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Background: The paradigm shift in the locus of control in many health systems brought about by consumerism, makes it imperative for consumers of health services to be involved in setting agenda for quality improvement.. This study sought to identify service quality gaps in a public hospital using the clients’ judgement. Methodology: Sixty-eight consenting clients attending the State House Hospital, Yenagoa, were administered an adapted version of the SERVQUAL instrument to rate their expectation before and perception after the encounter with the practice. Negative gap scores indicated that the actual service (the perceived score) was less than what was expected (the expectation score) and thus requires some form of quality improvement. Criteria having high expectation scores from the clients were also of importance to the administrators of the facility. Result: Majority of the raters were married (71.2%) and female (55.9%). Significant gaps were elicited in clients’ desire for up-to-date equipment for patient care (-1.15); desire to be able to trust staff (-1.06) and feel safe with hospital’s employees (-1.11). All 5 dimensions showed some degree of inadequacies but none crossed the pre-set critical line. Majority of the clients showed general satisfaction with the performance of the hospital (88.4%), a likelihood of return (76.3%) and recommending to others (81.0%) Conclusion: The identification of symptoms of dysfunction in this organization through this instrument provided a starting point for the examination of underlying problems that inhibit the provision of quality service.

Setting agenda for quality improvement in a public hospital in Nigeria using the consumers’ judgement