We also located a gap opportunity for healthcare marketers to help delight their patient customers.
Trying to get the answers to these questions is where we started. Our thought was that if nursing managers know more about how nurses think about quality, it should help in recruitment and retention of quality-care-delivering nurses. What we found may be of wider application because, with effective internal marketing programs, consumer perception of the quality of their care may be improved.
The reasons for the worldwide shortage of nurses according to the nursing literature include aging of the profession with shrinking class sizes for RNs--as much as 50% smaller compared to the '70s and '80s. Further, the women's movement of the '70s and '80s dramatically expanded the professional opportunities for women globally.
]9 he overall falling numbers have hit intensive care units (ICUs) particularly hard. ICUs have historically attracted and required younger registered nurses (RNs). The percentage of RNs under age 30 has fallen by nearly 40% since the '80s. The rapid decline in the number of RNs under age 30 in the workforce, together with the aging RN population (nearly 60% of the current RN workforce is age 40 and older), certainly helps explain the current acute shortages in the ICU. With the dramatic changes in nursing demographics, administrators are scrambling to get and retain quality nurses in order to deliver quality healthcare to patients. To address the problem, we first needed to define what quality patient care is--what it looks like--and to define the qualities of good nursing according to nurses.
Quality Nursing Defined
We examined service quality literature to determine what dimensions explain the variance in customer perception of quality services. The literature indicates that, in service industries such as nursing, achieving and maintaining quality service begins with recruiting the right employees with the right attitudes and the required technical expertise. Training to orient the employee to their expected performance levels then follows good recruitment. Following training, successful managers empower their employees to do their jobs and support them in their efforts. Finally, organizations retain these employees through job satisfaction. All these steps must occur in an environment of a self-monitoring culture of self-motivating employees. That isn't easy to achieve. Successful nursing administrators certainly earn their keep.
Beginning in the mid-'80s, researchers Len Berry, A. Parasuraman, and Valarie Zeithaml, at Texas A&M University, addressed the major service quality marketing questions of
(1) What is service quality
(2) What causes service quality problems and
(3) What can service organizations do to improve quality They found that quality is whatever the customer defines as quality--not management's or even the employees' definition.
Customers' expectations shape their assessment of the quality of the service. When a