Service Quality Analysis of Mental Care Employees

05 Apr 2018

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The gap between professionals and client was one of the central elements of our study. The perceptual gap between providers and clients is often studied in order to measure and analyses service quality (Brown & Swartz, 1989; Klose & Finkle, 1995; Luk & Layton, 2002; Peiro 2005; Zeithaml 1990). Our findings that clients are tend to overestimate service quality is different from the findings by Peiró and colleagues (2005), which have shown that employees are tend to overestimate service quality they are offering in a context of hotels and restaurants. Here we can suggest that service quality gaps characteristics (overestimation vs underestimation) much depends on type of service provided by the organizations. According to this comparison we assume that professionals working with PIDs have more vulnerable ethical issues in service, in other words empathy can be on higher position which itself can affect the way the service is provided by the professionals to the benefit of the client’s demands.

People who are in charge to help and assist persons with intellectual disabilities with nearly every level of need, including physical, counseling, and education can be already considered as stress related. And ethical issues are deep rooted in the professional role (Raines, 2000). Employees facing ethical dilemmas in service often have mental conflict offering service as they are trained, or offering the service as clients (relatives) are asking, or demanding: what is good (virtue) or what is duty (right)? (Aroskar, 1997). Our results confirm this divergence showing that there is less congruence in service quality evaluation from the clients and employees. Overestimation from clients’ represents that service is provided the way they prefer, which itself is connected to professionals’ decision – to adjust service to clients’ needs and demands. On other hand in case of professionals overestimation of service quality we have decreased clients’ satisfaction which, continuing the same logic is result of that they have different approach to the kind of service PIDs need. In this case when employees prefer to conduct service they consider is right contradicts to the service evaluated by clients, finally it leads to client underestimation and causes low level of satisfaction. These findings are similar to the study results by Emari and colleagues (2011) which tested that causal relationship is significant between perceived quality of service and client satisfaction.

According to our study overestimation from employees not only connected to low client satisfaction but also decreased quality of life of users. Results reported that higher is the evaluation of service from professionals lower is the quality of life of persons with intellectual disabilities. In other words when employees perceive that service provided by them is good, relatives think that this service decreases quality of life of PIDs. Here we have to recall that these organizations are designed to care the QoL of individuals with intellectual disabilities (Martinez-Tur, Peiro, Moliner, & Potocnik, 2010). And these organizations are important source of QoL for people with intellectual disabilities (Moliner, Gracia, Lorente, & Martinez-Tur, 2013). Situation is quite complex, when service quality is perceived differently by clients and employees. Non-congruence and different views between them about service quality impacts organizational facets and goals; if we have satisfied clients we have emotionally exhausted professionals, and on the other hand we have lower client satisfaction and lower quality of life of PIDs. Here moderation roles are important to dilute these relationships. The moderators tested in our study have less to contribute to weaken the above mentioned relationships. Moreover, high supervisor trust can be related to increasing sense of responsibility from employees; similar to study findings conducted with social workers which reported that emotional exhaustion is significantly related to good performance (Wright & Cropanzano, 1998). According to our study justice perceived by relatives has no influence on the relationship between service quality gap effects on their satisfaction. Despite of the fact that organizational justice doesn’t revealed moderation effect on gap impacts, it has direct effect on client satisfaction; results reported that they are significantly related. Also quality of service perceived by PIDs doesn’t have moderation role on relationship of service quality gap and their quality of life.

Our study shows that at Mental Care organizations employees are tend to underestimate the service quality they offer. Additionally, when employees’ overestimation is higher for service quality, clients are less satisfied with the organization. In line with previous studies (Brown and Swartz, 1989; Klose and Finkle, 1995, Peiro, Martinez-Tur, & Ramos 2005), a shared vision between employees and customers is required. If the delivery of services is overestimated from professionals, the client satisfaction and their service evaluations suffer. If the service is overestimated from clients we have employees’ emotional exhaustion. Although gaps between employee and clients’ perceptions involve different alternatives (overestimation, congruence and underestimation), the predominant situation in our study involves employee underestimation. A principal theoretical contribution of this study is the incorporation of service relational benefits to gap analyses, in order to clarify their role in predicting employees’ well-being, client satisfaction and quality of life of PIDs. The data also presented interesting observation that high supervisor trust may have undesirable impact on employees’ mental health. The findings presented above indicate that the distinction between clients and employees’ gaps is an important theoretical issue.

Considering the integral role that work plays in the well-being of people s (e.g., Kahn & Byosiere, 1992) and peoples well-being plays the important role for organization, e.g. turnover (Wright & Cropanzano, 1998), managers must be prepared to address and utilize interventions related to the type of service is provided by their employees. Organizations must focus more attention to bring in agreement perceptions of high quality service. Also it is important to increase the organizational experience of listening to clients and do monitoring of how far are disagreement in service quality evaluation. Also there is a need for effective and continuous training programs for the employees who work at centers of intellectual disabilities to learn how to cope with emotionally demanding communications with clients. In addition, supervisors should be trained to learn how to provide assistance for front-line employees to reduce emotional exhaustion. With particular focus on potential barriers organizations can overcome the problems related to divergence in perceptions and related to it issues.

The findings have several implications for future research related to the limitations of this study. Given that the samples in this study were restricted to mental care service centers, these type organizations are different from ordinary service organizations since this is a case when service users are less able to assess and evaluate service quality; and it is evaluated by their relatives (non-direct users of service). According to this argument the findings can’t be generalized and the present hypotheses need to be replicated in other service organizations. Also Future effort in this direction could contribute to a better understanding of service gap differences in terms of functional and relational dimensions, and how far differently they impact on organizations, clients, and employees.

Also it’s important to continue research in direction of factors which can moderate the service quality gap effects. One of the suggestions can be quality of life of persons with disabilities can moderate gap impact on clients’ satisfaction. Improving the life of PIDs can affect clients’ satisfaction level despite of the incongruence on service quality perceptions. Also we have to have in mind that in presented study service quality, organizational justice and quality of life all were evaluated from clients; we can consider that this is one of the limitations of the study. Future studies would be beneficial to collect data from multiple sources to minimize the potential threats. Supervisor trust role in emotional exhaustion also needs further investigation from different perspective; according to research conducted by Moliner1, Martínez-Tur, Peiró, Ramos and Cropanzano (2013) lowest levels of burnout of employees were observed in situations of perceived over-benefitted reciprocity in their relations with supervisors; also study conducted with hotel employees found that perceived organizational support can significantly impact on employees’ emotions (Karatepe, 2011). Having in mind that organizations and employees differ in the degree and the way to which they are perceive shared systems, structures and rules affecting their behavior (Greenwood & Hinings, 1996; Peiró & Martínez-Tur, 2008) we assume that future research can benefit to investigate the role of supervisor trust perceived by the employees. Also there is suggestion about time: since the service is no single time activity and it is continuous in time, service quality evaluation can be repeated over time, the impact of service quality gaps on organization facets could be followed at different temporal moments.

Presented study described service quality gaps and problems derived from them, evaluated by professionals and clients of Mental Care Centers. Study showed the disagreement in service quality perception among clients and employees. Employees’ experienced emotional exhaustion in situations of overestimation of service quality form employees. Service quality overestimation form employees occurred harmful for organizational satisfaction and also decreased the level of quality of life of PIDs. The findings in this study suggest some theoretical and organizational implications, as well as suggestion for future researches.

Endless improvement in ethics is anticipated to be an integral and routine part of the job of everyone in mental care area. The results of our research can be also used to improve structural aspects of mental care service organizations.

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