Brian Moores

Towards the measurement of internal service quality

In the service sector literature, both marketers and organizational behaviourists emphasize the importance of the internal dynamics of the organization in terms of a network of customers and suppliers interacting together to satisfy customers. Reports on the progress of an ongoing project aimed at identifying and measuring those factors which determine how hospital ward staff perceive the quality of the support they receive from other units in hospitals.

Feelings of alienation among nursing staff in hospitals for the mentally handicapped

Background As part of a study concerned with the direct and indirect effects of different nurse staffing levels on the patterns of patient care, an attitude questionnaire was developed. The prime purpose of this was to determine the extent of the prevailing variation in the perceptions nursing staff held of the latent potential of the patients in their care. The reports of that part of the exercise are reported elsewhere (Moores and Grant, 1976). During the course of developing* the questionnaire it became obvious that nursing staff held strong views about various organisational characteristics of their particular hospital. Numerous pilot versions of the document were returned with long observations on this theme in the section provided for comments. Perhaps not surprisingly many of these criticisms related to what is probably best described as the ‘too many chiefs’ syndrome but the majority related to the extent to which the respondent felt that her views were either not solicited or heeded when important decisions were taken with respect to patients. It was therefore decided to incorporate questions related to this issue in the final version of the questionnaire, a copy of which is shown in Table 1.

Optimists and pessimists: Attitudes of nursing staff towards the development potential of mentally handicapped patients in their charge

Over recent years a good deal of research has been conducted into just what is the level of pctential accomplishment of mentally handicapped persons. Equally importantly a number of demonstration-type projects have been undertaken which have established that many mentally handicapped people are capable of living far more independent existences than ‘had previously been assumed to be the case. Discussions with staff in a wide range of situations, both inside and outside hospitals, served, however, to reveal that many were not familiar with the results of some of these projects. As it was felt that such ignorance could adversely affect the pattern of care provided, measuring the attitudes of nursing staff, in particular, to the potential level of patient accomplishment appeared a necessary first step if, eventually, efforts were to be directed towards changing such attitudes.

The 'Avoidance ' syndrome in hospitals for the mentally handicapped

Baekgreund In order to examine to what extent the level of nurse staffing influenced both the pattern of patient care and staff activities, a study was mounted in two hospitals for the mentally handicapped which were quite dissimilarly endowed with resources. The observational part of the work involved the determination of how the patients occupied their time and a quantitative analysis of the nature and frequency of all the interactions which took place between nursing staff and patients. The patient activity profiles (Grant and Moor-es, 1976~) revealed that when these were grouped under the two broad heads of adaptive and maldzptive, there were significant differences in the observed profiles in the two study hospitals. The interaction part of the study (Grant and Moores, 1976b) revealed that there were significant differences between the two institutions in both the number and pattern of interactions received by the patients. Since the time of that last publication a number of readers have asked whether it would be possible to analyse the data further to ascertain whether any pattern emerged as to which patients actually received the interactions. This current paper presents the results of just such a requested analysis. Method The two study hospitals, Seaview and Greentree were selected on account of their substantially different staffing levels. Rather than present absolute staffing levels which would facilitate the identification of the two hospitals it will suffice to report that at Seaview there were 57 nurses of all grades for every 100 patients, whereas at Greentree the corresponding figure was 42 nurses/100 patients. In both hospitals, matched samples of 30 patients were observed by 2 observers for a total of 21 hr over a 3 day period. The matching of the patients would have been relatively straightforward had patient records existed, which would have enabled the selection of only those patients whose IQ. assessments had shown no improvement over a period. The records at both institutions,

Attitudes towards student nurse allocation programmes

DURING the course of a substantial research project into how differing nurse staffing levels effect both the activity patterns of nursing personnel and the pattern of patient care a number of disturbing features of student nurse allocation programmes were encountered. As trainee nurses currently provide around 50 per cent of the direct patient care in British hospitals it is obviously desirable that their movements are planned effectively. The consequences arising from poorly organised programmes can be both direct and indirect. When one encounters, as we have, three student nurses on a ward one week and seventeen on the same ward the next the effect on the quality of training is obviously direct. When one encounters a student nurse who, on her first experience of night duty, is unofficially swapped between four wards it comes as no surprise to find, as Bendall did, that there is a close relationship between wastage and the number of allocations a student experienced throughout her training.* The underlying problem, of course, is that the General Nursing Council training requirements are often felt to be in conflict with the needs of the wards for “pairs of hands”. This perceived ‘conflict’ has led to a number of attempts to bring a more quantitative approach to the organisation of the student nurse allocation programme. These various schemes have met with varying degrees of success. It is not intended to comment on these approaches here save to report that the vast majority of allocation programmes are still organised and controlled on more traditional lines. At the moment a number of measures are being developed which it is hoped will enable the operating characteristics of any particular programme to be judged against the norm for that characteristic. Amongst these will be: (a) Average number of clinical instructor hours available per student. (b) Average duration of an allocation. (c) Number of allocations experienced by a student during her training.

A glossary of terms encountered in quality and customer service

A glossary of terms and definitions relating to the fields of quality and customer care, exemplified by reference to health care.

Lessons from some of the USA's most respected service providers

Each year Manchester Business School organizes and intense study tour of leading companies operating in the service sector. In this article an attempts is made to pick out some of the common features which characterize such organizations.