LUNAR INTERNATIONAL COLLEGE

SCHOOL OF BUSINESS AND ECONOMICS

DEPARTMENT OF PROJECT MANAGEMENT
RESEARCH METHODS FOR PROJECT MANAGERS

GROUP WORK ON PROPOSAL PREPARATION

ASSESSMENT OF CUSTOMER’S SATISFACTION AT ADDIS ABABA

HOSPITALS: CASE STUDY ON TIKUR ANBESSA HOSPITAL

PREPARED BY: EBA KEBEDE………….……….GSR/0186/14

HABTAMU DESSISA………….GSR/0189/14
ZEBIBA MUNIR…….………….GSR/0519/14
SECTION TWO

SUBMITTED TO: ZELALEM E. (PhD)

14 JANUARY 2021

ADDIS ABABA, ETHIOPIA

 Contents
1. BACKGROUND OF THE COMPANY...................................................................................................1
2. STATEMENT OF THE PROBLEM.........................................................................................................2
3. RESEARCH QUESTION.........................................................................................................................3
4. OBJECTIVES...........................................................................................................................................3
4.1. GENERAL OBJECTIVES.................................................................................................................3
4.2. SPECIFIC OBJECTIVES..................................................................................................................3
5. DELIMITATIONS OF THE STUDY.......................................................................................................4
6. SIGNIFICANCE OF THE STUDY..........................................................................................................4
7. DEFINITION OF TERMS........................................................................................................................4
8. RESEARCH DESIGN AND METHODOLOGY.....................................................................................5
8.1. RESEARCH DESIGN........................................................................................................................5
8.2. SAMPLE SIZE AND SAMPLING TECHNIQUE.............................................................................5
8.3. TYPE OF DATA AND METHOD OF DATA COLLECTION.........................................................6
8.4. RESEARCH ETHICS AND INSTRUMENTATION PROCEDURES..............................................6
8.4.1. RELIABILITY..........................................................................................................................6
8.4.2. VALIDITY ISSUES..................................................................................................................7
8.4.3. RESEARCH ETHICS...............................................................................................................7
8.5. METHOD OF DATA ANALYSIS....................................................................................................7
9. TIME AND BUDGET BREAKDOWN....................................................................................................8
A. TIME SCHEDULE..............................................................................................................................8
B. BUDGET BREAKDOWN..................................................................................................................9
10. REFERENCES........................................................................................................................................9

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 1. BACKGROUND OF THE COMPANY
Nowadays, to evaluate the quality of health care services given at different health care
institutions, client satisfaction becomes the primary reason. Client satisfaction is also a key
indicator of the level of success of providers to meet client expectations and values. This time,
most countries around the world have a quality assurance and accreditation process which
requires the satisfaction of clients to be measured on a regular basis.

Patient satisfaction is the extent to which patients are happy with their healthcare, both inside
and outside of the doctor's office. A measure of care quality, patient satisfaction gives providers
insights into various aspects of medicine, including the effectiveness of their care and their level
of empathy. Satisfaction had a great impact on whether a person seeks medical advice, adheres
with treatment, and it helps to keep up a positive relationship with health care providers. Also
Patient satisfaction can be defined as the degree of congruency between a patient’s expectations
of ideal care and his/her perception of the real care(s) he receives.

In the competitive economy, customer’s satisfaction has come under limelight due to stiff
competition where organizations are trying to take competitive advantage through the human
factor and customers (Singh, 2006). Hence, in order to win this intense competition and maintain
their market share of the hospital industry; they must give attention to the existing and potential
customers need, want and preferences to maximize their satisfaction and loyalty plus to that they
must make continues customer service quality improvement program. Since the importance of
making continuous customer service quality improvement program is to make profit, build good
images, lead the market, and retain customers which lead customer loyalty.

Prior to 1972, the SoM was located on the main campus for preclinical training and the then
Princess Tsehay Memorial Hospital (now, the Armed Forces General Hospital) for clinical
training. Later, with the opening of the Tikur Anbessa Specialized Hospital (TASH) in 1972, the
hospital became the only site for training Medical Doctors. In 1998, the TASH, the largest referral
hospital in the country, with 700 beds, was transferred to the School by the Federal Ministry of
Health, and it has since become a University teaching hospital. The Tikur Anbessa Specialized
Hospital is now the main teaching hospital for both clinical and preclinical training of most
disciplines. It is also an institution where specialized clinical services that are not available in
other public or private institutions are rendered to the whole nation.

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The TASH has 200 doctors, 379 nurses and 115 other health professionals dedicated to providing
health care services. The various departments, faculties and residents under specialty training in
the School of Medicine provide patient care in the hospital. The hospital also has 950 permanent
and contract administrative staff to support the hospital activities. In addition, almost all regional
and federal hospitals in Addis Ababa are affiliated to the School of Medicine as clinical services
and training sites.

In recent year’s Ethiopian ministry of health tried to improve customer’s satisfaction at the
hospital level. The development of Ethiopian hospital reform implementation guide line (EHRIG)
is one of the basic steps in achieving this goal (MOHF, 2010). A component of effective health
care services is the measurement of patient satisfaction. Patient satisfaction assists in the
evaluation of health care services from the patients’ point of view. It also facilitates the
identification of problem areas and generates ideas for resolving these problems. Monitoring
patient satisfaction is an important and useful quality improvement tool for hospital services in
particular and health care organization.

2. STATEMENT OF THE PROBLEM

Many a times it happens that with a competent doctor and a compliant patient, the problems
persist because of the policies, work culture, and attitude shown by the hospital. Traditionally,
hospitals have had discrete functional services such as house-keeping, dietary services, pharmacy,
laboratory, etc. Unfortunately, this specialization has led to more fragmentation, costly care, and
less than ideal customer service.

It is imperative that service companies’ measure and monitor service quality and satisfaction with
a view of influencing the behavioral intentions of their customers (Safavi, 2006). Customers have
expectations and criteria when they judge whether the provided hospital services is satisfactory or
not. At the same time, due to the high competition in a hospital sector, the perception of
customers and potential customers are also divided according to the services that they want to
achieve. The proper identification of customer satisfaction helps to retain customers and to
increase brand awareness, profitability and effectiveness of hospital’s services.

However, there are a number of problems hindering the smooth delivery of the hospital services.

There is customer’s dissatisfaction over the service offered and the available services don’t match
the expectation of the customer (Cronin, 1992). Research suggests that customer dissatisfaction is

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still the major reason of hospital customers’ switch to other hospital (KefaleAT, 2016). This
dissatisfaction could be because of a variety of reasons. The causes of dissatisfaction are well
known empirically these are no new technologies to satisfy their customers and shortages of
rooms for the customer. The problem with service failure is that it may lead to a destroyed
relationship between the customer and the organization. Thus, the importance of customer
satisfaction in today’s dynamic corporate environment is obvious as it greatly influences
customer’s repurchase intensions whereas dissatisfaction has been seen as a primary reason for
customer’s intentions to switch.

3. RESEARCH QUESTION
 How is the level of customer satisfaction in case of Tikur Anbessa Hospitals?
 What factors affect customer satisfaction in case of Tikur Anbessa Hospitals?
 What kind of strategy does the Hospital employing in order to satisfy its end service user?
 How the company ascertain those strategies employed to bring customer satisfaction are
implemented as planned?

4. OBJECTIVES

4.1. GENERAL OBJECTIVES

The general objective of this study is to assess the level of customer satisfaction and to assess
whether customer satisfaction strategies are deployed or not on Hospital of Addis Ababa,
Ethiopia.

4.2. SPECIFIC OBJECTIVES

 To assess the status of satisfaction of customers receiving service at Tikur Anbessa.

 To identify factors affecting the satisfaction of individual customers receiving service at

Tikur Anbessa.

 To identify what kinds of strategy does the hospital employ in order to satisfy their
customers.

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 5. DELIMITATIONS OF THE STUDY
The study will delimit to customer satisfaction in case of Tikur Anbessa hospital in its hospital
around Tikur Anbessa. The population of the study delaminates to ultimate customers and
medical director of Tikur Anbessa hospital .From the nature and diversity of the service users the
study will focus on the hospital departments like Pharmacia, ER, OPD and other departments. The
departments selected because there are different kinds of customers in that areas. The time
delimitation of the study is from 2019 to 2021 to identify the latest problem of the hospital.

6. SIGNIFICANCE OF THE STUDY

The result of this study might serve as an input for the community, Hospital customer service
officers, future researchers and policy makers and other relevant about factors affecting
satisfaction of hospital customers.
 The findings of this study may benefit the society in that identification of the factors
affecting hospitals customer satisfaction enables the community to easily set the best
possible solutions to deal with the issue related with satisfaction with hospital services.
 This study may provide a clue for customer service officers about factors affecting
customer satisfaction. So, having an idea about factors affecting customer satisfaction,
customer service officers which are the centre of service quality make a necessary
adjustment in the delivery of hospital service which is eventually leads to improvement
in service quality.
 It provides solution for hospital industry service quality problems and it may give them
an idea of where they are presently in terms of their service quality and what they
should do in the future.
 It may show the hospitals employee treatment level for their clients and their ability of
working performance.
 Finally this study may use for different researchers as information tool.

7. DEFINITION OF TERMS
 Customer (client):-is a person who is the recipient of good, service, product, or an
idea obtained from seller, vendor, or supplier. But in this context customer is an
individual who is a patient or patients care taker who use the hospitals service.
 Service quality:-is a comparison of perceived expectations of a service with
perceived performance. In this context service quality means quality health care which

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 is defined as consistently delighting the patient by providing effective and efficient
health care service according to the latest clinical guidelines and standards which meet
the patients’ needs and satisfies providers. (Ali Mohammed Mosadeghrad.int J Health
care Qual assur.2013.)
 TASH:-TikurAnbesa Specialized Hospital
 MoH:-Ministry of Health
 OPD:-out patient department, it is the first contact point between the patient and
the hospital
 ER:- means emergency room
 PHARMACY:-a shop or hospital dispensary where medical drugs are prepared or
sold.

8. RESEARCH DESIGN AND METHODOLOGY

8.1. RESEARCH DESIGN

Research designs are plans and the procedures for research that span the decisions from broad
assumptions to be detailed method of data collection and analysis (Creswell, 2009). Since the
research topic is an assessment of service performance in Tikur Anbessa Hospital, the research
method will be descriptive research design which helps to describe the characteristics of service
performance and its dimensions.

8.2. SAMPLE SIZE AND SAMPLING TECHNIQUE

The populations of this study will be customers and customer satisfaction of Tikur Anbessa
hospital to accomplish this study, the student researcher will use non probability sampling
technique, particularly convenience sampling technique. Particularly using convenience sampling
method enables the student researcher to locate and distribute questionnaires to people who have
serviced in the hospital of Tikur Anbessa. Tikur Anbessa Hospital will be selected by the student
researcher since valuable information could be gathered there and significant numbers of
customers will be served. Yemane(1967) is used usually for finite and large population sample
size formula with 95% confidence level is employed. According to Yemane(1967), a sample of
300 customers will be selected from the customer.

The formula used to obtain this sample size is presented below.

n=N/ (1+N (e) 2)

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 8.3. TYPE OF DATA AND METHOD OF DATA COLLECTION
Types of data which we will use in our research are primary data which we will collect directly
from the customers and staff of Tikur Anbessa Hospital. Secondary data which we obtain from
different source which done before our research. The study will employ in order to gather primary
data questionnaires and structured interview in collecting the primary data. We will distribute
questionnaires to customers and structured interviews to the selected medical director of Tikur
Anbessa Hospital and staff of Tikur Anbessa Hospital. A structured interview question will adapt
from different related works of literature. The question includes the client socio-demographic
factors, the satisfaction questions and system-related questions that can potentially affect
customer’ satisfaction to the Tikur Anbessa Hospital service.

The satisfaction questions cover two aspects. The first 6 questions address study participants’
satisfaction towards the Tikur Anbessa Hospital service approach or communication skills. The
Second 7 questions address participant satisfaction on the medication guide provided by Tikur
Anbessa Hospital servant. In all the satisfaction questions, the clients were asked to rate their
satisfaction on a five-point scale (1—very satisfied, 2—satisfied, 3—neutral, 4—dissatisfied, 5—
very dissatisfied). For descriptive interpretation the five scales were converted into a three scale
form at by combining very satisfied and satisfied as satisfaction, and dissatisfied and very
dissatisfied as dissatisfaction.

The questionnaire will be prepared in English and then translated to Amharic language and then
retranslated to English to ensure consistency. The data will collect through interviewer-
administered face to face interview. The secondary data which will be collect from existing
literature will form the literature review of this study. The secondary data will be gather from
books and different documents of the organization like journals, websites and brochures that are
used as a reference.

8.4. RESEARCH ETHICS AND INSTRUMENTATION PROCEDURES

8.4.1. RELIABILITY

To insure the reliability of the interview guide it will adopt from similar research collected and
with some customization it will be verify by an expert in the area. Even though the interviewer is
also a Customer of the organization, as most the customer who are interviewed here with have no
line management relationship (no one managed by him). This will reduce the participation biased.

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As the researcher is also new to the organization, the bias that would have occurred in analysing
and interpreting the result is expected to be minimum.

8.4.2. VALIDITY ISSUES

Care was given to insure internal validity of the research work by controlling the process of the
interview from being affected by morality and historical perspective of the key informants.
Considering the proper representation of all views of customer in the organization that are
associated with the research , it is believed that the findings have external validity and the lessons
can be replicated to other research in the organization or other organizations that have similar
customer and set up.

8.4.3. RESEARCH ETHICS

Ethical clearance was obtained from the Departmental Research and Ethics Review Committee
(DRERC) of the School of Medical Sciences; Addis Ababa University. In addition to DRERC, a
permission letter was obtained from Tikur Anbessa Hospital. The objectives of the study were
explained to the study participants and written informed consent was obtained before interviewing
each participant. All the information obtained from the study participants was kept confidential.

8.5. METHOD OF DATA ANALYSIS

The survey questionnaires will be (collected, check for its completeness, and be analyzed) by
using software that are used to analyze samplings. Descriptive statistics will perform on the socio-
demographic data.
A 5-point Liker scale rating of very dissatisfied (1 point), dissatisfied (2 points), neutral (3
points), satisfied (4 points), and very satisfied (5 points) will use to calculate the level of patient
satisfaction on different services at the hospital. The percentage satisfaction or dissatisfaction will
be calculated by dividing the number of satisfied or dissatisfied responses by the total number of
respondents excluding neutral response ratings, respectively.
The overall rate of satisfaction by5 Liker scale will calculate as (number of very satisfied rating
×5) + (number of satisfied rating ×4) + (number of neutral rating ×3) + (number of dissatisfied
rating ×2) + (number of very dissatisfied rating ×1) divided by the total number of ratings (1–5)
for the specific service of different departments at the hospital and finally we will show the results
of the questionnaires by using descriptive tables.

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 9. TIME AND BUDGET BREAKDOWN

A. TIME SCHEDULE

NO Activity Approximate time

Part 1.

1 Work in Research proposal December 1 - December 21,

2021

2 Improvement in proposal December 22-December

31 ,2021

Part 2.

3 Chapter Two literature review January 1- February 9, 2022

4 Questioner and interview checklist preparation February 10-February 17, 2022

5 Data collection period (field research February 18-March 21,2022

Part 3.

6 Writing chapter three, data presentation, analysis and March 23- April 23,2022
interprtation

8 Writing chapter four, summary of major findings, April 24- May 15.2022
conclusion, recommendations and References

9 Gathering appendix May 16- May 22 2022

10 Final research paper submission May 22- May 25, 2022

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B. BUDGET BREAKDOWN

NO Activity Cost in Birr

1 Stationary Cost 450

2 Transportation cost 500

3 Internet cost 350

4 Print cost 900

5 Copy 625

6 Other costs 350

Grand Total 3175

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satisfaction of Pharmaceutical care of primary care center sat Ministry of Health
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Creswell, J. (2009). Research Design Qualitative, Quantitative and Mixed. SAGE publications.
Cronin, J. J. (1992). .Measuring service quality; a re-examination and . The Journal of
Marketing, 55-68.
DejeneA,BekeleA, MekonnenY, TayeG, GirmaW, MekonnenA,etal.Levels of
outpatient satisfactionat selected health facilities Tikur Ambessa
Hospital.EthiopJHealDev.2011;22(1)

HailuT, EjiguE, GeremewE, AdinewA. Auditable Pharmaceutical Transactions and

Services:Findings
KefaleAT, A. (2016). Clients‘perceptionandsatisfactiontowardserviceprovided by
pharmacyprofessionalsatateachinghospitalinEthiopia. journal Integr Pharm ResPract,
85-94.
MOHF. (2010). EthiopianHospital
ReformImplementationGuidelinesMinistryofHealthEthiopianHospital. Addis Ababa.
Oljira L, Gebree-Selassie S. Satisfaction with outpatient health services at Jimma Hospital,
Southwest Ethiopia. Ethiopia J Health Dev. 2001; 15(3):179–184.

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Ongkiko, I. V. (2006). Introduction to Development Communication. In I. V. Ongkiko,
Introduction to Development Communication. University of the Philippines-Open
University.
Safavi, K. (2006). Patient-centered pay for performance. Journal of Healthcare Management,
215-218.
Singh, D. a. (2006). The Japanese Wow: Kaizen. VSRD international journal of Business and
management Research, Vol. 3, pp167-172.
Sodani PR, Kumar RK, Srivastava J, Sharma L. Measuring patient satisfaction: a case study to
improve the quality of care at public health facilities. Indian J Community Med.2010;
35(1):52–56.

Tedla M, Bineyam T. Patient’s satisfaction with laboratory services at antiretroviral therapy

clinics in public hospitals, Addis Ababa, Ethiopia. BMC Res Notes. 2012; 5:184

Tesfaye T. Assessments of patients’ satisfaction towards clinical laboratory services received

at uniformed service hospitals in Addis Ababa, Ethiopia. [Online]; 2016. Available from:
http://etd.aau.edu.et/

Van Riel, C. B., & Fombrun, C. J. (2007). Essentials of Corporate Communication. In C. B. Van
Riel, & C. J. Fombrun, Essentials of Corporate Communication. (p. 205). New York:
Routledge.

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