Abstract
BackgroundAssessing 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.MethodsWe 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).ResultsA 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.ConclusionsThe 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.
Highlights
Assessing patients’ expectations and perceptions of health service delivery is challenging
Satisfaction surveys have been commonly conducted by healthcare systems to understand the quality from the viewpoint of the patients and visitors, allowing the provider to understand the association between medical service quality and patient satisfaction [9]
Demographic and clinical features During the study period, 144 consecutive patients were admitted to the Intensive care unit (ICU), of whom 27 were excluded due to a lack of consent (n = 19), death within 24 h (n = 3), being transferred out within 24 h (n = 3), and readmission to this same ICU (n = 2)
Summary
Assessing patients’ expectations and perceptions of health service delivery is challenging. Assessing the patients’ expectations and perceptions of health service delivery remains challenging. Researchers have suggested that the provider should compare the expected and perceived service quality to identify gaps between them [7], apply the feedback from patients to improve the quality of care [10], assess the real experiences of medical care [11], and perceptions of quality as provided by the patients [12]. As service quality has become an important corporate strategy for healthcare organizations [6], measuring perception may be an important approach [13], and understanding the gap between expectation and perception may provide additional insight into the background of traditional satisfaction surveys
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