Using SERVQUAL in health libraries across Somerset, Devon and Cornwall

© Health Libraries Group 2003

Health Information and Libraries Journal

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Blackwell Science, Ltd

Using SERVQUAL in health libraries across Somerset, Devon and Cornwall

Susan

Martin, Trust Librarian, South Devon Healthcare NHS Trust, Torbay Hospital, Torquay, UK

Abstract

This study provides the results of a survey conducted in the autumn of 2001 byten NHS library services across Somerset, Devon and Cornwall. The aim of theproject was to measure the service quality of each individual library and toprovide an overall picture of the quality of library services within the south-westpeninsula. The survey was based on SERVQUAL, a diagnostic tool developedin the 1980s, which measures service quality in terms of customer expectationsand perceptions of service. The survey results have provided the librarianswith a wealth of information about service quality. The service as a whole isperceived to be not only meeting but also exceeding expectations in terms ofreliability, responsiveness, empathy and assurance. For the first time, the tenhealth library services can measure their own service quality as well as bench-mark themselves against others.

Background to the study

Over the last two years ten health library servicesacross Cornwall, Devon and Somerset have beenworking together to provide an equitable libraryservice accessible to all health care professionals.All are staffed by qualified librarians andparaprofessionals between the core hours of9.00

–5.00

weekdays, and each libraryprovides self-service access during evenings andweekends. Paper-based and electronic resourcesare provided to the whole health community andservices range from traditional library activities,such as interlibrary loans, to teaching evidence-based practice and designing library websites tosupport staff at work and at home.

Working with the local Workforce DevelopmentConfederation, whose key role is to commissionand purchase education and training for clinical

staff, common service specifications have beendeveloped alongside service level agreements forindividual health organizations. Formula fundinghas been used to ensure that educational leviesare distributed equitably and Trusts have beenrequired to contribute in part to library services.

1,2

As a result, each library aims to fulfil its role asoutlined in HSG(97)47

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and to support recentNHS initiatives, including ‘Information for Health’

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‘the NHS plan’

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and the clinical governance agenda.To date, across the ten health libraries, there has

been relatively little common measurement of theeffectiveness and quality of these services, exceptfor the annual collection of statistics for the NHSRegional Librarians Group and the three-yearlyaccreditation cycle. It has been recognized thatthere is a need to use or develop new performancemeasurement tools.

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In autumn 2001, the ten health library servicesundertook to measure, as a group, the servicequality of their libraries for the first time. Servicequality has been defined as ‘the discrepancy betweencustomer’s expectations and perceptions’

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or ‘a

Correspondence: Susan Martin, Trust Librarian, South DevonHealthcare NHS Trust, Torbay Hospital, Lawes Bridge, Torquay TQ27AA, UK. E-mail: [email protected]

Using SERVQUAL in health libraries,

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function of what customers expect from anexcellent service and what they perceive is theperformance of the firm providing the service’.

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Methodology

In order to research ways in which service qualityhas been measured over the last decade, a detailedliterature search was conducted using LISA(Library & Information Science Abstracts) and byreviewing papers from the biennial NorthumbriaInternational Conference on Performance Meas-urement in Libraries and Information Services.One of the more commonly mentioned diagnostictools is SERVQUAL, a survey instrument designedby Berry, Parasuraman and Zeithmal in the late80s.

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Used extensively in retailing and marketing,it has now started to be tested in the library arenaand in particular in the academic sector.

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SERVQUAL aims to measure the gap betweencustomer expectations and perceptions in termsof five dimensions, namely tangibles, reliability,responsiveness, assurance and empathy. Tangibles,for example, includes the physical environmentand equipment, whilst assurance includes theknowledge of the library staff and their abilityto convey trust and confidence. Using a series ofstatements, which represent the five SERVQUALdimensions, respondents are asked to rate theirexpectations and perceptions of a particular aspectof the service on a Likert scale. Ideally, perceptionsshould meet or exceed expectations for a highquality service.

From reading the literature, SERVQUAL seemeda suitable tool with which to measure specificaspects of an individual library service and fromwhich to create a set of benchmarking data. Also,with no research on its usage, merits and problemsin the UK health libraries arena, it was consideredto be an ideal candidate to test.

The survey was drafted and tested with the tenlibrary services and the Regional Library Unit overa period of three weeks. Several questions wereadded or removed at the request of health librariansand a five-point Likert scale was chosen to measureexpectations and perceptions. One demographicquestion was included to measure whether thelibraries were being used by the whole range ofhealth professionals and an ‘additional comments’

section was also included, to allow users tocomment on any aspect of the service they wished.

Consideration was given to providing an elec-tronic questionnaire for those library users access-ing services online. However, trying to span tendifferent health networks with different intranet/internet policies was not feasible within the timeallotted to undertake and complete the survey. Asa result, it was decided that, for the first survey, thispart of the user population would be excluded,unless they were visiting or requesting informationfrom the library staff during the survey period.

The survey was sent out to each of the librarianswith detailed instructions on how to manage thesurvey. All agreed to start the survey on the samedate and to undertake opportunistic sampling oflibrary users. This meant that any person accessingthe service in any form would be sent a survey, orbe asked to complete a survey in person. The localWorkforce Development Confederation askedfor approximately one hundred returns from eachlibrary. It was estimated that it would take betweenone and two weeks to undertake the survey and afurther week to collate the information.

The survey was undertaken and completed inearly October 2001, with eight of the ten healthlibrarians reporting that the survey had beenundertaken without any difficulties. All ten librar-ies then received a pre-formatted spreadsheet ontowhich to input their data. The spreadsheets weresubsequently sent to the Librarian at South Devonfor individual and group analysis.

Results

All ten libraries provided data for individualanalysis, which was undertaken and fed back to eachof the services. However, data from two librarieswas excluded from subsequent joint analysis, astheir sample sizes were too small. One of these wasBodmin, a small satellite library, which was onlystaffed part time whilst the other, the library man-aged by North and East Devon Partnership NHSTrust, was not fully staffed during the survey period.

Response rates

All the remaining eight libraries were able tocomplete the survey within 10 days. A total of


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1216 surveys were distributed to library users and778 surveys were returned. The overall responserate was 64%.

Staff groups

84% of respondents indicated their professionalgroup on the survey form. As expected, across thelibraries, nurses, midwives, health visitors, medicaland dental staff form the main client base (Fig. 1).

Individually, four of the libraries have slightlyhigher medical and dental profiles, whilst in theother four libraries, nurses, midwives and healthvisitors figured larger. Allied health professionalsare using all eight libraries.

Quality of library service

Using the SERVQUAL diagnostic tool, users wereasked to rate from a list of 20 factors how essentialeach one was for ensuring an effective libraryservice. They were then asked to rate theirperceptions of levels of service given by theirlibrary. The combined results are detailed in Fig. 2and are indicated as columns on the two charts.

In most cases the health libraries exceedexpectations and provide an effective libraryservice. Customers perceive they are provided withservices right the first time, and at the promisedtime. The library staff understand the needs of theirclients and provide a prompt and courteous service.

From the joint analysis, the main areas of theservice that customers perceive to be of concern are:

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access to electronic library resources from workand appropriate IT equipment,

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comprehensive library catalogue,

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sufficient spaces for working,

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offering appropriate services and resources.

Benchmarking the individual libraries againstthe factors:

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Yeovil, Exeter, Plymouth and Cornwall arerated less effectively in terms of sufficient spacefor working. South Devon exceeds expectations.

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Taunton, Plymouth, Exeter and Cornwall arerated lower in terms of access to electronic libraryresources from work and appropriate IT equip-ment, whilst the electronic resources and IT onoffer at Northern Devon exceed expectations.

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South Devon, Cornwall and Plymouth are allrated lower than average in terms of comprehen-siveness of their library catalogues.

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Northern Devon is rated higher than average interms of offering appropriate services andresources compared with all the other healthlibraries in the south-west peninsula.

Non experiences and comments

Users were also asked to record where they had noexperience of a service and to supply additionalcomments about their particular library service.

Respondents overall had least experience ofaccess to electronic library resources from home,with all the libraries reporting that this was themost common ‘non experience’. The second mostcommon ‘non experience’ was access to otherhealth libraries. This is not surprising given thelarge distances between most of the health librar-ies and the dispersed, largely rural population.

A total of 173 users made comments about theirlibrary services. Over half were positive, withcomments from ‘Excellent, consistent service—very prompt and staff are well informed’ to ‘Verygood and efficient library service.’ Of the remainingcomments, the issue of inadequate resources cameup across all eight libraries. Mostly, commentsconcerned books and journals and some respondentsmentioned inadequate IT resources. Only twocomments were received regarding the design ofthe survey. One commented that the layout waspoor whilst the other found it ‘difficult to understand’.

Ranking of the service

As part of the survey, respondents were alsoasked to allocate 100 points against five factorspertaining to library services. In total, only 84% of

Figure 1 Breakdown of respondents by staff group across the eight libraries


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respondents managed to complete this part of thesurvey. Whilst all had filled it in, some had allocated100 points to each factor or had not managed toallocate 100 points across the five factors. For thepurpose of this analysis, they were excluded.

The combined results and the individual ana-lysis of the eight libraries show that most factorsare seen to be of equal importance, with only theappearance of the libraries being substantially lessimportant (Fig. 3).

Figure 2 Service quality dimensions


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Discussion

From the joint analysis of the data, it can be seenthat there is multi-professional use being made ofthe health libraries in Somerset, Cornwall andDevon. The libraries are providing a high qualityservice in terms of reliability, responsiveness,empathy and assurance. Customers expect andvalue a professional service, and the libraries,with their common standards and servicespecifications, are able to provide a consistentlyhigh quality service across the peninsula.

With the exception of one library, all the healthlibraries have service quality issues with regard toaccess to computers at work and/or library stock.Northern Devon is the only library to exceedexpectations in all these areas and it is noticeablethat they are the only library that is perceived tobe offering appropriate services and resources. Itseems it is no longer sufficient to provide 24-haccess to appropriate resources and even provideconvenient hours of staffing. Customers expectto have access to appropriate IT and electronicresources from within their workplace.

The issue of ‘non experience’ of electroniclibrary resources from home is a useful reminderthat, although a large amount of money is spent insupporting these types of services, some parts ofthe health community may not choose or be ableto access services and resources in this way. It isclear that paper-based services and resources stillneed to be provided and access to IT at work andhome monitored carefully.

Finally, with regard to the survey itself, it waseasy to administer and it provided a high responserate over a relatively short period of time. Datainput was straightforward once the spreadsheet

was designed and individual and joint analysistook about 30 hours to complete. In hindsight itwould have been more useful to list the staff groupsin a more prominent position on the survey, inorder to elicit a higher response. Also, the ‘rankingof service’ question should have been redesignedto ensure more respondents could have filled it insuccessfully. In addition, careful consideration needsto be given to producing future electronic-versiononly SERVQUAL surveys, given the lack of accessto IT within the various health communities.

Conclusion

The SERVQUAL instrument has been a usefuldiagnostic tool. It has proved to be effective inproviding a snapshot of the service quality of thelibraries in Somerset, Devon and Cornwall. Forthe first time, the librarians have been able to studythe service quality gap for different aspects oftheir service. They can also now compare theirperformance against that of another library andmeasure themselves against the whole peninsula-wide service.

From undertaking the first large-scale surveyacross the south-west peninsula, the aim is torefine the tool further and repeat the survey in thefuture. In the meantime, other performance meas-urement tools and methods will be used to reviewnon-usage of libraries, as well as the impact of newteaching initiatives on local health communities.In the long term, the aim is to develop and makeuse of several different performance measurementtools, which can measure the effectiveness and thequality of library services. The SERVQUAL toolfor the ten health library services has provided auseful beginning.

Acknowledgements

Thanks to Laura Coysh for providing assistancewith the literature search and design of the survey.

References

1 Cornwall & South Devon Education Purchasing Consortium. Library Review Project Steering Group.

Access to the Knowledge Base: Health Libraries for a New Millennium: a Strategy for Cornwall and South Devon

. Dartmouth: Dart Publishing 1999.

Figure 3 Ranking of service for the eight health libraries


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2 Somerset & North Devon Education Purchasing Consortium. Library Review Project Steering Group.

Access to the Knowledge Base in Somerset, North and East Devon

. Plymouth: Somerset and North Devon Library Review Project 2000.

3 NHS Executive.

Library and Information Services

. London: NHS Executive 1997,

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(97) 47.4 Burns, F. Information for health: an information strategy

for the modern NHS 1998–2005: a national strategy for local implementation. Leeds: NHS Executive 1998.

5 Department of Health.

The NHS Plan: a Plan for Investment: a Plan for Reform

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6 Hewlett, J. Performance indicators in NHS libraries.

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, 245–53.7 Zeithaml, V. A., Parasuraman, A. & Berry,

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Delivering Quality Service: Balancing Customer Perceptions and Expectations

. New York: Free Press 1990.8 Nitecki, D. A. Assessment of service quality in academic

libraries: focus on the applicability of the SERVQUAL.

Proceedings of the Second Northumbria International Conference on Performance Measures in Libraries and Information Services

. Newcastle: University of Northumbria 1998, 181–96.

9 Zeithaml, V. A., Parasuraman, A. & Berry, L. L.

Delivering Quality Service: Balancing Customer Perceptions and Expectations

. New York: Free Press 1990.10 Hernon, P. & Altman, E.

Assessing Service Quality: Satisfying the Expectations of Library Customers

. Chicago: American Library Association 1998.

11 Crossno, J. E., Berkins, B., Gotcher, N., Hill, J. L., McConoughey, M. & Walters, M. Assessment of customer service in academic health care libraries (ACSAHL): an instrument for measuring customer service.

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paradigm: using SERVQUAL to measure library service quality.

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Appendix 1

The ten health libraries, although based in individual Trusts,serve their own local health communities. The health librariesin Somerset, Devon and Cornwall are:• Cornwall Healthcare Trust (based at Bodmin, and a satellite

library managed by Royal Cornwall Hospitals NHS Trust);• East Somerset NHS Trust;

• Exeter and District Community Health Services NHS Trust;• Northern Devon Healthcare NHS Trust;• Plymouth Hospitals NHS Trust;• Royal Cornwall Hospitals NHS Trust;• Royal Devon and Exeter Healthcare NHS Trust;• Somerset Partnership NHS and Social Care Trust;• South Devon Healthcare NHS Trust;• Taunton and Somerset NHS Trust.

Documents

Using SERVQUAL in health libraries across Somerset, Devon and Cornwall