Clients’ understanding of the role of nurse practitioners

Introduction: Nurse Practitioners (NPs) have an emerging role in the Australian healthcare system. However, there remains a dearth of available data about public understanding of the NP role. ---------- Aim: To evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. ---------- Method: All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales (NSW) were invited to recruit five consecutive clients to complete the self-administered survey. ---------- Results: Thirty two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (p=0.005), and where applicable would to prefer to see a NP rather than a doctor (p=0.022). ---------- Discussion: Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction more awareness of the scope of the NP role is required.

Towards more complete satisfaction of customers in construction

In an environment where economic, political and technological change is the rule, a fundamental business strategy should be the defence of traditional markets and thoughtful entry into new markets, with an aim to increase market penetration and stimulate profit. The success of such a strategy will depend on the success of firms to do more and better for customers than their competitors. In other words, the firm’s primary competitive advantage will come from changes they implement to please their customers. In the construction industry, complexity of technical knowledge and construction processes have traditionally encouraged clients to play a largely passive role in the management of their project. However, today’s clients not only want to know about internal efficiency of their projects but also need to know how they and their contractors compare and compete against their competitors. Given the vulnerability of construction activities in the face of regional financial crisis, constructors need to be proactive in the search to improve their internal firm and project processes to ensure profitability and market responsiveness. In this context, reengineering is a radical design that emphasises customer satisfaction rather than cost reduction This paper discusses the crucial role of the client-project interface and how project networks could facilitate and improve information dissemination and sharing, collaborative efforts, decision-making and improved project climate. An intra-project network model is presented, and project managers’ roles and competencies in forming and coordinating project workgroups is discussed.

‘I can’t get no satisfaction’...or can I? A study of satisfaction with financial planning and client wellbeing

This paper reports findings from an ongoing collaborative research project with the Financial Services Council (FSC), which contributed funding and facilitated the survey of financial planners’ clients through FSC member organisations. The article draws on the report to the FSC that was prepared by the QUT researchers, reporting findings on the initial exploratory stage of the project.1 The lyric in the title of this paper has become a catchcry for consumers dissatisfied with a range of financial services and products, and, as recent Federal Government inquiries have revealed, there is some truth to the claim. But as financial planning undergoes a series of reforms, including increased professionalism (FPA 2009) and improved quality of advice (Australian Government 2011), there are good reasons to explore the conditions under which clients report satisfaction with their financial planners; not least because the provision of effective financial planning and advice, delivered in accordance with, or transcending, the rules and norms of industry best-practice has the potential to benefit clients, not just financially, but across a number of life domains. In this paper, we report findings from an exploratory study investigating whether financial planning and advice contribute to client well-being, beyond effects on financial well-being. While anecdotal evidence supports psychological benefits such as a sense of security, little research has explored these links in any systematic or theoretically driven way. However, theory and research from cognate disciplines, such as psychology, indicate clear links between planning, goal setting and well-being that are likely to arise in the financial planning domain. Surveyed clients were asked to indicate their satisfaction with their financial advisers, the planning process and the advice they received. Clients responded to items designed to reflect key areas for financial planners in the shift towards increased professionalism, improved disclosure and greater client focus (e.g. FPA 2009). Clients also reflected on their financial situations before and after seeing their advisers, and considered the impact of their financial situations on a number of life areas including family relationships, mental health and well-being, and overall life satisfaction.

Patients’ satisfaction with acute care hospital foodservice: does age matter?

In an aging population, healthcare providers should understand the foodservice preferences of the elderly to reduce the risk of malnutrition through adequate nutrition. Conflicting reports exist for elderly patient satisfaction regarding foodservice.1 This study aimed to investigate the relationship between age and foodservice satisfaction within the acute care hospital setting. Patient satisfaction was assessed using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire with data collected over three years (2008–2010, n = 785) at The Wesley Hospital, Brisbane. Age was grouped into three categories; <50, 51–70 and >70 years. ANOVA was used to measure age related differences in patients’ overall foodservice satisfaction, four foodservice dimensions and two independent statements (meal size and hot food temperature). Results showed that older patients were more satisfied than younger patients and indicated increasing satisfaction with increasing age regarding food quality (F2,767 = 15.787, p < 0.001), staff/service issues (F2,768 = 12.243, p < 0.001), physical environment (F2,765 = 5.454, p = 0.004), meal size (F2,730 = 10.646, p < 0.001) and hot food temperature (F2,730 = 10.646, p < 0.001). While patients aged >70 years also reported greater satisfaction with meal service quality, those aged 51–70 years indicated the lowest (F2,762 = 9.988, p < 0.001). Overall patient satisfaction across all age groups was high (4.26–4.43/5) and a trend of increasing satisfaction with increasing age was evident (F2,752 = 2.900, p = 0.056). These findings suggest patients’ satisfaction with hospital foodservice increases with age and can assist foodservices to meet the varying generational expectations of their clients.

A leap into foodservice satisfaction in the private acute care setting

Monitoring foodservice satisfaction is a risk management strategy for malnutrition in the acute care sector, as low satisfaction may be associated with poor intake. This study aimed to investigate the relationship between age and foodservice satisfaction in the private acute care setting. Patient satisfaction was assessed using a validated tool, the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire for data collected 2008–2010 (n = 779) at a private hospital, Brisbane. Age was grouped into three categories; <50 years, 51–70 years and >70 years. Fisher’s exact test assessed independence of categorical responses and age group; ANOVA or Kruskal–Wallis test was used for continuous variables. Dichotomised responses were analysed using logistic regression and odds ratios (95% confidence interval, p < 0.05). Overall foodservice satisfaction (5 point scale) was high (≥4 out of 5) and was independent of age group (p = 0.377). There was an increasing trend with age in mean satisfaction scores for individual dimensions of foodservice; food quality (p < 0.001), meal service quality (p < 0.001), staff service issues (p < 0.001) and physical environment (p < 0.001). A preference for being able to choose different sized meals (59.8% > 70 years vs 40.6% ≤50 years; p < 0.001) and response to ‘the foods are just the right temperature’ (55.3% >70 years vs 35.9% ≤50 years; p < 0.001) was dependent on age. For the food quality dimension, based on dichotomised responses (satisfied or not), the odds of satisfaction was higher for >70 years (OR = 5.0, 95% CI: 1.8–13.8; <50 years referent). These results suggest that dimensions of foodservice satisfaction are associated with age and can assist foodservices to meet varying generational expectations of clients.

Examining the influence of participant performance factors on contractor satisfaction : a structural equation model

Participant performance is critical to the success of projects. At the same time, enhancing the satisfaction of participants not only helps in problem solving but also improves their motivation and cooperation. However, previous research related to participant satisfaction is primarily concerned with clients and customers and relatively little attention has been paid to contractors. This paper investigates how the performance of project participants affects contractor project satisfaction in terms of the client's clarity of objectives (OC) and promptness of payments (PP), designer carefulness (DC), construction risk management (RM), the effectiveness their contribution (EW) and mutual respect and trust (RT). With 125 valid responses from contractors in Malaysia, a contractor satisfaction model is developed based on structural equation modelling. The results demonstrate the necessity for dividing abstract satisfaction into two dimensions, comprising economic-related satisfaction (ES) and production-related satisfaction (PS), with DC, OC, PP and RM having significant effects on ES, while DC, OC, EW and RM influence PS. In addition, the model tests the indirect effects of these performance variables on ES and PS. In particular, OC indirectly affects ES and PS through mediation of RM and DC respectively. The results also provide opportunities for improving contractor satisfaction and supplementing the contractor selection criteria for clients.

Raising levels of awareness of rights and obligations in the provision of financial product advice to retail clients

In September-December 2012, 548 financial planning retail clients and 77 financial advisers responded to online surveys addressing consumer satisfaction with financial planning services and the provision of information concerning regulatory and rights issues. Retail clients commented on areas related to the best interests duty in s 961B of the Corporations Act 2001 (Cth), in particular the extent to which advisers considered their clients’ financial objectives and lifestyle situations, and the client-centredness of the financial advice they received. Retail clients also indicated their level of awareness of their substantive rights in relation to receiving advice, the legal obligations imposed on advisers, and whether they would access internal and external complaints processes if warranted. Advisers reported on the extent to which they provide clients with information relating to their substantive rights, and complaints processes available to them. Responses were analysed in relation to client demographics (e.g., age, gender, education), and experience of financial advice. This article reports on the findings of the surveys and their implications for financial planners.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Antecedents of loyalty to a brand : Apple clients vs. non-clients

Apple is undoubtedly a sui generis and remarkable brand in what concerns to its branding and brand experience, and remains an indisputable reference in the consumer electronics and computer industries. The aim of this study encompasses the development and empirical testing of two conceptual models that evaluate and allow to draw a comparison between Apple clients and non-clients’ perceptions, regarding brand experience, brand perceived value, price perceptions and brand trust; and that determine the antecedents of clients’ loyalty to the brand. Therefore, the contribution of this study to the literature relies on the research of the impact of brand experience on brand perceived value and on price perceptions, as well as the influence of price perceptions (positive and negative) on trust, satisfaction, and commitment to the brand. Two surveys were used to test each conceptual model, through a sample collected across the portuguese academic community. The findings prove the strong influence of the sensory and affective aspects of brand experience on both clients and non-clients. They also reveal that the negative role of price is neutralized in the presence of strong brand experience, and that the fact that Apple is viewed as an “expensive brand” may highlight its association to higher quality and prestige. Also, this study reinforces the important role of satisfaction and commitment in building customer loyalty, corroborating the existent literature. Managerial implications derived from the findings are also discussed.

Identifying the component structure of job satisfaction by principal components analysis among extension officers in North West Province, South Africa

The component structure of a 34-item scale measuring different aspects of job satisfaction was investigated among extension officers in North West Province, South Africa. A simple random sampling technique was used to select 40 extension officers from which data were collected. A structured questionnaire consisting of 34 job satisfaction and 10 personal characteristic items was administered to the extension officers. Items on job satisfaction were measured at interval level and analyzedwith Principal ComponentAnalysis. Most of the respondents (82.5%) weremales, between 40 to 45 years, 85% were married and 87.5% had a diploma as their educational qualification. Furthermore, 54% of the households size between 4 to 6 persons, whereas 75% were Christians. The majority of the extension officers lived in their job area (82.5), while 80% covered at least 3 communities and 3 farmer groups. In terms of number of farmers covered, only 40% of the extension officers covered more than 500 farmers and 45% travelled more than 40 km to reach their farmers. From the job satisfaction items 9 components were extracted to show areas for job satisfaction among extension officers. These were in-service training, research policies, communicating recommended practices, financial support for self and family, quality of technical help, opportunity to advance education, management and control of operations, rewarding system and sanctions. The results have several implications for motivating extension officers for high job performance especially with large number of clients and small number of extension agents.

Customer satisfaction in the banking industry: a comparative study of Ghana and Spain

La satisfacció és una preocupació crucial pels clients i per les organitzacions, incloent els bancs. L'estudi examina la satisfacció global dels clients dels bancs a Ghana i Espanya. Així s'analitzen aspectes com la relació entre satisfacció global i les dimensions de qualitat dels serveis bancari, així com les pròpies dimensions principals de la qualitat d'aquests serveis. Finalment, les percepcions sobre aquestes dimensions son comparades entre els bancs de Ghana i Espanya. S'han analitzat els clients de 819 bancs de Ghana i Espanya, els resultats van mostrar que els clients espanyols estaven més descontents respecte les dimensions tangibles i empatia metre que els clients de Ghana puntuaven pitjar la dimensió conveniència. En general, els clients de Ghana estaven força més descontents amb els serveis bancaris que els d'Espanya. La fiabilitat, l'empatia i la conveniència son els predictors de satisfacció global en Ghana, mentres que la fiabilitat és la única dimensió que explica la satisfacció global a Espanya.

User satisfaction with allied health services delivered to residential facilities via videoconferencing

We have investigated the role of videoconferencing in allied health service provision to high-care clients in rural residential facilities. Videoconferencing equipment was set up at a rural aged-care facility and a metropolitan allied health centre; ISDN transmission at 384 kbit/s was used to link the equipment. Twelve residents were assessed by both videoconference and face to face across five allied health disciplines (a total of 120 assessments). User satisfaction was measured using questionnaires and focus groups. Face-to-face assessment took significantly longer than videoconferencing assessment. However, the mean satisfaction ratings for face-to-face assessments were higher than for videoconferencing and the majority of the staff preferred the face-to-face format. Videoconferencing was particularly useful for consultations and the initial stages of the assessment process. A number of issues relating to the videoconferencing equipment, to the environment in which assessments were performed and to the clients themselves need to be addressed in order for this form of service delivery to be effective.

Empowerment through education : enhancing quality of life of clients on anticoagulant therapy

This particular study was a sub-study of an on-going investigation by Porter and Kazcaraba (1994) at the Veterans Administration Medical Center in Miami. While the Porter and Kazcaraba study utilizes multiple measures to determine the impact of nurse patient collaborative care on quality of life of cardiovascular patients receiving anticoagulant therapy, this study sought to find whether health education could empower similar clients to improve their quality of life. A health education program based on Freire's belief that shared collective knowledge empowers individuals to improve their lives and their community and Porter's nurse patient collaborative care model was used. Findings on a sample of thirty-eight subjects revealed strong correlations between self-esteem and life satisfaction as well as a trend towards increased power post-treatment. No group comparisons were made at posttest because the sample size was too small for meaningful statistical analysis.