Today, the perspective on quality focuses on satisfaction. Improving quality has become an important task for hospitals. The purpose of the existence of enterprises: to satisfy the customer, to keep the customer, and to ensure customer loyalty. The concept of customers in the health sector covers not only patients, but also all individuals and institutions/organizations participating in the health care process in a broader dimension. In the face of changes in the healthcare industry, increased competition and consumer pressure, healthcare organizations are looking for ways to deliver more cost-effective and higher quality services. Measuring the quality of health services is the basis for improving the service. In this section, solutions are presented by focusing on the studies on employee satisfaction in hospital management in Turkey and around the world in the context of quality management in health services.
TopIntroduction
Quality in Health Sector
Quality has different meanings for different stakeholders in the health sector. The way to dominate the system is to take into account and monitor different stakeholder expectations. A system with accountable qualifications must be balanced between the different expectations of suppliers, patients and doctors (McGlynn, 1997).
According to the definition on the official website of the Turkish Ministry of Health (2012), quality; In order to achieve the best health results, it is expressed by well-trained experts in facilities with sufficient resources, without compromising employee safety and satisfaction, to ensure equal service at the right time with the right practices.
Literature Review
Dimensions of Quality in Health Services
According to Donabedian (1988), quality in health care can be considered as the product of health care science and technology and the application of this science and technology. This product can be characterized by a variety of characteristics including effectiveness, effectiveness, efficiency, optimality, acceptability, legality and fairness (Figure 1). When taken individually or in various combinations, they form a definition of quality and, when measured in some way, show the degree of quality.
Figure 1. Characteristics of Quality in Health Services
Efficacy
Efficacy, when used under optimal conditions, is the ability of health care science and technology to make improvements in health. When it is not possible to determine “optimal conditions”, the term “under certain conditions” can be used instead.
The factor is not checked when evaluating the quality of the application. The factor is given to us in advance as a product of research, experience and professional consensus. The relative effectiveness of alternative service strategies is determined through well-controlled clinical trials or technology evaluation. The most effective strategy of clinical management determines the upper limit of what can be achieved; this is the technological limit.
Effectiveness
Effectiveness is the degree to which it actually achieves improvements in health that are now achievable. This requires comparing actual performance with performance that is expected to reach healthcare science and technology, ideally or under certain conditions. Figure 2 describes effectiveness.
Figure 2. Effectiveness in a self-inflicted disease
To better explain Figure 2, let's consider a self-inflicted disease after a period of time, for example, a moderately severe upper respiratory tract infection that is not life-threatening. On the axis of ordinate, there is a measure of health status, such as the ability to perform daily life activities. Time is shown on the axis of the abscess.
As shown in Figure 2, the person examined (or the average of a group of people) begins with a level of health close to the state of “well-being”. The bottom line in the path indicates that when the disease begins, health deteriorates for a while, and then begins to improve (since the disease is assumed to pass by itself), eventually reaching a level similar to the initial one. The top line indicates the course of the disease when the current most active service is provided. The middle line is the course of the disease, when treated with the method to evaluate its effectiveness.
Area A in Figure 2 shows the effect of treatment. The composition of area A and B shows the effect of the best treatment. In this case, effectiveness can be demonstrated by (A) / (A + B). This rate is in health; the ratio of the improvement in real practice to the improvement that could have been made if the best treatment had been given. Therefore, effectiveness is a relative concept and can be formulated as follows: