Service design in the ER

Date

2010-04-08T21:40:34Z

Authors

Steinke, Claudia

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Abstract

The Service Profit Chain is a simple conceptual framework linking employee satisfaction and loyalty, customer satisfaction and loyalty, and financial performance. Although widely used by practitioners, the Service Profit Chain's series of hypothesized relationships between employee, customer, and financial outcomes has seldom been tested using data that span all components of the model. Using a modified version of the Service Profit Chain, this study explores service design in the ER. In essence, the Service Outcome Chain asserts that certain structural elements. through their impact on process, have the potential to positively influence outcomes in the ER. The Service Outcome Chain proposes that for quality service to be delivered to the end-user (patients). service providers (nurses. physicians) must receive the support of those who serve them (management, training, the design of jobs and the design of the physical setting). Organizations that create the proper set of structural conditions for employee work also provide a basis for the development of a positive service climate. A positive service climate influences service quality and the end results of patient satisfaction with service and patient empowerment. In this study, using data from frontline service providers and service recipients in the ER, principle chain relationships are explored. A mixed methods approach is applied to examine the relationships identified in the Service Outcome Chain. A survey of emergency nurses is conducted followed by case studies of two ERs where survey, interview and photographic methods arc applied. Insights into the relationship between the structural, process and outcome elements of service design are gained. In addition. findings about the how managerial practices and physical design significantly influence service climate and service quality are revealed. Some of the strongest results of this study point to the role of physical design and service climate in setting the stage for a quality service strategy in the ER. In sum, this research provides the first theoretical and empirical examination of the Service Profit Chain or a modified version of it. applied to public sector health care in general and ERs in particular. It also provides the first empirical examination of physical design, service climate and patient empowerment in the ER. The importance of these three elements has been highlighted by this research.

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Keywords

Emergency service, Hospitals

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