What is a Service-Oriented Hospital?

Last Sunday, my wife and I went to see a 12 year old secondary school student at a hospital in our city. He had been involved in a motor accident along with over 28 other students. They were going for an excursion when a trailer rammed into their bus. The students sustained varying degrees of injury with one reported death.

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On getting to the hospital, a scene of utter chaos met us. Relatives and friends were milling all over the premises. The entrance to the main emergency ward was securely locked by stern faced and absolutely rude security officers. The nurses and doctors going in and out of the place were even ruder. There was no one to calm down agitated relatives. There was no waiting area for parents to stay. Parents were absolutely at sea as to what was happening to their children.

Ironically, there was a sign close by that read something like:

‘We are a Service Oriented Hospital. You have the right to be served right. We are here to serve you right’

That got me thinking. What really is a Service Oriented Hospital? Is it a hospital that proclaims it is? Or is it a hospital that focuses on treating patients without being nice to them? Is it a hospital that says one thing and does another?

 In the scenario above, the hospital was faced with a crisis situation and needed to act fast to save lives. (I have often seen sympathizers, "empathizers" and onlookers who come to the hospital and make things worse for both patients and personnel). But was there no better way of handling agitated relatives? Where was the Public Relations Officer? Did hospital personnel have to be rude and hostile to relatives in order to do their jobs effectively? What does it take to be service oriented?

The example that readily comes to mind is a 5-star hotel. A Professor of Production Management once commented that the skills needed to run a hotel are similar to the skills needed to run a hospital. Indeed, a hospital can be likened to a hotel because it provides lodging, feeding and other conveniences for admitted patients. But a hospital provides much more. It also functions like a manufacturing firm because production takes place in the hospital. The production in the hospital involves the process of transforming a patient into a healthy person through the input of drugs and skills. A hospital is also similar to an educational institution. This is fairly obvious because like in a school, knowledge is transferred on a daily basis in the hospital; from the doctor to the nurse, doctor to a fellow doctor, pharmacist to the doctor e.t.c.

So, back to the question: What is a service oriented hospital? A service oriented hospital is one that has service to clients as its primary focus. It is a hospital where the perception of good, courteous, efficient and effective service is an established culture. Having this perception of service delivery could just be the key to changing the present unfriendly attitude of many hospital personnel to a more welcoming, understanding and supportive one. Attitude can be modified and changed through education and training.

A service oriented hospital must recognize the following 5 things:

1.     The hospital must recognize that its core product is good health and it should do all within its power to provide good health to clients. The hospital product is largely intangible i.e. good health cannot be seen, tasted, felt, heard or smelt before purchase. A customer shopping for a car can see the car and even test-drive it before purchase, but a patient cannot do either when purchasing health. The patient does not know how he/she will feel after you provide service to him/her. He/she comes to you with a high level of trust. Providing shabby service is an abuse of that trust. A service oriented hospital must therefore create tangible evidence that will provide information about its product and transmit confidence to the patient. Tangible evidence could be the hospital environment, staff dressing, availability of standard facilities and availability of hospital consumables etc

2.     A service oriented hospital must also recognize that there is a close proximity between workers and clients. This element means hospital service is usually inseparable i.e. both the service provider and client must be present before service can occur. It is near impossible to take a history, examine, investigate and treat a patient without his/her physical presence. A service oriented hospital must therefore ensure that the conduct, attitude, appearance and level of skill of the service provider (doctor, nurse, laboratory scientist, and pharmacist e.t.c) must be at an optimal level at all times.

3.     Thirdly, the hospital must know that it is easy for clients to detect human frailties. As a result of the close proximity between workers and clients during service delivery, it is easy for clients to detect when employees are tired, bored, upset or angry. This can affect client perception of treatment quality. This is the element of Variability. Services could become variable because of different skill levels, and varying emotional dispensation of personnel. In spite of this variability, providers should always strive to reduce variability. The emphasis should be on consistency in service delivery. A service oriented hospital can achieve this by training personnel on handling stressful situations, ensuring personnel are not overworked and identifying personnel that may require psychological help.

4.     The hospital must be aware that unused services cannot be stored. This means hospital services are Perishable. A manufacturing firm can store products until they are sold but a hospital cannot store bed space. The lost revenue from unoccupied beds cannot be recovered the following day. A service oriented hospital is one that has maximal use of resources as a goal. Efficiency and effectiveness are necessary watchwords in all service oriented organizations.

5.     Finally, a service oriented hospital must recognize that most patients expect the result of service to be immediate or at least expect immediate attention (Urgency). A service oriented hospital is one that is timely in its response to patients. Not one that keeps patients waiting for hours before they can access care. Timeliness is also necessary in dissemination of information to concerned relatives. The nature of healthcare calls for a very small margin of error. A service oriented hospital will ensure personnel display a high level of skill and professionalism at all times.

To make your hospital a service oriented one, you must understand the basic principles of service organizations outlined above. You must also educate your employees about those elements of your service that should always be addressed. They are intangibility, inseparability, variability, “perishability” and urgency.

Using the story above, a truly service oriented hospital should have kept relatives in a proper waiting area. They should have also given regular treatment updates to parents. Finally, the healthcare providers should have being more courteous and supportive.

In my next post, I will be looking at the dimensions/levels of the hospital product. See you soon.