This critique reviews a quantitative study by Kerry Ellis-Jacob on the impact of patient satisfaction on rural hospitals’ revenue generation. The critique is structured under the following key areas: introduction, purpose and problem statement, literature review, research framework and hypothesis, sample size and design, research implications and recommendations, and a conclusion.
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The article is titled “A qualitative correlational study on the impact of patient satisfaction on a rural hospital.” The study was conducted by Kerry Ellis-Jacobs, a Laboratory manager of the Okmulgee Memorial Hospital who is based in Okmulgee, Oklahoma, United States. The study is a peer reviewed publication of the College of Allied Health and Nursing at the Nova Southeastern University. It is dedicated by the author to the allied health professional practice and education (Ellis-Jacob, 2011).
This article has been published on the internet journal of allied health sciences and practice, volume 9, issue 4, from page 1 to 6. It is not clear whether the researcher received sponsorship from the Okmulgee Memorial Hospital or the Nova Southeastern University to complete the study. It can, however, be assumed that the aforementioned institutions supported the researcher during the study.
The researcher does not make any claim of obtaining approval from any Institutional Review Board. However, the research methods applied do not seem to pose any threats to the participants of the study. The investigator does not use any vulnerable subjects in the study. It took 25 months to complete the study, which involved collecting data from patients and hospital staff. In the process, the researcher sought informed consent from the potential participants before obtaining any information from them. In addition, the researcher assured the respondents of anonymity during and after the study as per the standard research guidelines and policies.
The research methods employed, permitted a close relationship between the participants and helped the researcher to facilitate easy and efficient exchange of information among the former. The participants were free to ask the researcher any questions and the latter was to respond to them in a timely manner. It is evident that the benefits of this research outweighed the possible risks considering the advantages the nursing profession can gain from the findings. The researcher availed the study findings to the participants, researchers, and other interested parties at
Purpose and Problem Statement
The research problem is clear and concise. Patient satisfaction holds the power to the financial success of hospitals, particularly in the rural areas (Ellis-Jacob, 2011). As of October 2012, patient satisfaction was to be used as a quality mandate for hospital reimbursement by Medicare (Ellis-Jacob, 2011).
Therefore, the hospitals’ services would be paid by Medicare based on patient satisfaction. According to Ellis-Jacob (2011), many rural allied nursing practitioners lack the relevant customer service skills leading to consumer dissatisfaction. Uncompassionate staff, long waiting time, and rude staff are some of the characteristics of rural based hospitals, which hamper customer satisfaction (Ellis-Jacob, 2011).
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The statement of the research problem is clear and understandable. The general problem of the study was stated as “excellent services from health care practitioners to the customer no longer a choice, but an expectation from the patients” (Ellis-Jacob, 2011, p. 1). This is influenced by the recent trends in patient care and changing government policies (Ellis-Jacob, 2011). The specific problem in this research was stated as “the closure of rural hospitals due to decreased reimbursement from the government” (Ellis-Jacob, 2011, p. 1).
This is thought to be because of new government policies, which base their reimbursement on customer satisfaction scores. Patient satisfaction can be improved by training and educating health care practitioners (Nieswiadomy, 2008). This will improve the patients’ experience and chances for fast recovery (Nieswiadomy, 2008). The two variables of the study were patient satisfaction and the hospital’s revenues. Health practitioners should treat their patients carefully and understand their satisfaction has a direct impact on the revenue generated by their health care facility.
The study was undertaken in Northeastern Oklahoma and took 25 months to complete. The patient satisfaction survey records were investigated to obtain the mean scores from several rural hospitals. They were obtained from the hospital’s management and compared with customer satisfaction mean scores to determine the correlations for each recorded month. Data in the form of figures, tables, revenue reports, and patient satisfaction questionnaire forms were analyzed.
The study was purely quantitative, as in such a research, social phenomena are expressed numerically, data analyzed statistically, and a generalization of the data obtained using the relevant measures of central tendency (Creswell, 2003). Quantitative research is, therefore, effective in evaluating cause and effect relationships (Tewksbury, 2009). In this study, it is clear from the title of the study that the approach adopted is quantitative. The title clearly states that it is a quantitative correlation study.
It also involves the use of mean and other measures of central tendency to prove the hypothesis. These characteristics are the distinguishing factors between a quantitative and a qualitative study. Qualitative research tries to examine human attitudes, perceptions, and understanding of a social phenomenon through the use of descriptive words, while a quantitative study uses statistics and measures of central tendency (Polit, 1996).
The study shows a clear consideration of all ethical issues in research, such as privacy and seeking informed consent from the respondents. All the facts stated in the research paper are properly and adequately acknowledged as per the MLA referencing style. A list of eleven references has also been provided on the last page of the paper. A glance at the references indicates they are correct, credible, and well cited.
The study was conducted for 25 months at the Okmulgee Memorial Hospital, which is based in Northeastern Oklahoma. It can be concluded that the researcher undertook the study during his spare time, which was mostly after work. The study offers significant insights into how patient satisfaction can have notable impacts on the revenue generated by the health care facility and its sustainability. The recommendations offered by the researcher serve as an eye opener in relation to how nurses can improve customer satisfaction through improved service delivery.
The Review of the Literature
Ellis-Jacob (2011) offers a concise and comprehensive literature review on the implications of patient satisfaction on revenue generation in rural hospitals. Reliable sources, such as the Center for Medicare and Medicaid Services (CMS), have been used for the study. The materials reviewed are relevant and current as per the time of the study. Ten out of the eleven sources reviewed were published between 2006 and 2011.
The eleventh article was published in 1988 and is used to give a historical perspective on the patient satisfaction ideology. All the sources used are acknowledged appropriately as specified in the MLA style. The review flows in a logical and chronological sequence, allowing the reader to understand the researcher’s ideas and arguments with ease. Most of the sources quoted support the hypothesis of the study that customer satisfaction is paramount for the sustainability of a health care facility. All these sources are listed in the reference list, with no error noted.
Research Framework and Hypothesis
The take care of patient (TCOP) model adopted in the study is based on assumption that, if rural health care facilities take care of their patients well to ensure customer satisfaction, they will get higher reimbursement from Medicare (Ellis-Jacob, 2011). Statistical methods have been used to identify the correlation between patient satisfaction and the revenue generated in the rural hospitals.
Pearson correlations were calculated to determine the relation between patient satisfaction scores for in-patient and emergency departments and the monthly revenues collected by the hospitals. The correlation data obtained was used to test the hypothesis. The relation between these variables is considered significant if the p-value is less or equal to 0.05. The research question was stated as, “What is the relationship, if any, between allied health care practitioners’ customer service skills and the hospital’s gross revenue?” (Ellis-Jacob, 2011, p. 2).
As regards the research question, the researcher developed two hypotheses, including “no correlation exists between the hospital’s allied health care department’s revenue and various measures of allied health care customer satisfaction from April 2008 to April 2010” (Ellis-Jacob, 2011, p. 2) and “a correlation exists between the hospital’s allied health care department’s revenue and various measures of allied health care satisfaction from April 2008 to April 2010” (Ellis-Jacob, 2011, p. 2).
The hypotheses are concise, clearly stated, and connected to the objective of the study. The variables stated in the hypotheses are customer satisfaction and the revenue generated by the health care facility. The scope of the research or the study population is specified as patient records that fall between 2008 and 2010. These hypotheses can be tested empirically to prove or disapprove their predictions. The design of the study and the use of Pearson correlation were important in testing the research hypotheses.
Sample Size and Design
The study was done in the rural hospitals in Northeastern Oklahoma for 25 months. The number of hospitals involved in the study is not specified. The quantitative research method adopted was appropriate in identifying the cause-effect relationship between the variables of the study (Polit, 1996). Furthermore, it established the relationship between the hospital’s total revenue and the customer satisfaction in the study period (Ellis-Jacob, 2011).
Discussion of Research Findings
The null hypothesis was rejected in the emergency department, but not in the in-patient one. Correlations were found between customer satisfaction and the hospital’s revenue. Kurtosis and skewness tools and procedures were used evaluate the correlation and normality coefficients (Ellis-Jacob, 2011).
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Implications and Recommendations
Ellis-Jacob (2011) suggests a simplified mock-up for customer service should be tested and realized to enhance service delivery to patients. Improved service delivery will lead to patient satisfaction and the sustainability of the health facility. The study utilized a take care of patient (TCOP) mock-up. It assumed customer satisfaction was met by improved services by nurses, meaning the total revenue generated by the hospitals under study would increase and make them more sustainable (Ellis-Jacob, 2011).
It can be concluded that the qualitative research by Ellis-Jacob (2011) titled “A qualitative Correlational study on the Impact of Patient Satisfaction on a Rural Hospital” is rigorous and in-depth. The findings of the research can help advance the nursing profession by ensuring patient satisfaction, higher Medicare reimbursements, and a better sustainability of rural hospitals.
Creswell, J. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd ed.). Thousand Oaks, CA: Sage Publications.
Ellis-Jacob, K. (2011). A qualitative correlational study on the impact of patient satisfaction on a rural hospital. The internet Journal of Allied Health Sciences and Practice, 9(4), 1-6.
Nieswiadomy, R. M. (2008). Foundations of nursing research (5th ed.). Upper Saddle River, NJ: Pearson Education Inc.
Polit, D. F. (1996). Data Analysis and statistics for nursing research. Stanford, CT: Appleton & Lange.
Tewksbury, R. (2009). Qualitative versus quantitative methods: Understanding why qualitative methods are superior for criminology and criminal justice. Journal of Theoretical and Philosophical Criminology, 1(1), 38-58.