The Perceptions of patients versus employees on service quality at specialty hospitals: a case study of city eye hospitals Nairobi and Nyeri County, Kenya

Abstract

The healthcare industry is highly competitive and hospital management must continuously find new and innovative ways to sustain their competitive advantage. Service quality is a key component of service delivery, which is one of the World Health Organization (WHO) healthcare building blocks. WHO estimates that at least 2.2 billion people worldwide are affected by near and distant vision impairments with eye problems remaining one of the most common yet preventable public health problems in LMICs. However, various studies have shown that even though eye hospitals are specialty hospitals, they are still part of the service industry, and just like other hospitals, patient expectations are continuously changing due to increased competition and technological advancements. Additionally, researchers have emphasized on the importance of incorporating employee perceptions when measuring service quality and reconciling the differences between patients and employees to improve service quality. Perceived service quality is deemed to exist along a continuum between ideal and unacceptable service. Thus, this study sought bridge a knowledge gap by comparing the perceptions of patients versus employees on service quality using the SERVQUAL model at City Eye Hospital. The specific objectives were to determine the perceptions of patients on service quality at CEH, to determine the perceptions of employees on service quality at CEH, and to determine how the similarities and/or differences could be leveraged to improve service quality at CEH. This study was anchored by the personal construct theory by George Kelly and had five independent variables namely: tangibility, reliability, assurance, responsiveness, and empathy and one dependent variable (perceived service quality) based on the SERVQUAL model. This was a descriptive, cross-sectional, quantitative study which adapted a positivist research philosophy. The target population was 500 patients and 120 employees where respondents were sampled using the convenience non-probability sampling method. Structured questionnaires hosted on the Kobo Open Data Kit were used for data collection, and data analysis was carried out using the SPSS software. The study had 378 patient and 84 employee respondents, and a pilot study was conducted before data collection to assess the reliability and validity of the questionnaire. For objective one, the study results established that patients’ perceived tangibility highest, and reliability lowest based on the means, while for objective two, employees perceived tangibility highest, and empathy lowest also based on the means. Employee perceptions were higher than patient perceptions for all the independent variables. For objective three, the study results established that there was a difference in perceptions of service quality between patients and employees, with reliability and empathy having the strongest positive correlation with the dependent variable PSQ for both patients and employees based on the overall correlation analysis. The regression model results also showed that focusing on empathy, reliability, and tangibility would result in improvements in PSQ that were significant. Thus, the study concluded that for management at CEH to leverage on patient and employee perceptions on service quality, which was the key knowledge gap that this study sought to bridge, they should focus on improving reliability and empathy while sustaining tangibility. The study also recommended that these results may be used as a baseline for further service quality studies by specialty hospitals. Additionally, the government, policy makers and CEH management may also use the results as a data-driven approach in service quality policy formulation and improvement, and training employees on service quality. The scope of this study was however limited to specialty hospitals, specifically eye hospitals, and did not incorporate qualitative data from participants.

Keywords: Perceived Service Quality (PSQ), SERVQUAL, patients, employees