Report On

1

A Study On The Bas is Of . . . .

Square Hospital

Course Title Marketing ResearchCourse Code: MKT - 463Submitted to: Golam Md. Forkan Asst. Professor

Faculty of Business Administration

GROUP NO : 1

G roup Members: ID:

Tanvir Ahmed 062200042Sheikh Zubayer Sobhan 062200053Rakibul Hassan Sunny 062200071Khayrum Sultana 062200054

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Letter of Transmittal

June 30, 2009

Golam Md. Forkan

Asst. Professor

Department of Business

Eastern University

Dear Sir:

It gives us immense pleasure to submit you our report on “Patients satisfaction on Square

Hospital service Delivery”, which was assigned us for the requirement of the course

“Marketing Research”.

It was a great and worthy experience for us to work on such an interesting topic. As

B.B.A. students, this experience will act our credential and as well as our working life.

We have come to know the prevailing situation and activities of these prestigious

companies.

We would like to thank you for your supportive suggestions and helping us in this study.

You can call us whenever you wish to, if you face any problem regarding the report.

Sincerely yours,

Tanvir Ahmed Sheikh Zubayer Sobhan

(062200042) (062200053)

Rakibul Hassan Sunny Khayrum Sultana

(062200071) (062200053)

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Acknowledgement

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One of the most pleasant parts of submitting a report on a project is the opportunity to thank those who have contributed to it. Unfortunately the list of expression of thanks no matter how extensive is always incomplete and inadequate. This acknowledgement is no exception.

We are taking this privilege to deliver our gratefulness to each and every people who are involved with us in every phase of our life.

Firstly, we are grateful to our parents without them we cannot be here. Then we sincerely acknowledge our debt to our faculty Golam Md. Forkan for his valuable counseling towards the improvement of the report. Without his encouragement this would have been impossible. He is a very helpful and friendly person and been always there, where we needed him.

Thanks must go to our friends whose unflagging patience and astounding capacity for creative work and long hours made the work both possible and successful- under the pressure of impossible deadlines.

Once again thanks to those who have helped us to improve the report with various advice.

EXECUTIVE SUMMARY V

1.INTRODUCTION 01

1.1 Origin 011.2 Purpose of the report 011.3 Scope 011.4: Limitation 021.5 Source and methods of collection data 021.6 Report preview 03

2.0 PRESENT SCENARIO OF HEALTH CARE IN BANGLADESH 03

2.1 How well health service provider communicate 062.2. Getting care without long waits: 082.3 Providing care how many times: 092.4 How often doctors talk both patients & its close person:

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2.5 Efficiency of nurse care 112.6 Receptionists 112.7 Friendliness of the people caring for the patient 122.8 Emergency departments 122.9. Follow up 132.10. Overall quality 14

3.0 Findings and conclusions: 15 Appendices

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With the recent rapid changes in the health care delivery system,

health care purchasers, consumers, and providers have become increasingly interested in assessing the quality of care. Several components of the quality of health care can best be assessed by patient reports on their experience; these include access to care, interpersonal aspects of medical care, and some aspects of outcomes of care.

For the last five decades, the government has systematically nurtured the private health sector. This consistent support and encouragement to the private health sector are very important for the growth of the health care service providers.

Square Hospital is a new health care service provide in Bangladesh. It aims to provide unparallel service to the people of Bangladesh by delivering the highest possible level of care.

There are approximately 9 % patients are taking medical service form square Hospital. To review the patient’s satisfaction of square hospital we directly asked a sample of 35 people about its service delivery. Gaining customer satisfaction through- care, information, friendliness is important for Square Hospital. Square hospital is following some rules for its Patients Satisfaction. Like:-

No needless deaths No needless pain or suffering. No unwanted waiting No needless helplessness No waste

Around 70-80 percent of the people relied on the public hospital, but most of the public and private hospitals performance are poor. In addition, hospitals produce stress in a variety of ways. There are few health care organization that are Created pleasant, comfortable, and informative environments to relieve stress and Promote satisfaction among patients, their families, and staff square hospital is one of them . Moreover square hospital is improving its performance day by day through its doctors, staffs, and owner dedication, hard work, good communication skills

1.0 INTRODUCTION:

This report is a part of our Marketing Research (MKT 463) course. Our course instructor authorized us to do a research on marketing related topic. For this we selected a topic on “Patients satisfaction on square Hospital service Delivery.” This report is only appropriate for square Hospital of Bangladesh, other than this the report will not work at well.

1.1 ORIGIN OF THE REPORT

We are the students of BBA 10th Batch. In this semester we are doing the Research Marketing (MKT 469) course. For this purpose our course teacher Mr. Golam Md. Forkan authorized us to do a research on Patients satisfaction on square Hospital service Delivery. We formed a group of four students. The topic was selected by our self.

1.2 PURPOSE OF THE REPORT

There are some particular reasons & purposes of doing the survey. The purposes are: to Know the on Patients satisfaction on Hospital service Delivery in Bangladesh and what actually health care industry does for patient’s satisfaction.

1.3 SCOPES

This report tries to give a brief idea about the Patients satisfaction on Hospital service Delivery in Bangladesh. As being business students we have to write report, make inquiries and make research. As BBA students we make some small survey as our course requirements, like marketing, International Business, Business Law etc. so we have some experience of survey. But we don’t have the full knowledge and enough experience on it. We choose one health care service provider by a lottery. Name of that health care service provider is:

Square Hospital Ltd.18/F West Panthapath, Dhaka - 1205,Phone No: 8159457 www.squarehospital.com

We have tried to enhance our practical knowledge with the helps of the theoretical concepts. In addition, we have tried to find out the differences between the conceptual studies with the practical experiences.

1.4 LIMITATIONS

We have tried our best to make the report perfectly. Instead if our best try we think there is some lacks in data & information. At the time of doing the report we have faced many difficulties. Like:-

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First of all, we would like to mention the time and monetary limitations.

Some time respondents did not provide information’s.

At last, some time the respondents do not take it seriously so that it need time to convince them to participate to answer these questions.

1.5 METHODOLOGIES:-

The survey encompassed one sample group:

Medical Patients

For this Survey we are using primary data. We have Collect Primary Data from the patients, by asking questions. Based on their information we conduct this research. The survey was administered by using direct interview and questionnaires. Participation in the survey was entirely voluntary and confidential. We get Secondary Data from the web site and catalog of Square Hospital Ltd.The questionnaires were given to a random number of 35 patients. To be selected in the survey, patients had to be:

Adults (age 18 and older) Admitted for at least a one night stay in the hospital

Here is a picture of all patients who completed the survey:-

Gender Age65% female 42% under age 6535% male 58% age 65 or older

1.6 THE REPORT PREVIEW:-

The health care industry in Bangladesh has undergone tremendous change. Health care providers must view their health care delivery organizations as businesses and must use the tools of business, to ensure customer satisfaction.

Square Hospital is a new health care service provide in Bangladesh. In this report we focus only customer satisfaction. The Mission of Square Hospital Bangladesh is: - Deliver QUALITY health care within 5 CORE standards.

Adhering to high ethical and moral standards at all times Making service quality top priority in all we do Training staff to work within a quality care environment Providing quality health care service in all processes Delivering customer satisfaction through quality service

Hospital provides service not only to cure but also to comfort the sick to ameliorate pain, discomfort, and emotional distress. To ensure that sufficient level of “caring” as well as “curing” are provided, it is necessary to identify and objectively measure patients perceptions of caring . This report focus on some unique satisfaction items for patients (e.g. skill of nursing care, Recovery of physical health, and respect for patient’s opinions and feelings,) were significantly associated with overall satisfaction. This report also focus common items (e.g. recovery from distress and anxiety and doctor’s clinical competence) also related significantly to overall satisfaction. Suggest what Square hospital must do to satisfy its patients so as to achieve its financial objectives.

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2.0 PRESENT SCENARIO OF HEALTH CARE IN BANGLADESH:-

Gaining patient’s satisfaction is a bigger issue for today’s hospitals or health care industries .what the hospital must do to satisfy its patients so as to achieve its financial objectives to answer this question, managers must initially identify the firm's target market and clarify its patient care objectives using their critical success factors.

Today's health care organizations are more focusing to reduce the costs, improve the quality of care and meet stringent guidelines and this has made it necessary to re-examine the method of evaluating the service performance. Because Health care services are intangible, patients or customers often rely on tangible cues, or physical evidence, to evaluate the service before it purchase and to assess their satisfaction with the service during and after consumption. Physical evidence is the environment in which the service is delivered and in which the firm and the customer interact, and any tangible commodities that facilitates performance or communication of the service. Today's health care organizations are following a process to ensure patients satisfaction:

Physical evidenceService Services cape Other Tangibles

Hospital

Building exterior

Parking Signs Waiting areas Admissions

office Patient career

room Medical

equipment Recovery

room

Uniforms Reports/

Stationary Building

statements Websites

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Square Hospital

What do patients want? Both interpersonal relations and technical skill are rated highly. A systematic review on patients' priorities for general practice care was conducted as part of our project the most highly rated aspect of care was "humaneness." This was followed by "competence/accuracy," "patients' involvement in decisions," and "time for care.” For example, patients in our survey placed greatest importance on having a "doctor who listens and does not hurry. Patients increasingly expect to participate in decisions about their care, but these aspirations (something that you hope to achieve) are rarely met. Failures in communication and incorrect assumptions about patients' preferences are surprisingly common.

Doctors and patients don't always agree on priorities. Patients gave much higher priority to sufficient consultation time, availability of appointments at short notice, and being given detailed information about their illness, whereas doctors tended to place greater emphasis on coordination of care, home visits, and continuity.

The patient wants to be an informed and empowered consumer, but the doctor prefers a long term relationship with a docile (quiet and easy to influence, persuade or control :) patient.

According to our server we have found few Skills that Doctors or a physician should need for salesmanship. Those are:-

Organizational skills Personal skills Interaction skills Analytical skills Communication skills Teaching skills

SKILLS THAT DOCTOR SHOULD NEED FOR SALESMANSHIP

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What SkillsDoctor should need for salesmanship

General, generic graduate skills

Organizational skills: Time and resource managementTask prioritization Teamwork Reflection and being self-critical

Personal skills: Lifelong learningRetrieving, managing and manipulating information Presentation/communication of information Studying topics in depth Mentoring others

Interaction skills: Dealing with uncertaintyWorking in a changing environment Risk management Ethical decision-making

Every hospital says that it is patient-focused and patient-centered, but how many could say that the patient is in control of his or her experiences in the hospital. Patient-centeredness is the key to improving work design and processes at hospitals. Few hospital treat [patients] as guests, these hospitals are serving as laboratories of learning, where improved practices are brainstormed and tested.

Square Hospital is following some rules to ensure patients satisfaction. Like:-

No needless deaths No needless pain or suffering. No unwanted waiting No needless helplessness No waste Clean environment

2.1 HOW WELL HEALTH SERVICE PROVIDER COMMUNICATES IN SQUARE HOSPITAL:

The pie graphs show how respondents answered a series of questions that asked people how often their doctor or other health provider:

1. Listened carefully to them2. Explained things in a way they could understand3. Showed respect for what they had to say4. Spent enough time with them

Percentage who Said their doctors

Percentage who Said their doctors

Percentage who Said their doctors

Sometimes or never Usually Always

Communicated well Communicated well Communicated well

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Intellectual attributesAttitude: Reflective and inquisitive attitudeImpact of value judgments

Analytical skills: Problem recognition, definition and prioritization, Information analysis, interpretation, evaluation and prioritization

Clinical and practical skills: Clinical skills (specific list)

Communication skills: Communicate with patients and relatives (listening, explaining, mediating and negotiating, handling complaints)

Teaching skills: Principles of medical educationExhibit creativity/resourcefulness

Clinical and practical skills

Communication skills

Teaching skills

Worst survey results Best survey results

How well doctors communicate

28%

11%

61%Sometimes or never

Usually

Always

Form the respondent answer we found 11% of the patients said doctors sometimes or never communicate well at Square Hospital. On the other hand 28 % of the patients said doctors usually communicate well and 61% the patients said doctors always communicate well.

A random number of 35 patients were asked about 1. Is the Nurses Listened carefully to their word? 2. Are they Explained things in a way that the patients could understand?3. Are they Show respect for what the patients had said?4. Are they spent enough time with them?

How well Nurses communicate

5%

26%

69%

Sometimes or neverUsuallyAlways

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From the respondent answer we have found 5% Nurses sometimes or never communicate well with the patients, 26% said they usually communicate well and 69% said they always communicate well with the patients.

2.2. GETTING CARE WITHOUT LONG WAITS:

A busy doctor is often a popular doctor with a great reputation. However, by waiting too long for an appointment, patients may compromise their health. Square Hospital always tries to reduce patients waiting time, but it is not always possible because if they do, it will simultaneously eat up other patients consulting time. The pie chart shows how patients getting care without long wait. To identify it we have asked a series of questions about how often the Doctors:.

1. Got treatment as soon as they wanted when they were sick or injured.2. Got an appointment as soon as they wanted for regular or routine health

care.3. Waited only 15 minutes or less past their appointment time to see.

Percentage who Said they

Percentage who Said they Percentage who Said they

Sometimes or never Usually Always

got care without long wits

got care without long wits got care without long wits

Worst survey results Best survey results

A random number of 35 patients were asked about are they getting care without long waits Form the answer we found 19 % of patients sometimes or never got care without long wits. On the other hand 29 % of the patients usually got care without long wits and 52% the patients got care without long wits.

Got care without long wait

19%

29%

52%

Sometimes or never

Usually

Always

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2.3 PROVIDING CARE HOW MANY TIMES:

SQUARE Hospital aims to provide unparallel service to the people of Bangladesh by delivering the highest possible level of care .A random number of 35 patients was surveyed about the average visit by doctor to patients

0

10

20

30

40

50

60

70

80

Percent %

< 2 3 to 5 6to 7 8 to 9 10 or more

Number of visit

How many time doctors Visit a patients

Times < 2 3 to 5

6 to 7 8 to 9 10 or more

% percent 23% 73% 4% 0 0

According to our survey the mean is 1.66 that’s means the average visit by doctor to patients in square hospital is 3-5 times per day. On the other hand in case of Nurses were the average visit by nurse to patients in a health care organization is 6-7 times per day. To measure the percentage of patient’s satisfaction we have asked a question about are they satisfy the doctors visit time?

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Patients satisfied with doctors visit time

80%

15%5%

a)      Yesb)      Noc)      Don’t know

According to their answer we have found 80% patients are satisfy with doctors visit time which is 3-5 times per day. When nurses and doctors give more time in patients visit, they play an Instrumental role for shaping patients satisfaction.

2.4 HOW OFTEN DOCTORS TALK BOTH PATIENTS & ITS CLOSE PERSON:

Square Hospital, Dhaka, Bangladesh, a concern of Square Group is a 300 bed tertiary care hospital. Its vision is that Square Hospital will become the location of choice for Bangladeshis' and people of South and Southeast Asia for quality healthcare and an integrated centre for clinical services, medical and nursing education and research. For the study of disease it is more important for the doctors to talk with the patient’s closely related person.

0

10

20

30

40

50

60

%

pe

rce

nta

ge

Almostalways

Often Sometimes Never Don’t know Refused

How often

How often the doctors talk both patients and its close person

How often % percent

Almost always 7%

15

Often 26%

Sometimes 60%

Never 7%

Don’t know 0

Refused 0Total 100%

According to the response of patients, we found that 60% of the square hospital doctors sometimes talk both patients and a person they are close to like parents, friends and spouse. Then 26 of the doctors talk both patients and a person they are close often talk both patients and their close person. 7% health center almost always and 7 % never talk both patients and a person they are close.

2.5. EFFICIENCY OF NURSE CARE:-

A random number of 35 patients were asked about do they think Square Hospital have enough nurse staff and doctor? According to their answer we have found 85% patients think Square Hospital have enough nurse staff and doctor. 10% patients think Square Hospital don’t have enough nurse staff and doctor.

Enough nurse staff and doctor

85%

10% 5%

a)      Yes b)      No c)      Don’t know

According to our survey we have found Square Hospital has nursing team considerably over the past 3-4 years and they now offer a full range of nursing care from an appropriately skill-mixed team. It was very pleasing to note that almost all the respondents (89%) considered that the quality of the nurses’ care, attention and explanations was either ‘very satisfied’, ‘somewhat satisfied’.

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76%

13% 5% 3%2% 1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

  Verysatisfied

Neutral       Verydissatisfied

Efficiency of nursing care

2.6. RECEPTIONISTS

Reception staff communicates with patients is important for health care organization. When asked to rate how helpful they found the receptionists, and how they found they are usually treated by the receptionists, nearly all respondents (86%) said they were ‘excellent’, ‘very good’ or ‘good’. This reflects the hard work and commitment of the reception and administration staff that is very important part of the service.

Efficiency of receptionists or staff care.

14%

12%

7%6% 1%

60%

Excellent Very good Good Bad Very bad Don’t know

2.7. FRIENDLINESS OF THE PEOPLE CARING FOR THE PATIENT:

Hospital provides service not only to cure but also to comfort the sick to ameliorate pain, discomfort, and emotional distress. To ensure that sufficient level of “caring”

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as well as “curing” are provided, it is necessary to identify and objectively measure patients perceptions of caring .

Friendliness of the people caring for the patients is important for health care organization. When asked to rate how friendly the stuffs and doctors are and how they usually behaive with the patients, nearly all respondents (86%) said they were ‘excellent’, ‘very good’ or ‘good’. This reflects the hard work and commitment of the people caring for the patients of square hospital.

2.8 EMERGENCY DEPARTMENTS:

This Report presents several different indicators that describe how well Square hospital emergency departments perform and whether its patients are satisfied or not. . Emergency departments (EDs) provide a critical function within the Square Hospital. Approximately nine thousand patients pass through Square EDs every year. Likewise, this report did measure the satisfaction of the patients who receive care in EDs. Nearly all respondents (89%) said they are Very satisfied, somewhat satisfied about square hospital emergency departments.

2.9 FOLLOW UP:-

Health care organizations are an institution which is primarily engaged in providing medical, diagnostic and major surgery facilities for medical care and treatment of sick and injured persons on an inpatient basis under supervision of duly licensed physicians and 24-hour nursing service. A person receives medical attention, care, or treatment when they are ill or injured. To ensure patients satisfaction and repeat business square hospital sometime do follow-up. We asked a random number of 35 patients about Do the patients care unit call them patients when they are at home to see how they are doing?

Follow-Up By the Health care organization

20%

70%

10%

      Yes,     No,     Refused

According to their answer we have found only 20% times Square hospital does follow up. This should not be the custom. Patients think square hospital should improve this to ensure more customer satisfaction

2.10 OVERALL QUALITY:-

Square Hospital, Dhaka, Bangladesh, a concern of Square Group is a 300 bed tertiary care hospital. Its vision is that Square Hospital will become the location of choice for

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Bangladeshis' and people of South and Southeast Asia for quality healthcare and an integrated centre for clinical services, medical and nursing education and research. The measure of overall quality helps to identify patient’s impression of the quality of care received. This indicator has been shown to be closely related to clinical outcomes.

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Excellent Very Good Good Fair Poor

Overall service

Excellent Very Good Good Fair Poor

A random number of 35 patients were asked to rate the overall satisfaction, nearly all respondents (83.1%) said they were ‘excellent’, ‘very good’ or ‘good’

3.0 Findings and conclusions:

Poor health care quality is a major public health issue in Bangladesh. In fact, according to a WTO Health study funded by The Robert Wood Johnson Foundation (RWJF), patients have only about a 50 percent chance of receiving appropriate care for their health problems in Bangladesh. The physical evidence and service environment is poorest in Bangladesh health care industry. We asked about patients about satisfaction with different care of square Hospital. The high satisfaction levels were expressed with Friendliness of the doctors, and nurses. The service design of Square hospital environment creates satisfaction. Good air quality and ventilation, adequate lighting is linked to patient satisfaction as well as that motive patients to became fit. For hospital patients, quality of care is strongly linked to the performance of nursing staff. Over time, square hospital nursing and physical evidence has increased its appeal to the patients. As a result, square hospitals providing quality health care through

Providing all patients private rooms Providing indoor air quality with well-designed ventilation systems and air

filters. Made hospitals quieter. Providing better lighting and access to natural light to reduce stress and

improve patient safety.

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Created pleasant, comfortable, and informative environments to relieve stress and

Promote satisfaction among patients, their families, and staff. Made hospitals easier for patients and their families to navigate

Now if we look at the following table we can easily measure the patient’s satisfaction of square hospital.

Average overall patient satisfaction

83

85

82

86

83

85

86

83

20

92

89

79

78

0 10 20 30 40 50 60 70 80 90 100

emergency department

nurses explain in way patients understand

doctors listen carefully

Physical evidence

Feedback call

Service Provider Communicate

Providing Care how many times

Sat

isfa

ctio

n S

core

Quality of Care Question

Moreover the healthcare in square Hospital Bangladesh are improving their performance and patients satisfaction day by day through its doctors, staffs, and owner dedication, hard work, good communication skills.

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Questionnaire

Topics: Patients Satisfaction on Square Hospital Service Delivery

A. HOW WELL HEALTH SERVICE PROVIDER COMMUNICATES IN SQUARE HOSPITAL

5. Listened carefully to them□Sometime or never □ usually □ Never

6. Explained things in a way they could understand□Sometime or never □ usually □ Never

7. Showed respect for what they had to say□Sometime or never □ usually □ Never

8. Spent enough time with them□Sometime or never □ usually □ Never

B. GETTING CARE WITHOUT LONG WAITS:

4. Got treatment as soon as they wanted when they were sick or injured.□Sometime or never □ usually □ Never

5. Got an appointment as soon as they wanted for regular or routine health care.□Sometime or never □ usually □ Never

3. Waited only 15 minutes or less past their appointment time to see □Sometime or never □ usually □ Never

C. HOW MANY TIME DOCTOR VISIT A PATIENTS?

□< 2 □3 to 5 □6 to 7 □8 to 9 □10 or more

D. HOW OFTEN DOCTORS TALK BOTH PATIENTS & ITS CLOSE PERSON?

□Almost always □Often □Sometimes □Never □Don’t know□Refused

E. ENOUGH NURSE AND DOCTORS?

□ Yes □ No □ Don’t know

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F. EFFICIENCY OF RECEPTIONISTS OR STAFF CARE?

□ Excellent □ Very good □ Good □ Bad □ very bad □ Don’t Know

G. FRIENDLINESS OF THE PEOPLE CARING FOR THE PATIENT:

□ Excellent □ Very good □ Good □ Bad □ very bad □ Don’t Know

H. EFFECTIVENESS OF EMERGENCY DEPARTMENT

□ Very satisfied □ Satisfied □ Neutral □ Dissatisfied □ Very Dissatisfied

I. DO THE PATIENTS CARE UNIT CALLTHEM PATIENTS WHEN THEY ARE AT HOME TO SEE HOW THEY ARE DOING?

□ Yes □ No □ Refused

J. OVERALL QUALITY OF THE SQUARE HOSPITAL:

□ Excellent □ Very good □ Good □ Fair □ Poor

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