CHAPTER 6 CONCLUSION The previous chapter presented the results based on statistical techniques used for data analysis followed by discussion
CHAPTER 6
CONCLUSION
The previous chapter presented the results based on statistical techniques used for data analysis followed by discussion. This chapter will highlight the main findings and on the objectives that were set. Recommendations will be made based on the findings of the mix-method approach used. The chapter ends with the limitations of the study and the managerial implications.
6.0 Main FindingsThe aim of the study was to assess patient satisfaction in outpatient department in Brown Sequard Mental Health Care Center and the influence of patient satisfaction dimensions on service quality and patient loyalty. For the purpose of this study, a mixed method considered as the post positivist paradigm was used to assess patient satisfaction in the outpatient department.
The first objective was to identify patient satisfaction dimensions in order to develop a scale to assess satisfaction from a patients’ perspective. The five factors based on employees’ feedback and literature review that emerged were healthscape, accessibility, waiting time, communication and OPD personnel. It is also important to highlight that all OPD staff interviewed mentioned communication and a holistic client-centered approach are necessary for quality service delivery and patient satisfaction. A need for continuous upgrading of technical skills and use of technology were also mentioned by staff.
The second objective was to assess patient satisfaction in OPD from patients’ perspective. Patients found patient satisfaction satisfactory and the mean score ranked highest for OPD personnel (4.30), communication and waiting time (4.22), healthscape (3.56) to lowest accessibility (3.47). This implied that patients found that OPD staff were kind, courteous and competent and respecting their right and dignity. Overall, they perceived that there exists a degree of teamwork, and that a client centered/ holistic approach was adopted. Perceived quality of communication too was satisfactory based on good interpersonal relationships and interaction with patients and their relatives. Patients also acknowledged that treatment is run scheduled, the OPD has convenient hours of operation and waiting time before treatment is reasonable. However, low score for healthscape related to the space and comfort of chairs in the waiting area, up-to-date facilities and equipment and use of technology suggest that improvements are needed. Patient satisfaction was lowest related to parking facilities for picking up and dropping off and lack of parking lots reserved for disabled people which have an impact on accessibility.
The third objective was to assess the impact of patient satisfaction dimensions on service quality. A conceptual model with two dependent variables, namely service quality and patient loyalty, and five independent variables, that the patient satisfaction dimensions: healthscape, accessibility, waiting time, communication and OPD personnel was proposed to test three hypothesis. Multiple linear regression was conducted to determine the significance of the impact of each dimension on both service quality and patient loyalty. The result of the multiple regression analysis confirmed that communication and OPD personnel significantly and positively impacted on patient satisfaction at 1% level. The second hypothesis was to determine the impact of patient satisfaction dimensions on patient loyalty and the same two predictors communication and OPD personnel significantly and positively impacted on patient loyalty at the 1% level. The last hypothesis tested in order to validate the conceptual model by means of Pearson’s correlation coefficient shown that the two constructs service quality and patient loyalty are positively correlated. The insignificant dimensions healthscape, waiting time and accessibility do not imply that they are not important, but simply that those two dimensions have more influence on patients’ perception of satisfaction. The findings of this study are consistent with other studies, especially concerning the human element and empathetic communication skills that evoke positive feelings in patients leading to developing relationships with hospital.
The findings of this study and objectives set for this study have been attained. have been reported in this study. To conclude, Ssatisfaction is perceived positively from patients’ perspective. Quality of service is an antecedent to both patient satisfaction and loyalty. Patient satisfaction has a strong impact on loyalty. This implies that when satisfaction is perceived high, patients feelings toward OPD service is positive and they will revisit, recommend service to other and will also share positive WOM with others. 6.1 Limitation of the study
There were some limitations to be reported in this study. The fact that simple random sampling was used to select patients did not guarantee proportionate representation in terms of their demographic attributes, which could lead to a slight bias during cross-sectional analysis. Secondly, with respect to multiple regression analysis, the same respondents provided responses to the independent variables ( patient satisfaction dimensions) and each of the dependent variables service quality and patient loyalty. This may have introduced key informant bias (Baumgarth, 2010), which might have slightly altered the regression coefficients in both models.
It is also important to note that dimensions used in this questionnaire may not represent all satisfaction aspect and other dimensions may be added or adopted for future studies.
The study also considered the perspective of employee and patient, future study with hospital administrators and managers would provide their perspective as well.
6.2 Scope for Future ResearchFuture research is needed with sample power calculation to be representative of the study population so that the findings can be generalized. Future research can also be carried to find if findings are supported and for additional knowledge. 6.3 RECOMMENDATIONS Managerial ImplicationsFindings have shown that both hospital personnel and communication are important patient satisfaction dimensions that impact significantly and positively on service quality and loyalty. Service quality also has a strong impact on loyalty. Therefore, hospital managers need to closely monitor service quality and take appropriate action at their level so as to improve organizational performance and patient satisfaction.
The human element is a major capital in the healthcare sector, therefore it is necessary to implement training program regularly to better equip and motivate employees to provide quality service to satisfy patients and positive behavioral intention. Employees’ communication skills need to be enhanced as it contributes positively to patient satisfaction, service quality and loyalty.
The study also provided meaningful insight on petient,s perspective of satisfaction and revealed both positive and negative scoring. It is necessary to obtain patient,s perception on satisfaction level by means of feedback regularly so that quality can be monitored, assessed and improved to meet their needs. Benchmarking patient satisfaction in hospital is needed in order to join developed healthcare arena.
It is also necessary to implement and encourage compliance to regulations pertaining to promote the rights and dignity of mental patients, especially pertaining to accessibility, parking facilities and user friendly environment in psychiatric hospitals.
6.4 ConclusionThe findings of this study and objectives attained have been reported in this study. Satisfaction is perceived positively from patients’ perspective. Quality of service is an antecedent to both patient satisfaction and loyalty. Patient satisfaction has a strong impact on loyalty. This implies that when satisfaction is perceived high, patients feelings toward OPD service is positive and they will revisit, recommend service to other and will also share positive WOM with others. Abstract
Purpose: The purpose of this study was to assess patient satisfaction with the quality of service in the outpatient department of a psychiatric hospital. The first purpose was to identify patient satisfaction dimensions and develop a scale to assess OPD service. A conceptual framework was proposed and hypotheses to test the influence of patient satisfaction in relation to service quality and loyalty.
Design/methodology/approach: A mix-method sequential approach with a qualitative priority was used in this study. A convenience sampling technique was used and 16 OPD staff were interviewed. Based on qualitative findings and literature review a questionnaire was designed to assess satisfaction level from patients’ perspective. For the quantitative method,200 questionnaires were randomly distributed to out-patients receiving care at the psychiatric hospital. The response rate of participation was 73%. simple random technique was used, whereby a total of 200 questionnaires were distributed 1 psychiatric hospital and 146 were returned (73 per cent response rate) and considered valid for data analysis.
Findings: Cronbach Alpha reliability testing indicates that the five dimensions namely Healthscape, accessibility, waiting time, communication and OPD personnel were acceptable (0.70-0.95) and are distinct dimensions of patient satisfaction. The score of patient satisfaction ranked from: OPD personnel, communication, waiting time, healthscape and accessibility with an overall mean score of 3.95, indicating that patients are satisfied with the quality of service provided at the hospital. The findings of the study reveal that patient satisfaction dimensions OPD personnel and communication have a significant and positive impact on service quality and loyalty. The quality of OPD service is perceived positively from patients’ perspective. Service quality is an antecedent to both patient satisfaction and loyalty. Patient satisfaction has a strong impact on loyalty. This implies that when patient satisfaction level with quality of service provided is perceived high, patients feelings toward OPD service is positive and they will revisit, recommend service to other and will also share positive WOM with others.
Research limitations/ implicationsConclusion: Simple random sampling was used to select patients and may not be proportionate representation in terms of their demographic attributes, which could lead to a slight bias during cross-sectional analysis. The study provided a meaningful insight on patients’ perspective of satisfaction with quality of service and revealed both positive and low scoring on certain items. It is necessary to obtain patients’ perception on satisfaction and service delivery by means of feedback regularly so that quality of service can be monitored, assessed and improved to meet their needs. Hence, Benchmarking satisfaction level with quality of service in psychiatric hospital is needed in order to join the modernized developed mental healthcare arena.
