ABSTRACT
Background and objectives: The hoteling quality promotion is part of the health system development plan, based on which the physical appearance of laboratories of public hospitals are improved and renovated. The present study aimed to evaluate the policy-making gap in the hoteling quality promotion of the health system development plan in providing laboratory services in public hospitals in the Golestan Province, Iran.
Methods: This descriptive-analytical and cross-sectional study was performed on 384 medical staff and physicians working in laboratories of public hospitals affiliated with the Golestan University of Medical Sciences, Golestan Province, Iran. Data were collected using a 35-item researcher-made questionnaire that was distributed and collected over a period of six months. We examined the extent of the gap between the current and expected status based on the two components: the alignment of key stakeholders with health system development policies and stakeholders' opposition to health system development policies, as well as the extent of the gap
Results: The hoteling quality promotion was about -0.05 in providing laboratory services in public hospitals of the Golestan Province, indicating a low gap between the current and favorable status in the fifth axis of the health system development plan in terms of supervision.
Conclusion: The implementation of the hoteling quality promotion plan in providing laboratory services in public hospitals of the province is not consistent with the expected goals of the fifth axis of the health system development plan. Therefore, there is a need to examine and eliminate effective factors contributing to this gap.
Keywords: Gap, Policy-making, Health system development plan, Hoteling quality promotion
 
INTRODUCTION
In recent years, the health system has evolved from a service-oriented approach to a satisfaction-oriented and hospitable approach that engages people emotionally. This ultimately leads to overall improvement of quality of care and increased customer loyalty (1). Hoteling (accommodation services) refers to hospital diagnostic laboratories, hospitality, services, and non-medical factors related to the patients' stay at hospitals, which starts from the time of arrival until discharge (2). An emotional experience for laboratory service recipients goes beyond the traditional model of service delivery, and this includes the analysis of data obtained by all five senses (3, 4). A satisfactory experience increases the chance of revisit and even recommendation of the center to others (5). Hospitality, hygiene, and friendly laboratory staff are factors that every patient is looking for in a medical laboratory (6, 7).
The expectations of patients and their families caused the principles of hoteling to reach health centers over time (8). In recent years, laboratories and medical facilities considered higher customer satisfaction, fulfilling patients’ expectations, and financial factors in the design of physical space. These non-medical factors require careful planning and principled thinking (9, 10). Research indicated that physical, functional, and human factors significantly affect the level of hoteling services, and successful laboratories provide high-quality services through regular management of these factors (11).
Any factor that affects clients' image of the laboratory is a functional factor. Physical factors include inanimate factors such as smell, noise, and image (12, 13). Facilities, patterns, lighting, and other sensory factors communicate with clients non-verbally. Human factors consist of behavior and appearance of laboratory service providers, such as speech, tone, self-esteem, and clothing. Functional factors refer primarily to the nature of services, while human and physical elements refer to the method of providing these services (14, 15). Given the importance of hoteling, the fifth axis of the health system development plan refers to the way of promoting the hoteling quality in the diagnostic laboratories of public hospitals. However, some shortcomings lead to a gap between the current and desired status in this regard. Therefore, the present study aimed to determine the gap between the current and expected status in promoting the hoteling quality according to the health system development plan for providing laboratory services in public hospitals of the Golestan Province, Iran.
 
MATERIALS AND METHODS
This descriptive-analytical and cross-sectional study was performed on all medical staff and physicians working in laboratories of public hospitals affiliated with the Golestan University of Medical Sciences, Golestan Province, Iran. Given the large study population, using simple random sampling and the Morgan table, 384 individuals were considered as the study subjects. Demographic information of the subjects were recorded. Data collection tool was a 35-item researcher-made questionnaire that was distributed and collected over a period of six months. Necessary approvals were taken from the authorities and written consent was taken from all subjects. We utilized the proposed framework of the Public Issue Management Book (2014) to study the gap between the current and expected favorable status in the fifth axis. In the model, we examined the extent of the gap between the current and expected status based on the two components: the alignment of key stakeholders with health system development policies and stakeholders' opposition to health system development policies, as well as the extent of the gap (low gap, no gap, high or low gap)(16) (Figure 1).


 
Data were analyzed with SPSS 22 using the Kolmogorov-Smirnov test, Cronbach's alpha test, and one-sample t-test.  All analyses were performed at significance of 0.05.
 RESULTS
Table 1 shows the demographic characteristics of subjects.
Table 1. The demographic characteristics of subjects

 
Given the normality of data distribution, we first classified the questions about the fifth axis of the health system development plan (hoteling quality promotion in providing laboratory services at public hospitals of Golestan Province) into two groups, namely the perceptions (current status) and expectations (favorable status) to review and answer the main research question. Then, we examined the research questions.
As shown in table 2, the axis of the hoteling quality promotion in the laboratories of public hospitals is equal to -0.05 in the health system development plan, indicating a low gap between the current and favorable status. Given the sum of the mean obtained in the current and favorable status, the intersection point of these two points on the gap matrix (Figure 2) shows a low gap between the current and favorable status related to supervision.
Table 2. The gap in hoteling quality promotion in laboratories of public hospitals in the Golestan Province