Shree Krishna

Hospital
A Study on Indoor and
Outdoor Patients
Alok Dubey
Berenice da Gama Rose
 What is satisfaction
“Satisfaction is a state felt by a person
who has experienced a performance or
outcome that has fulfilled his or her
expectations.”

 Measured against the expectations

 Important element in the evaluation stage for a
service provider

Shree Krishna Hospital 3

Key Elements
Expectations
Performance
Comparison
Confirmation/Disconfirmation
Discrepancy

Shree Krishna Hospital 4

Determinants to Patient
Satisfaction
Reliability
Responsiveness
Assurance
Empathy
Tangibles

Shree Krishna Hospital 5

 Shree Krishna Hospital
Patient Profiles
 Outpatient
 Inpatient
 Heterogeneous
 Rural and Urban
 Educational Background-illiterate to multiple post-
graduate.
 Occupations-professional to agricultural labour
 Different Income Level
 Target Population of SKH

Shree Krishna Hospital 6

 Patient Psychology and
Common Expectations
listening to the patients, asking questions and
seeking answers, by doing something extra for
each patient, by admitting mistakes gracefully
Cure and taking corrective action.

“the customer is the king.” "Put yourself in

Care your patient’s shoes

Comfort
Differentiating factor

Shree Krishna Hospital 7

 Decision Problem
To assess whether the Shree
Krishna Hospital is meeting
its mission in providing
quality service to the patients
and how to further improve
its health care services.

Shree Krishna Hospital 8

Research Problem
To study satisfaction
of indoor and outdoor
patients and develop
strategies to make
services more
effective.

Shree Krishna Hospital 9

 Research Objectives
 To assess the level of satisfaction among
the patients and their relatives with regard
to quality of services provided by the
hospital in both In-patient and Out-patient
Departments.
 To find the key areas of appreciation and
complaints (in any) of the present
services provided by these departments.
 To suggest measures to overcome
complaints, if any.

Shree Krishna Hospital 10

Scope of Study
Outpatients
Inpatients
Relatives

Shree Krishna Hospital 11

Research Design By interviewing patients
to get an idea of the
drivers of satisfaction

Preliminary Insights
Questionnaire
Primary Data administration on a
sample of 240 patients
Secondary Data
From Journals and the
internet about patient
satisfaction studies in
both India and other
countries

Shree Krishna Hospital 12

 Sampling Plan

Indoor Patient Outdoor Patient Total

Krupa Non- Krupa Non-
Krupa Krupa
15 45 15 45 120

15 45 15 45 120

30 90 30 90 240

Shree Krishna Hospital 13

Data Requirement
 Information pertaining to the satisfaction
level with the Hospital as a whole
 Information pertaining to the satisfaction
level with the Staff (behaviour and
efficiency)
 Information pertaining to the satisfaction
level with the Services provided
 Information pertaining to the satisfaction
level with the procedures involved in
obtaining treatment (operational aspects)
 Information pertaining to the satisfaction
level with the Krupa Arogya Suraksha
scheme.

Shree Krishna Hospital 14

Scaling and Measurement
Tool
Likert Scale- 1 to 5
Importance
 “Very Important” to “Not at all
important”
Performance
 - “Highly Satisfied to Highly
Dissatisfied

Shree Krishna Hospital 15

Analysis

Quantitative technique
Qualitative technique Indices were calculated
Grouped under various
for the responses on
Comparisons: heads different incidents
the Likert scale. The
and suggestions
attributes or drivers to
 For Outdoor patients incorporated
patient satisfaction
 Krupa vs non Krupa were clubbed under 6
 Rural vs Urban heads, and composite
 For Indoor patients indices were calculated
 Krupa vs non Krupa for each of these heads
 Rural vs Urban
 For Krupa patients alone
 Responses on Krupa – specific questions – Indoor vs
Outdoor.

Shree Krishna Hospital 16

Findings

Three of the major deciders in a

non emergency situation
Physical access
Time Access
Information Access

Shree Krishna Hospital 17

 Indices
Indices
SeSer
rv vic
ice e
s sPPr
ro

20
40
80
120

00
20
6040
10060
80
100
120
LoLo..v.ide
caoc d
W W E tiaotnio
or o xEpx n
d o rd epe
f Mof rt srts
M
Hi Houthout
si h
Re R t.Asts.A
Va V puepu sosso
l foal tat ta
In Inr Mfor Miontion
Preference Criteria

fra fr o o
a a ane ne
Outpatients

Co Cnod Mndy y
nv nv e Me
en en d d
i e ie
Ef Ef SkSkni cence

Shree Krishna Hospital

fic fic ill ll D

Criteria
Criteria
ien ien Do o
cy cy mc c
m e
D
e d
Di is AdAddv
sc c a ve ert
an nd r t
d fr
SuSufpree ee
p p
Preference Criteria of Urban Outpatients
Preference Criteria of Rural Outpatients

AeAespt ororts
st het s
Gr Grhieeti tics
iev vacs
an nce
ce
18
 Indices
Indices
Se Se
rv rvi
ice ce
sP sP
ro rov

0
20
40
60
80
100
120

0
20
40
60
80
100
120
v i
Lo iLdoed ded
c a ca
W W E tEiontion
or or x xp
d d ope e
of f rt rt
M Ms s
H H ou ou
ist itsht th
Inpatients

Re Re.A .As
Va Vapu pusso so
Preference Criteria

l f l ftat tat
In Ionr Mor iM on ion
fra frao o
a ane ne
Co Cnod ndy y
nv nMv e Me
en end d

Shree Krishna Hospital

ie ie
Ef E Sk Snkce nce
fic fficill ill
Criteria
Criteria
ien ie D D
cy ncoyc oc
m m
e e
Di D Ad Add d
sc isc ve ve
an anr t r t
d d
Preference Criteria for Rural Inpatients

Su Sfuree fre
Preference Criteria for Urban Inpatients

p p pp e
Ae A or or
st est t s t s
Gr Ghet het
ie rieics ics
va va
nc n
e ce
19
Krupa vs. Non-Krupa

Outdoor krupa non-krupa

INDOOR

100 Krupa Non-Krupa

90
80100
70
60 80
Indices

50
Indices

40 60
30
20 40
10
0 20
Procedure and Infrastructure and Support facilities&
Doctors related Comfort
0 finance related medical facilities staff related
support
krupa Proced.&
76.44 fina. 76.85Doctors rel. 90.44Infrast.& m ed.
78.41 Com fort
79.09
serv.&staff
non-krupa 76.92 84.74 85.4 75.52 74.52
Krupa 78.57 90.88 84.89 85.7 80.47
Factors
Non-Krupa 75.14 86.54 85.56 79.85 81.41

Factors

Shree Krishna Hospital 20

Rural vs. Urban

OUTDOOR
INDOOR
90
90
8585
8080
Indices

7575
Indices

70
70
65
6560
support
Proced.& fina. Doctors rel. Infrast.& med. Comfort
55 serv.&staff

Rural
50 78.316 87.755 86.45 76.92 73.72
Proced.& Doctors Infrast.& support
Urban 75.876 85.65 86.9 Comfort79.39 76.5
fina. rel. med. serv.&staff
Rural 77.8095 87.22 85.83 82.02 80.94
Factors
Urban 76.23 86.42 85 81.25 81.743
Factors

Shree Krishna Hospital 21

Qualitative Aspects from
Outpatient Survey

 Time
 Health plan patients
 Locating the Right Department
Comfort
 Privacy during consultation and tests
 Afternoon OPD
 Partial treatment for friends and
relatives of staff
 Shuttle timings and frequency

Shree Krishna Hospital 22

Qualitative Aspects from
Inpatient Survey

 Needless Hospitalisation
 Needless tests to increase expenses
 Relatives
 Discharge Procedure and Legal Issues
 Lack of specialists round the clock
 Deluxe rooms
 Unsympathetic Treatment in the OB
& G Dept.

Shree Krishna Hospital 23

 Indices
In
fo
r
m

0
10
20
30
40
50
60
70
80
90
D 100
at
is D i on
e
as is c
es o u
c o nt
ve
re
d
Pr
ic
O e
pt
io
ns
M
ed
D ia
oc
um PR
en T
ta
Tr ti
e a on

Shree Krishna Hospital

Krupa Specific

D tm
Factors ou en
t
bt
s B oo
O cl k
th arif l et
er ic
As ati
Satisfaction with Krupa

s o on
O ci
th at
er io
St Be n
af
f h nef
os i ts
pi
ta
lit
y
Indoor
Outdoor

24
Other Issues
 Industrial Card Holders
 Coordination Problems and Rigidity in a
Professional Bureaucracy
 Infusing confidence –appearing to be good
is as important as being good!
 Good Behaviour - an important PR factor!
 Freeships and Concessions
 The other side of the coin
 Compassion: A crucial Ingredient
 The Much-maligned pharmacy
 Nurses – maintaining a delicate balance

Shree Krishna Hospital 25

Comparison for Outdoor vs.
Indoor Aggregate Indices

Inpatient vs Outpatient Satisfaction

100

90

80
Indices

70

60

50
Proc and Fin Doctors Infra and Fac Comfort Support & Staff

outpatient 77.16 85.07 96.67 76.19 75.03

inpatient 75 86.85 85.39 81.59 82.58

Satisfaction Drivers

Shree Krishna Hospital 26

BRAND REPOSITIONING
STRATEGIES

What is a brand?
Significance of Brand
Image Perception Study

Shree Krishna Hospital 27

Reason for Choosing a
Particular Hospital

Reason for going to health care centre

Spec 73

Price 68

Assn 20
Factors

Location 96

Time 98

Service 112

Preference

Shree Krishna Hospital 28

Familiarity with Shree
Krishna Hospital

FAMILIARITY WITH SHREE

Familiarity KRISHNA
of SKH HOSPITAL
in Anand
Familiarity of SKH in VVN

8% 1%
8% 0%
8% 2% 30% Never heard of
25%
35%
27% 32%
22% Heard of
Know a little bit
25% Know a fair amount
43%
Know very well
34%
Never heard of Heard of Know a little bit
Never heard of Heard of Know a little bit Know a fair amount Know very w ell
Know a fair amount Know very well

Shree Krishna Hospital 29

Favourability Image of
Shree Krishna Hospital

FAVOURABILITY IMAGE OF SHREE KRISHNA

FavourabilityHOSPITAL
Favourability image of
image of SKH
SKH in
in Anand
VVN

8% 10% Very Unfavourable

7% V er y Un fa v ou r a ble
19% 10% 8% 10%
Somewhat
20% Somunfavourable
ew h a t
18%
28%33% u n faIndifferent
v ou r a ble
38%In differ en t
30% 25% Somewhat
36% Somfavourable
ew h a t
Very Favourable
fa v ou r a ble
V er y fa v ou r a ble

Very Unfavourable Somew hat unfavourable Indifferent

Somew hat favourable Very favourable

Shree Krishna Hospital 30

 Brand Perception
Performance ranking
1 00

90

80
Indices

70

60

50
In fr a st .& su ppor t
Ex pen ses Doct or s Com for t
fa cilit ies ser v .&st a ff

Im por t a n ce 1 00 1 00 1 00 1 00 1 00
Per for m a n ce 77 86 86 7 9 .5 78
Factors

Shree Krishna Hospital 31

People’s reasons for not taking
treatment at Shree Krishna
Hospital
 Bad experience in the past
 Poor services
 No personalised attention
 Loss of time and unnecessary delays due to lack
of coordination between departments
 Community level attachment to another hospital
(eg: Zakaria Hospital)
 Costly with no reason and no extra services or
benefits
 Distance

Shree Krishna Hospital 32

Contd……

 Very few specialists and even fewer doctors

with a good reputation.
 Confusion regarding trainee doctors
 The pace of treatment
 Referrals to Baroda in lack of specialists
 Public image associated with going to a
private hospital
 Better personal attention by the private
doctors
 Misleading information about Krupa such
as patient is kept until bill reaches the
discount limit offered under Krupa i.e. Rs.
5000

Shree Krishna Hospital 33

Contd….
 Perception of Shree Krishna Hospital
being a “Civil Hospital”
 Lack of coordination
 Doctors attitude of trying to admit
patient
 No reliability: wrong diagnosis
 No integration and responsibility and
that the doctors are not experts

Shree Krishna Hospital 34

Brand building exercise

It can be done by:

reinventing the mission and its
core values
need decentralization in the
process of the thoughts and also
in its implementation to the
ground reality

Shree Krishna Hospital 35

Core Values

Innovation
Excellence
Urgency
Community
Spirit
Growth

Shree Krishna Hospital 36

Employee Induction
Programme

“SPARK” (the acronym stands

for - Shree Krishna Hospital:
Performance, Achievement,
Results; Knowledge).

Shree Krishna Hospital 37

Making Shree Krishna a
Brand for long time
Certainty
Organizational growth
Brand idea can be a glue to hold
different parts together
Not create a world of rule books
but rather a common set of ideas
that can steer attitudes and
behaviour
Shree Krishna Hospital 38
Networking the Brand
Marketing
Communication

Donors Partners

Customers Physical
Competitors
(Patients) Experience

Employees
Retailers
Digital
Experience

Shree Krishna Hospital 39

Brand Model

 Identity
 Brand Idea
 The nature of marketing
communications
 Employees’ interpretation of the
identity, and
 The nature of the services
 Image
 Positioning
 Reputation

Shree Krishna Hospital 40

COMPETENCE
MEASURE
External Environment Analysis
 Market Opportunity Analysis
 Opportunity Matrix
 Threat Matrix
Internal Environment Analysis

Shree Krishna Hospital 41

 Opportunity Matrix
Success Probability vs. Attractiveness

High( Success Probability) Low( Success

Probability)
H  Specialist services  Additional
 Customised Treatment facilities for
packages urban outpatients

L  General services  Advertisement

specialty  Insignificant
discounts (5%)

Shree Krishna Hospital 42

 Threat Matrix
Probability of occurrence vs. Seriousness

High (Probability of Low (Probability of

occurrence ) occurrence )
H  New Specialties  Opening of new
 Bad WOM (Delay in Hospital with
treatment or wrong same facilities
diagnosis) (e.g. EMRI)
L  Locational  High Cost
Disadvantage

Shree Krishna Hospital 43

Strengths/Weakness
Analysis

Strength
 Infrastructure and facilities
 Nursing and Tab Technician college
 Leadership
Weakness
 Integration problem
 Absence of specialty (Power brand)

Shree Krishna Hospital 44

 Module for Patient
Satisfaction Studies
 Designed on the basis of the survey
conducted by us
 User friendly
 Should be conducted at least once a
year to monitor progress and obtain
feedback
MODULE

Shree Krishna Hospital 45

Conflict and Cooperation
Patient
Cure and compassion Comfort and Cooperation

Doctors
Management Trust, Respect and Honesty,
Participative decision making

Shree Krishna Hospital 46

Shree Krishna Hospital 47
 Vision

We would strive to be a
Centre of Excellence in
all that we do; patient care
or teaching, research or
extension.

Shree Krishna Hospital 48

 Mission
To our patients,
comprehensive and
personalised health care
with commitment and
compassion at an affordable
cost, to their utmost
satisfaction, while keeping
ourselves abreast of state-of-
the-art technology.

Shree Krishna Hospital 49

 Innovation

Intellect, imagination and

creativity our credo;
High-impact ideas and
achievements our basic reason of
existence;
Value creation our way of life.

Shree Krishna Hospital 50

 Urgency

Commitment to deliver all the

time;
Strong work ethic the norm;
Focus on winning for everyone;
Our results speak for them
selves.

Shree Krishna Hospital 51

Excellence

Patient satisfaction paramount;

Integrity in all we do;
Quality without compromise;
Outstanding execution always;
Accountability for our action.

Shree Krishna Hospital 52

Community
Teamwork by all;
Open and honest dealings;
Recognition and achievements;
Leadership at every level;
Caring for others;
Trust

Shree Krishna Hospital 53

Spirit
Respect for the individual;
Everyone an owner, empowered
to succeed;
Non-political meritocracy;
Fun environment;
Courage to be different.

Shree Krishna Hospital 54

Growth
Personal and professional
opportunity;
Teaching organization; learning
and knowledge, sharing a way of
life;
Mentoring and guidance for all;
Open minded to new ideas.

Shree Krishna Hospital 55