Development and validation of a new tool (TerHosQual) for assessing service quality in a tertiary care hospital

Background: Evaluating service quality (SQ) is an important consideration in the era of ever-increasing inflow of patients through medical tourism. This not only influences the satisfaction of customers but also their purchase intentions. Objective: The objective was to develop and validate a new tool (TerHosQual) for assessing SQ in a tertiary care hospital in Mysore, India. Materials and Methods: Initial tool consisting of 72 items was drafted by synthesizing literature review and inputs from subject experts. The items were segregated into 13 dimensions in consultation with three internal experts. Content validation was done by 12 subject experts. Based on their inputs, 21 items were deleted from the initial tool (8 items for lack of relevance, 6 items for lack of appropriateness, 3 items for lack of clarity of words, and 4 items for redundancy). Response process validity of the final tool consisting of 51 items under 13 dimensions was done using cognitive interview (retrospective verbal probing method). Test–retest reliability assessment was done on ten prospective participants to assess the reliability of the tool before pilot testing the tool on 30 participants. Results: It was found that the Cronbach's alpha if item deleted did not show significant improvement for any of 51 items in the tool as well as for 13 dimensions. The Cronbach's alpha coefficient for 51 items in the tool was 0.95 and for 13 dimensions, it was 0.87, indicating a high degree of reliability of the items in the tool under these dimensions. Conclusion: The pilot study demonstrated the feasibility of using this new tool in a tertiary care hospital while indicating the reliability of the tool. However, the tool needs to be further evaluated using a larger sample size and factor analysis to validate these results of the pilot study.