A measure for service quality for hospitals: scale development and validation

Abstract

Service quality is defined as the difference between perceptions and expectations on the items representing the areas of performance specific to a service. The research was undertaken in order to understand these specific factors patients consider to assess the quality of services offered by any hospital. In particular, the focus of this study has been on a wide range of healthcare services offered by corporate hospitals in India. The objectives were: 1.To examine the various instruments available to measure service quality. 2. To develop an instrument to measure quality of healthcare services 3. To determine the dimensions used in assessing the quality of healthcare services. 4. To highlight how the instrument so designed could be used to develop a strategy for improving quality of services in a hospital. The study involved: 1. Surveying literature to find out existing instruments to measure service quality in general and healthcare service quality in particular 2. Establishing the need for a new instrument for measuring the quality of healthcare services in India. 3. Developing a pool of items which may reflect quality of healthcare services. 4. Reducing the number of items in the scale by dropping the items which may not be significant in measuring the healthcare service quality. 5. Extracting the dimensions which are used in assessing the healthcare services. 6. Validating the scale developed above. 7. Using the scale designed in quality improvement decisions. The pool of items for measuring healthcare service quality was developed with the help of literature search, in depth interviews with patients through hospital feedback forms, and a small survey among the patients and other service providers. This helped to identify 12 dimensions and 96 items. Data was collected from the patients and their attendants regarding expectations and perceptions on these items. Information on some other items was also collected for validation. There were 170 respondents belonging to various geographical areas and from different demographic segments. These responses were used to develop and validate a scale of measuring service quality for patients in the hospitals. This scale, named HEALTHSERVE had five dimensions and 20 items. The dimensions pertained to admission, nursing, housekeeping, discharge and overall service. HEALTHSERVE has been used to demonstrate how it could help in identifying the various aspects of service that are relevant to the patients. It can also help in prioritizing among these different aspects. A significant learning from this experience is that service managers should periodically conduct this kind of exercise to identify the dimensions of service quality for making the service quality better.