, H. Seval Akgün and A.F. Al Assaf
This paper aims to conduct a preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL. Design/methodology/approach – The…
Abstract
Purpose
This paper aims to conduct a preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL. Design/methodology/approach – The SERVQUAL scale is routinely used at the Baskent University Hospitals Network, Turkey. The study consisted of 550 randomly chosen patients who presented to any member of the hospital network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities.
Findings
The patients' perceived scores were higher than expected for an ordinary hospital but lower than expected for a high‐quality hospital. Young patients had a high‐expected service score gap and a low adequate service score difference. Highly educated patients had a high‐expected service score difference. Uninsured patients had a low adequate service score difference. Originality/value – Baskent University multidisciplinary healthcare teams have performed periodic patient satisfaction surveys in order to identify strengths and problem areas, formulate the quality improvement objectives and monitor progress towards achieving these objectives. However, patient satisfaction survey results are often highly positive. In these cases, improving care is not easy because measures are not sensitive enough to changes. Therefore a more sensitive measurement tool based on the SERVQUAL scale was developed. The authors believe that patient opinions are extremely important because they provide information that is not necessarily emphasized by managers or health care professionals, resulting in a more complete assessment of past performance and a clearer road map for future action.
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Coskun Bakar, H. Seval Akgün and A.F. Al Assaf
The aim of this paper is to document a study, in which the SERVQUAL scale was used to evaluate hospital services, conducting a preliminary assessment of patient attitudes…
Abstract
Purpose
The aim of this paper is to document a study, in which the SERVQUAL scale was used to evaluate hospital services, conducting a preliminary assessment of patient attitudes regarding the important aspects of service dimensions.
Design/methodology/approach
The SERVQUAL scale was implemented into routine use at the Baskent University Hospitals Network in Baskent, Turkey. The study consisted of 550 randomly chosen patients who presented to any member hospital in that network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The SERVQUAL scale was utilised to evaluate hospital services.
Findings
A questionnaire was completed by a total of 472 (86.0 per cent) patients. The perceived scores of the patients were higher than expected for an ordinary hospital but lower than expected for a high‐quality hospital. The highest difference between the perceived service score and the expected service score was found at the Alanya Application and Research Center in Alanya, Turkey.
Originality/value
The paper demonstrates the use of the SERVQUAL scale in measuring the functional quality of the hospitals assessed.
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Reza Salehi, Iravan Masoudi-Asl, Hassan Abolghasem Gorji and Hojatolah Gharaee
A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack…
Abstract
Purpose
A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap.
Design/methodology/approach
This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population.
Findings
Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas.
Practical implications
This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units.
Originality/value
Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.
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This paper explores how medical quality management has developed in the USA since the 1900s reviewing and summarizing the history of the movement through an extensive literature…
Abstract
This paper explores how medical quality management has developed in the USA since the 1900s reviewing and summarizing the history of the movement through an extensive literature review. With a particular emphasis on action learning as a theoretical construct, the paper then assesses the extent to which action learning can be applied to the quality process. Using two case studies from the literature, the paper suggests that the action learning process, can in fact overcome some of the problems related to the implementation of quality initiatives in medical settings, and in particular those related to the fear expressed often by physicians that quality procedures emphasize cost cutting at the expense of patient care.
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Ahmed Al Kuwaiti and Fahd A. Al Muhanna
A crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various…
Abstract
Purpose
A crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various strategies to overcome the challenges facing the privatization of academic medical centers (AMCs) in Saudi Arabia.
Design/methodology/approach
In this paper, the authors discuss the challenges faced in privatizing AMCs in delivering their core functions such as patient care, medical education and research. Further, the appropriate strategies are listed to overcome these challenges in privatization of AMCs.
Findings
The authors described the benefits of privatization that include a reduction in the financial burden on government healthcare expenditure, quick decision making and creation of new financial models to improve healthcare services. On the other hand, the profit motive of private management could create pressure on patients and may divert AMCs from their primary objectives. Therefore, it is imperative for the government to develop and implement appropriate strategies that balance the benefits of privatizing AMCs with eliminating the negative impact of privatization on patient care, medical education and research.
Originality/value
Though AMCs privatization is currently feasible in Saudi Arabia, appropriate strategies are essential to overcome the challenges of its implementation. The government should frame a uniform rules and regulations prior to privatizing public hospitals so that it will fulfill the purpose in an efficient manner.
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Janis L. Gogan, Ryan J. Baxter, Scott R. Boss and Alina M. Chircu
Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting…
Abstract
Purpose
Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting control theory, the aim of this paper is to discuss how these latter two disciplines can be combined to further improve patient safety in handoffs.
Design/methodology/approach
A literature review on studies of patient safety, clinical processes and clinical handoffs was conducted in leading medical, quality, and information systems journals.
Findings
This paper issues a call for research using a trans‐disciplinary methodology to shed new light on information quality issues in clinical handoff processes, which in turn should improve patient safety.
Research limitations/implications
The literature review employed systematic, heuristic, iterative and practical criteria for identifying and selecting papers, trading off completeness for multi‐disciplinarity. No prior empirical patient safety studies combined process management and accounting control theory.
Practical implications
The above‐noted trans‐disciplinary analytic approach may help medical professionals develop more effective handoff processes, checklists, standard operating procedures (SOPs), clinical pathways, and supporting software, and audit and continuously monitor their implementation.
Originality/value
This paper responds to recent calls for trans‐disciplinary research on healthcare quality improvement. The literature review is valuable for understanding clinical handoff problems and solutions from multiple perspectives. The proposed combination of two theories – accounting control theory and business process management – is novel and useful for describing, improving and monitoring handoff processes in the broader context of clinical processes, using a common terminology for information quality traits.
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Dana M. Johnson, Roberta S. Russell and Sheneeta W. White
This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The…
Abstract
Purpose
This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The purpose of this paper is to determine if the factors that influence perceptions of service quality change over time and if the change affects overall patient satisfaction.
Design/methodology/approach
Data were collected for three fiscal years (2012-2014) using a 36-question, Likert-scaled attitudinal survey. Multiple regression analysis was performed to identify which constructs of five different service quality dimensions were statistically significant in predicting overall patient satisfaction. Paired comparison of means and ANOVA F-tests highlighted significant differences across years and demographics.
Findings
Multiple regression models of overall patient satisfaction over a three-year time period had significant repeat variables, indicating salience of the dimensions and constructs of service quality that predict patient satisfaction. However, some dimensions of service quality did not remain significant from one year to another, indicating there may be a gap in the patient service cycle over an extended time frame.
Originality/value
This paper explored the sequential relationship between patient satisfaction survey data and perceptions of service quality over a multi-year time frame. The research focussed on outpatient medical clinics, while the majority of previous studies have focussed on acute care or inpatient stays. A longitudinal study is especially relevant for outpatient clinics where continuity of care is important.
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Hsiu‐Yuan Hu, Yu‐Cheng Lee and Tieh‐Min Yen
This study seeks to propose a conceptual approach to assess the perceived service quality properly using Fuzzy logic. First, it aims to verify whether it is a better solution than…
Abstract
Purpose
This study seeks to propose a conceptual approach to assess the perceived service quality properly using Fuzzy logic. First, it aims to verify whether it is a better solution than the Likert scale. Second, it seeks to evaluate patients' feedback towards hospital service quality using Fuzzy linguistic analysis.
Design/methodology/approach
The SERVQUAL questionnaire was developed according to the characteristics of each hospital's out‐patient service. Three regional hospitals in Hsin‐Chu, Taiwan were evaluated. After being completed and collected, first, the effectiveness of the Fuzzy linguistic scale and the Likert scale was compared. Second, gap values of each element were evaluated to find the core service quality attributes for continuous improvement. Finally, analysis of variance (ANOVA) was conducted to segment markets using certain service quality attributes and different demographic variables.
Findings
The result indicated that the Fuzzy linguistic scale is higher than the Likert scale in terms of reliability in the measurement. Moreover, through gap analysis and ANOVA, a better focus was achieved on the 8th, 10th, 14th, 21st and 3rd service quality attributes from the SERVQUAL measurement on which management should concentrate and which they should endeavor to work out. The 1st, 2nd, 14th and 16th items from the SERVQUAL measurement can be market segment factors, respectively.
Originality/value
The study successfully introduced Fuzzy linguistic analysis into the Gap theory and SERVQUAL measurements, and provided more internal consistency and stability than the Likert scale. After discussing the findings of the gap analysis and ANOVA, the organization could find the critical service quality attributes and create a value for improving or enhancing them.
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Kwabena G. Boakye, Charles Blankson, Victor R. Prybutok and Hong Qin
The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates…
Abstract
Purpose
The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates the role and effect of service quality on patient satisfaction and perceived value in Ghana’s healthcare delivery.
Design/methodology/approach
Data were gathered through surveys administered to 113 healthcare patients in Ghana. partial least square-structural equation modeling analysis was used to empirically test the research model.
Findings
Results show healthcare quality significantly influences satisfaction and perceived value of healthcare delivery. Additionally, perceived value’s impact on satisfaction and behavioral intention shows that increasing perceived benefits while reducing perceived costs leads to repeat behavior and paves the way for retention strategy for healthcare management.
Research limitations/implications
This study yields a series of limitations in its results and conclusions. These limitations and future research are discussed in Section 7 of the study.
Originality/value
This study contributes to the literature by examining the effects of healthcare service quality on patient satisfaction and perceived value, determining the effect of healthcare service quality on patients’ behavioral intention, and testing the proposed framework in Ghana, a fast growing and economically liberalized emerging country in Sub-Saharan Africa.
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Bylon Abeeku Bamfo and Courage Simon Kofi Dogbe
The study aims to examine the factors influencing the choice of private and public hospitals in Ghana.
Abstract
Purpose
The study aims to examine the factors influencing the choice of private and public hospitals in Ghana.
Design/methodology/approach
Purposive and convenient sampling techniques were used in selection of 225 respondents for the study. An independent samples t-test was used in ascertaining the significant difference in the opinions of both groups. Finally, binary logistics regression was used in ascertaining the factors that significantly influenced the choice of hospitals in Ghana.
Findings
In Ghana, patients’ choice of private or public hospital was significantly influenced by service quality, word-of-mouth, type of ailment and National Health Insurance Scheme (NHIS). Patients who made choice decision based on service quality were more likely to attend a private hospital. Word-of-mouth influenced the choice of public hospitals more than private hospitals. Patients preferred visiting public hospitals for more complicated ailments such as spinal defects, HIV/AIDS, heart-related problems, etc. Patients registered under the NHIS also preferred visiting public hospital to private hospital. Although services from private hospitals were more expensive, patients were more satisfied with services provided, as compared to patients from the public hospital. Cost of service and patient satisfaction, however, did not have a statistically significant effect on the choice of hospital.
Originality/value
Most comparative studies done on private and public hospitals studied in isolation focused on service quality, customer satisfaction, national health insurance and cost of health care or a combination of them. This study, however, considered all these selection criteria and extended it by adding word-of-mouth and the type of ailments suffered. The study, thus, provided a more comprehensive hospital selection criteria. The use of logistics regression in this particular area of study was also quite unique.