Effects of high-involvement work systems on employee satisfaction and service costs in veterans healthcare

Two strong imperatives for healthcare managers are reducing costs of service and attracting and retaining highly dedicated and competent patient care and support employees. Is there a trade-off or are there organizational practices that can further both objectives at the same time? High-involvement work systems (HIWS) represent a holistic work design that includes interrelated core features such as involvement, empowerment, development, trust, openness, teamwork, and performance-based rewards. HIWS have been linked to higher productivity, quality, employee and customer satisfaction, and market and financial performance in Fortune 1000 firms. Apparently, few prior studies have looked at the impacts of this holistic design within the healthcare sector. This research found that HIWS were associated with both greater employee satisfaction and lower patient service costs in 146 Veterans Health Administration centers, indicating that such practices pay off in both humanistic and financial terms. This suggests that managers implementing HIWS will incur real expenses that are likely to be more than offset by more satisfied employees, less organizational turmoil, and lower service delivery costs, which, in this study, amounted to over $1.2 million in savings for an average VHA facility.     

A quality tool for health insurers. A new scale measures "quality orientation" from the customer's point of view

This study defines a company's quality orientation as "all process-related activities that can be discerned by customers." This even includes certain processes internal to the company that can be seen and evaluated by customers. One significant contribution this study provides is scale development centered on customer rather than employee perceptions. To generate scale items, input was gathered from experts involved in the study, senior managers employed with the target company, focus groups of employees working on the front line with customers, and users of the services. Because the sale measures customer perceptions of quality in comparison with the firm's closest competitor, it provides managers with information for benchmarking performance relative to others in the marketplace.     

如何创建遗传学队伍质量信得过班组

学科建设是医院建设与发展的支柱。为推动医学遗传学学科发展,创建了遗传学队伍质量信得过班组。通过识别顾客及相关方关键需求,以提高顾客满意度和员工成长满意度为目标,建立了以员工成长为核心的管理体系。通过对管理目标进行分析,以全面管理为基础,建立了学习型团队,细化了工作内容,营造了班组文化,实行了标准化管理。团队成长满足了服务需求,顾客满意度和员工成长满意度得以提升,建立了可推广、可复制的学习型班组建设模式。     

Happy employees lead to loyal patients. Survey of nurses and patients shows a strong link between employee satisfaction and patient loyalty

A strong relationship exists between employee satisfaction and patients' perceptions of the quality of their care, measured in terms of their intent to return and to recommend the hospital to others. Employee dissatisfaction can negatively affect quality of care and have an adverse effect on patient loyalty and, thus hospital profitability. Therefore, health care marketers should regularly measure employee satisfaction as one way to monitor service quality. Health care marketers must work more closely with their human-resource departments to understand and influence employees' work environment and maintain a high level of job satisfaction. Marketers also should place an increased emphasis on both employee and patient perceptions of satisfaction when developing internal and external strategic marketing plans and formulating future research.     

基于顾客感知的医院服务质量满意度研究

目的 了解基于顾客感知的不同层级医院服务质量满意度情况,为医院服务质量持续改进提供参考.方法 根据PZB的服务质量模型,从有形性、可靠性、响应性、保证性、移情性5个方面设计调查问卷,于2013年4月～8月对广东省某三级医院、某二级医院的顾客进行随机抽样调查.结果 顾客对三级医院、二级医院服务质量总体比较满意,但在某些方面仍有差距,尤其是二级医院.结论 医院应重视基于顾客感知的医疗服务质量满意度,积极改进不足,努力满足顾客合理需求,促医疗服务质量不断提高.     

Taking the pulse of Internet pharmacies.

Like most businesses, online pharmacy companies will only be successful if they make sure customers are satisfied with the service they receive. But what attributes of service quality lead to satisfaction and dissatisfaction? This study identified 19 Internet pharmacy service quality dimensions in three categories: (1) product cost and availability, (2) customer service, and (3) the online information system. Our analysis uncovered attributes that tend to determine consumer satisfaction and points out ways to improve overall service quality in the Internet pharmacy arena.     

A call center primer

Call centers are strategically and tactically important to many industries, including the healthcare industry. Call centers play a key role in acquiring and retaining customers. The ability to deliver high-quality and timely customer service without much expense is the basis for the proliferation and expansion of call centers. Call centers are unique blends of people and technology, where performance indicates combining appropriate technology tools with sound management practices built on key operational data. While the technology is fascinating, the people working in call centers and the skill of the management team ultimately make a difference to their companies.     

Creating a healing environment: the importance of the service setting in the new consumer-oriented healthcare system

Over the last ten years, the healthcare industry has recognized that the physical environment is a valuable resource that can and does affect all of its customers. Although most service organizations give some thought to setting, its importance to the service experience has been most thoroughly understood by those who view and treat their customers as guests, that is, the guest service industry. An excellent healing environment will reinforce excellent clinical quality, but an inferior environment can detract from fine clinical care. One of the most important principles learned by the guest service industry is to provide the setting customers expect. Another is to create an environment that meets or exceeds customer needs for safety, security, support, competence, physical comfort, and psychological comfort. This article provides a detailed discussion of how such an environment can be created in healthcare facilities drawing from the experience of the best guest service organizations.     

Competing values in healthcare: balancing the (un)balanced scorecard

Facing a complex environment driven by two decades of dramatic change, healthcare organizations are adopting new strategic frameworks such as the Balanced Scorecard (BSC) to evaluate performance (Kaplan and Norton 1992). The BSC was not originally developed as a performance management tool, however. Rather, it was designed as a tool to communicate strategy and, as such, provides little guidance when actual outcomes fall short of desired outcomes. In addition, although the BSC is an improvement over exclusively financial measures, it has three conceptual limitations that are especially problematic for evaluating healthcare organizations: (1) it underemphasizes the employee perspective, (2) it is founded on a control-based management philosophy, and (3) it emphasizes making trade-offs. To address these limitations, we propose using the Competing Values Framework (CVF), a theoretically grounded, comprehensive approach to understanding and improving organizational and managerial performance by focusing on four action imperatives: competing, controlling, collaborating, and creating. The CVF pays particular attention to the employee perspective, is consistent with a commitment-based management philosophy, and emphasizes transcending apparent paradoxes to identify win-win solutions. Rather than focusing on customer satisfaction or employee satisfaction, the CVF looks for ways to satisfy customers and employees while still addressing financial constraints and growth opportunities. The CVF also can be used to assess both the culture of the organization and the competencies of individual managers, thereby providing a clear link between strategy and implementation.     

Quality evaluation in health care services based on customer-provider relationships

PURPOSE: To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. DESIGN/METHODOLOGY/APPROACH: Systematic review of the literature. FINDINGS: Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). ORIGINALITY/VALUE: This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.     

Customers' Precedence for Service Quality Dimensions in Indian Private Healthcare Setting: A Ridit Approach

Changes in demographic and sociocultural environment, improved health awareness, and information technology have considerably changed the outlook of healthcare sector in India. While both the public and the private healthcare sectors have priority of increasing access while minimizing costs, they try hard to achieve goals without letting the quality suffer. Customers with rising disposable income no longer have faith in the public healthcare system and are willing to migrate to the private healthcare sector, which is more professional, technology savvy, and trustworthy. However, there are enough loopholes in the private healthcare sector that are yet to be plugged. The purpose of this research study was to identify and assess the relative importance of the diverse service quality dimensions and prioritize them to draw meaningful conclusions. Survey responses from 370 customers were analyzed using factor analysis to find underlying relationships between the survey items. This allowed the individual items to be placed into related groups. Independently, a ridit analysis was conducted to determine the relative importance of each item to the survey respondents. Based on the ridit analysis a priority ranking was assigned to each item. An analysis was then undertaken of the degree to which the items grouped into each particular factor tended to have high or low priority rankings. The results of the study may be helpful to the managers of the private healthcare sector to focus their strategies and plan their efforts in line with the findings to gain superior customer satisfaction and retention.     

关于医院如何培养忠诚顾客的思考

文章作者对忠诚顾客的定义以及培养忠诚顾客的重要意义做了系统的阐述.针对医院如何培养忠诚顾客,提出了好的建议,包括通过提高顾客的满意度来提高顾客忠诚度,利用约束条件提高顾客忠诚度,通过服务补救提高顾客忠诚度.     

血站服务质量存在问题及建议

血站服务质量直接影响无偿献血者的招募和血液安全。针对目前血站服务质量存在问题,提出了应提高血站管理者对服务质量理念的认识;加大血站与服务对象的沟通力度;增强顾客满意度调查的科学性,重视顾客投诉与建议;强调全员参与,提高服务质量目标的可行性;服务承诺准确表达,量力而行;加强员工培训,提升员工素养等建议。     

顾客需求与医疗服务质量持续改进的实证研究

目的探讨以顾客质量需求为导向在改进医疗服务质量中的作用。方法采用留置问卷法随机收集我院2006年1—2月（改进前）和2006年7—8月（改进后）各500人次顾客质量感知信息,运用象限图法对数据进行分析,并对比调查结果。结果经质量改进后,医院的优势服务项目由10项增加到24项,顾客的总体满意度由77.6分提高到90.2分,忠诚顾客由34.7%上升至66.5%。结论运用象限图法对调查数据进行分析,可以了解顾客需求,有利于医院有针对性地实施改进措施,实现持续改进的医疗服务质量方针。     

Health care work environments, employee satisfaction, and patient safety: Care provider perspectives

BACKGROUND: Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction. PURPOSES: The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors. METHODOLOGY/APPROACH: We examined perceptions of nurses from three acute care hospitals in the eastern United States. FINDINGS: Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units. PRACTICE IMPLICATIONS: Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.     

An investigation of the suitability of the EFQM Excellence Model for a pharmacy department within an NHS Trust

Explores whether the EFQM Excellence Model provides a suitable framework for quality management within the pharmacy department at Hope Hospital, Salford Royal Hospitals NHS Trust. Research involved a literature search of the work of authors in the field of quality, generically and in healthcare, the development of quality awards, and practical cases of implementation of the model in NHS Trusts. Common themes were identified from this search. Interviews with staff and customers showed high levels of customer awareness, customer satisfaction and generic training. This was compared with the data from the literature search and the researcher's observations. The Excellence Model was seen to be a suitable framework for quality management provision, although there was little knowledge of it in the pharmacy department. A quality service was still being provided in spite of this, but the model could build further on this good work and provide a more structured approach.     

Clients’ Perceptions of Service Quality and Satisfaction at Their Initial Title X Family Planning Visit

Family planning service quality and clients’ satisfaction with services are important determinants of clients’ contraceptive use and continuation. We examine women’s experiences at family planning clinics on a range of dimensions, including patient-centered communication (PCC), and identify experiences associated with higher ratings of service quality and satisfaction. New female clients (n = 748), ages 18–35 years, from clinics in three major metropolitan areas completed computer-administered interviews between 2008 and 2009. Factors associated with primary outcomes of service quality and satisfaction were assessed using multinomial and ordinary logistic regression, respectively. Higher scores on a Clinician–Client Centeredness Scale, measuring whether clinicians were respectful, listened, and provided thoughtful explanations, were associated with perceptions of good quality care and being very satisfied. Higher scores on a Clinic Discomfort Scale, measuring staff and waiting-room experiences, were associated with reduced satisfaction. Clients’ interactions with clinicians, especially PCC, influence their perceptions of service quality, whereas their satisfaction with services is also influenced by the facility environment. These measures are adaptable for agencies to identify the factors contributing to their own clients’ satisfaction–dissatisfaction with care and perceptions of service quality.     

Customer convergence: patients, physicians, and employees share in the experience and evaluation of healthcare quality

This article explores the interrelationships between three categories of service quality in healthcare delivery organizations: patient, employee, and physician satisfaction. Using the largest and most representative national databases available, the study compares the evaluations of hospital care by more than 2 million patients, 150,000 employees, and 40,000 physicians. The results confirm the relationship connecting employees' satisfaction and loyalty to their patients' satisfaction and loyalty. Patients' satisfaction and loyalty were also strongly associated with medical staff physicians' evaluations of overall satisfaction and loyalty to the hospital. Similarly, hospital employees' satisfaction and loyalty were related to the medical staff physicians' satisfaction with and loyalty to the hospital. Based upon the strength of the interrelationships, individual measures and subscales can serve as leverage points for improving linked outcomes. Patients, physicians, and employees, the three co-creators of health, agree on the evaluation of the quality of that service experience. The results demonstrate that promoting patient-centeredness, enhancing medical staff relations, and improving the satisfaction and loyalty of employees are not necessarily three separate activities in competition for hospital resources and marketing leadership attention.