Researchers: Eyal Zimlichman¹, Oded Maimon², Michal Menashe¹

Background: Measuring the quality of the provided healthcare services is one of the most important topics in the health sector today. Service quality has been a matter of concern for public and private healthcare institutions across the world. The increased focus on patient-centred care has led to several researches in exploring what determines service quality and how can it be measured.

Objectives: The objective of this study was to explore the available pool of published literature metrics, as well as to understand the underlying dimensions of healthcare service quality, and how they can be assessed. As a result to propose a conceptual framework through which the dimensions of service quality in health care sector, hospitals in particular, could be tapped and the way measure it.

Method: A qualitative empirical study to construct effective indices for the model, which includes two focus group and took place at Sheba Medical Center during 2018-19, facilitated by an independent professional moderator. First a general discussion was conducted and later the participants asked to rank a list of ten measurements by their importance. The rest of the meeting was focused on the participants' understanding, attitudes and importance of each one of the measurements presented in the list. Each session was audio taped and later transcribed verbatim. Than a thematic networks qualitative analysis was done followed by a parametric quantitative analysis, identifying the differences between both patient groups.

Findings: Twenty participants divided into two focus group, i.e., patients and hospital personal, reached almost the same sequence of indices importance list. The top-five were: "Waiting times to ER physician"; "Inequity hospitalization" (in a corridor); "Cancellation of surgeries"; Waiting times to hospitalization"; and
"Waiting times to outpatients clinic physician".

Conclusions: We succeeded to establish six meaningful indices, representing truly patients-centeredness approach, utilizing operational data, having minimal gap for gaming. These indices also verified by a group of hospital staff, having a significant positive and high correlation between both focus groups.
Naturally, such a study has some limitations, such as budget and time frame constraints, as well as having sample size at the lower acceptable bound of such studies.

Recommendations: As a summary, the research team offers the carry out a three-stage pilot, as a path towards implementing the suggested indices. The first stage will examine the applicability of half of the indices at 3 medical centers, including Sheba medical center. Then, after analyzing the outputs, to continue with the other half, and at the end to group together all stakeholders to discuss the outcomes. As a final step, and if the pilot is successful, it is proposed to incorporate the appropriate metrics with in MOH national program for measuring service quality in hospitals.

Research end date: 06/2020