Service Transaction Analysis Question 1 This service transaction analysis (STA) was conducted for Prince Court Medical

Center (PCMC). PCMC is a 300-bed private healthcare facility located in the heart of Kuala Lumpur, Malaysia. The service concept of PCMC is to provide comprehensive medical care to the highest international standards through world-class facilities, innovative technology & excellent customer services. The STA will focus on a specific process which is the Outpatient Payment Process. This analysis will concentrate on the customer experience following the consultation with the doctor. The customer experience after consultation with the doctor is divided into four major phases: a. going to the waiting room; b. waiting for payment; c. paying the bill at the cashier d. exiting the cashier room The phases described above are common for most patients. However, events occurring after leaving the cashier room are not included here since each patient may have an individual route depending on where he/she is coming from and where he/she is going. According to Johnston (1995), it is assumed that customers enter a service process with a consciously or sub-consciously held view of what constitutes an acceptable, less than acceptable and more than acceptable level of service based upon prior experiences or the organizations image. In the case for PCMC, the patients experience preceding the payment process, such as a layout similar to 5 star hotel and excellent customer service so far, has set a high level of expectation. From an overall perspective, the patient would expect a continuation of the excellent experience received so far to truly make this a rewarding visit. However, there were several unpleasant details that added up to make the experience of this process unimpressive. By going into the details of the four phases, several issues surfaced: 1. Going to the waiting room: This phase was pleasant, the attentive nurse guides a new patient to the payment waiting room took away any anxiety for a new patient of trying to look for the room. 2. Waiting for payment: This phase can be divided into several sub-phases which are the waiting area and the waiting room and the general wait before being called for payment. a. The number of outpatients waiting to make a payment was greater than what the waiting area had been designed for. In fact it didnt seem that any thought was put into its design since there were only 5 couches there. Thus the area was crowded with several unseated waiting patients pacing around. b. However, the nurse was attentive and caring enough to realize the shortage of couches and leads the patient to the waiting room and leaves politely. But no information was given in terms of how many patients are ahead of the customer in the queue, how long the wait may take or how the customer will be notified of his/her turn to make a payment 1

c. The waiting room caused the most annoyances. Not only did it look more like a store room rather than a waiting room, with printers and files on shelves, it seemed as a badly planned stop-gap solution for the seating problem in the waiting area. This also explains why more patients preferred standing in the waiting area rather than sitting in the small room. d. The wait: the waiting room completely did not match the overall design of the medical center; there were no reading materials, t.v screen, paintings or even pictures on the walls to ease patient stress, anxiety and boredom while waiting. e. Notification of patients turn to pay: With the cashier calling out the patients name it can lead to several embarrassing situations including if the name was pronounced incorrectly or if the announcement was loud and clear enough for the patient to hear from the waiting room. It is also rather surprising that PCMC uses a very rudimentary paging system when the rest of the facility is flushed with the most technologically advanced equipment. 3. Paying the bill at the cashier. This phase also led to similar annoyances as the waiting room. The room was cramped with a couple of seats facing the cashiers and the cashier table was full of bills waiting to be collected. The seats for the patient were uncomfortable and both the cashier table and seat looked cheap compared to other furniture seen at the medical centre. 4. Exiting the cashier room. The cashier was polite and attentive to check if a follow-up appointment with the doctor has been made.

Figure 1. Analyzing the stages in the outpatient check-out process Figure 1 above is the STA sheet which gives a summary of the settings for the stages in the outpatient check-out process. The situations that affected the experience negatively in the 2

process above could have been avoided if the overall concept of creating world-class facility wasnt deviated here. However, these issues added up to create negative user experiences. The area that stands out in failing to meet expectations is the servicescape, which is the physical environment that customers encounter at the service site. This in turn elicits internal reactions from patients leading to the display of approach or avoidance behaviors. According to Bitner (1992) the servicescape environment consists of three core components: ambient conditions; spatial layout and functionality; and signs, symbols and other objects. In the case described above, the negative experience is directly linked with two of core components mentioned above. These are the spatial layout and functionality of the environment which relates to the layout and physical condition of the areas, fixtures and furnishings; and signs which are used to convey to customers expectations, instructions, general guidance and rules of behavior (Bitner, 1992) The spatial layout and functionality aspect of the outpatient check-out process at PCMC is inconsistent with the quality delivered by its staff. It was noted earlier that the waiting and cashier room were small while the interior design of both rooms were clearly inferior and unattractive. Furthermore the waiting area is also not designed to be functional for customers with limited numbers of sofas. To improve the aesthetics and functionality of the waiting area, waiting room and cashier room, would not require significant resources. It would require only minor material expenses to increase the number of sofas in the waiting area, improve the quality of the cashier room furniture to the similar level of quality with the rest of the facility and removal of the clutter in the waiting room. As for the second factor which is signage, it is directly linked with waiting experience of the customer. It is noted by Kostecki (1996) that in medical institutions, patient satisfaction is often a consequence of the waiting experience, it is nonetheless surprising that so little attention is paid by PCMC to optimize patient waits. PCMC will need to implement a system that lets patients know their place in the queue through an electronic display; this will allow the patients to engage in other activities while being alert to hear their name or number when it is called. Furthermore, a customer-centered wait experience requires designing the wait experience that includes engaging customers in queue, reducing their anxiety and creating a sense of progress in the way the queue attended. Failure to implement these will lead to increased patient dissatisfaction and turnover (Rondeau, K. 1998).Waiting customers require active engagement which may include entertainment or reading materials. In fact the wait period can be used as an opportunity to market PCMCs unique selling points or educating customers on healthcare issues via electronic advertisements. Researchers have acknowledged that tangible factors such as servicescapes and intangible factors such as responsiveness, assurance, reliability, and empathy are complementary in their effects on customers evaluations of service quality (Kotler, 1973; Wall & Berry, 2007). And since the customer perceives the environment in a holistic way and inconsistencies can have a negative impact on the customer's overall impression of the experience, change is necessary for PCMC otherwise this will impact PCMCs economic health which depends on customer retention (Ford. et. al, 2001). The STA analysis is an excellent tool to identify the important mismatches between operation managers perceptions and design of service; and the experience of their customers with these services. For the manager the STA analysis illustrates how small details can affect the customer experience considerably. However, the improvements needed to make the customer experience 3

better may be very small and require minor financial investments. The analysis can be used for follow-up purposes to see whether improvements have been made, and the exercise may be repeated in assessing how the changes have affected the customer experience (Rasila, et. al, 2009). Finally it is important to note that whilst marketers have a key role in influencing preexperience expectation thresholds, operations managers have an important role in managing customers perceptions during the service process (Johnston, 1995).

References Bitner, M. (1992) Servicescapes: The Impact of Physical Surroundings on Customers and Employees, Journal of Marketing, Vol. 56, pg.57-71 Ford, R., Heaton, C. & Brown, S. (2001). Delivering Excellent Service: Lessons from the Best Firms California Management Review, Vol. 4, No. 1, pg.39-56 Johnston, R. (1995) The Zone of Tolerance: Exploring the Relationship between Service Transactions and Satisfactions with the Overall Service, International Journal of Service Industry Management, Vol. 6, No. 2, pg.46-61 Kostecki, M. (1996) Waiting Lines as a Marketing Issue, European Management Journal, Vol. 14, No. 3, pg.295-303 Kotler, P. (1973). Atmospherics as a marketing tool, Journal of Retailing, Vol.49, No.4, pg.4864. Rasila, H., Rothe, P. & Nenonen, S. (2009) Workplace experience a journey through a business park, Facilities, Vol. 27, No. 13, pg.486-496 Rondeau, K. V. (1998) Managing the Clinic Wait: An Important Quality of Care Challenge, Journal of Nursing Care Quality, Vol. 13, No.2, pg. 11-20 Wall, A., & Berry, L. (2007). The combined effects of the physical environment and employee behavior on customer perception of restaurant service quality, Cornell Hotel and Restaurant Administration Quarterly, Vol. 48, No. 1, pg.59-69