Middleton Hospital – A case in MR

Alfred Robson, superintendent of Middleton Hospital, became quite concerned after having read a consumer survey that indicated that public opinion toward hospitals and the medical profession in general was quite low. According to the survey, the public viewed the cost of health care to be as serious a problem as the high costs of food, clothing, fuel and other necessities. While three out of four survey respondents worried a great deal about product prices in general, almost 70 percent were equally concerned with the cost of medical care.

People were also concerned with the quality of health services they were receiving. One out of every four respondents thought that hospitals and the medical profession were doing a poor job in serving consumers, while only one out of five respondents thought they were doing a good job. The only other major industries rated significantly worse than hospitals and the medical profession were the oil industry and automobile manufacturers, which were judged to be going a poor job by one out of every three respondents. Furthermore, when respondents with a favorable attitude toward consumer activism were asked to select industries that should receive the attention of the consumer movement in the near future, more than 40 percent of these respondents selected hospitals and the medical profession. This was second only to the food manufacturing industry, where the figure was 45 percent.

Robsen knew there was little he could do about the public’s concern about the high cost of health care. Costs were rising for all hospitals, and the most he could do would be to manage Middleton Hospital s efficiently as possible. However, he felt he could address the concerns patients had about the service they received. Middleton Hospital had always been regarded as the best of the city’s four hospitals, and Robsen wanted to maintain that reputation.

Robsen described the findings of the survey to his staff at its next meeting. He asked staff members to comment on particular areas of patient care that might be causes of patient dissatisfaction.

Ms Bacon who was responsible for admitting new patients, thought that waiting might be a real problem. In admitting and releasing patients, for instance, the delay could be considerable. Paperwork was heavy and getting heavier. Here could also be delays, she knew, in others areas of the hospital; it was not uncommon to wait for physical therapy or for X-rays to be taken. Sometimes, in emergency situations, this was unavoidable. There were times however when patients were simply escorted to the special service area before personnel were available to take care of them.

The nursing supervisor, Ms. Hala thought that patients would form their opinions of the hospital largely on the basis of whether their treatment was courteous and efficient. She felt that special care should be taken to see that patients were courteously escorted to their rooms, that their visitors were pleasantly received and that their treatment and are were considerate throughout. Further, if calls for assistance were answered promptly, if food was served on time, if patients were bathed regularly, and if rooms were kept neat and clean, patient would most probably be pleased with the service.

Dr. Sentry the hospital’s chief of staff thought that the attitude of the staff could be an important factor. A positive attitude on the part of doctors, nurses, and volunteers was a critical element of quality patient care, He said that the patient’s care and treatment should be explained to him or her as fully as possible, and he urged staff and other personnel to do so.

The supervisor of volunteer workers suggested that perhaps the volunteers were in a better position to hear certain complaints than any other of the hospital staff. Some of those complaints were minor, but they might be annoying to the patient. Such complaints might have to do with noise in the hallways, or not being able to get magazines and newspapers or books from the lending library. Another question that often came to the attention of volunteers concerned the availability of a chaplain or religious services.

After having thought about what was said at the meeting, Robsen decided that it would be useful to conduct some research to find out which hospital characteristics and services were perceived as really important and how Middleton Hospital was rated on each of those characteristics. He thought that such information could reveal the hospital’s reputation or image, and perhaps even tell him the hospital was perceived in comparison with the city’s other hospitals. It was unclear to Robsen, though, whether the research should involve only recent patients of Middleton Hospital or recent patients of all the city’s hospitals. There also appeared to be some merit in interviewing the general public, for most of the hospital’s future patients would be drawn from that group.

Middleton Hospital use marketing research to its advantage by surveying hospital’s patients current and in the recent past and note their problems and suggestions for improvements.

Mr Robsen after convening a meeting of his key staff members discuss the improvement suggestions given by the hospital users as a result of the research. All groups who used the hospital services must be studied.

  • Amanjuneja75

    Middleton Hospital Case

    Introduction and Case
    background: The case has to be summarized giving a
    brief background of some situational issues faced by the management.

    Management Decision
    Problem: Alfred Robson, superintendent of Middleton
    Hospital, in order to maintain its reputation as one of city’s best hospital
    wanted to know patients’ perception of its services compared to that of its

    Marketing research
    problem: Perception/ satisfaction survey of
    patients on hospital characteristics and quality of services provided by
    Middleton Hospital.


    Sub-problem 1: To determine image of Middleton Hospital on quality of services and
    hospital characteristics.

    Research question 1: What are the various hospital characteristics, areas of patient
    care that may be a cause of patients’ dis-satisfaction.

    Sub-problem 2: To make a competitive analysis with other city hospitals.

    Research Question 2: Where does the Middleton hospital stands in comparison to other
    city hospitals on the various hospital characteristics and service parameters.

    Research Methodology:

     Part 1:
    Sources of Data.

    Secondary source:

    1)      Report of consumer survey on public opinion towards hospitals.

    2)      Some minutes of meeting with hospital staff identifying areas of
    patient dissatisfaction.

    Primary Data source:

    1)      For exploratory phase, the internal staff members of the hospital
    who will be identifying all parameters of hospital services and characteristics
    which go into building up reputation or image or perception of the hospital in
    the minds of the patients.

    2)      For descriptive phase, recent patients of Middleton and other city
    hospital and general public residing in nearby areas.


    Part 2: Research Design.

    the parameters of hospital services and characteristics are not clearly
    identifiable even after getting inputs in a meeting with the hospital staff, so
    it is advised to take another round of interviews with the internal staff
    during the first phase of research to complete the list of parameters which
    goes into building patients’ perception about the hospitals.

    it is proposed to have a two phase research process.

    Phase 1: Exploratory research: Initial research to be conducted with the
    internal staff/management of the hospital and few recent patients in order to
    completely identify the list of variables which build up the patients’
    perception on hospital services/characteristics. We can develop a conceptual
    framework in the form of a single construct called “Service Quality” covering
    all concepts and corresponding variables related to the above construct. For
    eg. Transaction/operation time, Behavior of the hospital staff, Ambience of the
    rooms, attitude of the staff, assistance of volunteers, food and library
    services etc.

    The data
    collection/research methods used in exploratory
    phase can be in depth interviews or focus group interviews with Middleton
    hospital staff to get an insight into the parameters which determine hospital
    “Service Quality”.

    Phase 2: Descriptive research: The second phase is a quantitative and is proposed
    to be descriptive research phase where the structured questionnaire is prepared
    to measure the factors of service quality on appropriate scale.

    Data collection method should include survey from recent patients of Middleton and other
    city hospitals along with some public in general. The respondents will be asked
    to rate the variables of service quality as per their perceptions as well as
    the importance they attach to each of these variables. The final scores which
    are calculated can be used for data analysis.

    Part 3: Sampling Design.

                    For Exploratory Phase

    Target population: Internal
    staff, management and recent patients of Middleton and other city hospitals.

    Sampling Framework: Database of
    employees and patients.

    Sampling method:
    Non-probability method (Judgement Sampling) taking a sample from all
    departments and wards of the hospitals.

    Sample Size: Small sample 3

                    Ha2: Middleton
    hospital has a better perception of “service quality” than other city


                    H0: D = 0

                    Ha1: D > 0

     Where  is the mean difference in the rating of
    Middleton hospital with other city hospitals.

    Part 5: Results and findings.

    The results of hypotheses
    tested can be inferred and used as the basis of recommendation to Mr. Robson.

  • Prateek Arya

    How can Middleton Hospital use Marketing research to advantage?