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RIAZ AHEMAD, MBA, B PHARM
A Project Report on
“Customer satisfaction on global baroda hospital”
At
Manjalpur, Vadodara
Submitted to
MBASubmitted by
RIAZ AHEMADSM20092001
Under the Guidance of
Faculty Guide Company
GuideMr Rahul Sharma Mr. Pravin Kumar
Lecturer Marketing
Manager
Gujarat Global Baroda
Hospital
July, 2010
DECLARATION
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RIAZ AHEMAD, MBA, B PHARM
I here by declare that the summer project report titled “To study the Customers Satisfaction in
Global Baroda Hospital” is an original piece of work done by me for the fulfillment of the award of
degree of Master of Business Administration. And whatever information has been taken from any
sources had been duly acknowledge.
I further declare that the personal data and information received from any respondent during survey
has not been shared with any one and is used for academic purpose only.
Riaz Ahemad
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ACKNOWLEDGEMENT
It is a fact that none of the human being in this world is 100% perfect and in order to gain
some perfection in itself an individual surely needs a helping hand. The same was with me with
respect to the project that I was undergoing during this session of 2 months. I selected for my
research at the initial stages, I got acquainted with it slowly and steadily through efforts and surely
from various intelligent and helpful personalities.
To start with, I would like to convey my gratitude to Mr Praveen Kumar, MarketingManager Global Baroda Hospital, for his co-operation. I would also thank the other entire
employees who work there and give me support during my project and training.
I personally would like to thanks my faculty coordinator Mr Rahul Sharma for assisting me
throughout the project period, guiding me and assisting at various stages and thus sharing his
valuable knowledge with me to enhance my knowledge and helping me in preparing a project. I
would also like to extend my thanks to all the respondents who spared their valuable time and
helped me in filling up the questionnaire by providing the needed information.
Lastly, I would like to thanks all of those who have helped to furnish this project
successfully.
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Riaz Ahemad
EXECUTIVE SUMMARY
This report is for analysis of “To study customer satisfaction in Global Baroda Hospital,
Vadodara for the last 2 months. This report provides some recommendations for how to address
the quality services for Customer satisfaction.
In my project, I have used descriptive research methodology and convenience sampling
design. I have done Chi- Square Testing in my project work. I have done my data analysis on
SPSS (Statistical Package for Social Science) software. and factor analysis tests are studied to
know the whether there is a relationship between the customers satisfaction and Quality of services.
For this SPSS (Statistical Package for Social Science) software is used.
Most of the respondents prefer Quality services as an important Objectives. Most of the
respondents’ ages between 35-55 years are well aware about Quality of Services.
The finding of this survey would go a long way in helping the Indian Healthcare sectors for
better understand not only existing customer but also potential ones. The finding of the survey
would help Global Baroda Hospital to find new customer and to get new business.
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TABLE OF CONTENTS
Chapter – 1 Page No
1.1 Why, Whom, Where, When and How. 7
1.2 Identifying the variables and parameters for the particular study.Establish the theoretical relationship among variables. 9
1.3 Definition and Background information about the topic. 10
Chapter – 2 13
2.1 Company Profile, History
2.2 Growth & Development 15
2.3 Benchmark & Milestone 17
2.4 Who’s who 15
2.5 Industry Profile, Competitive Scenario 26
2.6 Market Share 27
2.7 Industry Life Cycle & Growth 28
2.8 Industry Spectrum. 29
2.9 Government Rules & Regulation. 33
3.1 Chapter – 3 Overview of Functional Area
3.2 Finance 35
3.3 Marketing 363.4 Human Resource 41
3.5 Operations 43
4.1 Chapter – 4 Model Application, Strategic Advantage Profile 52
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4.2 Porter’s Five Forces Model 45
4.3 ETOP (Environmental Threat & Opportunity Profile). 56
4.4 BCG (Model). 54
4.5 Value Chain. 48
5.1 Chapter – 5 Research Methodology , Objectives and purpose
of the study
58
5.2 Scope of the study, Benefits of the study 59
5.3 Assumptions
5.4 Types of research design 59
5.5 Unit of Analysis 60
5.6 Methods of data Collection
5.7 Sampling if applicable
5.8 Reliability & Validity of the study 61
5.9 Appropriate tools for data analysis
6.0 Limitations of the study. 61
6 Chapter – 6 Data Collection & Analysis 62
7 Chapter – 7 Findings 73
8 Chapter – 8 Suggestions/Recommendations/Bibliography. 84
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Chapter – 1
Introduction:-Services are becoming an increasingly important element of national economies and it is crucial toappreciate the distinguishing qualities of services and resulting management implications withspecific focus on healthcare services. The delivery of quality healthcare services and the integration
of thereof in healthcare policies is a concern in various health organizations across the world. In the past decade in particular, patient satisfaction has become an important performance measure andoutcome of healthcare. Research on healthcare satisfaction is vital to ensure a high quality of careand patient satisfaction and to maximize the benefits of scarce resources. Thus determining thefactors associated with patient's satisfaction is critical for public healthcare providers in order tounderstand what is valued by patients, how the quality of care is perceived by the patients and toknow where, when and how service changes and improvements could be made.
Why Organizations Focus on Customer Satisfaction:-
Businesses monitor customer satisfaction in order to determine how to increase their
customer base, customer loyalty, revenue, profits, market share and survival. Although
greater profit is the primary driver, exemplary businesses focus on the customer and his/her
experience with the organization. They work to make their customers happy and see
customer satisfaction as the key to survival and profit.
Customer satisfaction is tied directly to profitability, if your customers are happy, theytend to be loyal. And if they are loyal they not only buy more, they refer other customers. Wellestablished research by Bain & Company found that, for many companies an increase of 5% incustomer retention can Increase profits b 25% to 29% . The same study found that it cost six toseven times to gain a new customer than to keep an existing one.
When to Conduct Customer Satisfaction Research:-
Many managers wonder how frequently they should conduct customer satisfaction surveys. Theanswer depends on the size of the customer base and the purpose of research. There are two keytypes of surveys and they very different purposes.
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Transactional surveys solicit feedback directly from the product or service user about that
particular encounter. They are conducted immediately after each customer transaction. For example, a survey may be administered after a call center experience. Transactional surveys aresent out at the discretion of whoever has contact with customers—but the data should be collectedimmediately after the interaction while the experience is still fresh in the customer’s mind.
How Many Customers to Survey:-If your company has more than 2000 customers and it is not economically feasible to survey all of them, you can survey a subset. In this case you will need to consider the following conceptsrelating to sample selection and accuracy of results.
Random Selection:-
First, it is essential that a random selection of customers be contacted to avoid introducingBias into how the customers were selected and to help ensure the sample of customers isRepresentative of the entire customer base. For example if a company surveyed only customers who
Contacted customer service, those individual may be very different from customers who havenot contacted customer service.Margin of Error:-
Next you need to establish the level of precision you want to have in the accuracy of the results. Themargin of error also known as a confidence interval is an indicator of sampleAccuracy for random samples. It is the plus or minus figure that is commonly reported with News polls. Such as plus or minus four points in a customer satisfaction example if the reported result is80% satisfaction with a 4 –point margin of error, that means the true answer is somewhere between 76% (80-4)and 84%(80+4) assuming the whole population of customers had beenasked. The larger the sample size, the more accurate the result(or the smaller the confidence interval)
Confidence Level:-Then you need to determine how certain you want to be that the survey result are within theMargin of error. The confidence level indicates the level of certainty that the survey results are withinthe confidence interval for random samples. Typically researcher use 95% confidence level.Together the confidence level and margin of error together describe the certainty you have in the precision of the data . For example for a reported result of 80% satisfaction at the 95%Confidence level with a 4-point margin of error, you can say that you are 95% certain thatPercentage of satisfied customers is between 76% and 84%.The table below outlines the sample sizes needed for different customer bases at varying levelOf accuracy at the 95% confidence level.
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Size of Customer Base
Sample Size Needed(95% ConfidenceLevel)
+/-3% +/-5% +/-10
2,000 696 323 92
3,000 788 341 94
5,000 880 357 95
10,000 965 370 9620,000 1,014 377 96
50,000 1,045 382 96
100,000 1,058 383 96
Another important consideration in determining the sample size is how much analysis will need to be done on groups of customers .To analyze customers in particulars or Regions, the sample size should be adjusted to at least 75 people in each group.
How to Distribute Your Survey:-
The best means of distributing a survey depends on whether it is a transactional or relationshipsurvey. A transactional survey is conducted at the point of customer contact. Depending on thenature of the customer contact, an in –person, telephoneOr online survey may be appropriate.Relationship survey , on the other hand are most cost-effectively conducted online.
Service Quality in Public Healthcare:-Grönroos (1984) was the first who attempted to define and explain service quality anddifferentiated between the process of delivery (functional quality), which relates to the perceivedquality and the actual output of the service (technical quality), which relates to objective quality.Technical quality in healthcare is the accuracy of diagnosis and procedures and functional qualityrefers to the manner of delivery of healthcare.
Firstly, services have fewer search qualities that can easily be assessed before a use or purchase.Healthcare is characterized by high involvement of the consumers due to the higher risk in terms of outcomes, yet it requires the complete involvement of these customers during the service production and delivery process. This implies that the quality of the process and outcome is of
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equal importance.Secondly services tend to exhibit more experience qualities that can only be assessed after use,such as the quality of medical consultation and treatment resulting in better health.Lastly services tend to exhibit more credence qualities that consumers may have difficultyassessing, even after the purchase, because they may not have the necessary knowledge or experience. For instance, even after undergoing an operation, a patient may be unable to assesswhether the quality of service received was good or not.Quality within healthcare service delivery refers to services that meet set standards, implyingexcellence, and satisfy the needs of both consumers and health -care practitioners in a way thatadds significant meaning to both parties healthcare experiences. Internationally, healthcare qualityis a still a concern as reflected by the various studies published recently. The most popular modelof service quality is SERVQUAL, a set of structured and paired questions designed to assesscustomers’ expectations of service provision and the customers’ perceptions of what was actuallydelivered. This instrument is structured in five dimensions, namely: Tangibles, Reliability,Responsiveness, Assurance, Empathy.
2. Definition & Background Information:-
What is Customer Satisfaction?
The definition of customer satisfaction has been widely debated as organizations increasingly
attempt to measure it. Customer satisfaction can be experienced in a variety of situations and
connected to both goods and services. It is a highly personal assessment that is greatly affected by customer expectations. Satisfaction also is based on the customer’s experience of both
contact with the organization (the “moment of truth” as it is called in business literature) and
personal outcomes. Some researchers define a satisfied customer within the private sector as
“one who receives significant added value” to his/her bottom line—a definition that may apply
just as well to public services.
Customer satisfaction differs depending on the situation and the product or service. A
customer may be satisfied with a product or service, an experience, a purchase decision, a
salesperson, store, service provider, or an attribute or any of these.
Customer satisfaction is a highly personal assessment that is greatly influenced by individual
expectations as follows
Quality factors that are important for customers, including:
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Timeliness and convenience,
Personal attention,
Reliability and dependability,
Employee competence and professionalism,
Empathy,
Responsiveness,
Assurance,
Availability, and
Tangibles such as physical facilities and equipment and the
appearance of the personnel.
Timely service is an especially strong determinant of quality across different types of public
services.
Over the years, quality of services has assumed far greater importance in health systems of both
developed and developing countries. In WHO’s framework for health system performance
assessment; health, responsiveness and fairness of financing are three major goals of a health
system. With each component having particular importance, the responsiveness element entails
safeguarding the rights of patients to adequate and timely care.
With numerous assessment measures, consumer satisfaction – which overlaps responsiveness invarious dimensions – is one important evaluation measure of quality and performance of any heathsystem. Similarly, ‘legitimate’ expectations about service quality also serve as key tool inunderstanding patients’ aspirations and needs for better health care. The evaluation of servicesvis-à -vis consumer satisfaction is, therefore, a dynamic rather than a static process. It providestime continuous information regarding relative improvements (or shortfalls) in health carestandards.Generally, in the case of developing countries, it has been noted that patient satisfaction is notgiven much importance. It is a self explanatory fact that formal evaluation mechanisms includingconsumer satisfaction are absent in the health systems of most developing countries. It has beenargued that consumer perceptions on health care are largely ignored by health care providers in low
income countries. Moreover, it is also noted that health being the exclusive industry – unlike others – which ignores its clients.The prehistoric mindset of doctors that only they understand what should be done ignore patients’inputs, which is not living in reality. It is argued that absence of accredited standards, lack of healthcare evaluation, and insensitive attitude of management towards patients’ needs are few of thefactors responsible for low quality of health care in both public and private sectors.
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In macro context, low public sector spending on health is also cited as a significant factor for deteriorating quality of health care in India. With critical social and economic issues including burgeoning population, low nutrition levels, increasing incidence of poverty and disease, wideningof income disparities, inflationary pressures, and increasing health costs; government spending onhealth is miniscule. According to the Economic Survey of India, in 2005, the government spentmerely 5 percent of GDP on the health sector or US$36 per capita.
ii Responsiveness is a relatively newer area in health research. It has often been defined, in thecontext of a system, as the outcome that can be achieved when institutions and institutionalrelationships are designed in such a manner that these are cognizant and respond appropriately touniversal expectations of individualsiii In addition to evaluation of health status through morbidity and mortality estimates, there has been equal emphasis on quality of care indicators in health systems research . Therefore, patient
satisfaction can be used as an instrument in health managementinformation system which can improve the quality of services by tracking certain dimensions of quality.iv Legitimate needs are defined as being universal rather than individualistic and confirms torecognized principals or accepted rules and standards.v In developed countries, patient satisfaction surveys are conducted in hospitals on a timely basis asa measure to monitor the performance of health establishments.vii The concepts of patient satisfaction, patient rights, and protection, therefore, carry littlesignificance in most hospitals and medical establishments of India.
With ineffectuality of public sector in health care provision; over the years, private referral andmedical treatment has become an increasing phenomenon. Based on 2005 figures, private spendingon health (including household expenditures) is estimated at $ 14 per capita – almost four timesmore than public health expenditure per capita. Relatively higher income groups in urban centersdespite access to public hospitals and tertiary medical institutions prefer to consult and receivetreatment in private hospitals, which are considered as more quality oriented. Generally, in absenceof accreditation of health establishments in developing countries studies have noted that for-profitestablishments also compromise on quality standards.Poor provision of health care services, relevant health indicators unambiguously demonstrate atrend towards increasing impoverishment and vulnerability of the populace. Tightening of fiscalspace and limited budget allocations, and underutilization of public sector developmentexpenditures; ‘health for all’ appears a distant reality in India. Therefore, the concept of social protection of health – through risk pooling – appears to have assumed critical importance. Themechanism not only can serve as an important policy instrument to prevent vulnerable households
from falling into ‘health poverty’ but it can also provide them access to health services.However, their efficacy in terms of scope, service delivery, and quality requires comprehensiveevaluation.
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Theoretical framework :-
A service satisfaction survey is to be conducted in 2010 amongst patients treated at a Global
Baroda Hospital. The attitudes of the patients were tested regarding pre-identified service qualityaspects related to healthcare. A total of 100 patients (50 in- and 50 outpatients) are to be personallyinterviewed during the research. Although an attempt is to be made to select the patients randomlyit is not always possible due to patients that are not able and/or willing to complete thequestionnaires. In such cases substitutes is selected to overcome the problem of no-responses.
The expectations and perceptions of in- and out-patients with regard to the hospital’s
responsiveness services is reported in this paper. The two dimensions represented a mirror-imageof each other.
A five - point Linker type scale is used to measure the levels of perceived performance of the
hospitals as well as the expectation levels of the patients. Respondents are to be asked to indicatetheir evaluation on the scales in which 1 = Very important (Excellent) and 5 = Not important at all
(Not good at all.)
A total of 6 items were used to measure the responsiveness related variables as offered by the
hospital. An item analysis is to be carried out to test the validity and the reliability of the
questionnaire and an overall coefficient Alpha to be measured for expectations and performancerespectively.
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Chapter – 2
www.globalbarodahospital.com
COMPANY PROFILE:-
GLOBAL BARODA HOSPITAL:-
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It is a division of Baroda Medicare Pvt. Ltd. which came into existence with effect from November
2009 as Global Baroda Hospital Pvt Ltd, Company registered with the office of the Registrar of
Companies; Gujarat. The philosophy of the company remains to be patient centric, follower of
ethical medical practices, and a provider of world class healthcare to global clientele.
Global Baroda Hospital owned and managed by its four Directors:-
Dr Rajeev Shah, Dr Bhikhu bhai Patel, Dr Meenaxi Patel and Dr Bina Shah, is the new hospital
chain in Gujarat.
It is engaged in providing high quality medical and surgical care in a host of critical specialties
such as Cardiology and Joint Replacement Therapy, Neurology and Laparoscopic- surgeries, Nephrology and Kidney Transplant, GI Medicine and Surgeries, Hematology, Oncology and Onco-
surgery, Critical and Emergency Care, Trauma and Orthopedic, Neonatology as well as General
Medicine and Surgeries.
GLOBAL BARODA HOSPITAL
• Is 110 bedded multi-specialty tertiary care hospitals, equipped with state of the art
infrastructure situated at Manjalpur Vadodara .
• It has 110 beds, 5 high tech operation theatres and 20 ICU beds and HDU beds.
• The wide range of state of art OT equipments include latest surgical operating microscopes,
lights and remote controlled multi tasking operation tables, C-arm with DSA Facility,
anesthesia machines, multi-Para monitors, ventilators, video endoscopes, surgical pendants
by ultra modern sterilization departments.
• The company has a medium sized 110 beds capacity hospital.
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WHO’S Who
Executive directors:-
Dr .Rajeev Shah- executive director
Dr .Bhikhu bhai Patel- executive directorss
Dr .Meenaxi Patel- executive director
Dr. Bina Shah-executive director
Executive:-
Dr. Sushma Patel-CE0
Dr. Nirav Shah-Medical Administrator
Mr. Mitesh Shah-Sr, Executive
Mr. Vaibhav Joshi-manager accounts
Miss.Hinal Parik-Manager Accounts
Mr. Praveen kumar-manager marketing
Miss Nirali Parik-manager OPD
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Miss Bhoumika Soni- floor manager
Mr. Navueet Trivedi-Store manager
Medical Infracture And Set up
The hospital consists of four floors and this architecture plant is a combination of the classic
natural building and modern natural building.
Ground floor :-
T he first floor consists of
• Patient waiting hall
• Reception
• 7 OPD,s(1-,general ,2-surgery,3-gyenecology,4-ophthalmic,,5knee joint replacement,6-
orthopaedic,7-physiotheraphy)
• Emergency Room/Minor OT
•Pharmacy
• Preventive Health Check up
• Pathology
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• Administration
• Radiology
BASEMENT:-
• Cafeteria
• Store/Purchase dept
Frist floor :-
•
Rooms for inpatient(general/AC/NON AC Room/Day Care/General AC)• Child care NICU
Second floor :-
• Waiting room
• Operation theater(4 Ranging from joint replacement,Ortho, IrI&L )
• ICU
• HDU(high dependency unit)
• Dialysis
Third floor :-
• Inpatient rooms( suit/deluxe/Air-condition)
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Health care Facilities and Services(growth and development)
Specialties and Super Specialties:-
• Core specialties include: Cardiology, cardiothoracic Surgery, Ophthalmology, Neurology,
Neurosurgery, Orthopedics, Critical Care,Urosurgery, Nephrology & Oncology
• Other specialties include Anesthesiology, Dermatology, General Medicine, ENT, General
Surgery, Gynecology & Obstetrics, & Vascular Surgery,
Rheumatology,Pulmology,Pediatrics,Physiotherapy, Neonatology,Onco- Hematology,
Onco-gynecology Onco Surgery, Ophthalmology, Pediatrics, Psychiatry.
Prestigious Services The Hospital Offer:-
• Computer assisted surgery centre
• Laser surgery centre for spine, ophthalmic, vascular and ENT Problems
• Minimally invasive spine surgery centre
• Bariatric surgery centre
• Back and Neck schools
Services:-
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MISSION AND VISION:-
GLOBAL BARODA HOSPITAL aims to redefine the dimensions of health services by providing
comprehensive healthcare solutions with compassionate care, innovative practices and patients
centric services.
Benchmark and Milestone
JOINT REPLACEMENT THEATRE:-
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It is the only of its kind in the districts as it has total steel body, modular in design with class 100
Air filtration systems. It is a unique intelligent operation room as it is equipped by classic open
navigation system to drive joint replacement surgeries with tremendous precision. The integrated
operating suite also consists of body exhaust system in a hermetically sealed room lined by PU
flooring and antibacterial, antifungal color coating.
INTENSIVE CARE UNIT
20 ICU beds with individual and Hi- tech centralized monitoring systems, new generation state
Of art invasive and non –invasive ventilators, special facility for acute and chronic dialysis,
Defibrillators, syringe infusion pumps, centralized medical gas supply systems and centralized
closed systems with round the clock coverage by intensives.
PREVENTIVE AND OCCUPATIONAL HEALTH CHECK UP:-
The GLOBAL BARODA HOSPITAL offers comprehensive preventive health check up plans that
screens each organ closely to detect even the smallest symptoms that could be an indication of a
major disease. It also serves as a personal medical record for further reference.
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Occupational , industrial and work related health disorders are specially addressed by hospital’s
preventive medicines departments as we believe that prevention and cure of such health hazard is
our
prime social obligation.
Material Purchase and Storage Department
The Material and Storage Dept. is headed by Mr.Navueet Trivedi(manager stores).The standard
operation procedure is followed as below:-
Receipt STORE PROCEDURE Issue
Items Check by Securities & Inward
Register Entries with Stamping
Department Requisition
Items check & verification with P.O.
Delivery challan & Bills. Put up the items in
Store Requisition Slip
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incoming material
If short quantity recorded inform to
purchase department & suppliers .If items
are recorded in broken condition inform to
purchase department and supplier
Full Description with item codes & prepared by
sign
Items received & entry in store inward
register with stamping GRN prepare in
software. Put the item Code & Prepared
GRN register
HOD/Authority Sign
Items are storages in location wise & item
code wise with GRN no.
Send To Store Department
If P.O. Pending ,inform to purchasedept.pending items received &inform t o
related dept
Requisition Slip Check, Verification andcounseling
If items are returned to supplier –Make G.P
Returnable or Non returnable basis
Item issue and posting in software
Prepared Store outward Resister withnecessary details Security Out ward
Resister .Entry and Check
Shortages list prepared
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Send to purchase department
AN ORGANIZATIONAL STRUCTURE OF THE FIRM
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BOARD= REPRESENTED BY DIRECTORS
ADMINISTRATION =REPRESNENTATED BY CEO
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Global baroda Hospital is not limited to Baroda only , it has also spread it’s a new branch
in Bharuch newly
On 5TH JULY.2010.
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BOARD= REPRESENTED BY DIRECTORS
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ADMINISTRATION =REPRESNENTATED BY CEO
INDUSRTY PROFILE:-
Competitive Scenario:-
Organization has been following either low cost leadership, differentiation strategy or
Focused strategy , it varies directly customers need and profile.
Global Baroda Hospital has been meticulously emphasizing on delivering best quality
Services to customer.
Global Baroda Hospital has been "keeping abreast of the latest developments" keeping
In view of the its counterparts likely Sterlings Hospital, Baroda Heart Hospital,
Metro Hospital, and Bhailal Amin Hospital.
Its major strengths lies on compassionate care, innovative practices and patients centric
services,
Which has delivering Global Baroda Hospital a Competitive Advantage.
Market Share:-
It is known that Global Baroda Hospital is pvt. Ltd. It is anticipating to occupy a firm
Position in Market Share over the period of Time.
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Service Life Cycle:- (Stage Characteristics)
1. Market introduction stage
1. costs are high
2. slow sales volumes to start
3. little or no competition
4. demand has to be created
5. customers have to be prompted to try the product
6. makes no money at this stage
Remarks:-
Global Baroda Hospital has been surpassing the this stage effectively and now ,marching
down to attain its best Growth stage.
2. Growth stage
1. costs reduced due to economies of scale
2. sales volume increases significantly
3. profitability begins to rise
4. public awareness increases
5. competition begins to increase with a few new players in establishing market
6. increased competition leads to price decreases
3. Maturity stage
1. costs are lowered as a result of production volumes increasing and experience curve effects
2. sales volume peaks and market saturation is reached
3. increase in competitors entering the market
4. prices tend to drop due to the proliferation of competing products5. brand differentiation and feature diversification is emphasized to maintain or increase
market share
6. Industrial profits go down
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4. Saturation and decline stage
1. costs become counter-optimal
2. sales volume decline or stabilize
3. prices, profitability diminish
4. profit becomes more a challenge of production/distribution efficiency than increased sales
According to following stages, Global Baroda Hospital has been achieving its introduction
stage and growth stage in the better direction.
Health Spectrum;-
Spectrum Health is dedicated to finding the most effective ways to electronically connect
our patient health information with physicians and their offices.
Health spectrum has been instrumental to provide this information electronically, which
helps our physician community become more efficient and, more importantly, improves patient
care because the information can be accessed throughout a patient’s life.”
Spectrum Health to improve care collaboration and coordination throughout the entire
continuum of patient treatment.”
Government Rule & Regulation:-
Government has given the direction to follow the following norms in the
Premises of the Hospital.
Following certificate and licenses , Hospital must comply:-
1. Narcotic Certificate
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2. PNDT Certificate
3. Spirit Certificate
4. Lift Certificate
5. Multi Storage Buildings.
ENVIRONMENTAL FRAMEWORK:-
SOCIAL FACTORS:-
Global Baroda Hospital has been doing its best to establish trustworthy doctor-patient
Relationship which has become instrumental to end long awaited quest for the best multispecialty
a Tertiary Care Centre.
Global Baroda Hospital has been servicing with compassionate care, innovative practices and
patient centric services.
Since its inception, Global Baroda Hospital has been providing Free and Concessional Healthcare
to the deserving and needy. The Department of Social Work streamlines the process of granting
such concessional care. The department evaluates patients who require or ask for such free and
concessional care at the hospital, both as outpatients and inpatients.
The vision and mission of the staff is to enrich and preserve-to inspire and be ‘Inspired by Life’. To
that end we have a strong commitment to deliver Quality health services to Patients. The same
resources and medical expertise available to those who can afford the treatment is made availableto the needy and deserving patients who cannot afford the cost of the treatment.
Global Baroda Hospital has been providing the following ;-
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1. Free Health Check Up Plan
2. Well Women Camp
3. Bone densitometer Camp
4. Diabetes Camp
5. Preventive Care Seminars
6. Healthy Student & Healthy Nations Camp
1 HEALTH CHECK UP PROGRAMS
Global Baroda Hospital care for your well being. We all know that a healthy person can live life to
the fullest and excel in every sphere. With today’s sedentary lifestyle, man is getting prone to anumber of ailments and diseases like diabetes, hypertension, heart disease, and osteoporosis. All
we need is to develop a consciousness about health and lifestyle. We have launched various health
checks to determine and prevent occurrence of diseases.
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Doctor's consultation with complete medical examination.
Complete hemogram (hemoglobin, hematocrit, total leukocyte count, differential leukocyte
count, platelet count, erythrocyte sedimentation rate, peripheral smear)Blood group (ABO, Rh).
Blood sugar (fasting and post prandial).
Blood urea.
Serum creatinine.
Serum uric acid.
Lipid profile.
Urine examination.
X-ray chest PA.
E.C.G.
Eye examination.
Gynecologist consultation and Pap smear test.
Post check-up consultation.
2 Bone Mineral Densitometer Camp
Bone mineral densitometry is an x-ray technique used in the diagnosis and
prevention of osteoporosis. By comparing x-ray images taken at different
intensities, or of different materials, physicians can calculate a patient's bone mass(or lack thereof). Weak, brittle, osteoporotic bones contain a lower concentration
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of minerals like calcium; a quantitative x-ray imaging camera such as those produced by DALSA
Life Sciences can detect these subtle variations in bone mineral density.
DIABETES CAMPS:-
Diabetes Camp there provides additional educational component that helps Patients learn how to
manage their disease. For instance, they may learn how to adjust their diet or insulin when planningexercise, or they may learn how to give themselves their own shots for the first time.
As with “regular” camps, there are all types and arrangements of diabetes camps. There are family
weekend camps, The American Diabetes Association (ADA) has created guidelines for the proper
care of diabetes at camp, and all diabetes camps have access to them.
ECONOMIC FACTORS:-
The economic environment comprises of:
Income and wealth:-
So far as the Income is concerned , since inception of Global Baroda Hospital
Till now it has certainly achieved its breakeven point of business.
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It has Fixes Assets of worth 12 Crores Rupees and its liabilities form Canara Bank
Is also already have paid back.
As it is the beginning phase of Global Baroda Hospital , it has doing services swiftly
And anticipating to do better over the years.
Employment levels:-
More than one hundred twenty five (125) employees have been serving in the
Global Baroda Hospital, Gujurat.
Productivity:-
Productivity of the hospital is calculated as ROI , Return of Investment
Which is satisfactory.
The Break Even point in terms of Business is also achieved , since its
Inception.
TECHNOLOGICAL FACTORS:-
• It has 5 high tech operation theatres and 20 ICU beds and HDU beds.
• The wide range of state of art OT equipments include latest surgical operating microscopes,
lights and remote controlled multi tasking operation tables, C-arm with DSA Facility,
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anesthesia machines, multi-Para monitors, ventilators, video endoscopes, ssurgical pendants
by ultra modern sterilization departments.
Zero Error OT, with sophiscated high tech computer guided navigation system
For joint replacement and spine surgery. (1st Guj rat)
Global Baroda Hospital believes to exchange knowledge and education via
INDO-US research study.
Joint replacement theatre has its total steel body modular in design with class 100
Air filtration system.
It is a unique intelligent operation room.
LEGAL ASPECTS OF HEALTHCARE:-
For treatment of the patient there is a Supreme Court ruling that medico-legal aspects are secondary
to life of patient. Treatment should never be withheld due to reason that medico-legal examination
has not been done. Every effort should be made to save the life of patient. To fix the responsibility
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Global Baroda Hospital’s duty roster and attendance registers should be maintained.
Prescription should be on proper slip with name, age, sex and address. It should be in legible
handwriting. All the prescribed medicines should have proper doses & instruction. All the
investigations requested should be mentioned on it along with their results so that noncompliance
by the patient if any comes to the notice immediately. Follow-up date should be clearly mentioned.
It should always bear the signature, name, seal & registration number of the doctor. It will be a
very good practice to have the thumb impression of the patient over it so that if later on there is any
problem of identification of the patient it could be solved satisfactorily.
While issuing the certificates there should be no carelessness. A false certificate should never be
issued. Copy of the certificate must be kept for record so that if doctor is called in the court to
testify the correctness of the certificate, he will not be afraid that what for he is being called in the
court. Identification marks, signatures or thumb impression of the patient must be on it. If called by
court must attend court to certify the issued certificate. Always mention self name and registration
number. It should also bear the seal.
All the records of the patient must be kept for at least 3 years. It is a must to provide copy of the
records within 3 days of asking. All copies should be duly attested before giving it to the patient.
Maintain confidentiality of the records by keeping in safe custody. Professional secrecy must be
maintained while issuing the copies of records
Hospital Staff & Doctors should not be involved in adultery; they should not help or do pre nataldetermination of sex and do illegal abortions. They should not consume liquor or drugs and be
intoxicated on duty. Consultations whenever required should never be avoided.
One should never refuse service on religious grounds. A doctor should always be ready to help
during emergence.
Receiving or giving commission (dichotomy) is a bad practice and should not indulge in it. Talking
disparagingly about colleagues is a bad habit and should be avoided. Whenever a doctor agrees to
treat a patient there is a doctor patient contract of care
In poisoning cases inform police; give treatment, record signs/symptoms carefully. If patient is
serious, arrange for recording his dying declaration. Samples of gastric lavage, vomited matter,
urine, blood samples should be preserved, seal & send to police under proper receipt.
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One should be aware of the relevant acts while doing general practice so that he does not come in
conflict with the laws. He should e aware of the CPA 1986, Rules 1987, MTP Act 1971, Rules
1975, PNDT Act 1994, Rules 1996, Transplantation of Human Organs Act 1994, Mental Health
Act 1987, Registration of Births & Deaths Act 1969.
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MARKETING DEPARTMENT
The Marketing Department is responsible for implementation of Hospital
marketing programs, including external and internal communication, patient
satisfaction monitoring, and advertising. Graphics, Volunteer Services,
Community Education, and Wellness are all included within the department.
STRUCTURE OF MARKETING
DEPARTMENT
CEO( Dr.Sushma Patel )
MARKETING MANAGER( Mr
Praveen kumar )
EXECUTIVE
P.R.O
floor coordinator
floor coordinator
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PRO---- Administrator(PRO reports to Administrator for any need he want
from ADMIN)
SWOT ANALYSIS:-
STRENGTHS: (Internal)
Knowledgeable staff(GNM & ANM,BSC Nursing)
Excellent Ambience to work
More bang for the information buck
Efficient searching; cost-effective searching
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Well organized information
Quality information
New technologies(Computer assisted surgery centre,Zero bacteria surgery
centre, Minimally invasive spine surgery centre.ss )
Outstanding customer service
Responds to customer (the organization’s staff) needs
Knowledge and understanding of information organization and structure
Service-oriented staff(25 FULL time DRs, More than 75 visiting doctors,
Nursing staff ICU 1;1,
General word 5;1, Special word 3;1)
WEAKNESSES: (Internal)
Perceived gaps in the collection
Library in easily-accessed location to be
Set up.
Blood bank to be set up.
24 hr call center to be developed
Telemedicine center to be developed.
Gym for the patients to be developed
Health care magazines for OPD patients,
To be established.
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International Marketing(Medical Tourism Team Development.)
OPPORTUNITIES: (External)
Magnet status (in nursing) of hospital
Clinical librarianship; rounding; information’s
Electric medical records
Information Technology including internet based technology, Telemedicine,
Education and Training,
Weekend/evening access; after-hours service
Network access; wireless
Newsletter articles; editing
Open access movement
Internet availability
Teaching classes; CME and CNE credits
What do clients want?
Library web site
Self-service
Desktop delivery of articles
Any time, any place library
Table of contents via email
Cooperative purchasing
Market research
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Consumer health library access in the community for the organization, Teaching
consumer health information.
THREATS: (External)
End-user searches
Publication costs and increases
Free-standing surgicenters and specialty clinics
Perception of the library as a “monetary black hole”
The library needs an identity; needs branding
Hot buttons, e.g., current political situation, disaster management
Library staffing levels
low reimbursement; low patient census
Administrations’ lack of understanding of the library
Information access and decision-making
Standardization
Enmeshment
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HUMANRESOURCE DEPARTMENT:-
Function of marketing
1 Analysis and forecasting i.e., marketing research
2. Product development and design
3. Influencing the demand design, advertising etc
4. Service distribution after sales, service etc.
Mr. Mitesh Shah has been serving as HR Manager in the Global baroda
Hospital.
CEO( Dr.Sushma Patel )
HR MANAGER
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HR EXECUTIVE
Medical Administrator(Dr. Nirav Shah)
As a HR Manager he has been taking care of
Organizational management
Personnel administration
Manpower management
Industrial management
Other activities involving are as follows:-
1. Payroll
2. Work Time
3. Benefits Administration
4. HR management Information system
5. Recruiting
6. Training/Learning Management System
7. Performance Record.
Global Baroda Hospital has been tied up with Canara Bank, which has
been financing its Operation.
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OperationActivity:-
Tertiary Care Multispeciality Hospital
Operation activities involves activities related to activities pertaining to
OPD handing, ICU & HDU Handling
And Customer handling during registration and effective billing.
• Emergency
1 Ambulance Service
2 Health Checkups
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Diagnostic Services:
3Lab Services
4Radio-Diagnosis
5Endoscopy Lab
6 24 Hours Pharmacy
1 Out Patient Consultations
Main OPD Block
Registration
Consultation
IPD Schedule
» Inpatient Services:
• Admission
• Room Categories
• Intensive Care Units
• Day Care Rooms• TPA / Insurance
• Inpatient Pharmacy
• Outpatient Pharmacy
The hospital is at the forefront of medical technology and expertise. It provides a
complete range of latest diagnostic, medical and surgical facilities for the care of
its patients.
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Chapter – 4
MODEL APPLICATION:-
Porter's Five Forces
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A MODEL FOR INDUSTRY ANALYSIS
The model of pure competition implies that risk-adjusted rates of return should
be constant across firms and industries. However, numerous economic studies
have affirmed that different industries can sustain different levels of
profitability; part of this difference is explained by industry structure.
Michael Porter provided a framework that models an industry as being
influenced by five forces. The strategic business manager seeking to develop an
edge over rival firms can use this model to better understand the industry
context in which the firm operates.
Let’s apply Michael Porter models on Global Baroda Hospital as Follows,
1. Internal Rivalry –
o about 03 hospitals in Baroda City, likely Metro Hospital, BhailalAmin
o Hospital & Sterling Hospital etc.
o Fierce internal rivalry, because Many competitors
o Operation costs vary
o Substantial excess capacity – occupancy rate < 70% at many hospitals
o Stagnant or declining demand
2. Internal Rivalry – TPA Took Advantage Third Party Administrator,
(TPA)
o (TPA, insurance companies) took advantage:
o Contract with hospitals offering the most favorable rates
o Lower the co-pay to encourage patients to choose those hospitals
Diagram of Porter's 5 Forces
SUPPLIER POWER
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BA
RR
IE
RS
TO
E
N
T
R
Y
Absolute costadvantages
Proprietarylearning curveAccess toinputsGovernment
policyEconomies of scale Capital
requirements Brand identity Switchingcosts Access to distribution Expectedretaliation Proprietary products
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Supp
lier
conc
entrat
ion
Importance of volume tosupplier
Differ
entiat
ion of
inputs
Impact of
inputs on costor
differentiatio
n
Switchingcosts of firms in theindustry
Presenc
e of
substitut
e inputs
Threat
of
forward
integration
Cost relative to total purchases in
industry
T
H
R
E
A
T
O
F
S
U
B
S
T
I
T
U
T
E
S
-Switc
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hing costs -Buyer inclination to substitute-Price-performance trade-off of substitutes
BUYER POWER
Bargaining leverage
Buyer volume
Buyer information
Brand identity-Intermittentovercapacity
Price sensitivity
-Product differences
Threat of backward integration
-Switching costs
Product differentiation
-Brand identityBuyer concentration vs.
industry
-Diversity of rivals
Substitutes available
-Corporate stakes
Buyers' incentives
o Due to high price elasticity, demand increase – hospitals are
more homogenous3. Internal Rivalry – TPA Took Advantage
o Negotiations between TPA and hospitals were secret,
hospitals in disadvantageous position
o Contracts are infrequent – hospitals assumed pressure
The Porter Five Forces Analysis offers a good explanation for the profitability of an industry, and the firms within it.
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o Established brand identity
o Diversified into related products, e.g., skilled
nursing services
o Differentiated their services, e.g., Joint
Replacement Therapy, etc.
o Patients required hospital in neighborhood –
increase loyalty2. Entry - Barriers
o Government regulation on new hospital
construction
o Hospitals are capital intensive
o Brand identity not easy for new hospitals
3. Entry – The Other Side
o Manjalpore area grew
o Innovations allowed smaller niche hospitals
4. Substitutes and Complements
o
Few inpatient services could be performed outsidethe hospitals
o But improvement in surgical techniques made it
possible
o Outpatient diagnostic facilities (ODF) – substitutes
o But ODF can also be complement – hospitals
already had technology
and experience to do it – economies of scope
5. Suppliers
o Demand for nurses high, supply low
o Price rising for drugs and other medical supplies
6. Buyers
o Insurers wield substantial power
o Insurers are large size – high negotiation power,
o Highly skilled physicians became strong buyers
who brought patients
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VALUE CHAIN:-
Value Chain highlights the explorations of internal
analysis of a chain of business activities. It explores the
role and contribution of organization's resourcescorresponding to primary and support activities in a cost-
effective way to gain cost advantage. As for the
Balanced Scorecard, it emphasizes the evaluation of
organizational.
All in all, it is important to be aware of their benefits and
weakness as well as the potential problems of three approaches
when applying them real business operations, and it largely relieson successful implementation by senior managers in
organizations.
Introduction In today's dynamic and competitive business
environment, survival, growth and profitability are the essence
goals of all industries.
The essence of these three frameworks is that they can help senior
managers to make right decision and build and sustain
competitive advantages in the organization level.
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Using the value chain to analyze costs to identify firm's strengths
and weaknesses is much more useful than traditional cost
accounting protocol that most companies are still utilizing.
Applying Value Chain to Global Baroda Hospital, followings are
the analysis:-
SUPPORT ACTIVITY:-
Firm Infrastructure:-Global Baroda Hospital infrastructure is
appealing with its
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• Unique seven(7) OPD,s(1-,general ,2-surgery,3-
gyenecology,4-ophthalmic,,5knee joint replacement ,6-
orthopaedic,7-physiotheraphy)
• Emergency Room/Minor OT
• Pharmacy
• Preventive Health Check up
• Pathology
• Administration
• Radiology
Human Resource Management:-
HRM of Global Baroda Hospital has been playing pivotal role in
followings;-
1. Payroll
2. Work Time
3. Benefits Administration
4. HR management Information system
5. Recruiting
6. Training/Learning Management System
7. Performance Record
TECHNOLOGY DEVELOPMENT:-GBH
i. It has 5 high tech operation theatres and 20
ICU beds and HDU beds.
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STRATEGIC ADVANTGE PROFILE
Strategic advantage profile is known as SAP. It shows strength and weakness of anorganization. Preparation of SAP is very similar process to the ETOP. There are generally
five functional areas in most of the organizations. These areas are Production or Operation,
Finance or Accounting, Marketing or Distribution, Human Resource & Corporate Planning,
and Research & Development.
Global Baroda Hospital has been using its strength to make the organization to
Have competitive advantage and doing its best to improve its area of Improvement.
(Weakness).
STRENGTHS(Internal)
Knowledgeable staff(GNM & ANM,BSC Nursing)
Excellent Ambience to work
More bang for the information buck
Efficient searching; cost-effective searching
Well organized information
Quality information
New technologies(Computer assisted surgery centre ,Zero bacteria surgery centre,
Minimally invasive spine surgery centre. )
Outstanding customer service
Responds to customer (the organization’s staff) needs
Knowledge and understanding of information organization and structure
Service-oriented staff(25 FULL time DRs, More than 75 visiting doctors, Nursing staff ICU
1;1,
General word 5;1, Special word 3;1)
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WEAKNESSES: (Internal)
Perceived gaps in the collection
Library in easily-accessed location to be
Set up.
Blood bank to be set up.
24 hr call center to be developed
Telemedicine center to be developed.
Gym for the patients to be developed
Health care magazines for OPD patients,
To be established.
International Marketing(Medical Tourism Team Development.)
Marketing Fierce competition, company position secure:-
Global Baroda Hospital has been providing the following to strengthen the marketing
activity:-
1. Free Health Check Up Plan
2. Well Women Camp3. Bone densitometer Camp
4. Diabetes Camp
5. Preventive Care Seminars
6. Healthy Student & Healthy Nations Camp.
Operational Activities -excellent -parts & components available:-
1 It has 5 high tech operation theatres and 20 ICU beds and HDU beds.
The wide range of state of art OT equipments include latest surgical operating
microscopes, lights and remote controlled multi tasking operation tables, C-
arm with DSA Facility, anesthesia machines, multi-Para monitors, ventilators,
video endoscopes, surgical pendants by ultra modern sterilization
departments.
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1. Zero Error OT, with sophiscated high tech computer guided navigation
system
2. For joint replacement and spine surgery. (1st Gujarat)
BCG Growth-Share Matrix
The BCG growth-share matrix displays the various business units on a graph of the market
growth rate vs. market share relative to competitors:
Resources are allocated to business units according to where they are situated on the grid as
follows:
• Cash Cow - a business unit that has a large market share in a mature, slow growing
industry. Cash cows require little investment and generate cash that can be used to
invest in other business units.
• Star - a business unit that has a large market share in a fast growing industry. Stars
may generate cash, but because the market is growing rapidly they require
investment to maintain their lead. If successful, a star will become a cash cow when
its industry matures.
• Question Mark (or Problem Child) - a business unit that has a small market share
in a high growth market. These business units require resources to grow market
share, but whether they will succeed and become stars is unknown.• Dog - a business unit that has a small market share in a mature industry. A dog may
not require substantial cash, but it ties up capital that could better be deployed
elsewhere. Unless a dog has some other strategic purpose, it should be liquidated if
there is little prospect for it to gain market share.
The BCG matrix provides a framework for allocating resources among different business
units and allows one to compare many business units at a glance.
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Applying BCG Matrix to Global Baroda Hospital , we can analyse that since
Its inception for the past six months , has acquired very good business in Baroda
City comparison to its competitors likely Metro Hospital, Bhailal Amin Hospital
& Sterling Hospital etc.
It is having better share too, with its minimum investment at initial level , so it is in the phase of Cash Cow. All the departments of Hospitals are working together to make the best
in Baroda city, I .e they are moving to make the organization Star over the period of time.
ETOP:-
Environmental threat and opportunity profile is referred as ETOP profile. It identifies the
relevant environmental factors. Such factors might be general environmental factors and task
environment factors. Thereafter, it is necessary to identify their nature. Some factors are
positive to the organization whereas others are negative. Therefore, it is necessary to find outtheir impact to the organization.
OPPORTUNITIES: (External)
Magnet status (in nursing) of hospital
Clinical librarianship; rounding; information’s
Electric medical records
Information Technology including internet based technology, Telemedicine, Education and
Training,
Weekend/evening access; after-hours service
Network access; wireless
Newsletter articles; editing
Open access movement
Internet availability
Teaching classes; CME and CNE credits
What do clients want?
Library web site
Self-service
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Desktop delivery of articles
Any time, any place library
Table of contents via email
Cooperative purchasing
Market research
Consumer health library
Teaching consumer health information access in the community for the organization
THREATS: (External)
End-user searches
Publication costs and increases
Free-standing surgicenters and specialty clinics
Perception of the library as a “monetary black hole”
The library needs an identity; needs branding
Hot buttons, e.g., current political situation, disaster management
Library staffing levels
low reimbursement; low patient census
Administrations’ lack of understanding of the library
Information access and decision-making
Standardization
Enmeshment.
Chapter – 5
Research Methodology
Purpose And Objectives Of The Research:-
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The purpose of this paper is to examine responsiveness as determinant of service quality in
Global Baroda Hospital.
The objectives of this study are twofold namely:
• To determine if equality exists between in- patients and out-patients for the service
responsiveness provided to patients in Global Baroda Hospital.
• To determine whether the expectations of in- and out-patients on how hospital staff
responds to their needs in terms of the responsiveness variables, are met (satisfaction).
In- patients refer to patients admitted in the hospital and out-patients refer to patients whoreceive medical consultation and/or treatment without being admitted. The service
responsiveness content under investigation includes the constructs: Prompt service duringregistration/admission, Reasonable waiting time for treatment, Reasonable waiting time for
receiving medicine, Responsiveness to complaints, Speediness of services by medical staff,Proper explaining of hospital procedure (what to do and where).
Research Methodology:-
Study Design, Sample Selection and Size, and Data Collection Methodology, DataReliability, Ethical Consideration in Data Collection and Limitation of the Study
1. Study DesignThis cross-sectional study is designed on the basis of PSQ approach. It represents arelatively shorter version of the approach comprising 10 questions. These related to differentaspects of health care services provided at the on the basis of these questions (or items);seven broad scales have been constructed representing key dimensions of services provided by the hospital. These broad scales are: (I) general satisfaction (ii) technical quality (iii)interpersonal aspects (IV) communication (v) financial aspects (VI) time spent with the
doctor and (vii) access and availability aspects. In each scale, consumer responses on itemshave been captured through five relative scores (Linker scales) which represent consumers’relative judgments on quality of health care service received at the hospital.
The pre-coded responses were recorded to attain higher item scores for favorably wordeditems i.e. indicating greater satisfaction in numeric values. For example, numeric value of ‘Excellent’ in the questionnaire was recorded from 1 to 5. Likewise, similar procedure of recoding was adopted for the remaining three Linkert scales.
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In consumer satisfaction studies, categorization of numeric values of scales measuringquality has been extensively used in various studies for relative analysis of satisfaction. Tofacilitate comparative analysis of consumer perceptions, aggregate scale scores have beenclassified into three broad categories which are: (I) High level of satisfaction (ii) Medium
level of satisfaction, and (iii) Low level of satisfaction. Distinction between these categories(or satisfaction ranges), for instance in low satisfaction, is calculated by taking average pointof minimum cumulated value of dissatisfaction score and minimum cumulated value of neither agree nor disagree scale.
Sample Selection and SizeAt Global Baroda Hospital; around 125 workers are registered under the health protectionscheme. Based on hospital estimates, on average, -30-50customers visit the premises eachday. Broadly, there are two types of patients: (I) OPD patients and (iii) Inpatients. As aninclusion criterion, the survey exclusively involves interviews with the first type of patients.Inpatient perceptions of care, therefore, are not under the purview of the study.
In addition, respondents with minimum age of 18 years (i.e. adults) were selected for the
study sample. It is based on the presumption that children possess little comprehensionabout complex medical procedures and quality of hospital services.The purpose of excluding children from the survey, therefore, was to increase the response
rate. The sample, however, makes no distinction on the basis of registration status of respondents i.e. whether if they are employed workers or dependents of registered workers.
Of total OPD patients who represent the sampling frame, following formula has been usedto select sample size.
Sample size = p (1-p)/e2
Where p = proportione = required size of standard error It is assumed that p = 0.5 whereas e = 0.05 (at 95 % confidence interval). The total sample
size was estimated to be 100 patients (or respondents). To adjust for non-participation (or non-responsiveness) factor of consumers, 120 individuals were interviewed in total.
Data Collection MethodologyData collection was done by a structured questionnaire comprised of ten questions (or items)related to different aspects of hospital services. As mentioned previously, the questionnairewas designed using PSQ as a reference point. A pilot survey of ten respondents wasconducted before carrying out the complete hospital survey. To overcome difficulties in
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identifying OPD patients from the consumer list, respondents were identified through‘random selection’ process on days when data was collected. Since consumers wereinterviewed in hospital’s premises, the data collection procedure was time-efficient andconvenient while keeping all the survey requirements of the study.
Data Reliability
In psychometric studies, estimation of data reliability is a requisite procedure. In literatureon perception studies (including consumer satisfaction), it is indicated that multi-itemscalesGenerally meet the reliability criteria when exceeds the 0.50 value for group comparisons ,
among various techniques.
For levels of consumer satisfaction for remaining scales the response rate of the sampleis estimated to be 97 % However, some studies have estimated less than 0.40 reliability values which do not infer insignificance. Such data estimates are reliable but relatively weak at high confidenceintervals.International studies. Item reliability is estimated at 0.80 whereas scales reliability comes to
0.790.
Limitations of the Study:-
Despite the fact that the present study is a benchmark on estimating patient satisfaction atthe Global Baroda Hospital, it has certain limitations. These are as following:
It exclusively examines the perceptions of patients to evaluate the quality of healthservices at the hospital. It has not incorporated the views of the medical staff
It is a particular case study of patient satisfaction at the Global Baroda Hospital.
It exclusively takes into account perceptions provided by OPD patients at the hospital.The findings do not apply to perceptions of inpatients who are admitted at the hospital.
Chapter – 6
Data Collection & Analysis
RESEARCH METHODOLOGY:-The research methodology that was followed for the investigation is consequently explained.
The data analysis illustrates the levels of importance, perceived performance and
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consequently satisfaction of one dimension of service quality dimensions for patients of the
hospital namely, responsiveness.
The sample framework, measuring instrument and data collection and analysis
A service satisfaction survey was conducted in 2010 amongst patients treated at GlobalBaroda hospital.The attitudes of the patients were tested regarding patients satisfaction in
healthcare. A total of 100 patients were personally interviewed during the research.Although an attempt was made to select the patients randomly it was not always possibledue to patients that were not able and/or willing to complete the questionnaires.
The expectations and perceptions of patients with regard to the hospital’s responsiveness
services is reported in this paper. A five - point Likert type scale was used to measure thelevels of perceived performance of the hospitals as well as the expectation levels of the
patients. Respondents were asked to indicate their evaluation on the scales in which 1 =(Excellent) and 5 = Not important at all (Not good at all.)
A total of 8 items were used to measure the responsiveness related variables as offered by
the hospital. An item analysis was carried out to test the validity and the reliability of the
questionnaire and an overall Cronbach coefficient Alpha of 0.975 were measured for
satisfaction respectively. Data was captured by a trained assistant and analyzed using the
SPSS version 15 statistical.
Case Processing Summary
N %
Cases Valid 100 100.0
Excluded 0 0
Total 100 100.0
Reliability Statistics
Cronbach's Alpha N of Items
0.975 16
Overall Satisfaction ( No of Respondents & Percentage%):-Particulars 1.excellet 2.Very good 3.Good 4.Poor 5.Not good
at all
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CzzzzWating Time 12(12.0%) 67(67.0%) 19(19.0.07
%)
2(2.0%) 0
Reception patient co-ordination 17(17.0%) 70(70.0%) 13(13.0%) 0 0
Service of Doctors 15(15.0%) 80(80.0%) 5(5.0%) 0 0
Service of Nursing staff 20(20.0%) 65(65.0%) 13(13.0%) 2(2.0%) 0
Radiological & pathological
Services
20(20.0%) 78(78.0%) 2(2.0%) 0 0
BB Billing and Pharmacy 5(5.0%) 70(70.0%) 20(20.0%) 5 (5%) 0
Administrative Dept 11(11.0%) 65(65.0%) 20(20.0%) 4(4.0%) 0
Quality of Hospital 15(15.0%) 78(78.0%) 7(7.0%) 0 0
Total 115(14.37
%)
573(71.62%
)
99(12.37%
)
13(1.62
%)
Chi-Square Test:-
Waiting Time
Observed N Expected N Residual1 12 25.0 -13.0
2 67 25.0 42.0
3 19 25.0 -6.0
4 2 25.0 -23.0
Total 100
Reception co-ordination
Observed N Expected N Residual
1 17 33.3 -16.3
2 70 33.3 36.7
3 13 33.3 -20.3
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Total 100
Service of Doctors
Observed N Expected N Residual
1 15 33.3 -18.32 80 33.3 46.7
3 5 33.3 -28.3
Total 100
Service of Nurses
Observed N Expected N Residual
1 20 25.0 -5.0
2 65 25.0 40.03 13 25.0 -12.0
4 2 25.0 -23.0
Total 100
Billing & Pharmacy Department
Observed N Expected N Residual
1 5 25.0 -20.0
2 70 25.0 45.03 20 25.0 -5.0
4 5 25.0 -20.0
Total 100
Radiological & Pathological Services
Observed N Expected N Residual
1 20 33.3 -13.3
2 78 33.3 44.7
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3 2 33.3 -31.3
Total 100
Administration Department
Observed N Expected N Residual1 11 25.0 -14.0
2 65 25.0 40.0
3 20 25.0 -5.0
4 4 25.0 -21.0
Total 100
Quality of Hospital
Observed N Expected N Residual
1 15 33.3 -18.3
2 78 33.3 44.7
3 7 33.3 -26.3
Total 100
WaitingTime
Reception co-ordination
Service of Doctor s
Service of Nurses
Billing &PharmacyDepartment
Radiological &Pathological Services
Radiological &Pathological Services
Qualityof Hospital
Chi-
Square
99.920a
60.740 b 99.500 b
91.920a
114.000a 94.640 b 90.480a 90.740 b
Df 3 2 2 3 3 2 3 2Asym
p. Sig.
.000 .000 .000 .000 .000 .000 .000 .000
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Chapter – 7
FINDINGS:-The patients reported fairly high Satisfaction on all the responsiveness variables (table 1).This clearly signals that all patients were shown excellent responsive levels. The two most
important issues (in terms of their expectations) for patients in general were: Proper explaining of hospital procedure (what to do and where to go) and speediness of services bymedical staff. Interesting to note is that the perceived performance of the hospitals serviceswas in the same sequence, implying that satisfaction was met in terms of the rank. However if the mean is used as indication, satisfaction was not met as the means of expectations werelower than the perceived performance.
Descriptive Statistics
N Minimum Maximum Mean Std. Deviation
Waiting Time 10
0
1 4 2.11 .618
Reception co-ordination 10
0
1 3 1.96 .549
Service of Doctors 10
0
1 3 1.90 .438
Service of Nurses 10
0
1 4 1.97 .643
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Billing & Pharmacy Department 10
0
1 4 2.25 .626
Radiological & Pathological Services 10
0
1 3 1.82 .435
Administration Department 10
0
1 4 2.17 .667
Quality of Hospital 10
0
1 3 1.92 .464
Valid N (listwise) 10
0
*Significant on 0.95 level
Descriptive Statistics of Scale Items :-
Waiting Time for Appointment:-
The GS scale primarily entails Waiting Time for Appointment of the hospital. It includesitems related to consumers’ level of comfort in diverse hospital premises. In terms of consumer satisfaction, Waiting Time for Appointment was ranked (mean = 2.11). WaitingTime for Appointment was also found to be skewed towards relatively higher satisfaction(mean= 2.11.).
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Reception co-ordination:-
The GS scale primarily entails Reception co-ordination of the hospital. It includes itemsrelated to consumers’ level of comfort in diverse hospital premises. In terms of consumer satisfaction, Reception co-ordination was ranked (mean = 1.96). Reception co-ordinationwas also found to be skewed towards relatively higher satisfaction (mean= 1.96.).
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Service of Doctors:-
Customers s evaluated highest satisfaction with service of Doctors (mean= 1.90). Majorityof patients were satisfied with the doctor prescriptions of drugs at the hospital. Service of Doctors was also found to be skewed towards relatively higher satisfaction.
Service of Nurses:-
Customers s evaluated highest satisfaction with service of Nurses (mean= 1.97). Majorityof patients were satisfied with the services of nurses at the hospital. Service of Doctors wasalso found to be skewed towards relatively higher satisfaction.
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Billing & Pharmacy Department:-
Customers was evaluated highest satisfaction with service of Billing & PharmacyDepartment (mean= 2.25). Simply, this suggests that majority of patients were satisfied withthe services of nurses at the hospital. Billing & Pharmacy Department was also found to beskewed towards relatively higher satisfaction.
Radiological & Pathological Services:-
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Customers s evaluated very good satisfaction with (mean= 1.82). Simply, this suggests thatmajority of patients were satisfied with the services of radiology & pathology at the hospital.Radiology & pathology Department was also found to be skewed towards relatively goodsatisfaction.
Administration Department:-
Customers s evaluated very good satisfaction with (mean= 2.17), with administrativeservices. Majority of patients were satisfied with the administrative services of at thehospital. administrative Department was also found to be skewed towards relatively goodsatisfaction.
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Quality of Hospital:-
Customers were evaluated very good satisfaction with (mean= 1.92), with Quality of hospital.. Majority of patients were satisfied with the quality of at the hospital.administrative Quality of hospital was also found to be skewed towards relatively goodsatisfaction.
A non-parametric test procedure was used to compare the patient’s satisfaction with regard
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to the responsiveness variables with their perceived performance of the hospital, as
experienced by the sample as a whole. The test computes the differences between the meanvalues of two variables for each case and tests whether the average differs significantly
from 0. This test could be used as the observations for each variable pair was made under the same conditions. The aim was to determine whether performance on responsiveness
matches the expectations of patients or not.This variable was rated first in terms of expectations as well as their perceived performance
of the hospitals services. The overall second smallest deviation between expectations and perceived performance is the speediness of services provided by medical staff.This variablewas rated relatively important in terms of expectations.
Factor Analysis:-
Communalities
Init ial Extraction
Waiting Time 1.000 .852
Reception co-ordination 1.000 .715
Service of Doctors 1.000 .818
Service of Nurses 1.000 .872
Billing & Pharmacy Dept 1.000 .696
Radiological & PathologicalServices
1.000 .683
Quality of Hospital 1.000 .840
Administration Department 1.000 .841
Extraction Method: Principal Component Analysis.
According to factor analysis, extraction of Billing & Pharmacy department and
Radiological
Department were found as 0.696 and 0.683 respectively, (Magnitude of difference is .
137)which shows that there is a need For area of improvement for these two department of
Global Baroda Hospital.
if we see factor analysis revealed that waiting time and reception co-ordination were having
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0.852 and 0.715 respectively with a Magnitude of difference Of 0.10. This indicates both
the variables are comparatively very good for hospital.
While services of Doctors and nurses as well were having 0.818 and 0.872 respectively
with Magnitude of difference is 0.054 , also good for the hospital.
Our aim is to sort out any two variables out of the total eight (08) , whose area of
improvement is
To done and is imperative for betterment of the hospital.
The factor analysis table also indicated that Quality of hospital (in terms of infrastructure)
And Administration Dept were found to be 0.840 and 0.841 respectively which is quiet
good
For Hospital.
Total Variance Explained
Componen
t
Initial Eigen values Extraction Sums of Squared Loadings
Total % of Variance Cumulative % Total % of Variance Cumulative %
1 6.318 78.972 78.972 6.318 78.972 78.972
2 .741 9.257 88.229
3 .342 4.279 92.508
4 .316 3.944 96.452
5 .130 1.620 98.072
6 .075 .939 99.012
7 .042 .529 99.541
8 .037 .459 100.000
Extraction Method: Principal Component Analysis.
Component Matrix
Component
1
Waiting Time .923
Reception co-ordination .846
Service of Doctors .904
Service of Nurses .934
Billing & Pharmacy Dept .835
Radiological & Pathological
Services
.826
Quality of Hospital .917
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Administration Department .917
Chapter – 8
Suggestions/Recommendation
CONCLUSIONS AND MANAGEMENT IMPLICATIONS:-The results of the investigation hold important implications for future planning anddevelopment in the Global Baroda Hospital. Service managers should take cognizance of the most important service quality issues identified in this investigation. In this regard, (interms of their expectations) for patients in general were: Proper explaining of hospital procedure (what to do and where to go) and services by medical staff. Coincidently theorder in which they perceived the performance of the hospitals services was in the samesequence. Further measurements however confirmed that satisfaction were met.
The importance of these findings lies incontrovertibly therein that they prospectively
contribute towards a constructive paradigm shift that espouses the benefits of an improved
perception of service delivery. Based on the findings of this study it can be recommended in
the public health sector should consist of investment in, firstly, an analysis of patients’
perceptions of the performance of a hospital on ongoing and formalized basis and secondly,
of proper staff and management training sessions.
In conclusion, the findings of this study clearly identifies important positive and negative
perceptions regarding the healthcare services provided by the hospital under examinationand substantiate the conclusion that it is imperative the hospital management take the
necessary measures to improve the perceived performance of the hospital. A differentapproach should be considered and implemented to satisfy the needs of patients.
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References
1 Murray CJL, Frenk J. A WHO framework for health system performance assessment. GEPDiscussion Paper No. 6: Geneva WHO; 1999.2 Yildiz Z. Measuring Patient Satisfaction of the Quality of Health Care: A Study of
Hospitals in Turkey Journal of Medical Systems. Volume 28 (6) 2004; 581-589.3 White, Brandi (1999). Measuring Patient Satisfaction: How to Do It and Why to Bother.Family Practice Management, American Academy of Family Physicians.4 Government of Pakistan. Economic Survey of Pakistan. Ministry of Finance andEconomic Affairs, Government of Pakistan; 2005.5 Asian Development Bank. Technical Assistance to the Islamic Republic of Pakistan for theDeveloping Social Health Insurance Project. Asian Development Bank, Islamabad, Pakistan(TAR: PAK 37359); 2005.6 Akram M, Khan FJ. Health Care Services and Government Spending in Pakistan. PIDE
Working Papers 32. Pakistan Institute of Development Economics (PIDE), Islamabad,
Pakistan; 2007