Determinants of customer-oriented behavior in a health care context

Abstract

Purpose – Nurses in hospital settings are a primary contact point and the way their behaviors are perceived by patients is a critical determinant of overall patient satisfaction. The purpose of this paper is to empirically test and extend knowledge of the determinants of customeroriented behavior (COB) of contact personnel in a high-contact service setting (healthcare industry). The paper contributes to the literature by examining two groups of constructs – dispositional variables (e.g. personality traits of the service provider) as well employee perceptions of service climate, mediated by surface traits and organizational commitment, on the dependent variable, COB of nurses in a hospital context. Design/methodology/approach – The study involved both qualitative (focus groups) and a large-scale survey, with a final sample of 270 nurses from five hospitals in Thailand. The dependent variable was a selfreported measure of COB. Tests for common method bias suggested however that this was not a problem. All measures were sourced from the literature and demonstrated sound measurement properties. The conceptual model was tested using structural equation modeling. Findings – Analysis supported the hypothesized model. Basic personality (extraversion, emotional stability, conscientiousness, and agreeableness) as well as customer orientation as surface trait (COS)

all impact either directly or indirectly, on nurses’ COB. Nurses’ perceptions of the service climate and their commitment to the hospital are also significant predictors. Research limitations/implications – Future research might attempt to obtain objective measures of nurses’ performance in lieu of self-report measures. Further, as the healthcare industry has very specific characteristics (high affect, high anxiety among patients, high customization, etc.) this model should be tested in a variety of service settings. For healthcare managers, the findings, especially related to basic personality traits, have important implications for the type of person that should be recruited. The adage “Hire for attitude, but train for skill” certainly applies here. Originality/value – The paper’s contribution lies in analyzing the impact that both basic personality (extraversion, emotional stability, conscientiousness, and agreeableness) as well as surface traits, have on nurses’ behavior; and simultaneously examining the impact of nurses’ perceptions of service climate and organizational commitment.