Description

When creating and managing patient loyalty, medical institutes always focus on medical technicians, overall healthcare quality, and hospital brands, and the role of nursing seems to be underappreciated. Empirical evidence about the relationship between patient experience with nursing care and patient loyalty is limited, especially in the Chinese healthcare system. This study aimed to explore to what extent patient experience with nursing care influences patient loyalty to the hospital and the impact routes.

Nursing Care

There were significant direct and indirect effects between patient experience with nursing care and patient loyalty, explaining 32.0% of patient loyalty variance. Patient experience with nursing care had a direct and positive impact on patient loyalty, and better patient experience with nursing care was directly associated with better patient loyalty. In addition, the results also revealed the effect of patient experience with nursing care on patient loyalty was partially mediated by patient satisfaction with nursing care and overall hospital services.

This study confirmed the importance of nursing care in creating patient loyalty; improving the patient experience with nursing care would be beneficial to patient loyalty. When creating patient loyalty, hospital administrators and nursing managers should make efforts to develop positive patient experience of nursing care in daily clinical practice through organizational changes, culture shaping and staff education.

During the past three decades, competition in the healthcare industry has increased rapidly and become a challenge for healthcare institutions in many countries, such as Germany, Australia, France, and China. In a competitive situation, healthcare providers must pay attention to attracting and maintaining customers. Healthcare success is not only the result of satisfied health-related outcomes and excellent technical skills, but also of retaining patients. Loyalty is the customer’s behavior to continue receiving services from a service provider. Patient loyalty can be defined as the intention of re-selecting the same institution to meet future healthcare needs, or to recommend it to family or friends; it is regarded as a key success factor for healthcare providers. Patient loyalty is also positively related to a wide range of patient outcomes, particularly compliance with treatment plans and preventive measures. Thus, for the sake of both healthcare providers and recipients, hospital managers must manage patient loyalty effectively. To do this, understanding the factors determining patient loyalty is essential.

Patient-perceived service quality has been a well-recognized determinant of patient loyalty. However, with regard to the impact routes between quality and loyalty, no consensus has been reached. Several studies have showed that quality has an indirect influence on patient loyalty while Choi et al. concluded that quality had direct and indirect influence on patient loyalty.

Healthcare

Healthcare professionals have been one of the population groups with the highest number of quantified cases, related to direct exposure to diagnosed cases of COVID-19 during their professional activity. Additionally, they have suffered from stress and work overload due to the high incidence of cases. This was compounded by long working hours due to shortage of healthcare personnel, restructuring of services, and lack of protection due to lack of materials, with the consequent risk of contagion.9 Protective factors such as job satisfaction, high self-esteem, and perceived social support have also been described.

A variety of medical conditions and injuries must be treated in the ED. The ED is usually overcrowded, which contributes to difficulties in providing timely and safe treatment.1 However, the transformation of the health system in Saudi Arabia when it comes to improving patient access to care has made the time required to complete triage, assessments, and treatments in the ED the main indicator for hospital performance. The Ministry of Health’s target is that 86% of patients be triaged, assessed, and treated in less than four hours. With overcrowding and extensive data control in the ED, treating and dispositioning patients within the target time frame can be challenging. The situation in the ED is constantly changing; therefore, utilizing technology has had an impact on the quality of the services provided. The ever-changing circumstances require a real-time tracking system. The potential for an electronic tracking system called a dashboard to improve patient safety, decision-making, efficiency, and workflow has been reported.

The dashboard is the main electronic screen located at the most visual point in the department. The dashboard displays data from the main hospital electronic system, where the basic patient health history and updated data are located. These data are generated by the hospital health system and visualized by the dashboard; the data can be used by nurses and other healthcare providers to assess the current status of the ED, patient volume, staff performance, and patient clinical situations, hence providing an overview to clinicians and managers that can help them in making decisions. This advanced tool is being used to show concise patient information in a more useful way. A visualized dashboard offers an easy and accurate way to sort, analyze, and manage patients’ health information and helps medical teams stay updated about the patients’ real situations. This could assist in providing better health services that are consistent with international standards in less time.

More importantly, regarding the impact of nursing service quality on patient loyalty, many previous studies were less likely to accurately capture the essence of the inner-relationship between these two concepts and reveal nursing care’s unique attributes of patient loyalty. Most study instruments were about the overall healthcare and used limited items in measuring nursing services, which is inconsistent with the nature of comprehensive and multi-dimensional nursing care. Unrepresentativeness in the instrument makes it less sensitive to nursing care, and nursing seems to be underappreciated in the shape of patient loyalty. Nurses are the single largest group of the healthcare workforce, playing an essential role in the delivery of healthcare services. It has been well recognized that nurses have the prominent potential to develop a patient-centred healthcare system. Therefore, nursing should be attached more importance when cultivating patient loyalty.