Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis
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RESEARCH ARTICLE
Open Access
Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan Shu-Ju Lu1,2, Hsiu-O Kao1, Bao-Lin Chang1, Shu-Ing Gong1, Shu-Mei Liu1, Shih-Chi Ku3 and Jih-Shuin Jerng3,4*
Abstract Background: Assessing patients’ expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care. Methods: We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA). Results: A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The ‘tangibles’ dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in ‘reliability,’ ‘responsiveness’ and ‘assurance’ were located in the quadrant of high expectation and high perception, whereas most of the items in ‘tangibles’ and ‘empathy’ were located in the quadrant of low expectation and low perception. One item (item 1 for ‘tangibles’) was found in the quadrant of high expectation and low perception. Conclusions: The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families. Keywords: Intensive care units, Health services, Quality of health care, Expectations, Perception
* Correspondence: [email protected] 3 Department of Internal Medicine, National Taiwan University Hospital, No. 7 Zhongshan South Road, Taipei 10002, Taiwan 4 Center for Quality Improvement, National Taiwan University Hospital, No. 7 Zhongshan South Road, Taipei 10002, Taiwan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's C
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