Level of burnout in staff, sustainable quality service and patient satisfaction in healthcare institutions during healthcare crisis

Since the serious global infectious disease COVID-19 pandemic started, hospitals received a surge of patience in an unprecedented way that affected both the quality of health care services and customers' satisfaction. Meanwhile, COVID-19 pandemic has been changing the levels of burnout in staff (Doctors, Nurses and supportive personnel). According to Tabash et al., good service has a beneficial impact on customer satisfaction (2019). Service quality is described by Parasuraman et al as offering great service and exceeding client expectations (1985). Satisfaction according to Laferty is the process of customer comments and evaluation about a product or service that this product or service meets their needs and expectations or not (2001). Burnout is a work-related stress syndrome resulting from chronic exposure to job stress; the term was introduced in early 1970s by psychologist Freudenberger and has subsequently been defined by Maslach et al. as consisting of three qualitative dimensions which are emotional exhaustion, depersonalization and reduced personal accomplishment (1981). Burnout can occur in any kind of profession (Leiter, 1996). The goal of this research is to investigate the level of burnout in staff, perceived service quality of patients, and patient satisfaction in healthcare institutions during crisis such as COVID-19 pandemic. The purpose is to highlight the link between the level of burnout in staff and patients' perceived service quality. The findings are expected to help in developing suggestions about how to have sustainable quality service and customer satisfaction at hospitals by decreasing the level of burnout in staff. In this study the author used Maslach Burnout Inventory Human Service Survey for Medical Personne which is developed by BojanaMatejic (2015) to investigate level of burnout in doctors, nurses and supportive staff also used SERVQUAL scale adapted by Arasli (2008) to investigate perceived service quality and patient satisfaction at three Public and three Private hospitals in Kabul, Afghanistan. The findings showed that the mean value of personal accomplishment was very high and the health personnel do not feel energetic, relaxed, calm and effective during COVID-19 pandemic. Similarly, they are experiencing emotional exhaustion but depersonalization mean values are not very high. The results of analysis showed that the health personnel working in public and private hospitals are significantly different in terms of personal accomplishment dimensions but, no difference was observed for emotional exhaustion and depersonalization. The burnout levels of doctors and nurses working at private and public hospitals are not different, but both groups suffer from high levels of burnout. The one way ANOVA result showed that the mean values for emotional exhaustion, personal accomplishment and depersonalization of doctors, nurses and supportive staff are significantly different. Post-hoc comparisons showed that doctors are in worse than both nurses and supportive staff in terms of emotional exhaustion and personal accomplishment but, in terms of Depersonalization they are better than nurses and supportive staff. For perceived service quality and patient satisfaction, after explanatory factor analysis a two factor structure is obtained which are human related and environmental related factors. It seems that Afghan patients evaluated the service quality in two mentioned dimensions. Patients do not blame health personnel who are working under high pressure during COVID-19 pandemic. They understand them. They rather take physical environment factor into consideration when they evaluate their satisfaction from the hospitals. The results of the analysis showed that the perceptions of patients in public and private hospitals are significantly different in terms of human relation and physical environment dimensions. The service quality in private hospital is better than public and patients are more satisfied with the services of private hospitals.