Magazine article Journal of Services Research

Manager and Patient Perceptions of a Quality Outpatient Service: Measuring the Gap

Magazine article Journal of Services Research

Manager and Patient Perceptions of a Quality Outpatient Service: Measuring the Gap

Article excerpt


Benenden Hospital in the UK provides an outpatient service but how does management know that they provide a good quality service? They might reach this conclusion because the number of patients that complain is relatively low considering that nearly three thousand patients are seen in the department each month. This evidence is then supported by the organisation's annual patient satisfaction survey that reports high levels of satisfaction amongst the patients receiving care. However, the objective of the annual hospital satisfaction survey is not to measure specific clinical service provision but to achieve a broad measure of general satisfaction with the overall hospital service. What is unknown at present is how patients judge the quality of outpatient services? A vigorous measurement to determine the expectations of patients and managers views has never been undertaken. Therefore, through primary and secondary research, this issue will be the focus in this study. Secondary research consisted of desk research including the Beneden Hospital databases, academic literature and healthcare journals as appropriate. The primary research undertaken, examined patient and manager expectations on dimensions of quality, with a view to understanding the relationship between these groups and whether any gap is evident or important.


1. Explain the benefits of understanding and measuring quality.

2. Using an example from the author's workplace, describe the effectiveness of measuring quality and how the evaluation can be used in a positive way to improve service delivery.

The Benenden Healthcare Society Limited owns Benenden Hospital. The Society is a mutual, "not for profit" friendly society run by members for members. Benenden Hospital was founded in 1907 and became a centre for hospital treatment for members of Trade Unions and Friendly Societies and subsequently large numbers of public sector employees who joined here is now the Benenden Society. The Society now has almost one million members paying a weekly subscription of £1.10. The service at the hospital provide a wide range of consultation, diagnosis and treatment services. In 2007 the Hospital expected to be referred by nearly 13 thousand patients, resulting in over 39 thousand outpatient attendances and over six thousand admissions to the hospital. In recent years the hospital has increasingly been able to provide services for patients who are not members of the Benenden Healthcare Society. Local National Health Services (NHS) are increasing their use of the hospital facilities and should refer in the region of two thousand patients in 2007.

The hospital places great emphasis on quality, providing comfortable, clean and infection free accommodation and a range of clinical services that are tailored to meet the needs of individual patients. It is important for Benenden Hospital to offer a service that is considered a higher quality than would be experienced in the NHS because Benenden Hospital wishes to be attractive in a new world of 'choice' when every individual will be able to select their healthcare facility to deliver the service they need. The organisation's management team wants to ensure that the hospital remains an attractive option for the potential patient and their doctors. What benefits are there to delivering a good quality service in the healthcare environment today? This simple cognitive map below attempts to explain the perceived benefits for Benenden Hospital as seen by the observers.

If the benefits of good quality (figure 1) are to be realised then an understanding of quality and quality measurement is required. The literature suggests that discussion related to quality and quality measurement started within the marketing world, with the initial work coming from the manufacturing industry. Service quality measurement followed but within healthcare specifically, there appears a less vigorous approach to analytical quality measurement through satisfaction surveys. …

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