Impact of Consultants Performance with Special Reference to Retention and Patient Satisfaction

INTRODUCTION

The aim of any health care organization is to create satisfaction among users through its service quality. As patients are the main stakeholders within the health care system, therefore patient satisfaction is as an important measure for assessing health care quality. Patient satisfaction can be defined as the patients‘ feelings and their perception of delivered health care services. It has been observed that satisfied patients are more likely to follow medical advice and comply with treatment recommendation, thereby improve the outcome of care. Studies have shown that there is a direct association between quality of care and patient satisfaction levels. Patient satisfaction is not only a significant, effective, and widely used indicator for quality measurement in health care but also measures the performance of physicians and hospitals. At present, hospitals not only have to contend with the dynamics of regulation and market forces but most importantly they must deal with the issue of service quality. Consumers (patients) expect more and more of healthcare providers and demand higher and higher standards of care and service. Patient satisfaction has become a frequently used outcome measure of the quality of healthcare delivery. In that sense, satisfaction represents a positive appraisal of provided healthcare with respect to the client‘s goals and expectations. On the other hand, healthcare worker job satisfaction is a very important parameter that influences productivity as well as quality of work. This complex phenomenon is an attitude towards one‘s job that has an impact not only on motivation, but also on career, health, and relations with co-workers. Healthcare worker job satisfaction has a great impact on quality, effectiveness, and commitment to work and at the same time on healthcare costs. Many different studies have shown that there is a great number of factors which can have an impact on healthcare worker job satisfaction, such as: gender, age, level of education, work experience, the way in which work is organized, working conditions, and many others. The present study was planned to determine the Impact of Consultants performance with special reference to retention and Patient satisfaction.

Authoritative atmosphere was characterized in 1968 by Tagiuri as a "nature of the inside condition of an association that: (an) is experienced by its individuals, (b) impacts their conduct and (c) can

administration, this definition exhibits a few purposes of intrigue. Initially, the significance of authoritative culture and atmosphere in the association since it has been demonstrated that there is an imperative connection amongst them and hierarchical execution results (Schneider et al., 2002). Second, the idea is equivocally characterized, and it is imperative to perceive the contrast between hierarchical culture and authoritative atmosphere. Third, few investigations analyze the significance of the atmosphere in social insurance area and extra research is expected to comprehend this perplexing associations. Hierarchical atmosphere hypothesis is generally examined in modern and authoritative brain science. Koffka (1935) contemplated the conduct condition; Murray (1938) broke down the identity issues on a level of profundity and solidness normally discovered just in the work of the therapist or psychoanalyst. Lewin et al. (1939) broke down the connection between administration style and atmosphere. In any case, at the outset the theoretical meaning of authoritative atmosphere and estimation procedures were conflicting. It was not until 1958 when the term hierarchical atmosphere started to show up in administration writing with an examination made by Argyris (1958) about Some issues in conceptualizing authoritative atmosphere: Pritchard and Karasick (1973) investigated the legitimacy of a measure of atmosphere build, and they introduced information on the connection between atmosphere, work execution and fulfilment. They presumed that fulfilment relates emphatically with atmosphere observations and occupation fulfilment (Pritchard and Karasick, 1973). Be that as it may, Guion (1973) reason that authoritative atmosphere speaks to a fluffy idea and fortified atmosphere estimation frequently utilized similar instruments and procedures apply to work fulfilment examine. James and Jones (1974) distributed their work about authoritative atmosphere: An audit of hypothesis and research, where they characterized hierarchical atmosphere as a develop alluded to the way in which hierarchical individuals see the workplace inside that association and its effect on their individual mental prosperity. They prescribed make a separation between atmosphere respected to authoritative trait (hierarchical atmosphere) and atmosphere respected to an individual quality (mental atmosphere). (James and Jones, 1974) Schneider (1975) proposed an exposition about hierarchical atmosphere. He introduces a proof with respect to the significance of atmosphere, which alludes to the impression of the general population about their work settings, each work association most likely makes various types of atmospheres and is identified with the result conduct (measurement) A few examinations showed that individual employment fulfilment is identified with impression of parts of the rms hierarchical atmosphere (Johnson and McIntyre, 1998; Ostroff, 1993; Pierce et al., 1996). Among the predominant hierarchical atmospheres, moral atmosphere assumes a key part in building up the setting in which workers work (Trevino et al., 1998). Ebb and flow examine shows that one imperative element that may influence the moral conduct of representatives is the hierarchical moral atmosphere (Sinclair, 1993). Deshpande (1996) found that an association could influence its workers work fulfilment by cultivating the moral atmosphere.

Though this area has been covered with vast literatures availability but still the study in the Indian context as not been in plenty hence the study on Impact of Perceived organizational climate on medical consultant's performance in large size hospitals with special reference to retention and patient satisfaction will bringing the required insight and open further research opportunities in future.

The main objective of the study is to analyse the Impact of Perceived organizational climate on medical consultant's performance in large size hospitals with special reference to retention and patient satisfaction.

To Achieve this objective the following sub objective of this study has been identified: - 1) To ascertain the role of organization climate in Consultant‘s performance level and patient Satisfaction. 2) To Study the role of organizational climate and culture in improving the perceived consultant‘s performance. 3) To examine the factors helpful improving the organizational climate to enhance the patient satisfaction level. 4) To identify the factors affecting consultant‘s performance level for monetary and non-monetary based incentives. 5) To know how organizational climate has helped in consultant‘s retention and 6) To suggest innovations, based on the findings of the study for effective implementation of structured organizational changes to improve Consultant‘s Performance, retention, and Patient satisfaction level.

H00:There is no significant association in organizational climate and consultant‘s perceived performances. H01: There is a significant association in organizational climate and consultant‘s perceived performances. H02: There are no significant impact of organizational climate and culture on consultant‘s performance in large hospitals. H22:There are a significant impact of organizational climate and culture on consultant‘s performance in large hospitals. H03: There are no specific factors to improve organizational climate to achieve enhanced patient satisfaction level. H33: There are some specific factors to improve organizational climate to achieve enhanced patient satisfaction level. H04: There is no significant relationship between monetary and non-monetary incentives with consultant‘s performance. H44: There is no significant relationship between monetary and non-monetary incentives with consultant‘s performance. H05: Organization‘s climate does not impact consultant‘s retention and achieving perceived patient satisfaction level. H55: Organization‘s climate does not impact consultant‘s retention and achieving perceived patient satisfaction level.

Sample Universe: 30 Large hospitals were selected Mumbai & Pune region and considered as a sample universe.

The research was conducted using structured questionnaire and survey methods to understand the role of perceived organizational climates in consultant‘s performance, hence the different variables has been selected to achieve the accuracy in the study. The quantitative section will be tested using SPSS 21(Version). The tools will be Chi-square analysis for categorical variables and to find the associations. Factor Analysis (PCA) will be identified to find out the best possible factors.

When calculating the minimum sample for respondents, which was required to represent the universe, 90% confidence level and 5 confidence intervals was considered for total population of N = 950 healthcare workers in 30 large hospitals. Lastly, when the frequency about tenure is reviewed, it is possible to conclude that there is an almost equal distribution of the tenure between 1 to 10 years of work. The majority mentioned that they have been working in the same institution for more than 10 years (50.3%). Remaining population stated that they have been in the same organization for 5 to 10 years (25.4%) and 1 to 5 years (21.1%). Only a minority of the population mentioned that they have been in the same organization for only less than 1 year (3.3%).

Subsequently, correlations were checked to confirm the hypothesized relationship between independent variables and dependent variables.

perceived organizational performance.

According to correlation coefficients of organizational climate and organizational commitment, these two concepts have a positive relationship, which is found to have a moderate strength level of 0.452. Therefore, it is possible to accept that there is a positive relationship between organizational climate and organizational commitment and thus, this finding supports Hypothesis 1. When correlation coefficient of organizational climate and perceived organizational performance is reviewed, the relationship is found to be positive with a significantly high strength level of 0.671. Therefore, it is possible to accept that there is a positive relationship between organizational climate and perceived organizational performance, and Hypothesis 2 is supported with this finding. As an overall result, it is concluded that organizational climate has a positive linear relationship with organizational commitment and perceived organizational performance on moderate to high level of strength in terms of correlation coefficients. According to the results from correlation analysis, organizational commitment and age have a weak, positive correlation at 0,05 significance level (0,174). This can be concluded as older employees tend to have higher levels of organizational commitment.

The findings from the regression concluded that there is a strong influence of organizational climate on perceived organizational performance and a moderate influence on organizational commitment. By using the equations which were constructed by results of regression analysis, it is possible to predict how much influence does organizational climate respectively.

The results of the study provided critical information regarding the influence of organizational climate on organizational commitment and perceived organizational performance in four largest public hospitals included in the study. Results from the regression analysis suggested that organizational climate has an impact on predicting organizational commitment and perceived organizational performance of the consultants in hospitals based out at Mumbai & Pune. Organizational climate is found to be statistically significant in determining the organizational commitment of the employees. Continuously, there was a positive and linear relationship between these two variables.High satisfaction score has been found in this study in all domains of patient satisfaction (general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with the doctor, and accessibility and convenience). Mean satisfaction in the interpersonal manner and communication domain was highest and lowest in general satisfaction.

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Research Scholar, Sunrise University, Alwar, Rajasthan