Waiting time was found to be a very big issue with many people. About 48 % responents said that they had to wait for more than 4 hours before being admitted .Quite high proportion of respondent were not that happy with the waiting time .Comparing with the Aintree hospital’s target of 98% of all patients being treated within 4 hours, Aintree will need to work hard if it was to reach its targets .In our research there was 66.7% of repondent who were neutral concerning outpatient delays which implies that they must have been seen very quickly to give such responses .Parking facilities also played an important role in decision of hospitals . Nearly 1 out of 2 people interviewed agreed on that matter saying it was a priority for them .We also had a good response concerning easy take home prescriptions ,most people agreed that it was among the best facilities that existed in hospitals actually .
The focus group exercise consisted of three males and one female. Two observators presented to record verbal content and observe nonverbal clues. The moderator asked about how people generally feel about this hospital. The result was that male A complained that it was scary, unfriendly and waiting time was too long. Obviously, he was disappointed with the treatment he received. The male B thought that waiting time was something that the hospital was very good at while male C was worried about the treatment level of the hospital. In his opinion, the doctor could not properly assess his illness and as a result his condition worsened. The female member also complained about the waiting time being too long .
According to the people ,there exists cases where doctors were practicing both in private and public hospitals. Their attitudes were different in public hospitals where they were more relaxed and under no sort of pressure to deliver the best treatment possible as compared with private hospitals where they work really hard.The male patient A argued that if he was paying so much tax every year he would normally expect a much better service ,which was not the case here .But the others agreed on the good services provided by the hospitals. In the subjective aspect of services satisfaction, four of the members of the patients considered that, they had a little satisfaction with the services of the hospital.Most of the people in the group accepted that the longer they had to wait the more fearful and anxious they become .
Summary
In general people had a good opinion about Aintree Hospitals .Even if waiting time was a big issue with them most people thought that they were getting the best treatment possible .They said that there is still room for improvement for issues such as security ,parking and waiting times .But then there is the case of location of Aintree hospitals which is well situated to cater for the needs of local and national population .Since it is NHS led people said that since it was free and easily accessible ,they prefered to choose Aintree Hospitals due to convenience and also on reputation .There was a wide range of services being offered there according to repondents and the existing facilities are modern .The process of continued research and development also incited people to go to Aintree Hospitals as they said they were among the few hospitals with the skills and expertise needed.One thing that most people said was that they would like to know about the quality of the care they would received and also they want all their personal information to be treated as private and confidential .They also said that it will be better to hire more staff who work on different shifts than to have a single person working all day long . A majority of repondents agreed that Aintree was regarded as the hospital providing the best facilities in terms of care and facilities in the Liverpool region.
Recommendation
Finally we have come up with a recommendation on the basis that it is used by most people whether patients or medical staff .The recommendation is that a set of questions should be drawn up for use by patients and professionals of Aintree Hospitals to help ensure important questions are asked and important information is given and received .
Rationale
After interviewing people in the mall we have found out that the confidence needed to engage fully in consultations and share decisions about treatment options does not come easily among many people .What do I need to know ?What questions should I ask?Can I even ask questions ?We have suggested that one way of empowering people in getting the information they want and make the most of limited time is through a set of basic questions to ask .These can be promoted through existing awareness campaigns or locally through inclusion in apointment letters.A corresponding set of questions for clinicians will be useful to help structuring consultations and ensure all the information needed by patients for accurate diagnosis were given.
The concept of questions sets is intended to empower both patient and professional to get the information they need from often limited time available. (It is also a way of introducing information needs into consultations and forming the basis for a much more two-way interaction between patient and professional which is associated with increased patient satisfaction. .In the Appendix 4 you will find a set of questions which we have developed.
Lead and Resource Implications
Further research is needed to more accurately assess the practicalities and specific resource requirements .
Proposed next steps and Implications
The next step will be develop the concept further through research focusing on both the practicalities of promotion and robustly testing out question sets with the public .This could be undertaken by those responsible to Aintree Hospital Trusts .Implementing this recommendation could greatly boost NHS service in general and will benefit patients. It might not be achievable in the next year as every 1 in 5 NHS trusts will go in debt soon as it is marketing-driven and that most hospitals are under enormous pressure due to considerable demand placed upon them by patients . Nevertheless, it would be a long-term solution.
A critique of the research process and methods adopted .
Abstract
Marketing Research is a process being carried out to enable better understanding to the clients needs and wants. It is particularly useful when the organization is facing or expected to face emerging changes. However we need to know how to evaluate the relation between the changes and clients needs in a systematic way. What are the procedures to carry out a research that can best represent the real situation and limitation of the procedures? In the following essay, critique of the research processes and methods adopted will be presented.
Background
Increasing hospital competition, payment by result and stronger standards and safeguard has arised out of the United Kingdom Government’s initiative to create a patient-led National Health Service (NHS).This has created an emerging needs for hospitals, particularly public hospitals, to evaluate on the potential impact and thus how the reposes to the changes. The ultimate goal of the hospital is to provide the right service in the right way such as to attract patients for choosing the hospital. Thus the market research aims to identify the needs and wants of client, current reputation, perception and expectation on the Aintree hospital
Marketing research processes and methods
Formulation of the problem was being carried out as the first step, which defines the purpose, target and to evaluate usefulness of the research. The purpose of our research was to examine Aintree Hospital NHS Trust’s existing reputation amongst the local community. To measure reputation which is related to perception, experience and expectation, we conducted a marketing research to investigate the patient views on Aintree Hospital and hospital service and facilities in general. By analysing the patient views, we may conclude about the reputation of the hospital and the future direction the hospital should head to.
Identification and segmentation of the target population of our research - patients was carried out after defining research purpose such as to enable the meaning design and thus gain useful information acquisition in the research. Our target of the research is the patients. We are particularly interested in the patients that have experience with Aintree Hospital, Royal University College Hospital and Whiston Hospital within the last three years, but other potential patients also deserve our attention. Eventually, segmentation was carried out according to their experience with hospital / Aintree hospital, frequency of visiting hospital (depends on illness), main usage of hospital (regular check-up, emergence, lifelong condition) and demographic data have also been considered. By identifying the possible different needs between segments research design can address each segment differently if needed.
Evaluation on the usefulness and flexibility of our research is undertaken so as to conclude if the research is going to be conducted or not. Due to the more informed patient and rigid competition, Aintree Hospital has to increase its attractiveness such as to maintain its current market position. We needed to know more about people’s impressions about Aintree and also about their real life experiences with the hospital and this could help them to make improvements to attract more people. With this information made available we think that Aintree could make the necessary changes to become more competitive .
Determination of research design is the next process undertaken after formulation of the problem. Any design consists of specification which is linked with the purpose or usage, so as questions like “what question needs to be answered” in the research was examined. In the research project, hospital reputation, patient perception and expectation was to be measured. Further questions were asked about how well Aintree Hospital clients were in relation to their previous experiences .
Deciding on which method to carry out the research was the next step taken. Studying the patients views on Aintree hospital and hospital in general is not easy.This was due to human biases and emotion which was mostly affected by their previous encounter with hospital. Aintree Hospital is having Nurse Strike on mid-June 2005, and the shortage in caterer and workers may cause a sharp decrease in service. Thus the research result reflected in this period may be largely different from those being done before the event. Thus at least one of the research methods we employed should be able to avoid significant different results caused by recent event. On the later paragraph on questionnaire design this issue will be addressed in more detail.
Focus group is the first research method taken, due to its nature and contribution. For an MBA student coming from a different country and living in Uk for less than six months, the knowledge and experiences with the local hospital can be very limited. Thus focus group is the best way that helps boost up the group member knowledge on the local National Health Service system. Besides this realistic limitation, focus group helps the design of questionnaire and many points that were not discovered by group discussion were revealed. An example of valid point is that one of the participants who said that a proper channel of complain / auditing is vital for public hospital. Thus by carrying out focus group, ignorance and hidden knowledge was discovered. Focus group also own an advantage in that its interactive nature simulate more and more idea and thus is very beneficial if carefully planned and led.
Focus group also has disadvantages. Being a qualitative research method, the scale of research is limited due to limitation on time and group member number. The responses are not representative and can only be taken as a reference. Another trap is that the participating individuals would try to make their decision sounds more easy by making up reasons which sometime they themselves don’t even recognize it. Thus a careful observer that would pay attention to the verbal content and non-verbal clues was needed.
Questionnaire is another research method we have taken. Using the result we summarized from the focus group, several factors were identified as important that affect the decision making of patients. Regarding the segmentation of patients, their needs can be discovered in the focus group because the focus group was consisted of a good mix of people. Thus our questionnaire aim were to
(1) classify the segment of the interviewee
(2). explore their usage and views on hospital
(3). explore their usage and views on Aintree hospital.
Using questionnaire as the research method have advantage in which the questionnaire and thus the possible result can be carefully planned and designed. The research process is standardized which is easy to control. The data we got from the questionnaire can be analysed using statistical methods and can act as a concrete evidence to prove the relation or existence of issues. The disadvantage of questionnaire is due to the relatively small sample size of our survey , the confidence level of results obtained from statistical analysis is low. And due to the greater number of choices in each question against the sample size the result we got on some question are not as relevant as that of a larger sample size. So a larger scale of research is needed if the result from questionnaires are to be made meaningful and relevant.
Regarding the design of questions in the questionnaire, questions are set such as to analyse the attitude, awareness, intention and behaviour from the respondents. Behaviour is the first part being asked in the questionnaire because it is easy to answer and if carefully planned tend to be non-embarrassing.The next questions will be related to some form of attitude questions which is word-associated and very easy to answer but which gives a powerful indication of their inner attitude. Then several factors which we identified in focus groups such as reputation, location, expertise, service, hygiene and facilities were listed and the respondents will have to rate the importance of each factor. Intention is measured by the remaining questions.
Other research methods were also being considered. Mail questionnaire and telephone interview were not appropriate due to the time needed for responses and incapability of getting facial expression and extra interaction that is only possible via face to face methods. Field study is not possible to be carried out due to its requirement to reach agreement on arrangement with hospital. Interview is not appropriate due to the amount of manpower and time available. Thus focus group and questionnaire, which fulfill our requirement within affordable manpower and time constraint was adopted.
Our group tried to diversify and balance the respondent in terms of age and sex. It is expected that elder people are more concerned on health and hospital issues when compared to youngster implying they may be more willing to participate. This may cause unbalanced sampling and thus biased result. So instead of using the “Choose the fifth passer-by”, a selective process is undertaken. If the previous respondent is an elder person, youngsters are preferred on the next round. By employing this mechanism our respondent are by far evenly distributed from the age group from 35 - 75+ and 10% of the respondent were aged 16-24. In term of sex of respondents, the same mechanism was applied and the result was that we got 60% of male and 40% of female. By selective picking respondent from different age group or sex , it is expected that the result would be closer to the actual situation.
After the research design and implementation, analysis on the data was carried out. Data were entered into computer to allow effective share of data. However, we decided not to use computer for analyze data. The sample size of the research we carried out was small and thus putting extra effort in pushing data into software and getting some bar chart was not worth the effort. The statistical analysis by computer is attractive but due to the sample size, the error can be high. Thus choosing a greater sample size is always better given that enough time and manpower is available. Our calculation were done by hand mainly which enable more understanding and time for thinking on question given the sample size is manageable
With the analysis and interpretation of the research result, recommendations have been presented. The aim of the recommendation is to point out what the current position is and if there is any gap in reaching the aims stated at the beginning of the research. The Recommendations presented in the research are general and may apply to various departments at the same time but not detailed enough to provide relevant implication to manager. Limitation on carrying out such recommendation were pointed out such that the reader , especially the managers can gain a better understanding of both the procedures and difficulties that they may encountered.
Conclusion
The aim of the marketing research is to let the producer or service provider keeping in touch with the needs and wants of the client. This aim has been achieved by our research with careful planning and design, choice of methodology and mechanism, control environment and practice, and with analysis and reporting as a presentable material to reflect the findings. It is hope that the research report will provide implication for managers about the strategy that most suit the needs and wants of its clients.
Appendix 1 - Questionnaire
Management School
MABA 115
Marketing Research
Title: Survey on hospital health care service in Liverpool and perception on Aintree hospital
Date of survey: 2nd Dec 2005
Place:Bootle Strand Shopping Centre
Introduction
Hi people
We ,students of Liverpool University are conducting a survey of people who live within the catchment area of Aintree Hospitals NHS Trust .The purpose of doing this survey will be to find a bit about the general views and opinions of Aintree Hospitals Trust so that changes can be made to improve the already existing services .
- Do you have any experience(s) / does your relative have any experience(s) with hospital in Liverpool within the last three years?
(1) Yes Goto Question 2 (2) No Goto Question 3
2 (a) How often you visited the hospital?
(1) Weekly (3) Half year
(2) Monthly (4) Yearly or above
(b) If yes ,which one ?
(1) Aintree Hospital (4) Private
(2) Royal University College Hospital (5) Others
(3) Whiston Hospital
(c)How many times have u visited a hospital withn the three years?
(1) 1-2 (2) 3-4 (3) 5-6 (4) more than 6 times
3 Have you ever visited Aintree Hospitals?
(1) YES (2) NO
4 What is the reason / purpose of visiting hospital?
5 Do you have any experience(s) / does your relative have any experience(s) with Aintree hospital within the last three years?
(1) Yes Goto Question 6 (2) No Goto Question 8
6 What is the first thing that comes into your mind when it comes to Aintree Hospital?
7 What are the two best qualities of Aintree Hospital in your/ your friends’ experience?
(1) Clinical Care level (4) Short waiting time and delay
(2) Friendly and Helpful Staff and nurse (5) Facilities
(3) Cleanliness (6) Patient record
(7) Others, please specific _________________________
8 If you need a simple operation / surgery, which hospital shown below will be your first choice?
(1) Aintree Hospital (4) Private
(2) Royal University College Hospital (5) Others
(3) Whiston Hospital
9 If you had an emergency operation to do, which one of the above hospitals would you choose?
(1) Aintree Hospital (4) Private
(2) Royal University College Hospital (5) Other
(3) Whiston Hospital
10 (a) Do you think Aintree Hospitals need to be improved ?
(1) YES (2) NO
(b) If Yes, what sorts of improvements would you like to see in your/ your friends’ experience?
11 Which of the service listed below at Aintree have a national (or within North West) reputation?
(1) Chest Medicine
(2) Maxillofacial
(3) Rheumatology
(4) Others, please specify ______________________
(5) Not Appropriate
We will be rating on a scale of (1) to 5((1) =strongly agree,2= agree ,3=neither agree nor disagree ,4=disagree,5=strongly disagree) some of the factors that might affect decisions of people going to NHS Hospitals .You should circle the one which corresponds to your choices.
How will the following factors affect your decision for a particular hospital?
12 Reputation of the hospital 1 2 3 4 5 (12
13 Location / Convenience 1 2 3 4 5 (13
14 Expertise of doctors / hospital 1 2 3 4 5 (14
15 Customer service level 1 2 3 4 5 (15
16 Facilities relating to the treatment 1 2 3 4 5 (16
17 Easiness of speaking with doctors, nurses and other staff 1 2 3 4 5 (17
18 Cleanliness of hospitals 1 2 3 4 5 (18
19 Outpatient delays 1 2 3 4 5 (19
20 Waiting time in case of emergency 1 2 3 4 5 (20
21 Food being served 1 2 3 4 5 (21
22 Quietness of hospital 1 2 3 4 5 (22
23 Parking or any access facilities 1 2 3 4 5 (23
24 Sufficient personnel care (e.g. Nurse) 1 2 3 4 5 (24
25 Waiting time 1 2 3 4 5 (25
26 Easy Take home prescriptions 1 2 3 4 5 (26
27 Continued Research and Development 1 2 3 4 5 (27
28 Could you tell me which of these age group you fall into?
(1) Less than 16 (5) 45-54
(2) 16-24 (6) 55-64
(3) 25-34 (7) 75+
(4) 35-44
29 Sex of respondent
(1) Male (2) Female
30 Additional comment: _________________________________________________
Thank you very much for your precious time.All information collected will remain private and confidential and will only be used for the purpose of this survey .
Appendix 2 – Result from questionnaire
Appendix 3 – Result from Focus group
Date : 5 Nov 2005
Time : 6:58pm
Helder : Prannav
observer : William , Michael
How many people take part : 4
3 Males and 1 Female
What is the feeling of hosptial ?
M1 : Scary , not friendly, waiting
He is disappointed with the treatment received till waiting time
M2 : Urgent service is the most important service
He will only go to hospital only in the case of urgency
M3 : Uncertainty is associated with hospital
His own experience is that doctor cannot tackle the illness and condition worsened.
F1 : Waiting time too long
M1 : get used to Family doctor
Environment of the hospital is important
Legal matter:
M2 : can sue a hospital ,
having channel to audit is very important , may be a strength of public hospital
knowing clearly what treatment and which doctor is serving is important
But somebody claim just for money
Public vs Private
Prannav : Same doctor is giving same treatment to both public and private hospital
so the creditability is the same
only attitude is different
What is important in hospital
M3 : expertise is important
M2 : paying tax for the service , so good quality is expected
M3 : System is the current issues , the staff are friendly , but the system is damaging the service standard
How about hygience
M2 : Generally the hygience is very good in hospital
Any more point ?
M1 : the customer is thinking in terms of "Price / Service"
Public hospital is not profit making , so a higher "Price / Service" is expected (in terms of tax
Appendix 4– Recommendation Questions
Can you tell me about this illness or condition?
- Are there any tests that might explain why I am getting this symptom?
- How common is this condition?
- Is there anything I can do to help myself?
- Are there any national guidelines for my illness?
- Can I get a second opinion?
How will I be treated?
- How will the treatment work?
- How soon will the treatment start?
- How long will the treatment take to finish?
- If my treatment is delayed will this make a difference?
- If I don’t have that treatment now ,what will happen and how will I be looked after?
- What side effects ,if any should I expect ?
- Can this treatment increase my risk of developing another type of illness?
- Will the treatment affect my fertility or sex life?
- Is there any help/suppport I can have at home should I need it ?
- Do you think I will be able to get back to normal after treatment?
How can I make right choice for me?
- How can I make a choice between the treatments you have offered me?
- Can I change my mind after I’ve started?
- Can I have treatment at home?
- How long will I need to stay in hospital?
- Will I be given different hospitals to choose from?
- How do different hospitals compare? Waiting times? Success rates? Cleanliness?
Appendix 5– Workload
Design Questionnaire – Michael, Kris
Day out for the Questionnaire – Kris, Michael
Focus Group – Pranav, William, Michael
Data Entry – William, Pranav, Michael
Analysis – Kris, Clare
Report writing – Michael, Kris
Proof-reading – Michael, Kris
Aintree hospitals, http://www.aintreehospitals.nhs.uk/aboutus/default.aspx
