Factors influencing patient loyalty to outpatient medical services: an empirical analysis of the UAE’s government healthcare system

Purpose The aim of this research is to uncover issues that inhibit patients' satisfaction and loyalty and identify factors that could enhance customer retention by government hospitals in the United Arab Emirates (UAE). The mediating impact of outpatient satisfaction on service quality, word of mouth (WoM), hospital image, outpatient–physician relationship and outpatient loyalty were tested. Design/methodology/approach The sample data used to test the hypotheses were drawn from a pool of patients served by a government healthcare agency in Abu Dhabi. Questionnaires were provided to 418 participants using methods such as short message service, e-mail and face-to-face delivery. The data were analyzed using SmartPLS 3.3.2 software. Findings The results indicate that service quality, WoM and outpatient–physician relationship positively impact outpatient satisfaction and indirectly effect outpatient loyalty; that hospital image positively impacts outpatient satisfaction and loyalty and has a partially mediating effect on loyalty; that waiting time satisfaction has no effect on outpatient satisfaction and no moderating effect on the outpatient satisfaction–loyalty relationship and that switching cost has a positive effect on loyalty but no moderating effect on the outpatient satisfaction–loyalty relationship. Research limitations/implications The first limitation of this study concerns the fact that only patients who had previously been served by these hospitals' outpatient units were included. Furthermore, the research was not able to obtain extensive findings related to the various factors that negatively impacted patient satisfaction and loyalty among all of the departments of government hospitals, such as inpatient care and emergency care. Practical implications Centered on the findings from this research, increasing switching costs would prevent patients from switching to other healthcare providers. Therefore, it has the potential to create a false loyalty or a hostage customer (Jones and Sasser, 1995). Additionally, making patients feel connected to their treatment plan and engaged in their care by developing a tool to maintain their enthusiasm about their health is important. It is therefore recommended that government hospital care providers and management consider providing online tools that patients can use to self-manage their care. Social implications The results regarding patients' satisfaction level suggest several areas for improvement. The first pertains to waiting area entertainment and comfort because patients indicated that there is not enough entertainment or ways to pass the time when waiting for services. In addition to enhancing the entertainment and comfort of waiting areas, government hospital staff should maintain contact with patients who are waiting to ensure that they are aware of the time they will spend. Another area for improvement is the parking lot. During summer, patients prefer to walk less in the sun, which causes them to seek parking closer to the door. Government hospital management should consider different methods for transporting patients closer to the door, such as golf carts or valet services. Originality/value This is the first study to investigate the mediating impact of outpatients' satisfaction between its antecedents and loyalty in the UAE. These results provide an improved understanding of the factors influencing patient choices and establish more accurate methods for increasing patient loyalty to retain more patients

Use of the Haddon matrix as a tool for assessing risk factors for sharps injury in emergency departments in the United Arab Emirates

We investigated the epidemiology and prevention of sharps injuries in the United Arab Emirates. Among 82 emergency nurses and 38 doctors who responded to our questionnaire, risk factors for sharp device injuries identified using the Haddon matrix included personal factors (for the pre‐event phase, a lack of infection control training, a lack of immunization, and recapping needles, and for the postevent phase, underreporting of sharps injuries) and equipment‐related factors (for the pre‐event phase, failure to use safe devices; for the event phase, failure to use gloves in all appropriate situations). Nearly all injuries to doctors were caused by suture needles, and among nurses more than 50% of injuries were caused by hollow‐bore needles

Suggestion systems: A usability-based evaluation methodology

Usability has been used to design and assess products and websites. This paper takes the concept of usability one step further and proposes a framework to assess suggestion systems. Thus taking the concept of usability one step further and applying it in the area of ideas management through suggestion system. The fundamental premise of the article is that a suggestion system designed, with usability in mind, will improve innovation among employees, and hence increase participation. This framework was then used to assess four suggestion systems in an oil and gas company in the middle-east. These systems were further assessed for employee perception of their usability and participation. After collecting data on these three different aspects conclusions are drawn. Out of the four systems analyzed, the most usable suggestion system had the highest participation rate and the least usable system attracted the fewest suggestions