The paper adds a new perspective towards understanding how the concept of service quality is adopted in a hospital sector. The author wishes that this study identifies areas of dissatisfaction that can be quickly remedied and ensures improvement in the areas of satisfaction with ongoing notice and importance. As medical costs accelerate, patients are finding alternatives for low-cost treatment and going abroad to get healthy seems very appealing.
Lured by the promise of high quality, reliable medical care at a lower cost, patients are flying across the globe for medical treatment that they otherwise would not have access to easily due to prohibitive costs, long waiting time or unavailability of treatment in their home country.
The promise of medical care and the attraction of exotic places are taking people places for medical care. The process of healthcare tourism is jointly facilitated by the corporate sector involved in medical and healthcare as well as the tourism industry — both private and public. Medical tourism has become a common form of vacationing, and covers a broad spectrum of medical services.
Medical tourism mixes leisure, fun and relaxation together with wellness and health care. There is a growing consensus within the NHS of the significance of obtaining feedback from patients in order to improve the quality of health care; consequently, many patient satisfaction surveys are now undertaken by health care sector. Against a background of growing consumerism, satisfying patients has become a key task for all healthcare activities.
Satisfaction in service provision is increasingly being used as a measure of health system performance. Many hospitals apply modern marketing ideas to serve customer markets in a more efficient and effective way.
An important strategic variable in this respect is service quality. This paper attempts to explore the concept of service quality in a health care setting. Wan Edura Wan Rashid, Hj. Kamaruzaman Jusoff, attempted to explore the concept of service quality in a health care setting. This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care.
It adopts the conceptual model of service quality frequently used by the most researchers in the health care sector. At the end, the researcher concluded that service quality in health care is very complex as compared to other services because this sector highly involves risk. Oswald and Douglas E. Turner investigated the effects of demographic factors on users and observers of perceived hospital quality and noted that previous research suggests the components of perceived service quality are industry specific, and that calls have been made for academics to integrate their theory into practice.
At the end, the researcher found that perceived quality is industry specific, users and observers differ in their perceptions of hospital quality and demographic factors do make a difference in perceived hospital quality. Ioannis E. Chaniotakis and Constantine Lymperopoulos aimed to study the effect of service quality SQ dimensions on satisfaction and word of mouth WOM for maternities in Greece.
Ritu Narang intended to measure the perception of patients towards quality of services in public health care centres in rural India. A item scale that tested well for reliability and construct validity was employed for the study. Mixed sampling technique was employed to select the sample. Education, gender and income were found to be significantly associated with user perception. The questionnaires were distributed in primary healthcare clinics that represent all heath care regions in Kuwait.
From the survey result, researchers found that the majority 87 per cent of the patients responded that the time for communication between physician and patient was not enough. Seventy-nine per cent of the surveyed patients said they would go to the emergency room of the hospital in future if needed instead of going to the primary care clinic. Regarding the quality of the communication relationship between physician and patients, most of the patients responded negatively.
Raman Sharma, Meenakshi Sharma and R. A cross-sectional study was conducted to assess the patient satisfaction level visiting the hospital with the objectives to know the behaviour and clinical care by the clinicians and paramedical staff and in terms of amenities available. A pre-designed and pre-tested structured questionnaire was given to the respondents after the patients had undergone consultation with the doctor.
From the survey result, researchers found that The Government subsidies, fiscal incentives and tax breaks form a major input for the growth. He suggested the promoted measures to improve infrastructure to support the medical tourism industry. Medical tourism is now far more than just an uninsured patient-based consumer issue. State legislators are also beginning to consider the financial benefits of medical tourism.
Several corporations are also investigating potential benefits of medical outsourcing because of rising health care costs.
Many major employers are self-insured, and they are considering medical outsourcing as an option for their employees in order to experience significant cost-savings. The export of patients to international hospitals is primarily based on the significantly lower cost of procedures offered outside the United States; however, the export of patients is just one aspect of this growing medical outsourcing practice.
Content validity wording and meaning was checked carefully by experts. A pre- test was then conducted with a group of patients, and minor changes to the scales were made accordingly to ensure that the questions were not repetitive. The researchers have used 41 structured and paired questions to measure Expectation E and Perception P for service quality of hospitals. The literature suggests that appearance is important to customers e. Baker, Dhruv and Parasuraman, It has two sub-dimensions and other variations.
Patients view reliability as a combination of doing it right and availability of all the information regarding treatment. So, the sub-dimensions of reliability are promises statements 17 to 19 in the scale and information availability statements 20 to 24 in the scale. It has two sub-dimensions — responsiveness statements 25 to 26 in the scale and empathy statements 27 to 33 in the scale. These sub-dimensions are very closely related and capture how the customer is treated by the employee.
Process is critical for the success of any medical service. This dimension does not have any sub-dimension. The instrument could also serve as a diagnostic tool to determine service areas that are weak and that need attention.
However, in spite of its wide applicability and rigorous development, the use of the instrument should be properly tested under different contexts in order to determine its validity and reliability. Encounter: Responsiveness 3. This is an analytical study based on the primary data collected through scientifically developed questionnaire.
List-wise deletion based on all variables in the procedure. Ahmedabad and Hail. A literature review was undertaken to identify what parameters to consider in research. The data was collected through questionnaire consisting of 3 parts. In Part I, there were 41 statements measuring the expected service quality from excellent hospitals. In Part II, the same items were measuring the service quality perceptions of private hospitals in Ahmedabad and Gandhinagar region of India and Hail city of Saudi Arabia.
Here, respondents were asked to evaluate the statements with regard to the hospital s. The last part of the questionnaire consisted of demographic questions. A questionnaire was constructed and piloted on 57 patients. The questionnaire was prepared keeping in mind the various outcomes possible. Care was taken to minimise the possibility of wrong interpretation and biased views.
The judgement sampling method is used who were admitted in hospital for minimum two days. In order to collect quantitative data for the study, a total of questionnaires were printed and distributed to respondents. The researcher selected 3 private hospitals in Saudi Arabia and 5 hospitals in India that include medium-scale clinics in which surgery is carried out were selected for survey. For all 41 statements of expectation and perception each, weighted arithmetic mean was calculated, and gap score was determined by deducting perception values from expectation values.
Dimensions-wise mean score of perception and expectation of private hospitals was determined and comparative analysis was prepared keeping in mind the gap score of each dimension.
The lowest Saudi hospital expectation score was obtained from question 15 This hospital provides for proper safety and comfort measures, e. The lowest Indian hospital expectation score was obtained from question 11 Amenities such as continuous electricity and water supply, housekeeping and sanitation facilities, comfortable conditions such as temperature, ventilation, noise, etc.
Out of five dimensions, Indian private hospitals perform better than Saudi private hospitals in 4 dimensions, namely physical aspects, encounter, process and policy, while Saudi private hospitals perform better than Indian private sector only in one dimension, namely reliability.
It should be replicated in other part of countries especially with all major cities. In future, the expectation and perception sections should be separated, although this may create difficulties contacting respondents just before their service and just after the service encounter. Future studies should also investigate the effects of service quality dimensions on the overall satisfaction, recommending behaviour and loyalty. Replication studies using large diversified samples elsewhere would be useful in order to corroborate our study findings.
The current research reinforces the fact that service quality is a complex and multidimensional construct. Our findings have important implications for Indian and Saudi private hospital owners, managers, government officials, academics and other related parties in the hospital services. Most customers are reluctant Ekiz, to make their needs and expectations explicit, including their complaints, although the opportunity to do so is clearly provided in order to promote healing environment.
Kamaruzaman Jusoff. Service Quality in Health Care Setting. Daniel Butler, Sharon L. Oswald, Douglas E. Journal of Management in Medicine ; 8 — 20 3. Chaniotakis, Constantine Lymperopoulos. Managing Service Quality ; 19, — 4. Ritu Narang. An International Journal ; 16, 35 — 49 5. Raman Sharma, Meenakshi Sharma, R. Leadership in Health Services ; 24, 64 — 73 8. Rust, R. International Journal of Service Industry Management ; 7, Sohail, M. Managing Service Quality ; 13, Uzun, O.
Journal of Nursing Care Quality ; 16, Valdivia, M. Karen L McClean. Trade in Health Services. Bulletin of the World Health Organisation. The International Journal of Public Health ; 2, — Outsourcing Your Heart. Time Magazine May 21, , accessed May 9, ; at: www. Their initial capital cost is high and their running cost year after year, especially for in-patient services is enormous. The first task of the health services is to reach all the people all the time at the best level of care the country can afford.
Hospital provision is only one part of the health service, and the money devoted to it must not impoverish the rest of the service.
At the same time, expenditure on health services, of which hospitals are a part should be regarded as an investment that will pay economic dividends in the form of lessened invalidity, reduced unemployment caused by sickness and increased industrial production. One of the primary means of attaining this desirable aim is via outreach programmes.
In these cases, the aim is to reach out into the community and provide quality health care delivery facilities so that the need to visit a hospital is kept to a minimum.
Outreach programmes cannot work unless there is effective hospital support in terms of material, manpower, money and management. The primary function of the clinical laboratories is to perform laboratory tests, which will provide information to clinicians in arriving at correct diagnosis and in the treatment and prevention of disease.
The practice of modern medicine requires more and more laboratory examinations. A couple of decades ago, laboratory determinants were done manually covering only basic diagnostics tests needed for patient assessment. Most labs are now equipped with, to a varying degree, sophisticated automated instruments such as analysers, which have increased productivity.
Tests are performed in a matter of minutes and with the highest degree of accuracy. MSVs specialise in designing and providing Command and Communication Centers and Trailers to law enforcement, fire, military and other agencies. It is applying its expertise in creating custom- designed multi-functional centres to local, country, state and federal government and first responders. These vehicles can be equipped with environmental defense systems to protect against nuclear, biological and chemical harmfulness.
The outreach programme for the lab facilities of a large corporate hospital could be effective and efficiently carried out through a mobile unit. The Need for such Facility A mobile sample collection unit is an integrated facility offering the state-of-the-art diagnostic facilities.
It combines convenience with affordability. The patients need not to come to the hospital. The lab services come to the patient. It will result in enormous savings in terms of zero travel and accommodation expenditure and reduced wastage of time. This unit offers tremendous flexibility and reach. E Continuous Medical Education programmes. Similar floating units are also seen on the River Godavari in Andhra Pradesh and in the backwaters of Kerala.
Many government and charitable institutions in India have mobile units designed for educational family planning surgeries and ophthalmic procedures.
Pandyarajah Ballal charitable trust in Mangalore. It has on board equipment for X-ray and ultrasound. It also has facilities to collect specimen samples that are taken from the peripheries to laboratories located in Mangalore. This van is also used as a critical care ambulance. It is a foot self-contained vehicle that includes two examination rooms and a work area. The rear examination room also serves as a mammography suite. The van is capable of providing everything from routine health screening to psychiatric evolutions and alcohol counselling.
The first is an occupational medicine unit on which physical examinations, health and wellness education programmes and hearing vision and pulmonary function testing can be done. The second unit is used to determine which outreach locations would support a fixed rural health clinic.
It is currently being equipped for telemedicine. Free cholesterol and blood tests were administered to raise corporate awareness and establish a presence in the outlying areas. The mobile programme is now concentrating on screening and preventive activities. The standard tests performed include those for diabetic, vision hearing and blood parameters. It also offers some specialised services. The UPMRC staff can make referrals to specialists who accompany the clinic, thereby saving the patient expenditure on travel and accommodation.
Their mission is to reduce the time who accompany the clinic, thereby saving the patient expenditure and travel. The following factors are responsible for the creation of a mobile sample collection unit: i The treatment to the patient depends on the results of diagnostic test, but due to late report delivery, treatment would be delayed. Delay in report delivery irritates these people and it made lead to switch to other hospital. So, next time they may switch on to some other hospital.
General Laboratory Procedures The following are the usual procedures for requesting and handling lab examination: zz Requests for examination should be in writing. The sample collection comprises the following: i. For blood collection, a separate sample collection has to be provided. Sterile tubes, needles and syringes are provided for blood collection. The specimens at collection are given a unique identification number. The request form should also carry the identification number as that on the specimen.
General Specimen Collection Guidelines The accuracy of any test procedure depends on the quality of the specimen, how and when it was collected, the care given to its preservation, and how soon it reaches the laboratory.
The common site of infection is often contaminated with indigenous flora, so precautions must be taken to obtain a valid specimen. Before specimens are bagged for pickup, they should be checked to be sure that all laboratory forms are completely filled out and each specimen is tightly sealed and properly packaged for safe delivery. It is the responsibility of the clinic to ensure that laboratory specimens are not a hazard to transport personnel or to laboratory personnel that handle specimens.
Laboratory personnel will be available at the laboratory for Sunday morning delivery by special arrangement. Sample Preparation and Storage The following should be noted in sample preparation and storage: i It is mandatory to carry out sample preparation activity as early as possible for efficiency and for maintenance of sample integrity. However, clinical trial samples are stored as per the requirement given by the sponsor.
All gel packs should be frozen for at least 24 hours and less than zero0C prior to use. Use separate transport boxes for each of the temperature ranges, e. The number of samples collected in the morning is and the number of samples collected in the afternoon is Therefore, the market survey was intended to send out feelers as to the acceptability and possible future use of this facility.
This is a product that the user may not be able to identify as the concept is introduced that we intend not to create a need rather to bring to the surface an unconscious need. Empathic research deals with identifying potentially critical customer needs. Table 2 depicts the questionnaire analysis. No Questionnaire Analysis 1 Is this your first visit to hospital? Nowadays, most of the people working in different areas are choosing better health care services including diagnostics within the short span of time with good quality of services.
As far as selling the concept to organisations is concerned, a more aggressive marketing approach has to be adopted. The use of this service must be primarily targeted at the convenience factor and the range of tests offered. This is in order to attract more people patients and also to fulfil the needs of the people that they are, in fact saving their time and money by using mobile sample collection units.
This is only a suggestive model. The use and sale of other facilities on the unit for a profit are assumed to contribute to the cash flow in a positive manner. The individual tests will be suitably priced so as to be competitive with the local facilities. The former is the total cost of all material used in a lab and the fixed costs include salary depreciation, insurance, road tax, fuel expenses, maintenance and convenience expenses. The rate of depreciation on medical equipment is taken as 7.
The straight line method is used. The chemical disinfection is carried out in a suitable receptacle kept at the workstation. Commonly used disinfectants are sodium hypo chloride, formaldehyde, Glutaraldehyde, phenol and hydrogen peroxide. The receptacle can be carried back to the base hospital where appropriate disposal through incineration is carried out. Hepatitis B virus. Salaries 1,44, 1,58, 1,72, 1,87, 2,01, 2.
Depreciation 3, 3, 3, 3, 3, 3. Insurance 2, 2, 2, 2, 2, 4. Road tax 1, 1, 1, 1, 1, 5. Fuel expenses 4, 4, 5, 5, 5, 6. Maintenance 6, 6, 7, 8, 9, 7. This idea is most acceptable to the organisation, if this is done.
The price can remain the same or even slightly higher for individual users. Our survey among visitors to hospitals has revealed that the idea is very appealing to them as individual users. Therefore, the capability and use of the van may be extended to meet their requirements.
This is further discussed under the recommendation section of the project. As far as selling the concept to organisations is concerned, a more aggressive approach should be targeted at the convenience factor and the range of tests offered. The package in price will have to be adjusted slightly higher than the average in order to attract more and also fulfil the psychological factor that they are in fact saving money for their companies by using this facility.
They are workflow and information flow. In the organisation of the work flow, the two important aspects should be noted: the procurement of specimens and their delivery to the laboratory. The tests are performed according to established procedures on the basis of several factors such as the number and types of tests ordered, the time they are ordered, the extent of automation of the laboratory, etc.
There are two phases in the information flow. In the first phase, the tests are ordered. In the second phase, the ordered tests are logged in and the results are reported. Two major factors that determine the efficiency, accuracy, workload and speed of performance of the laboratory are the extent of automation in the production cycle and the extent of computerisation of the laboratory. The lab processing system may be manual, partially computerised or fully computerised. There is an urgent need for cross-training efficiency.
A technician trained exclusively in biochemistry must learn about systems in clinical pathology or haematology. In short, an efficient core laboratory must have versatile staff. In this case, door-to-door service would not be possible. This is more acceptable in an area where laboratory penetration is minimal and imaging facility can be extended the USG and the high quality of services offered.
This can be done at their leisure preferably over the weekend. However, this will materialise only after a concerted marketing effort. Earlier attempts have mostly failed due to lack of proper planning and implementation. These vehicles can be converted into mobile van that will provide a powerful backup to each area. The remaining week has been kept free so that the vehicle may be in the used for some specialised campaigns.
For the needy, these programmes must be preceded by the well-designed media plan using both the press and local electronic media to educate the masses about facilities being offered. The concept has generated a lot of enthusiasm and interest in all the people involved during the course of the study.
The initiation of such project requires aggressive marketing and promotion. Even though the payback period of the project is considered to be rather extended, there are innumerable intangible benefits associated with this facility. In the long run, the hospital could expand and extend the facility using these mobile units to wider areas of operation, which will eventually revolutionise the concept of health care in the country.
It is hoped that such an idea becomes a reality in the foreseeable future. Theodore A. Kunders G. Government of New Zealand, Available at www. Pathology Laboratory, Available at www. Analytical designs, Available at www. Government projects, www.
Hospital management information system has enabled the provision of better care to patients by automating all the major functional areas of government hospitals. It is also facilitating the monitoring of pre-defined health indicators by generating periodic reports for the hospital management as well as state-level administrators. The development in the sector permeates every human activity; social, economic, cultural, religious, political and healthcare.
Almost all the industries in the western countries are highly dependent on information technology and information systems even healthcare is not an exception.
With increasing complexities of business operations, technology and management, organisations want to grow and keep the firm in good strategic position. This is possible only if the firm has adequate, fast, consistent and reliable information about the business environment. Information system is an important tool that provides information required by the business organisation and its stakeholders so that managers can initiate decisions which help growth of the organisation.
As the modern business environment is highly interconnected, information is readily available as well as exposed to a growing number and wider variety of intimidation and vulnerabilities. Information technology has revolutionised the way medicine is practiced and how healthcare information is documented, archived and retrieved at the point of care.
It is apparent that the use of modern information system offers tremendous opportunities to reduce clinical errors e. While information system is facing challenges of adoption, communication technology is striving to create health information exchanges for connecting providers within multi-organisation environments and across disparate geographical boundaries, using secure and fail-safe internet connectivity for high speed data, voice and video communication.
Information technology should play a vital element in reducing the risk by streamlining care, catching and correcting errors, assisting with decisions, and providing feedback on performance. Information technology has the potential to improve the quality, safety, and efficiency of health care.
Healthcare professionals can no longer ignore the application of information technology. In this context, healthcare managers and professionals rely on a variety of information systems that use information technologies in their day-to-day operations.
Drivers of investment in IT include the promise of quality and efficiency gains. Barriers include the cost and complexity of IT implementation, which often necessitates significant work process and cultural changes.
The successful development and utilisation of Integrated Information Systems in healthcare setup is considered to be a great challenge. The book is filled with real-world projects and examples of applying design to health. Bon Ku and Ellen Lupton. Search Search. Search Advanced Search close Close. Health Design Thinking Creating Products and Services for Better Health By Bon Ku and Ellen Lupton Applying the principles of human-centered design to real-world health care challenges, from drug packaging to early detection of breast cancer.
Publications Can people afford to pay for health care? New evidence on financial protection in Europe See all key publications. Skip to content mytopbookspace.
Author : Watfa, Mohamed K. Emerging information and wireless communication technologies in health and healthcare have led to the creation of e-health systems, also known as e-healthcare, which have been drawing increasing attention in the public and have gained strong support from government agencies and various organizations. E-Healthcare Systems and Wireless Communications: Current and Future Challenges explores the developments and challenges associated with the successful deployment of e-healthcare systems.
The book combines research efforts in different disciplines including pervasive wireless communications, wearable computing, context-awareness, sensor data fusion, artificial intelligence, neural networks, expert systems, databases, and security.
This work serves as a comprehensive reference for graduate students in bioengineering and also provides solutions for medical researchers who are faced with the challenge of designing and implementing a cost-effective pervasive and ubiquitous wireless communication system.
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