Service Blueprint Service blueprinting is defined as a tool for simultaneously depicting the service process
- 1. Service Blueprint: Service blueprinting is defined as a tool for simultaneously depicting the service process, the points ofcustomer contact, and the evidence of the service from the customer’s point of view. Service blueprints can be used to better deliver a successful customer experience. The proposed blueprintallows for a quantitative description of critical service elements, such as time, logical sequences of actions and processes, also specifying both actions/events that happen in the time and place of the interaction (front office) and actions/events that are out of the line of visibility for the users, but are fundamental for the service. Chosen Service Industry - Hospital Industry. Khulna Medical College Hospital The Khulna Medical College (KMC) is a teaching facility within the Khulna Medical College and Hospital that was established in 1992 in Bangladesh. It is located in the city of Khulna, near the inter-district Bus Stand at the entrance to the city. Khulna Medical College was established in 1992. With only a few students and little infrastructure initially, KMC began training undergraduate students. Post-graduate training was also given at the College. The College is affiliated to the Bangladesh College of Physicians and Surgeons. Facilities for academics, research and residency are available. Some students from the institution have already completed post-graduate degrees in various fields. The current principal is Professor Mahabubul Mohammid. The sequential procedure for the service blueprint for Khulna Medical College Hospital was obtained by interviewing intern Dr. Ratna Roy, Khulna Medical College.
- 2. Physical Evidence: Services being intangible, customers often rely on tangible cues, or physical evidence, to evaluate the service before its purchase and to assess their satisfaction with the service during and after consumption. Elements of the services cape that affect customers include both exterior attributes (such as parking, landscape) and interior attributes (such as design, layout, equipment, and decor). General elements of physical evidence are shown in the blueprint. They include all aspects of the organization’s physical facility (the services cape) as well as other forms of tangible communication. These are the props and places that are encountered along the customer’s service journey. It’s a common misconception that this lane is reserved for only customer-facing physical evidence, but any forms, products, signage, or physical locations used by or seen by the customer or internal employees can and should be represented here. Hospital parking: Here the hospital premises is used as parking lot which is creating problem while transporting patients in and out of the hospital. Both private cars and ambulance are kept on the footpath in front of the hospital which is creating problem in the movement of general public. Ambulance: There are two government ambulance. Patient can call the ambulance over telephone. Number of the hospital is 041-761509. Stretchers/ wheel chair: There are around 20-22 stretchers in the hospital and it is used when the patient is unable to walk or so much sick that he/she can’t move. In the orthopedic department there are some wheel chair which is used for the patient’s movement. Registration desk: In outdoor patient department patient come and collect ticket for specialist department by telling the problem, name, age. The price of the ticket is much lower and the price is same for all the department which is TK.10 per ticket.
- 3. Special department desk: After collecting the ticket from the registration desk patient goes to the specialist department with the ticket and submit the ticket to the attendant to the desk who register the information (name, age, registration number, date & serial number) of the patient into the register book. According the serial number in the register book patient is allowed to consult the doctor. Consultation room: After preliminary history taking and examination of the patient by the medical officer in the outpatient department, critical cases are referred to the residential medical officer (RMO) for superior consultation. Here the RMO takes detail history and examines specifically then refer the critical cases to in patient department for admission. Examination room: Two types of patient are examined in the examination room before admitting them in the patient department. One group comes by referral from the outpatient department and another group comes directly to the in-patient department with acute problems. Medicine shop: The selected drugs sponsored by the government are delivered from here. To collect drugs, one have to show the ticket signed by the doctors attending patients. As these drugs are free of cost, this medicine shop plays a great role in the treatment of general public who are unable to buy the drugs. Laboratory: Base level blood and urine examination are done in the hospital pathology department. There is also a blood transfusion department which is recognized in Khulna for its blood transfusion service. Patient’s cabin:
- 4. There is around 40 cabins for patients. Each cabin has two beds (one for the patient and one for the attendant) one side table, one dressing table, one table, one chair and an attached bathroom. In addition to cabin there is also 40 pain bed on the third floor. Hospital infrastructure: Though it was established with 250 beds in 1992, in mid-2008 it was upgraded to a 500 bed hospital. As the initial infrastructure was planned for a 250 bed hospital after upgrading the hospital to 500 bed the infrastructure becomes insufficient. This situation is same in case of manpower. Customer action: For getting service customers need to do some activities which are called customer actions. Any service can be failed by customers miss leading activities. For that reason customer also need to be careful about these actions. In Khulna medical college hospital a general patient or customers has to do the following actions- Arrival at hospital: For getting treatment, at first patient need to come to the hospital. This is the first action after which the service process is started. Help from staff: There are several staffs within the hospital. A patient can ask for help from anyone. In general, every staff knows how to get service form hospital. Tell health problem: Patient have to tell their specific health problem to the staffs so that they can inform them about the service accordingly. All we know that there are different doctors for different diseases. So the health problem should be very specific to get better treatment. Go to specialist: Patient go to specialist for different diseases. Specialist notes their problems and prescribes treatment and medicine. They can ask for different test for understanding the problem more deeply.
- 5. Go to consultation room: Patient who needs advice for specific problem can go to the consultation room. Some diseases are not fully cured and for that reason patient need advice to control these diseases from getting severe. For this type of diseases consultation is necessary. Go to examination room: In this room patient’s body is examined by different medical equipment. In this room sample like blood, urine etc. is also collected for testing. Disagree to continue: Sometimes patient do not agree to continue lengthy service process. This is actually the failure of service delivery system. Customers’ disagreement for future processing explains the dissatisfaction of customers. Customers may go to other service providers for better service. Agree to continue: If the patient agrees to continue the service then he/she will go for future processing like therapy, operation etc. which are suggested by the doctors or specialist. In this stage patient get faith on doctor and also get experience about the service. Buy medicine required: If the patient agree to continue the service then she/he may need to purchase some medicine or other required things according to the suggestion of the doctors. To collect drugs, one have to show the ticket signed by the doctors attending patients and the medicine are free of cost. Those supplies can be purchased from inside store or outside store of the hospital. Leave the hospital: After getting required service patient will leave the hospital with satisfaction or dissatisfaction along with a lot of experience.
- 6. Front Stage /On Stage Activities: Service blueprints clarify the interactions between customers and employees and how those interactions are supported by additional activities and systems backstage. It is called line of interaction between customers’ action and employees’ front stage actions. Because they show the interrelationships among employees’ roles, operational processes, information technology, and customer interactions .Blueprint can facilitate the integration of marketing, operations and human resource management within an organization. In this assignment we are showing a blueprint of Khulna Medical College Hospital, Khulna. So we are giving details about the front stage activities of this service organization. Processregistration: When a patient will come into the hospital, he/she needs to tell health problem to the person who is available in the process registration desk. It is the first interaction step with the employees. He/she has to give all the primary information to the registrar such as name, address, main problem of health etc. Sometimes this place is called outdoor department where patients come to get treatment. Most of the time patients have to wait in a long queue for registration. Often there create noise in the queue for breaking serial. Processregistration: Again when a patient will go to the special department (like eye, brain, heart etc), he/she need to make further registration for getting the opportunity of meeting doctors. It is not so common all the time in the entire department. Here they have to give detail information about themselves. Doctor notes problem: Getting information from process registration desk. It is easy to find out the consultation room which is needed for patient’s specific problem. Patients go to the consultation room for their particular health problem. Here he/she gives detail information about his/her health problem. Their problem is seriously and meticulously diagnosed. It is a very important place
- 7. for every patient. Most of the remedy depends on the best diagnosis .Doctor diagnosis problem and also notes the problem for giving future advice to the patients. Problem area exam and follow up date for: Patients are given a follow up date for future consultation. They are also given some different type of body test to be sure about their exact health problem. Patients will come to the follow up date carrying their test result so that it would be easy for doctor to make sure the medicinee which will be perfect for the patients. Staffs collect sample follow up date for report: When patients go to the examination room they have to wait sometime because of the waiting queue. It is luck if they get a small waiting queue. Staffs who are available in the examination room they take different sample of testing like blood, urine, cough etc. It is very rare to give report of the test immediately because some time are needed for testing .Besides this as there are a long queue it is not possible to give report at that time. So the staffs give a follow up date to collect the report. Dr. Readreport and examine patient: Collecting the exam report at the follow up date patients come to the doctor at the pre specified date. In this day doctor read the report thoroughly and examine the report to find out which is the actual problem of the patients. Here, doctor give the actual suggestions for patients and give some advice for them. Treatment prescribed: Doctor gives a prescription where all the treatment for patients is written. Some medicine, physical exercises are advised by doctor in the prescription. Doctor makes an overlook to the medicine purchased by patients which are prescribed. Doctor gives a follow up date to see the progress by using those treatments. Note recoveryprogress: When patients come at the follow up date doctor makes notes of all the recovery progress of the patients’ health problem with previous and present. Here, doctor gives necessary advice and treatment for patients .If the health problem condition is better they are not given any
- 8. follow up date. But if the health condition is not so much better they are given follow up date and sometimes also given some test to see the present condition of health. Line of visibility: It separate the on stage from back stage action. Everything that appears above the line of visibility can be seen by the patients, while everything under the line of visibility is invisible for the patients. Below the line of visibility, the blueprint identifies key actions that should take place to ensure that each front-stage step is performed in a manner that meets or exceeds those expectations. Backstage contact persons: The steps and activities that occur behind the seen to support on stage activities. Dr. makes provisional diagnosis: In on stage after conducting general and systemic examination if the doctor thinks then he referred the patient for provisional diagnosis. The doctor who conducts the diagnosis is backstage person with whom the patient has no direct interaction. Various kind of examination is done here according to the patient need such as ECG, Eco, X-ray, city scan, urine test, and blood test, ultrasound etc. Conduct mentioned test: From on stage staff collected blood and urine sample are tested in the pathology department. And other prescribed test by doctor also conducted in related test department. The tested sample are kept in form of report. In some cases patient’s presence is required to test the patient such as x-ray, ultra sound. Responsible person take necessary steps to conduct the test. Preparation of report: After testing the sample the authorized person prepare report based on the result of the test. This report send to the doctor for diagnosis the patient health problem. People who conduct the test are expert for preparing this report. This report is supplied in the hospital report form.
- 9. Dr. Make final diagnosis: Doctors check the report to identify the patient problems. Doctor identify the patient’s problem based on the conducted test. In some cases doctor only hears the patient’s problem symptoms. Based on this doctor provide some general treatment where the diseases is not complex. On the hand when test required to identify exact problem, they prescribed the test. Then they give proper treatment to the patient’s for the cure of diseases. Doctors prescribe the patient medicine to take for their diseases. Further diagnosis: In some complex cases further diagnosis is required to test complex health problem. Sometimes doctors make further diagnosis to check the patients to become assure the exact problem if needed. Some patients suffer complex diseases. Further diagnosis may require to check the special problem. Line of internal interaction: This separates conduct employee’s activities from those of other support activities and people. The ‘internal line of interaction’ separates the contact employees from the support processes. These are all the activities carried out by individuals and units within the hospital who are not contact employees. These activities need to happen in order for the service to be delivered. Support processes used throughout the service delivery: The fourth critical component of a service blueprint is the “support processes” that customer contact employees rely on to effectively interact with customer. Documented below the line of interaction, these are the actions that support the service. These processes are all the activities contributed by employees within the company who typically don’t contact customers. These need to happen, however, to deliver the service. Clearly, service quality is often impacted by these below-the- line of interaction. Registration system: In the registration system patients personal information is recorded. This information is stored in hospital registration book. And a registration form also supplied to the patient. Patient’s name, address, contact number etc. are kept in the registration form. In the
- 10. registration system, different department information is kept separated. Patient’s problem, mentioned test, prescribed medicine is also recorded for further access. Provisional diagnoses become final diagnosis: Doctor’s provisional diagnosis become the final diagnosis of patient problems. This is final report of the patient’s problem that inform to the patients. Also this final diagnosis send to the register for recording the patient’s information in the hospital record. Patient detail record: After collecting the information from provisional diagnosis, test conducted, prepared report, final diagnosis of the doctor, register keeps a detail record of patient. This record help to identify the patients if needed. This information include the patient name, address, contact information, patient problem, doctor’s information who check the patient, prescribed medicine, date of admission in and release from the hospital. Preparation of bill: After making all diagnosis and providing proper treatments and prescriptions, if needed the doctor can suggested the patients to admit in the hospital or release himher from the hospital. When there is no need to admit in the hospital, register prepare bill against the service provided based on patient record of service delivered. After the bill prepared the bill transferred to the patient. Patients submit their bill to the person who responsible for taking the charge and leave the hospital. A good blueprint should draw attention to points in service delivery where things are particularly at risk of going wrong. From a customer perspective, the most serious fail points, marked in our blueprint by are those that will result in failure to access or take the core product. Reasons for service failure: 1. Hospital parking: He re the hospital premises are used as parking lot which is creating problem while transporting patients in and out of the hospital. There is no specific parking lot. There is no responsible person for this specific task who can manage the movement of car in front of the hospital. Both private cars and ambulance are kept on F
- 11. the footpath in front of the hospital which is creating problem in the movement of general public. 2. Ambulances: There is only two government ambulance for hospital service purpose which is not adequate enough. Both of the ambulance is old and not equipped with modern technology and unable to gain customer satisfaction. The hospital has to hire ambulance from private organization. Those hired ambulance do not follow any rules and regulation of the hospital. This create serious problem for serious patients. 3. Stretcher/wheel chair: There are 20-22 stretchers which is not adequate for such a large hospital. In orthopaedic department most of the admitted patient need wheel chair but the number of wheel chair is not sufficient for serving the patient. 4. Consultation room: In the consultation room most of the time the specialist is absent and only on RMO is responsible for consultation but many patient wait for consultation. So the manpower is inadequate. 5. Consultation room: For the shortage of technical person patient have to wait a long time for conducting the test. Which create dissatisfaction among the patients. 6. Patient cabin: In comparison to the number patient the number of cabin is insufficient. The cabin has capacity for admitting two patient but because of the shortage of the cabin 9-10 patient are admitted sometimes. There is only one attached bathroom in each cabin and this is used by all those patient which is very much unhygienic. The floor and overall environment inside the cabin is so much unhealthy. 7. Most of the wards in the hospital have admitted patients more than two or three times their capacities. Doctors and nurses often get embroiled in disputes with family members and relatives of patients in the overcrowded wards. 8. Hospital Infrastructures: The hospital is unable to provide necessary service due to various problems, including inadequate manpower and equipment. The air conditioner which was set up in the operation theatre of the hospital has long been out of order. In some wards of the hospital there has been a crisis of electric fans and lights. The
- 12. whole inside environment of the hospital is dirty and unhygienic and there is shortage of manpower for cleaning and maintaining the hospital. Signage in the building that is confusing. 9. Help from the staffs: There is no responsible person for giving information to the patient about service process. There are some brokers who misguide the patients and charge higher price. 10. Buy supplied requirements: Patients can collect medicine from the medicine shop of the hospital. Only the government sponsored medicines are available there. But most of the doctor prescribed medicine are not available. For this patient have to go outside for their prescribed medicine. decreasing waiting times for elective surgery and emergency department care improving access to services streamlining our services to achieve better value for money valuing the views of our patients and staff working smarter and using resources more wisely.