Doctor of Business Administration
Sydney Business School
Wienholt, Louise Anne, Identifying key attributes that requestors associate with quality in public- hospital pathology: a qualitative study, Doctor of Business Administration thesis, Sydney Business School, University of Wollongong, 2013. https://ro.uow.edu.au/theses/4072
This thesis examines service quality in a pathology laboratory at a large metropolitan public teaching hospital. The objective for this study was to clarify the nature of quality and value in public-hospital pathology and understand how these constructs relate to satisfaction.
A modified conceptual framework was developed from the literature, and interpretative phenomenological methodology was used to identify the dimensions that physicians associate with quality. As part of this, satisfaction with service accuracy and overall quality was also measured.
In-depth semi-structured interviews were conducted with 21 physicians from 13 clinical specialities, using purposive sampling. Analysis using dual text mining software (NVivo and Leximancer) identified dimensions relating to service delivery as the most important construct in the overall assessment of quality. The most significant attributes associated with the provision of quality service included: timeliness, reliability and accuracy of results and open lines of communication between the laboratory and the requestor.
All clinicians highly valued the reliability of results at the study site; however, most had a lower assessment of the overall quality of the service. Factors associated with pre- and post-analytical components of testing featured highly in the overall assessment of quality, as well as perceptions of poor service. Communication was a key service element that was shown to encompass many aspects of quality service; however, the two mostly frequently identified themes that were shown to be important to requestors were an accessible, easily used electronic interface and the rapid communication of significantly abnormal patient results.
The results of this study highlight a disconnection between the analytical and functional service quality in public pathology provision. In light of this research it is evident that pathology services must view quality as consumers do. From this, it can be concluded that laboratory quality assurance must encompass all activities from the moment a clinician orders a pathology test until the result is received.