Analysis of Nursing Service Quality Gaps and Improvement Strategies in VIP General Wards Based on Patient-Reported Outcomes

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2026-09-15 DOI:10.1111/jep.70599

Xueyan Luo, Jianying Li, Xi Liu, Jiaying Liang, Xiaoxian He

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Abstract

Background

In the context of patient-centered healthcare, VIP wards are becoming increasingly common due to their commitment to an excellent service experience. This study aimed to investigate the associations between nursing service quality, patient-reported health status, and patient satisfaction in VIP wards.

Methods

A single-center retrospective cross-sectional secondary analysis was conducted from January 2025 to March 2026, involving 266 discharged patients from the VIP general ward of a tertiary hospital in China. All primary study outcomes were patient-reported. The five-dimensional service quality (SERVQUAL) scale was used to assess nursing service quality gaps, the patient-reported outcomes measurement information system 29-item profile (PROMIS-29) scale was used to evaluate patient-reported outcomes (PROs), and overall satisfaction, along with socio-demographic information, was collected. Data were analyzed using descriptive statistics, analysis of variance, correlation analysis, and multiple linear regression.

Results

Among 266 participants, a significant gap existed between patients' expectations and perceptions of nursing service (overall gap score: −0.45 ± 0.61), with the largest gap found in assurance (−0.63 ± 0.85; paired Cohen's d_z = −0.74), indicating a moderate-to-large standardized discrepancy. Patients reported lower physical function and higher anxiety, fatigue, and sleep disturbance than the general population reference. Patients who opted for the VIP payment package reported significantly smaller gaps in reliability, responsiveness, and assurance than patients using other payment methods, but no significant differences were found among the three payment groups across the seven PROMIS-29 domains or pain intensity. Multiple regression analysis revealed that the empathy deficit (β = −0.447, 95% CI −0.562 to −0.333, p < 0.001) and anxiety level (β = −0.299, 95% CI −0.424 to −0.174, p < 0.001) had the largest standardized coefficients; the reliability deficit (β = −0.226, 95% CI −0.347 to −0.106, p < 0.001) and sleep disturbance (β = −0.124, 95% CI −0.223 to −0.024, p = 0.015) were also significant, whereas the remaining candidate variables were not. Importance-performance analysis (IPA) identified four high-importance, low-performance items including ‘Individualized attention’, ‘Sufficient nursing knowledge’, ‘Nurses willingness to help’, and ‘Patient safety’, as priority areas for improvement.

Conclusion

In VIP wards, there is significant room for improvement in nursing service quality, particularly in the empathy and assurance dimensions. Use of the VIP payment package was associated with a more favorable service-process experience in selected dimensions but was not associated with better patient-reported health status in this cross-sectional study. Targeted improvement should focus on individualized communication and anxiety management, supported by appropriate nursing training and organizational resources. Because this was a single-center cross-sectional study, these findings should not be interpreted causally and should be generalized cautiously.

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基于患者报告结果的重症普通病房护理服务质量差距分析及改进策略

背景：在以患者为中心的医疗保健背景下，VIP病房越来越普遍，因为他们致力于提供优质的服务体验。本研究旨在探讨重症病房护理服务质量、病人健康状况及病人满意度之间的关系。方法：对某三级医院VIP普通病房2025年1月至2026年3月的266例出院患者进行单中心回顾性横断面二次分析。所有主要研究结果均由患者报告。采用五维服务质量（SERVQUAL）量表评估护理服务质量差距，采用患者报告结果测量信息系统29项概况（promiso -29）量表评估患者报告结果（PROs），并收集总体满意度以及社会人口统计信息。数据分析采用描述性统计、方差分析、相关分析和多元线性回归。结果：266名参与者中，患者对护理服务的期望与感知存在显著差距（总差距得分：-0.45±0.61），其中安全感差距最大（-0.63±0.85；配对Cohen’s d_z = -0.74），表明存在中等到较大的标准化差异。与一般人群相比，患者报告的身体功能较低，焦虑、疲劳和睡眠障碍较高。与使用其他支付方式的患者相比，选择VIP支付方案的患者在可靠性、响应性和保证方面的差距明显较小，但在7个promise -29域或疼痛强度方面，三个支付组之间没有发现显著差异。多元回归分析结果显示，护理人员共情缺失（β = -0.447, 95% CI = -0.562 ~ -0.333, p）显著提高了护理服务质量，特别是在共情和保证两个维度上。在本横断面研究中，VIP支付套餐的使用与选定维度中更有利的服务过程体验相关，但与患者报告的更好的健康状况无关。针对性的改善应侧重于个性化的沟通和焦虑管理，并辅以适当的护理培训和组织资源。由于这是一项单中心横断面研究，这些发现不应被解释为因果关系，应谨慎推广。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.