Healthscape role towards customer satisfaction in private healthcare

Role of servicescape in patients' clinic care waiting experience: Evidence from developing countries

The aim of this research is to investigate the role of servicescape on re-patronage and recommended intention through pleasure feeling and satisfaction in healthcare settings that put substantial contribution in the process of healthcare service delivery. Data were collected through cross-sectional convenience sampling via a self-administered survey questionnaire from 431 clinical outpatients who revisit the same hospital of metropolitan areas of Punjab, Pakistan. Structural Equation Modeling (SEM) was carried out for path analysis through AMOS (24.0 V), while statistical measures were analyzed using SPSS (25.0 V). The present study results revealed that patients' intention optimistically triggered through partial mediation and affirm the direct and indirect association with servicescape. It also revealed that patient-recommended and re-patronage intentions to visit the clinic were statistically substantial and positively influenced by intervening constructs of pleasure feeling and satisfaction. Additionally, it is found that servicescape and pleasure feeling contributed to 30% change in satisfaction. Moreover, pleasure feeling, and satisfaction contributed to 50% change in re-patronage and 31% change in recommendation intention of the patients. The current study findings contribute significantly to servicescape literature from a theatrical perspective and reevaluate the patterns and operations in healthcare. It also helps managers and administrators of private hospitals to make strategies to increase patient satisfaction.

Effects of Servicescapes on Interaction Quality, Service Quality, and Behavioral Intention in a Healthcare Setting

This study develops a conceptual framework that encompasses servicescapes and customer perceptions and behaviors, and conducts an empirical investigation of healthcare service facilities. Structural equation modeling is performed using a sample of 271 patients who received treatment within one year at hospitals and clinics located in the metropolitan area of Seoul, South Korea. The results of the empirical analysis show that service quality improvements and patient revisits to healthcare facilities can be induced through servicescape improvements and interaction quality. These results make theoretical contributions to the service management literature and have practical implications for the operations of healthcare facilities.

Assessing Spatial User Experience for Design Guidelines: A Comparative Study of Outpatient Waiting Rooms With Conventional Versus Modern Features

OBJECTIVES

Identify waiting room design features that are most appreciated by outpatients and their companions in conventional and modern waiting rooms. Evaluate if end users evaluate the environment differently from experts and in what aspects. Provide evidence-based design guidelines that orient designers and healthcare managers.

BACKGROUND

Built environments are relevant in patients' evaluation of overall healthcare service. For outpatients, waiting frequently consumes the largest amount of time; thus, waiting room interior design has great potential to enhance their experience.

METHODS

This study compares perceptions of two types of waiting rooms-conventional and modern-based on the spatial user experience (SUE) model. In the first stage of the study, we compared user evaluations of conventional waiting rooms (n = 137) and modern waiting rooms (n = 426) with respect to the eight SUE model dimensions using multigroup structural equation modeling. In the second stage, an expert ergonomist and two professional interior designers assessed both types of waiting rooms.

RESULTS

Results showed that modern waiting rooms were perceived to be significantly better in all SUE dimensions. We also found experts' evaluations were overall consistent with users' perceptions. Discrepancies were only found in temperature perception, signage evaluation, and spatial appreciation.

CONCLUSIONS

Participants valued modern style waiting room features such as good quality signage, use of armchairs and sofas, a controlled environment, and decoration. We suggest involving end users in the design process to respond to their needs and promote a positive experience. Finally, we provide easy-to-adopt design guidelines to improve patients' waiting room experience.

Maternity Healthscapes: Conceptualization and Index Development

OBJECTIVES

This article provides a conceptualization and an index of the multidimensional concept of maternity healthscapes (MHS).

BACKGROUND

Healthscape has emerged as a potential key aspect to improve patient experience. Surprisingly, there has been little effort to delineate the concept of MHS from a design perspective, while maternity wards have unique characteristics and particular challenges. Indeed, patients in maternity wards are usually not acutely ill but can feel highly vulnerable due to the pain, stress, and the many uncertainties surrounding labor and delivery-which can heighten patients' need for intimacy, supporter comfort, and additional supporting services. Thus, healthscapes need to be designed to account for the specificities of childbearing and needs of those patients and their family.

METHODS

A multidisciplinary literature review and 39 in-depth interviews were conducted with various stakeholders-mothers, midwives, heads of midwives, and chief executives.

RESULTS

The authors develop a conceptualization to establish a comprehensive understanding of the dimensionality of MHSs. Based on that comprehensive conceptualization, the authors develop an index providing a census of the aspects in the MHS that various stakeholders-such as healthcare providers, designers, and architects-should take into account when conceiving MHS.

CONCLUSIONS

Healthcare providers, designers, and architects can use this conceptualization and index to closely monitor and measure for evaluations and further improvements of the MHS, thereby enhancing patient experience in maternity wards.

The Role of Servicescape on Emotions and Satisfaction of Patients in Indian Hospitals

Purpose

The purpose of this study is to propose and test the causal relationship among the constructs servicescape, emotions and satisfaction among users of corporate hospital services.

Design/Methodology/Approach

A review of literature was done, and items were adapted construct-wise from existing scales. Data were collected from 220 respondents, and the reliability and validity of the scales were tested. The relationship among the constructs was tested using structural equation modelling.

Findings

The model in this study postulated that (a) servicescape is positively related to satisfaction, (b) servicescape is positively related to positive emotions and negatively related to negative emotions and (c) positive emotions are positively related to patient satisfaction and negative emotions are negatively related to satisfaction. All the hypotheses were supported, and it was confirmed that servicescape has both direct and indirect relationships with satisfaction.

Originality/Value

The article has direct implications for healthcare service providers. Healthcare executives are encouraged to monitor the physical environment of their healthcare units. This study shows that emotions of patients play an important role in determining their satisfaction with hospital services.

Perceived quality factors that discriminate parents of orthodontic patients according to their satisfaction

Purpose

Monitoring the perception of quality by parents and the satisfaction with their children’s treatment is crucial in developing high-level health-care services. The purpose of this paper is to identify the perceived quality factors by parents of paediatric orthodontic patients according to the levels of satisfaction.

Design/methodology/approach

A survey with 316 parents of paediatric orthodontic patients of 45 offices in a big Brazilian city was conducted. The questionnaires included statements on the parents’ satisfaction and perception of quality concerning their children’s treatment. The data were analysed using multivariate statistics (exploratory factor analysis, cluster analysis and discriminant analysis).

Findings

Parents were classified into three clusters according to their level of satisfaction. This survey identified 11 quality factors perceived by parents of patients regarding their children’s orthodontic treatment. Among them, five factors discriminated the clusters: orthodontist’s technical skills, administrative organisation, location (accessibility and convenience), treatment duration and dental supplies.

Practical implications

This research identified the perceived quality factors that most impacted parents of orthodontic patients’ satisfaction, contributing to dentists in developing strategies and actions to improve the quality of services in dental offices.

Originality/value

This paper included 11 perceived quality factors in the hypothetical model, identified through literature review and a qualitative phase. Moreover, multivariate statistical analyses confirmed the validity and reliability of the questionnaires, classified respondents in clusters and identified the perceived quality factors that most discriminated them. Therefore, the current investigation presented a more comprehensive and robust analysis than the previous studies on this topic.

User satisfaction with Dental Specialty Centers in Brazil: Proposal of satisfaction index and associated factors

OBJECTIVES

To investigate the satisfaction of users of Dental Specialty Centers (CEO) in Brazil employing the Service Satisfaction Index (SSI) and identify associated factors.

METHODS

This quantitative, evaluative, and cross-sectional study used secondary data extracted from the Second External Evaluation of the Program for the Improvement of Access and Quality of Brazilian Dental Specialty Centers (PMAQ-CEO) held in 2018 in 901 municipalities, accounting for 1097 CEO, of which 1042 were investigated. A total of 10391 users participated in the study. Considering user satisfaction as an aggregate variable, SSI was classified into two categories: Lower Satisfaction (SSI < 20) and Maximum Satisfaction (SSI = 20). Data were analyzed by descriptive and inferential statistics using the SPSS^® software. The exploratory factor analysis verified the statistical correlations between attributes and SSI.

RESULTS

The maximum satisfaction with the service was 21.1%; factors that expressed the most significant influence on SSI were waiting time (OR = 1.17; CI 95%: 1.05-1.31), feeling that CEO has good conditions of use (OR = 7.05; CI 95%: 5.15-9.65), not wishing to be assisted at another CEO (OR = 4.17; CI 95%: 3.12-5.57), not having treatment interrupted due to lack of material (OR = 2.05; CI 95%: 1.70-2.47), age up to 40 years of users (OR = 1.31; CI 95%: 1.18-1.46) and higher education (OR = 1.30; CI 95%: 1.14-1.49).

CONCLUSIONS

SSI appropriately described the user's satisfaction with the service. The maximum satisfaction with the service was influenced by age, education, waiting time, not having treatment interrupted, and considering CEO clean and hygienic environment.

Examining the effect of servicescape, perceived service quality and emotional satisfaction on hospital image

Purpose

Emotions have been extensively studied in hedonic service sectors but not in utilitarian service sectors. This study aims to address this gap by examining how hospitals’ Servicescape influences the Emotional Satisfaction of their customers, their perception of Service Quality and its subsequent effect on Hospital Image.

Design/methodology/approach

Data were collected from 220 respondents from corporate hospitals in the National Capital Territory of Delhi and the neighboring cities of Noida and Gurgaon. The reliability and validity of the scale were established and the relationship among the constructs was tested by structural equations modeling.

Findings

Results show that all dimensions of Servicescape, i.e. ambient factors, design factors and social factors have a positive impact on both Emotional Satisfaction and Perceived Service Quality. However, between Emotional Satisfaction and Perceived Service Quality, only Emotional Satisfaction had a positive impact on Hospital Image.

Research limitations/implications

The results of this study can help researchers in understanding the role of Servicescape in the health-care industry.

Originality/value

The results emphasize that hospitals should seek to understand their patients’ perceptions particularly focusing on their emotional reactions to enhance their brand image.

Analyzing health-care service environment with Malaysian general practice clinics

Purpose

The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others for future treatment in GP clinics.

Design/methodology/approach

Data are collected from 367 respondents using a paper-based survey questionnaire. Partial least square (PLS) is used to evaluate the proposed model and hypotheses relationships.

Findings

The findings reveal that ambience and service delivery have a high significant influence on patients' emotional satisfaction (β = 0.27, t = 4.31, p = 0.00) and (β = 0.26, t = 4.81, p = 0.00), respectively, while interior décor has a positive and significant influence on satisfaction (β = 0.13, t = 1.98, p = 0.04). The results indicate that exterior design and cleanliness are not associated with satisfaction. Patients' emotional satisfaction is highly related to WoM (β = 0.55, t = 13.44, p = 0.00). The results also show that emotional satisfaction has a significant mediating effect on the relationship between clinic service environments (ambience, interior décor, service delivery) and WoM (β = 0.15, t = 3.94, p = 0.00), (β = 0.073, t = 3.94, p = 0.04), (β = 0. 0.143, t = 4.13, p = 0.00), respectively.

Originality/value

The study will provide insights regarding Malaysian health consumers' perceptions toward GP clinics' service environment, whether they remain utilitarian or have evolved to entail hedonic appreciations. The contribution to the service environment could be adopted by future health-care studies, particularly those intended to examine GP clinics and other clinic-based institutions.

Expectations from a private multi-speciality hospital: a moderated-mediation analysis

Purpose

A highly competitive market incentivizes private healthcare providers to deliver high quality services. The purpose of this paper is to identify the perceived expectations of a new private multi-speciality hospital in a non-metro city. To this end, the paper develops a model using identified relevant factors.

Design/methodology/approach

A structured questionnaire was administered to 900 people. Exploratory factor analysis and confirmatory factor analysis were then applied to the data, and partial least square-structural equation modelling was used to test the moderated mediation model.

Findings

Word-of-mouth and safety (WM) and access to the hospital and the cost of medical services are found to be important factors for the perceived expectations of the hospitals by medical facility and treatment at a hospital. High quality medical facilities can lead to improved perceived expectations of hospitals, mediated by positive WM. Levels of access to the hospital and the cost of services can significantly moderate the perceived expectations of a hospital, despite good medical facilities.

Practical implications

The study has implications for policymakers and hospital authorities in the context of private sector multi-speciality hospitals in non-metro cities. It will help healthcare managers and service providers to better understand customer perceived expectations, and thereby develop effective strategies for customer service. Decision-makers are encouraged to focus on positive word-of-mouth and enhancement of customer safety to bring about favourable expectations of hospitals. Beyond merely having excellent medical facilities, hospitals that ensure ease of access to the hospital and keep costs low can achieve positive consumer expectations and satisfaction levels.

Originality/value

The paper makes three novel contributions as follows: the mere presence of high quality medical facilities and practices does not equate to positive expectations about the hospital among the patients; access to the hospital and the cost of its services are important in bringing about positive expectations among healthcare consumers; and WM can significantly moderate positive expectations of the hospital. The authors are not aware of any of these findings being previously reported.

The influence of servicescape and service credibility on older adults' intention to recover

PURPOSE

Based on the stimuli-organism-response (SOR) model and relationship marketing theory, the paper aims to examine whether servicescape influences trust, service credibility and affective commitment amongst older adults, and their effects on the intention to recover in a rehabilitation setting.

DESIGN/METHODOLOGY/APPROACH

The study takes a quantitative approach, applying confirmatory factor analysis and structural equation model to examine the responses. A total of 400 data were collected using questionnaires distributed to older adults in Malaysia. Respondents were selected based on two criteria: they should be over 65 years, and they should have been visiting the rehabilitation centres in the last 12 months.

FINDINGS

The results suggest that trust and affective commitment play significant roles in increasing the intention of older adults to recover. Contradicting previous research findings, service credibility does not have any significant impact on the intention to recover as hypothesised. The direct effect of service credibility on trust and affective commitment enhances the premise further that the relationship between service credibility and intention to recover is primarily indirect. Even though we expect servicescape to be a significant driver in forming the behaviour of older adults, its impact on intention to recover, trust and affective commitment remain non-significant, with the exception of service credibility.

ORIGINALITY/VALUE

Past studies have focused on the roles of servicescape and service credibility separately. We have extended the literature by examining the combined effects of both servicescape and service credibility. The findings, therefore, contribute to a deeper understanding of the literature on the intention-behaviour relationship in the context of healthcare, as well as in service marketing.

Graduate experiences with transnational nursing education: a qualitative enquiry

PURPOSE

The purpose of this paper is to share insights, research findings and discuss key issues related to graduate experiences with transnational nursing education (TNE).

DESIGN/METHODOLOGY/APPROACH

The authors used a qualitative approach and sampled national and international nurse graduates to identify challenges and best operating practices in cross-border nursing program facilitation.

FINDINGS

This research paper has provided a platform for graduates to lend their voices to the promotion of effective cross-border nursing education delivery and suggests that although international collaborations endeavor to maintain high academic standards in TNE, there is still a need to re-engineer, revise and adapt curricular content, learning, teaching and assessment practices to aid the nursing student.

RESEARCH LIMITATIONS/IMPLICATIONS

Identified challenges affecting the facilitation and delivery of cross-border nursing education programs can act as levers to improving service quality of present and future cross-border programs to the nursing student. This will assist future nursing students to recognize culture shock and embrace their decision to pursue nursing.

PRACTICAL IMPLICATIONS

The experience of being involved in TNE for nursing students may not be that much different than students of other disciplines. While not able to be generalized to the entire population, the reports by the nursing students in this sample appear to be valuable and worthwhile to continue supporting and encouraging other TNE opportunities.

ORIGINALITY/VALUE

This paper explores cross-border nursing education experiences from national and international perspectives. The authors were able to explore inherent TNE challenges from diverse population and cultural backgrounds.

Do the servicescape of public and private hospitals differ? The Malaysian context

Purpose

This study aims to explore if public and private hospitals have differing servicescape attributes.

Design/methodology/approach

The study uses a two-stage (EFA and CFA) procedure for identifying the servicescape attributes and examining their validity in the context of public and private hospitals.

Findings

The findings indicate that, in different contexts, patients would expect different aesthetics of servicescape attributes and how they are influenced by the hospital premises.

Research limitations/implications

It is interesting to note that: not all of the attributes that appear in both contexts are exactly the same; patients do not seem to face difficulties in analysing and interpreting directional cues, even though the spatial orientation in private hospitals is relatively smaller; the way patients of public hospitals draw inference about the ambient conditions is not consistent with private hospitals; and patients perceive that private hospitals pay special attention to developing a built environment that facilitates treatment and recovery process via interior layout, as well as decoration and architecture attributes.

Practical implications

The study grounds the servicescape attributes and provides insights to effectively promote public and private hospitals.

Originality/value

This study may be amongst the first to offer servicescape evidence in both the public and private hospitals.

Physical therapists' perspectives on using contextual factors in clinical practice: Findings from an Italian national survey

Background

Contextual factors (CFs) represent a potential therapeutic tool to boost physiotherapy outcomes, triggering placebo effects. Nevertheless, no evidence about the use of CFs among physical therapists is currently available.

Objective

To investigate the use of CFs and the opinion of Italian physical therapists specialized in Orthopaedic Manual Therapy (OMTs) on their therapeutic benefits.

Design

An exploratory cross-sectional online survey.

Methods

A 17-item questionnaire and 2 clinical vignettes assessed the perspective of OMTs on the adoption of CFs in daily clinical practice. The target population was composed of 906 OMTs. An online survey was performed in 2016 using SurveyMonkey Software. Data were analyzed by descriptive and inferential statistics.

Results

A total of 558 volunteers (61.6% of the target OMT population) participated in the study. Half of the participants (52.0%) claimed to use CFs frequently in their practice. More of 50% of OMTs valued the therapeutic significance of CFs for different health problems as determined by a combined psychological and physiological effect. OMTs considered the use of CFs ethically acceptable when they exert beneficial therapeutic effects and their effectiveness has emerged in previous clinical experiences (30.6%). They disagreed on the adoption of CFs when they are deceptive (14.1%). Moreover, OMTs did not communicate the adoption of CFs to patients (38.2%), and CFs were usually used in addition to other interventions to optimize clinical responses (19.9%). Psychological mechanisms, patient’s expectation and conditioning were believed to be the main components behind CFs (7.9%).

Limitations

Considering that the data collected were self-reported and retrospective, recall and response biases may limit the internal and external validity of the findings.

Conclusions

OMTs used CFs in their clinical practice and believed in their therapeutic effect. The knowledge of CFs, placebo and nocebo mechanisms and their clinical effects should be included in physical therapists’ university studies.

Hospital responsiveness and its effect on overall patient satisfaction

Purpose Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran. Design/methodology/approach This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18. Findings The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction. Originality/value Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician.

A Systematic Underpinning and Framing of the Servicescape: Reflections on Future Challenges in Healthcare Services

Ever since Bitner defined the term “servicescape” as the physical environment in which the service is assembled, several scholars have attempted to better understand the impact of the built environment in the context of different service settings. While servicescape is a topic of increasing academic interest among scholars and practitioners, most studies in the area are dedicated to understanding the built environment of hedonic service. More studies are needed to examine utilitarian servicescape and in this paper, we have focused on the healthcare environment. This study aims to identify the gap in servicescape and healthscape studies by providing a theoretical structure of the current servicescape literature and comprehend the academic differences between hedonic servicescape and utilitarian healthscape studies. After reviewing 44 selected papers based on rigorous criteria, we: (1) framed the servicescape factors; (2) analyzed the servicescape literature from the perspectives of terminologies, research fields, methodologies, and frameworks; and (3) identified the current paths of healthscape research. Through this work, we highlight the significance of adopting different dimensions and factors to evaluate the distinguished service environment by the servicescape type and propose several research agendas for future studies on healthscapes. The research findings can contribute to a deep understanding of healthscapes and can introduce a new viewpoint for interpreting the servicescape in diversified service settings.

Topographies of 'care pathways' and 'healthscapes': reconsidering the multiple journeys of people with a brain tumour

People diagnosed with brain tumours enter new and unfamiliar worlds in which they must make complex and previously unimaginable decisions about care, treatment and how to live their lives. While decisions are increasingly based around care pathways, these are embedded in values that often fail to accord with those of patients. In this article, we examine the cases of people with a brain tumour and how they, their families and healthcare professionals navigate and intervene in the course of life-threatening disease. We use ethnographic data (2014-16) and modified social theory to highlight: (1) patients' interpretations of disease and care and how they might differ from dominant biomedical logics; (2) complexity and contingency in care decisions; (3) rapid and unanticipated change owing to disease and bodily change; and (4) how people find ways through a world that is continually in motion and which comes into being through the combined action of human and non-human agencies. Our modified 'healthscapes' approach provides an analytic that emphasises the constant precariousness of life with a brain tumour. It helps to explain the times when patients' feel bumped off the pathway and moments when they themselves step away to make new spaces for choice.

From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic's Service Perspective

Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics’ servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics’ servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists’ loyalty to a medical clinic.