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.


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