Verifying alternative measures of healthcare service quality

[Internal validity and reliability of an instrument for evaluating quality of nursing care services for patients, nurses, and family members]

AIM

To analyze the internal validity and reliability of the instrument for evaluating the quality of services adapted to three interest groups: patients, nurses, family members, and primary caregivers.

MATERIAL AND METHOD

Our research was conducted meticulously, employing a mixed methodology with two phases: qualitative, using the focus group for internal validation of the instrument, and quantitative. Subsequently, the survey was passed to the interest group of 430 patients, 525 relatives, and 298 nurses. Chronbac's alpha reliability analysis, the multiple linear regression model as a point estimator of the parameters, and exploratory factor analysis with a maximum likelihood factor using Kaiser-Meyer-Olkin to analyze the constructor and its indicators were performed to validate the adaptation. Finally, confirmatory factor analysis determines their respective measurement models' unidimensionality, validity, and reliability.

RESULTS

The result shows that the factor loading of each subconstruct is more significant than 0.5 in the three models, which indicates that the aptitude indices of the model were met. In addition, the model meets the discriminant validity criteria. The behavior of the SERVPERF questionnaire was analyzed in terms of consistency, Cronbach's alpha=0.94.

CONCLUSION

The scale items' discrimination concerning the questions on global satisfaction is confirmed. This shows that the instrument is valid, reliable, and useful.

Examining Soft and Hard Attributes of Health Care Service Quality and Their Impacts on Patient Satisfaction and Loyalty

BACKGROUND AND OBJECTIVES

Many studies have confirmed the influences of various service quality dimensions on patient satisfaction and loyalty, but no existing theoretical model accounts for variation in how different types of patients evaluate service quality's soft and hard attributes. This research gap may cause problems for administrators needing to decide how to distribute resources appropriately across multiple departments. Therefore, this study establishes a theoretical model of the differences between inpatients' and outpatients' evaluations of hard and soft qualities and compares such evaluations' influences on patient satisfaction and loyalty. Also, to supplement statistical analysis and respond to scholars' calls for more mixed-methods studies of health care quality, this research incorporates analysis of online reviews to provide a holistic, close to real-time picture of patients' service experience perceptions.

METHODS

This study's survey sample comprised 292 inpatients and 137 outpatients from a Taiwanese hospital. We used partial least squares structural equation modeling to test the hypothetical model and importance-performance map analysis to identify factors that were significant to the service process but performed poorly. Finally, we used a text-mining technique to scrape 536 reviews posted on Google Maps, and Leximancer Portal to perform automated content and sentiment analyses on those data, as a means of mapping the critical concepts and themes that influenced patient experiences.

RESULTS

This study's analyses support the ideas that both hard and soft qualities are critical dimensions of service quality, and that each has different influences on inpatients' and outpatients' satisfaction and loyalty. Specifically, the sampled inpatients strongly valued the hard qualities of the hospital but were not satisfied with it. On the other hand, soft qualities attracted outpatients' attention and influenced their satisfaction and loyalty. In addition, content analysis revealed that soft qualities were the main reason patients left comments, whether positive or negative. Waiting time emerged as another critical element in triggering patients' unfavorable reviews.

CONCLUSIONS

Patient population type, whether inpatient or outpatient, has been found to impact perceptions of service quality within health care institutions. As such, health care administrators should be cognizant of this phenomenon and make informed and tailored decisions when addressing quality within their respective services. Emphasis on the development of both interpersonal and professional skills among health care personnel may prove beneficial in enhancing the patient experience and ultimately fostering positive online reviews.

Patients’ perception of service quality in a healthcare not-for-profit organisation

Background

Service organisations should be aware of those elements that are perceived as excellent quality and incorporate these as part of their service offering. However, a not-for-profit (NPO) healthcare organisation consists of a diverse group of stakeholders who have different perspectives and interests. Service quality therefore requires a multidimensional definition that comprehends all their needs and expectations.

Methods

Perceived service quality experienced by patients was measured by completion of the Service Performance (SERVPERF) questionnaire. A total of 111 patients completed the questionnaire across three mobile clinics supported by an NPO.

Results

The research results suggested that service quality at the mobile clinics was of a very high standard, with no meaningful differences between clinics, age groups or gender. However, the responses had very little variance and could have been subjected to response bias or extreme bias. The absence of a comparator organisation could also have had an influence on responses given by respondents.

Conclusion

Healthcare service organisations should strive towards maintaining high standards and engage in continuous measurement and improvement of their service quality as part of their quality management process. By measuring the current level of service experienced by patients, insights have been identified where adjustments might have a positive effect on perceived value. Future research recommendations include suggestions to increase the sample population, taking the service setting into account and further studies to confirm the validity and reliability of solicited service quality questionnaires in a NPO setting.

Evaluating patient and medical staff satisfaction from doctor-patient communication

PURPOSE

The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive respectively in public hospitals, focusing on the factors that affect their communication.

DESIGN/METHODOLOGY/APPROACH

The study used a cross-sectional survey with a sample of 426 participants from two general hospitals in Greece-Pella and KAT Attica. Data were collected through a questionnaire in March-May 2020 and was analyzed with mean comparisons and correlations.

FINDINGS

The results showed discrepancy in the satisfaction rate, with 67.3% satisfied patients from doctors' communication vs. 83.7% satisfied doctors. Improvements in hospital staff - patient communication are required especially on alternative therapies' discussion and time spent on communication. All respondents agreed that staff shortage is a deterrent factor for effective communication. Seamless for all respondents' groups, the factors that affect the communication satisfaction level are the duration of communication, time allowed for expressing questions and interest in patients' personal situation.

PRACTICAL IMPLICATIONS

Strengthening the communication skills of medical staff and providing clear guidelines on when and how to inform patients are essential.

ORIGINALITY/VALUE

This study contributes to the growing body of research on doctor-patient communication. Its originality lies on the fact that communication satisfaction level was examined simultaneously for doctors, nurses and patients. The study provides additional evidence supporting the link among satisfaction and duration of communication and personalized relationship. The study's findings are important in the training of medical staff and the management of patients' expectations.

Validation of a Spanish-language scale for evaluating perceived quality of care of medical abortions before 9 weeks gestation

Background

Spanish Organic Law 2/2010 legalizes abortion within 14 weeks of gestation. Medical abortion with mifepristone and misoprostol is around 97% effective and is offered at primary care centers during the first 9 weeks of gestation. It consists of the administration of 200 mg of mifepristone by a healthcare professional and of the self-administration 800 mg of misoprostol by the patient at home, along with prescribed analgesics. However, the quality of this process as perceived by patients has never been assessed. This study aims to validate a scale designed to assess the perceived quality of the entire process, structure and results of at-home medical abortion.

Methods

Validation study of a Spanish adaptation of the SERVPERF scale. In total, 289 patients completed a self-administered questionnaire consisting of 26 items previously evaluated by a group of experts. A re-test was performed on 53 of these patients 15 days later to assess interobserver consistency.

Results

The highest non-response rate for any single item was 2.1%. The floor effect was 26% and the ceiling effect did not surpass 83%. The linearly weighted Kappa coefficient was good to excellent, in general. An exploratory factor analysis was performed with Varimax rotation, obtaining a total of 7 dimensions that explain 65.9% of the variability. The internal consistency (Cronbach's alpha) for all items was 0.862.

Conclusion

This psychometric instrument is valid and reliable for assessing the quality of care of medical abortion. Medical abortion is efficient, effective and eliminates the need for hospital care, anesthesia and surgical risk. However, user satisfaction has yet to be determined. This study offers a validated scale to assess perceived quality of care, their quality experience and person-centered care for abortion as a fundamental part of overall service quality as a fundamental part of overall service quality.

Facility managers’ responses to user post-occupancy feedback: a conceptual framework

Purpose

This study aims to explore the various approaches used in the general customer service industry to develop a conceptual framework for evaluating the responses of facility managers to user post-occupancy feedback.

Design/methodology/approach

This study uses conceptual analysis based on a comprehensive review of relevant literature.

Findings

The results of the study established 24 propositions which are categorised under organisational response dimensions specific to facilities management (FM): timeliness, facilitation, redress, apology, credibility of explanation, attentiveness, effort and their relationships with overall satisfaction and post-feedback behaviour, such as word of mouth and acceptance to continue using the facilities.

Research limitations/implications

The established propositions are derived from existing theories using a deductive approach. The framework can be further enhanced to suit various applications in FM services.

Practical implications

This conceptual framework is a generic model, appropriate to many FM scenarios. The framework can be used to develop standard policies and procedures to foster and encourage collaborative relationships between users and facility managers. It reinforces transparency and trust between facility managers and users during the operation and management of the facilities, and improves FM effectiveness, facility performance and user post-occupancy experience.

Originality/value

In the FM area, no systematic approach has been previously established to evaluate and improve the response process to the users’ feedback. The proposed framework is a pioneer contribution in this area.