IOSR Journal of Business and Management (IOSR-JBM) e-ISSN: 2278-487X, p-ISSN: 2319-7668. Volume 12, Issue 4 (Jul. - Aug. 2013), PP 51-55 www.iosrjournals.org www.iosrjournals.org 51 | Page Improving Customer Satisfaction: Implementing Decentralised Inpatient Discharges At Ward Level 1 A R. Abdul Aziz, 2 M B.Nishazini , 3 N. A. Azizan 1,2 KPJ Seremban Specialist Hospital 3 University Malaysia Pahang Abstract: Before January 2009, inpatient discharges were done through central discharges system at the ground floor of finance department. Effective January 2010 a new decentralise inpatient discharges system at wad level was implemented . Before the implementation of the new system, data were collected from July 2009 to December 2009 on the total number of feedback form received, number of complaint on hassle of discharge and complaint of long waiting time. After the implementation of the new system, the same data were collected from January to June 2010. The two set of data were compared to see the impact of the new discharge system. Further monitoring was done by collecting data for the first six month of 2011 and the first six month of 2012.Based on the data collected it was found that for a period of July to December 2009, 295 complaints on hassle of discharges and 46 complaints on long waiting time. For the period from January to June 2010, there was no complaint on the hassle of discharges but 38 complaints on the long waiting time. Further monitoring was done from January to June 2011 and it was found that there was no complaint on the hassle of discharges but complaints on the long waiting time had reduced to 8 cases. For the period from January to June 2012, there was no complaint about the hassle but only 6 cases on the long waiting time. Revenue of the hospital grows by 35% from year 2009 to 2012 and PBT grows by 250% from year 2009 to 2012. Key Words: hospital discharges, patient complaints, financial growth I. Introduction KPJ Seremban Specialist Hospital with 145 beds is a private hospital in Malaysia which belong to KPJ Healthcare Berhad, the biggest change of private hospital in Malaysia. This hospital is a five storey building which started business in November 2004 for Emergency services and January 2005 for inpatient and outpatient services. This hospital was able to achieve breakeven in less than three years. Before end of 2009, patients’ discharges were done through central discharge counters located at the ground floor. All patients or relatives have to go down to settle their bills upon discharges .Based on the patient’s feedback received, many complaints on the hassle of going up and down during discharge and on long waiting time to settle the bills. Therefore in order to improve patient’s experience, the hospital had implemented the new system of discharges by doing discharges at ward’s level. The new system was implemented on 1 st January 2010. Patients or relatives can settle their bills at the counter of every ward. For patients who can’t walk, the ward staff will go to their rooms to process the bill. Patient satisfaction may be an element of health status and is a highly desirable outcome of clinical care in the hospital (Donabedian, 1998). The American Customer Satisfaction Index (fortune 1998) gave hospitals an overall 67% satisfaction rating, ranking 27th out of 31 industries. This ranking placed hospitals 10 percentage points below the tobacco industry and just above the Internal Revenue Service. 80% of respondents believe hospitals cut corners to save money, and 77% believe that these cuts have endangered patients as being reported in a National Coalition on Health Care survey. Patients who had been admitted to academic health centers and teaching hospitals generally reported more problems than those cared for in community hospitals. To create a culture of customer service excellence in hospitals and achieve outstanding patient satisfaction, it is necessary to understand the intangible aspects of perception and expectation that contribute to patient satisfaction. The “First Law of Service” provides a useful, simple mathematical model of satisfaction (Maister, 1984). The formula for this model is Satisfaction = Perception – Expectation. There will be a corresponding degree of satisfaction if a patient’s perception of their hospital experience meets or exceeds the expectation,. However there will be resulting dissatisfaction, if the perception does not meet the expectation. Thus, patient satisfaction results from meeting or exceeding patients’ expectations. Patient perceptions of care can be measured directly from patient satisfaction surveys, focus groups, and telephone surveys. A hospital’s reputation and market share are indirect measurements of patient perceptions. There are 2 main directions in which patient satisfaction can be influenced: by working on what the patient perceives and on what the patient expects.