Lesley White

A critical review of patient satisfaction

– This paper aims to review the patient satisfaction literature, specifically meta‐analyses, which critically analyses its theory and use; then to present evidence for perceived service quality as a separate and more advanced construct., – Papers that judiciously review the development and application of patient satisfaction were identified; along with studies addressing the conceptual and methodological deficiencies associated with the concept; and the current perceived service quality theory., – Patient satisfaction has been extensively studied and considerable effort has gone into developing survey instruments to measure it. However, most reviews have been critical of its use, since there is rarely any theoretical or conceptual development of the patient satisfaction concept. The construct has little standardisation, low reliability and uncertain validity. It continues to be used interchangeably with, and as a proxy for, perceived service quality, which is a conceptually different and superior construct., – The persistent use of patient satisfaction to evaluate the clients perception of the quality of a health service is seriously flawed. The key to solving this dilemma may be for the healthcare sector to focus on perceived health service quality by considering the specific concepts and models that can be found in the services marketing literature. This literature offers more advanced consumer theories which are better differentiated and tested than existing healthcare satisfaction models., – The paper points out that there is an urgent need for differentiation and standardisation of satisfaction and service quality definitions and constructs, and argues for research to focus on measuring perceived health service quality.

Customer orientations and usage of financial distribution channels

This research examined the survey responses of 801 financial customers who provided information regarding their usage of, and attitudes towards, financial distribution channels. The study found that there were distinctive segments within the financial market that had significantly different levels of usage of financial distribution channels. Financial customers were asked to indicate their orientation towards convenience, service, technology, computers, change, knowledge about methods of accessing money, and confidence in using electronic banking. Financial customers’ usage of human tellers, automated teller machines, electronic funds transfer at the point of sale, credit cards, cheques, Internet banking and telephone banking was investigated, and this information was used to determine if relationships exist between customer orientations and the usage of financial distribution channels. Further results and implications of the study for financial services are addressed.

Switching barriers in business-to-business services: a qualitative study

Purpose – To investigate the determinants of behavioural brand loyalty amongst dissatisfied customers in the business‐to‐business (B2B) services sector.Design/methodology/approach – A qualitative study was conducted, with 28 personal interviews undertaken with managers who are involved in the choice of service providers. The respondents belonged to 24 organisations located in Australia. Template analysis and eyeballing were techniques used to analyse the data collected.Findings – Assessment of the reasons why dissatisfied customers stayed with the service providers resulted in six categories. The categories were found to be, in order of decreasing frequency, impact of alternative providers, switching costs (18), others (17), inertia (14), investment in relationships (13), and service recovery (13). The results not only confirmed factors found in the literature, but also uncovered 11 other factors.Research limitations/implications – The sample size, whilst appropriate for qualitative research, should be co...

Why customers stay: reasons and consequences of inertia in financial services

This research investigated inertia in a financial‐services context, with particular focus on the reasons for consumers’ dissatisfaction and inert behaviour, and studied customers’ complaining behaviours and past and future inertia. The study utilised a two‐part methodology, including both qualitative and quantitative research. A total of 20 in‐depth interviews provided the preliminary data required for developing a questionnaire that was subsequently completed by 410 respondents. Determinants of dissatisfaction included the number and size of account fees, whilst determinants of inertia were the perception of similarity between financial institutions and the complexity, costs and time inherent in switching. Factors differentiating future inertia and future active customers included the type of account, length of time the account had been held, membership of a number of financial institutions, income and level of consideration given to changing financial institution.

A model of customer retention of dissatisfied business services customers

Purpose – The purpose of this paper is to present a theoretical framework of the factors that potentially influence dissatisfied customers to continue purchasing from their existing service provider in the business‐to‐business (B2B) services sector.Design/methodology/approach – This review paper synthesises the findings from previous studies on switching barriers, and relationship variables, dependence, and calculative commitment.Findings – Five major factors deter customers from switching to an alternative service provider: switching costs; interpersonal relationships; the attractiveness of alternatives; service recovery; and inertia. These factors are mediated by dependence and calculative commitment.Originality/value – This is the first comprehensive study of the factors that potentially influence dissatisfied customers to remain behaviourally loyal to a service provider in the B2B services sector. This important study has significance for marketers in developing strategies for customer retention and s...

Service co‐creation in community‐based aged healthcare

Purpose – The purpose of the paper is to identify and describe the themes underlying four concepts: client orientation, client involvement, provider empowerment, and client empowerment, which have been reported in the literature as influencing service participant interaction in the formation of a service. The meaning that service participants assign to each of those themes is also to be examined.Design/methodology/approach – Triadic studies were undertaken in two separate locations with three discrete community‐based service networks, purposively recruited from the same aged healthcare organisation. Using a phenomological approach, 29 individual semi‐structured in‐depth interviews with managers, providers, and clients were conducted. Inductive and deductive analysis was used to identify the emerging themes and their meaning for each participant category.Findings – Key themes were identified for each concept, but the meaning ascribed to each theme was found to differ between the participant categories. It ...

Consumer perspectives of the Australian Home Medicines Review Program: Benefits and barriers

BACKGROUND The Australian Home Medicines Review (HMR) is a free consumer service to assist individuals living at home to maximize the benefits of their medicine regimen and prevent medication-related problems. It consists of a pharmacist reviewing a persons medicines and collaborating with the general practitioner to optimize the individuals medicine management. The uptake of this service has remained below the projected use, although the program has shown to successfully identify medication-related problems and improve drug knowledge and adherence of the patient. OBJECTIVES This study investigates the perceived benefits and barriers of the patients regarding the HMR service who have used the service and who are eligible for it but have never used it. METHODS Consumer perceptions were drawn from 14 semistructured focus groups, with patients and carers belonging to the general HMR target population and consumer segments that have been postulated to be underrepresented with regard to this service. RESULTS The major benefits reported were acquisition of medicine information, reassurance, feeling valued and cared for, and willingness to advocate medication changes to the general practitioner. Perceived barriers were concerns regarding upsetting the general practitioner, pride and independence, confidence issues with an unknown pharmacist, privacy and safety concerns regarding the home visit, and lack of information about the program. Participants agreed that the potential benefits of the service outweighed its potential barriers. CONCLUSIONS It is expected that direct-to-consumer promotion of HMRs would increase the uptake of this valuable service. It would be necessary to ensure that the process and benefits of the service are communicated clearly and sensitively to eligible patients and their carers to obviate common consumer misconceptions and/or barriers regarding the HMR service. Furthermore, any direct-to-consumer promotion of the service must enable patient/carer self-identification of eligibility.

Key determinants of hospital pharmacy staff's job satisfaction

BACKGROUND The level of job satisfaction among pharmacy personnel is of importance because it may affect performance and retention. OBJECTIVES The objectives of this study were to (1) examine the level of job satisfaction among pharmacists and pharmacy support personnel practicing in Australian hospitals, (2) compare the level of job satisfaction with career satisfaction, (3) investigate the key factors determining hospital pharmacy staffs job satisfaction and their relative importance, and (4) identify the influential factors on their perceptions related to the ideal job. METHODS A cross-sectional survey was sent to 350 pharmacy staff in Australia. Participants had the option of returning the completed survey by means of mail or online. Previously validated 5-point scales measured each of the study variables. Data analyses included descriptive statistics, analysis of variance, factor analysis, and multiple linear regression. RESULTS Responses were received from 188 subjects (53.7%). Job satisfaction was 3.62 ± 0.77, which was significantly higher than career satisfaction 3.38 ± 0.85. Different job satisfaction mean scores were seen among age groups (F=2.718, P<.05). Percentage of time spent in dispensing was negatively correlated to job satisfaction (β=-0.202, P<.01). Sex, job positions, education levels, size and location of the hospitals, and work experience were not significant factors in determining job satisfaction. Job-related predictors of job satisfaction were ability utilization and recognition. Ability utilization was the most important factor in their perception of the ideal job. CONCLUSION The primary determinants of job satisfaction were intrinsic aspects of the job; that is, what makes people satisfied is the work that they do or the way they are used. Hospital pharmacy staff need to feel certain about their future, so managers should strive to secure the pharmacists role in the provision of health care. It is suggested that pharmacy managers focus on altering the job to provide greater use of skills and abilities and to provide increased challenge in the work. Further research should focus on other predictors of job satisfaction and possible ways to enhance satisfaction level.

Web site performance measurement: promise and reality

Purpose – The purpose of this research is to examine the web site performance‐measurement activities of a range of businesses and to determine whether there are common measures that can be successfully applied to rate the performance of corporate web sites.Design/methodology/approach – Qualitative interviews are conducted with web site managers of 25 businesses, exploring web site activities and performance measures used.Findings – The study demonstrates that web site performance measurement is largely idiosyncratic and/or completely ignored. Retailing and business‐to‐business companies are more likely to use performance measures (including sales revenue and web‐analytics programs) to determine the value of a web site to the business.Research limitations/implications – The study covers a broad spectrum of company types and sizes, mainly based in Australia, but did not focus on the use of the internet by specific industries – such as retailing or financial services.Practical implications – The study should...

Pre‐purchase decision‐making for a complex service: retirement planning

Purpose – This purpose of this paper is to respond to calls for further research into consumer pre‐purchase decision‐making, and investigate the factors that cause a customer to make a decision to save for retirement.Design/methodology/approach – Exploratory research using eight focus groups was undertaken in Sydney, Australia with a total of 55 participants. The data were analysed using the approach suggested by Cresswell and includes coding into chunks, development of themes, interpreting, and validating findings.Findings – Three key findings emerged from the research. First, there are certain internal, external, and risk factors that have a major impact on propensity to save for retirement. These are: involvement level, motivation, needs and wants, family influence, marketer influence, competitive options, financial risk, functional risk, and psychological risk. Second, no clear and universal gender differences in the pre‐purchase decision‐making process emerged during the focus group discussions. Fina...