Gap Analysis for Department of Radiation Oncology, Deenanath Mangeshkar

Hospital, Pune

What is Gap Analysis?

Gap analysis is a market research technique used to identify and correct gaps between the clients expected
level of service and the actual or perceived levels of service provided. While originally developed to
measure gaps in client service delivery, the model can also be used to measure gaps in asset performance.

Gap analysis has significant application to asset planning in public sector organisations. It can be used at
a macro level, such as in an organisation wide service level review, or in a more specific application, as in
a review of building requirements or a particular service activity. By clearly identifying gaps in service
delivery or asset performance, the process of devising and prioritising solutions is made more objective
and quantifiable.

In this Quick Guide I examine the Department of Radiation Oncology of Deenanath Mangeshkar
Hospital, Erandwane, Pune.

Q. 1 Ask the Manager whether the organization suffers from any Gaps

As per my visit to the department, the concern person told me regarding the gaps they are facing. He
told me the conflict between the Patients (and their relatives) with the department staff. As the treatment
process in the department is very hectic and slow (because of the non availability of staff and inter
department conflict). Also. I noticed that, the patients are not so educated regarding the process before the
actual treatment.

Q.2 which factor does the manager consider most troublesome?

Obviously, patient should not switch over to other hospital. Because of the conflict between patient and
staff, hospital manager have to take care of under working staffs and even servants (attendants) by giving
performance rewards and taking a quality service for the patients.

Q.3 How does the company/hospital try to address these problems?

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According to manager, he told me that, they want to opt for the making of new polices for staffs and for
the Patients (including the relatives). Also they are present strategy of;

• Feed back form. (When patient gets discharge from the treatment/hospital, they give this feed
back form to patient and to fill the form to assess the overall treatment service to him/her in the
entire period)

• By taking rounds, at any time to assure that the overall process is in pace.

• Visit the patient and ask them that they are satisfied with the services is being offered. Else, if any
problem lies then trying to solve that particular problem as early as possible and make sure that,
patient will not suffer from that problem again and again.

• Staff problems solved by taking meeting once in the week.

• Also, encourage them to update their knowledge and services to the patient through various
(arranging classes, workshops, seminars, conferences, etc.) programs.

Q.4 If you were the Manager of the organization and wanted to close the gaps, which gap would

you start with and why?

If, I were the manager of the organization, I try to improve the quality of service and try to close the gaps
1 through 4 and keep them closed. The gaps model begins where the process of improving service quality
begins: - by gaining an understanding of the nature and extent of the customer gap given the strong focus
of the customer and need to use the knowledge about the customer/patients to drive the business strategy.

The centre horizontal line in the figure is the two boxes that correspond to the customer expectations and
customer perceptions. Customer perceptions are subjective assessments of actual service experiences;
customer expectations are the standards of, or reference points for, performance against which service
experiences are compared. Ideally, expectations and perceptions are identical: customers perceive that
they get what they think. In practice, a customer gap typically exists. Following are the steps I will
perform to close the gaps

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 Steps in performing a Gap analysis

1. Identify key aspects of performance as defined by Patients or not knowing what customer expect

2. Survey patient group or not selecting the right service design and standards.

3. Analyse results or not delivering to service standards.

4. Devise solutions to close gaps or not matching performances to promises.

5. Identify key aspects of performance as defined

It is important that gap analysis measure the aspects of service or performance that are perceived as
important by Patients or end users/occupants (patient relatives). Do not rely solely on management or
employee perceptions of what is important – find out from the Patient.

This is usually done using a series of focus groups in which a skilled facilitator elicits from small groups
of clients what they feel are the key aspects of service delivery or performance. The significance of each
key aspect will depend on the service context and the focus of the gap analysis. Gap analysis to analyse
building performance, tangibles will tend to predominate.

Key aspect of
Description
service/performance

Tangibles Appearance of physical facilities, equipment, personnel, and

communication material; quality of materials and products.

Reliability Ability to perform the promised service dependably and

accurately.

Responsiveness Willingness to help customers and provide prompt service.

Assurance Competence, knowledge and courtesy of employees and their

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 ability to convey trust and confidence.

Empathy Caring, individualized, and professional attention the service

provides its customers.

Survey patient group

A suitable sample of clients is surveyed using a self-complete questionnaire. The survey is designed so
that each key aspect identified in the focus group sessions is given an expectation / importance rating and
a perception / performance rating.

Analyse results

The average expectation / importance rating is then subtracted from the perception / performance rating.
This will reveal either a service / performance gap or a situation in which service / performance
expectations are being exceeded.

Devise solutions to close gaps

The survey instrument determines the critical gap between the patient’s service expectation and the
client’s perceived service levels – but what causes these gaps in the first place?
The gap between the patients expected and perceived service levels (known as Gap 5) is in turn caused by
gaps in other dimensions of service delivery – Gaps 1-4. By closing gaps 1-4, gap 5 should automatically
close. Solutions therefore should be aimed at closing gaps 1-4. It may be necessary to conduct further
gap analyses to clarify the specific nature of these gaps.

Gap 1 VS Actual or perceived service levels

Management perceptions of
patients/customer service

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 expectations

Management perceptions of
Service specifications (mandatory
Gap 2 patient/customer service VS
requirements/standards)
expectations

Service specifications

Gap 3 (mandatory VS Service delivery

requirements/standards)

External communications to
Gap 4 Service delivery VS
patients

Recommendations

• The ratio between gender and age varies unintentional age discrimination is being practiced
should be explored. A patient satisfaction survey is suggested.

• Promoting healthier life style is key to reducing the risk of disease, preventative measures are
necessary.

• Smoking cessation clinics need to be developed and ongoing help for the quitter to try to improve
the 12 month rate for quitting.

• Services should be located as close as possible to peoples’ homes and be designed to promote and
maintain independence. The majority of care should be delivered within a primary care setting
moving from the hospital setting, as care becomes more specialist and complex. Community
nurse led clinics are recommended providing better access to cardiac services for patients.

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• This information can then be used to measure need for access to treatment and preventative
services, as well as to audit the effectiveness of Primary Care service and Long Term Disease
management.

• Registrations should be treated with caution and initially data/data collection within the Primary
Care systems should be validated before comparing across different heath areas.

• Arranging seminars, conferences, workshops for the employees to enhance their skill and updated
knowledge of the service.

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