Academic journal article Journal of Applied Management and Entrepreneurship

Emotional Attachment to a Hospital: Bringing Employees and Customers into the Engagement Zone

Academic journal article Journal of Applied Management and Entrepreneurship

Emotional Attachment to a Hospital: Bringing Employees and Customers into the Engagement Zone

Article excerpt


A central idea of the service profit chain is the so-called satisfaction mirror (Heskett, Sasser and Schlesinger, 1997). The satisfaction mirror refers to a strong positive correlation between employee satisfaction and customer satisfaction in service organizations. Service organizations only achieve employee retention and customer loyalty by having very satisfied employees and customers, i.e. employees and customers with affective feelings toward the organization (Heskett et al., 1997). This is in accordance with a large and growing number of case studies making a distinction between rational and emotional satisfaction. Emotional satisfaction requires a strong emotional attachment to the organization, which is also labeled as 'engagement' (Fleming and Asplund, 2007). Based on these insights, employee and customer engagement or emotional attachment to the organization deserve particular attention.

In this study, the concept of emotional attachment of employees and customers is investigated in a hospital setting. To what extent do nurses, physicians and other employees of a hospital have affective feelings toward their organization? And is it reasonable to expect that a patient becomes 'emotionally attached to the hospital'? And finally, what impact does employees' and customers' emotional attachment have on their loyalty toward the hospital? The paper first explores the employee-organization linkage and the customer-organization linkage with an emphasis on the role of emotions, including a discussion involving the importance of loyalty. Next, an overview of the results of an empirical study of the emotional attachment of employees and customers to a large hospital is given. The findings, limitations and managerial implications are discussed in the last section.

Literature Review

The Customer-Organization Linkage

Customer loyalty can be defined as "customer behavior characterized by a positive buying pattern during an extended period (measured by means of repeat purchases, frequency of purchase, wallet share or other indicators) and driven by a positive attitude towards the company and its products and services" (De Wulf, 2003). Customer loyalty is considered as important because it brings several benefits for organizations. Benefits of customer loyalty include reduction of marketing costs, growth of per-customer revenue, decrease in operating costs, increase in switching barriers among loyal customers, and the opportunity to build long-term and profitable relationships with the customers e.g. Morgan and Hunt, 1994; Yi and La, 2004; Kuenzel and Krolikowska, 2008; Raimondo, Miceli and Costabile, 2008; Zhang and Bloemer, 2008). Otani, Waterman, Faulkner, Boslaugh, Burroughs and Dunagan (2009) investigated customer loyalty in the hospital sector and found similar results: repeat customers and customers who recommend the hospital to others are crucial for hospitals to survive. Regarding the benefits of customer loyalty, many organizations strive toward enhancing customer loyalty (Yi and La, 2004). Customer loyalty, however, can only be improved by understanding its detenninants. Several researchers considered satisfaction and trust as important determinants of customer loyalty (Morgan and Hunt, 1994; Ferguson, Paulin and Leiriao, 2006; Zhang and Bloemer, 2008; Raimondo et al., 2008). Recent research, however, demonstrated that (affective) commitment also is an important determinant of customer loyalty (e.g. Ferguson et al., 2006; Zhang and Bloemer, 2008).

According to Morgan and Hunt (1994), customer commitment can be defined as "an exchange partner believing that an ongoing relationship with another is so important as to warrant maximum efforts at maintaining it". Raimondo et al. (2008) argue that there is considerable overlap between customer commitment and attitudinal loyalty. The attitudinal approach of loyalty is more recent and focuses on the cognitive, affective, and conative aspects of loyalty, such as a positive attitude toward the organization, repeat purchase intentions, and commitment to rebuy a preferred product or service in the future (Yi and La, 2004). …

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