Thesis Paper

On

Employee Performance & Satisfaction of

Padma Diagnostic Center LTD.

Prepared by
Tanzina Islam
ID: 802031020
EMBA Batch 31
Department of International Business
University of Dhaka

Date of Submission: 16 July, 2023

July 16, 2023

Dr. Aditi Shams

Associate Professor
Department of International Business, University of Dhaka.

Madam:

Subject: Submission of Thesis titled ‘Employee Performance & Satisfaction of Padma Diagnostic
Center LTD.’

I have the honor to state that I have prepared this report as part of our course requirement. I am
submitting this report as a requirement of completion of the thesis course for EMBA Batch 31 in
the Department of International Business, University of Dhaka. The report was prepared under the
guidance and supervision of Dr. Aditi Shams, Associate Professor, Department of International
Business, University of Dhaka. Without her guidance it would not be this easy to prepare this
report so smoothly. The organization I chose for the report is Padma Diagnostic Center Ltd.
Though we are on the learning curve, this thesis report has enabled me to gain insight into the
healthcare industry and the organizational activities of institutions involved in the industry. It was
an extremely challenging and interesting experience and it has given me a plethora of knowledge.
Thank you for your supportive consideration for formulating an idea. I have tried my utmost to
complete the report within accordance to the desired requirements. However, should any additional
information be required, I would be honored to oblige.
Lastly, I would be thankful once again if you please give your judicious advice on the effort.

Sincerely,

_____________________
Tanzina Islam
EMBA Batch 31
ID: 802031020
Department of International Business, University of Dhaka

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 Acknowledgement
While the writing of this report has been difficult, the preparation for writing has been even harder.
It certainly would not have been possible without the help of many people. I would like to express
my gratitude to all the people that were involved both directly and indirectly in the preparation of
this report.

First and foremost, I extend my sincere gratitude to my research supervisor and esteemed teacher,
Dr. Aditi Shams, Associate Professor of International Business at Dhaka University. Her
invaluable guidance, support, and supervision played a pivotal role in shaping this research project.
Without her expertise and mentorship, this endeavor would not have been possible.

I would like to extend my sincere thanks to the research informants who actively participated in
this study, especially the workforce of Padma Diagnostic Center Ltd. and the management team.
Their willingness to share their insights, valuable opinions, and dedicated time greatly facilitated
the data collection process. I am truly indebted to them for their cooperation and assistance.

Finally, I would like to extend my sincere thanks to the Department of International Business at
University of Dhaka for providing me with the opportunity to conduct this research and gain
practical knowledge through my thesis. The department's academic environment and resources
have been instrumental in shaping my research skills and academic growth.

Once again, I express my deepest appreciation to all those mentioned above, as well as anyone
else who has supported me in any capacity during this research journey. Your contributions have
been invaluable, and I am truly grateful for your assistance.

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 Table of Contents
List of Figures ................................................................................................................................ vi

List of Tables ................................................................................................................................. vi

Abstract ......................................................................................................................................... vii

1.0 Introduction ............................................................................................................................... 2

1.1 Background & Motivation .................................................................................................... 2

1.2 Research Objectives .............................................................................................................. 3

1.3 Scope of the Study ................................................................................................................ 3

1.4 Limitations ............................................................................................................................ 4

2.0 Literature Review...................................................................................................................... 6

2.1 Performance Evaluation ........................................................................................................ 6

2.2 Employee Satisfaction .......................................................................................................... 9

3.0 Theoretical Framework ........................................................................................................... 13

3.1 Performance Evaluation: Healthcare Balanced Scorecard ................................................. 13

3.2 Satisfaction Evaluation: Periodical Pulse Survey ............................................................... 14

4.0 Research Methodology ........................................................................................................... 17

4.1 Subject & Data Collection .................................................................................................. 18

4.2 Designing the Measurement Instrument ............................................................................. 19

4.3 Data Collection Procedure & Sample ................................................................................. 19

5.0 Healthcare Industry & PDCL At a Glance ............................................................................. 23

5.1 Healthcare Industry Highlights ........................................................................................... 23

5.2 Diagnostic Centers in Bangladesh ...................................................................................... 24

5.3 Padma Diagnostic Center: The 40-year Journey ................................................................ 25

5.3.1 PDCL At A Glance ...................................................................................................... 25

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 5.3.2 The Journey of PDCL .................................................................................................. 26

5.3.3 Organization Structure ................................................................................................. 28

5.3.4 Quality Policies of PDCL ............................................................................................ 28

5.3.5 HR Policies of PDCL ................................................................................................... 29

6.0 Findings & Analysis ............................................................................................................... 32

6.1 Performance Evaluation of PDCL ...................................................................................... 32

6.1.1 Healthcare Balanced Scorecard Explanation ............................................................... 32

6.1.2 Calculating Performance .............................................................................................. 33

6.1.3 Analyzing Results ........................................................................................................ 35

6.2 Employee Satisfaction of PDCL ......................................................................................... 36

6.2.1 Periodical Pulse Survey Results................................................................................... 36

6.2.2 Survey Result Analysis ................................................................................................ 49

7.0 Conclusion .............................................................................................................................. 51

References ..................................................................................................................................... 52

Appendices .................................................................................................................................... 54

Appendix A: PDCL Performance Evaluation Scorecard .......................................................... 54

Appendix B: Employee Satisfaction Survey............................................................................. 54

Appendix C: PDCL Balanced Scorecard (Assumed for Year 2021-22)................................... 55

Appendix D: Survey Questionnaire .......................................................................................... 56

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 List of Figures
Figure 1: Total Quality Management (TQM) Framework by Sainfort et al. (2001) ...................... 8
Figure 2: Relationship between Employee Satisfaction & Performance by Kuzey (2018) ............ 9
Figure 3: Pulse Survey Mechanisms (Qualtrics, 2015) ................................................................ 11
Figure 4: Proposed BCS Framework for PDCL Performance Evaluation ................................... 13
Figure 5: Proposed Framework for Satisfaction Evaluation: Periodical Pulse Survey ................ 15
Figure 6: Padma Diagnostic Center Ltd. (PDCL) ......................................................................... 25
Figure 7: Key Landmarks in the history of PDCL ........................................................................ 27
Figure 8: Quality Policies of PDCL .............................................................................................. 28

List of Tables
Table 1: Performance Evaluation Perspectives & Measurements ................................................ 18
Table 2: Research Constructs & Definitions ................................................................................ 20
Table 3: Research Constructs & Items.......................................................................................... 21
Table 4: Perspectives & Assigned Weights .................................................................................. 32
Table 5: Overall Performance Score ............................................................................................. 34

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 Abstract

The healthcare industry, with its ever-increasing demand for quality services, is constantly
evolving to meet the needs of patients. Within this industry, diagnostic centers play a crucial role
in providing specialized medical procedures and tests. However, ensuring the efficacy and overall
satisfaction of the staff in these centers is of paramount importance. Therefore, there is a pressing
need to evaluate and measure employee performance and satisfaction in diagnostic centers.

That is why, the primary objective of this thesis is to propose potential framework to measure the
performance and satisfaction of those involved in such diagnostic centers. The test case for the
report is Padma Diagnostic Center Ltd. (PDCL) – one of the most prominent diagnostic centers in
Bangladesh. Two frameworks, namely the Healthcare Balanced Scorecard and the Periodical Pulse
Survey, are proposed to assess performance evolution and satisfaction evolution, respectively. The
aim of this research is to provide a comprehensive understanding of employee performance and
satisfaction within the organizational context of diagnostic centers.

For the report, several relevant literatures and previous research papers were reviewed to establish
a solid foundation and to gain insights into performance evolution and employee satisfaction in
organizational settings. Based on the literature review, key components and measurement criteria
were outlined. The measurement of constructs, variables, and the procedures for data analysis are
also detailed in one of the chapters in this report.

The report also provides an overview of the healthcare sector, with a specific focus on PDCL,
including its history and development. Finally the analysis of the collected data and discussions
on the findings within the framework of the proposed models were given before finally concluding
the report with a note for future research scopes in this arena.

It is important to note that this study, although comprehensive, may not address all aspects related
to diagnostic centers. Despite limitations and constraints, this research has been conducted in a
timely and effective manner to contribute valuable insights into employee performance and
satisfaction at PDCL.

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 Chapter 1

Introduction

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1.0 INTRODUCTION
Bangladesh's healthcare system has experienced notable expansion in recent years, particularly in
the area of diagnostic facilities. The expansion of these facilities around the nation has increased
access to the availability of crucial diagnostic services. This expansion, which includes the opening
of numerous clinics, hospitals, and medical facilities, is evidence of the healthcare industry's
general progress. A diagnostic center is essentially a specialized space with cutting-edge
technology and knowledgeable staff that is committed to performing a wide range of diagnostic
operations and tests. These facilities are extremely significant because they act as key nodes for
precise illness detection, patient management, and treatment planning. The Popular Diagnostic
Center, Ibn Sina Medical Center, Padma Diagnostic Center, Anowara Medical Lab, and Modern
Diagnostic Centers are notable instances of diagnostic facilities in Bangladesh. Given their
importance, it is crucial to assess the productivity and happiness of staff members at these
diagnostic facilities. By offering a thorough framework for assessing employee performance and
satisfaction in diagnostic centers, this thesis seeks to fill this gap and contribute to a better
understanding of their influence on healthcare outcomes and organizational effectiveness.

1.1 BACKGROUND & MOTIVATION

A diagnostic center is a specialized medical facility that performs a variety of diagnostic

procedures utilizing cutting-edge technology and qualified personnel. It is critical to assess
employee performance and satisfaction in these settings. The effectiveness of operations, the
standard of services, and adherence to standards can all be evaluated through performance. A
positive work atmosphere, decreased turnover rates, and talent retention are all impacted by
employee happiness. The framework for monitoring staff performance and happiness, improving
operations, patient care, and encouraging engagement and growth is what this thesis seeks to
present.

Padma Diagnostic Centre Ltd. (PDCL) stands as a prominent and advanced diagnostic facility in
Bangladesh, offering a comprehensive range of diagnostic services. With its inception dating back
to 1986, PDCL has emerged as the largest private sector diagnostic services provider in the
country. In its early years, PDCL operated from a humble rented space comprising three rooms,

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equipped with basic technology and medical equipment such as Colorimeter, Hot water oven, X-
Ray, ECG, and Ultrasonogram.

Under the visionary leadership of Dr. Manirul Islam, the founder, PDCL has undergone significant
growth and transformation over the past 37 years. Today, it operates as a sophisticated center
catering to a vast number of patients annually. The commitment to innovation and continuous
improvement has been a hallmark of PDCL, positioning it as a pioneer in introducing the latest
medical equipment and cutting-edge technology in the diagnostic field. PDCL is a private limited
company registered with the Ministry of Health & Family Welfare, People’s Republic Govt. of
Bangladesh.

With a workforce of over 300 employees, PDCL continues to provide around-the-clock medical
investigations and consulting services, playing a crucial role in the healthcare landscape of
Bangladesh.

1.2 RESEARCH OBJECTIVES

The key aim of this research is to develop a detailed framework to evaluate the employee
performance and satisfaction of Padma Diagnostic Centre Ltd. (PDCL). Other than that, we will
also assess PDCL on this research:

1. To get a holistic overview of the organization and see how it operates;

2. To identify the factors influencing the employee performance and satisfaction in the
healthcare industry, and diagnostic centers to be specific;
3. To test the proposed framework through a survey questionnaire and analyze the results;
4. To propose some recommendation based on our research findings of Padma Diagnostic
Centre Ltd. (PDCL)

1.3 SCOPE OF THE STUDY

This report has been meticulously crafted with the academic objective of providing a
comprehensive reference for further exploration of the diagnostic center and healthcare industry.
It serves as a valuable resource for both emerging and established organizations operating within
the healthcare industry. The scope of this report primarily focuses on the local landscape of the
diagnostic center industry. However, in order to gain a broader perspective, certain assumptions

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have been made based on research conducted on international trends, particularly within the
healthcare industry of neighboring countries, such as India, Pakistan and Nepal.

By delving into the various facets of the diagnostic center and healthcare industry, this report aims
to offer insights, analysis, and recommendations that can inform strategic decision-making, policy
development, and future research endeavors in this domain.

1.4 LIMITATIONS

The report, although comprehensive is not void of any limitations. The report is limited to the
assumptions taken only from the perspective of doctors, nurses, technicians. Due to resource and
time constraints, feedback and opinions from patients and other policy makers could not be taken
into consideration.

Again, the limitation of time played a factor to carry out any quantitative analysis on this field,
however one survey of the current employees in Padma Diagnostic Centre Ltd. (PDCL) has been
provided to strengthen the arguments provided in this report.

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 Chapter 2

Literature Review

5|Page
2.0 LITERATURE REVIEW
In this section, we aim to gain a comprehensive understanding of performance evaluation and
employee satisfaction within an organizational context. Furthermore, we will explore how these
concepts have been assessed and measured in previous studies specifically related to the healthcare
industry. Drawing upon existing research, we will then propose a novel framework tailored to
evaluate the employee performance and satisfaction at Padma Diagnostic Center Ltd (PDCL). By
synthesizing relevant literature and incorporating the unique characteristics of PDCL, our
proposed framework aims to provide a comprehensive and effective approach for assessing and
enhancing employee performance and satisfaction within the organization.

2.1 PERFORMANCE EVALUATION

A performance evaluation system is a systematic approach used to assess an individual's job

performance. It is also known as "employee appraisals," "performance appraisals," or
"performance assessments." Performance appraisals play a vital role in organizational functioning
as they serve various purposes, such as addressing performance issues, setting goals, implementing
incentives or disciplinary actions, and making employment decisions (Dickinson and Ilgen, 1993).
In essence, performance evaluations provide a structured method to assess an employee's
performance against predetermined standards (Grote, 2002). Edwin B. Flippo (1980) defined
performance appraisal as the periodic, objective, and systematic evaluation of an employee's
current job-related performance and potential for growth.

The primary objective of performance evaluation is to conduct systematic reviews of employee

performance within an organization to determine the value of their work. Effective appraisals are
believed to motivate employees to improve their performance (Longenecker, 1998) and contribute
to job satisfaction and enhanced morale (MacKenzie, 1995). Performance evaluation offers several
advantages, including providing information for decisions regarding salary determination,
confirmation, promotion, transfer, and demotion based on performance rankings. It also offers
feedback on subordinates' achievement levels and behavior, aiding in the identification of
performance deficiencies and setting new work standards if necessary. Additionally, performance
appraisals help diagnose skill and knowledge gaps in employees, determine training and
development needs, and contribute to preventing grievances and disciplinary actions.

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In order to increase organizational productivity and success, it is essential to measure employee
happiness and performance. Understanding employee satisfaction levels makes it easier to spot
problem areas, address issues, and build a productive workplace that encourages engagement and
motivation. Organizations can also identify top performers, give helpful criticism, and connect
personal aspirations with business objectives by evaluating employee performance.

Currently there are many frameworks that are in use to measure performance in a specific
organization. Most of them are based on the specific needs of the specific organization.

The Balanced Scorecard framework offers a thorough and fair method of performance assessment.
Incorporating several performance dimensions, such as financial, customer, internal, and learning
and growth, it extends beyond financial indicators. The BSC helps firms to evaluate their
performance from numerous angles and align their strategies as necessary by taking a variety of
indicators into account. To provide a fair evaluation of their entire performance, for instance,
companies like Siemens and Intel have used the BSC to link strategic objectives with particular
performance measurements (Kaplan & Norton, 1996).

Key performance indicators are specialized measurements that are used to evaluate performance
across various organizational functions. KPIs help track progress, spot opportunities for
development, and boost performance since they are in line with the aims and objectives of the firm.
Depending on the organization's goals and nature, these indicators may change. Revenue growth,
customer satisfaction scores, worker productivity, and cost effectiveness are a few KPI examples.
KPIs like user engagement metrics and income per user are used by companies like Google to
assess how well their digital advertising company is performing.

Performance dashboards offer real-time or nearly real-time visual representations of performance

data and KPIs. These dashboards provide managers and stakeholders with a rapid and clear
overview of performance metrics, allowing them to track developments, spot patterns, and make
data-driven choices. Performance dashboards are used by businesses like Microsoft and Amazon
to measure critical metrics across several departments and processes, enabling efficient
performance management (Manyika et al., 2016).

In order to increase employee performance and motivation, the Management by Objectives

framework places a strong emphasis on goal creation, performance reviews, and feedback. With

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this strategy, specific goals are established for employees that are in line with the organization's
overarching objectives. Employees can understand their accomplishments, opportunities for
development, and how their work contributes to the success of the organization through regular
performance assessments and feedback sessions. Peter Drucker established the idea of MBO, and
companies like IBM and Procter & Gamble have used it to improve performance management
procedures (Drucker, 1954).

A data-driven methodology called Six Sigma is dedicated to reducing defects and improving
processes. Organizations employing Six Sigma strive to attain a high level of quality by
minimizing process variances and errors via the use of statistical analysis and problem-solving
strategies. To improve performance and customer satisfaction, the Six Sigma approach entails
defining, measuring, analyzing, improving, and controlling processes. Six Sigma has been
effectively applied by businesses like General Electric and Motorola to boost operational
performance and increase customer loyalty (Pande et al., 2000).

A management strategy called total quality management places a strong emphasis on ongoing
development, client satisfaction, and staff involvement.

Figure 1: Total Quality Management (TQM) Framework by Sainfort et al. (2001)

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TQM entails putting quality control procedures into place, cultivating a culture of quality
throughout the business, and advancing customer-centric procedures. Customer focus, process
improvement, employee empowerment, and teamwork are among the core values of TQM. To
improve overall performance and guarantee customer happiness, businesses like Toyota and
Honda have adopted TQM concepts (Oakland, 2003).

2.2 EMPLOYEE SATISFACTION

Employee satisfaction is defined as a pleasurable or positive emotional state resulting from the
appraisal of one's job or job experiences. According to Hemalatha S, Ganapathy S, and
Poongavanam S (2020), the success of the healthcare industry is significantly influenced by
employer satisfaction in the workforce. Numerous variables that influence employee behavior and
organizational performance are related to employee satisfaction. The lack of employee satisfaction
makes it impossible for a working health system to be effective. Many workers leave their
profession each year because they are not satisfied with their job or because the benefits they
receive do not fulfill their satisfaction level.

Figure 2: Relationship between Employee Satisfaction & Performance by Kuzey (2018)

An employee who is happy with their work-life balance is more likely to be on time, productive,
and engaged. Therefore, it is important to ensure that the employer is satisfied with the rewards of
their job. Gopinath, R. and Kalpana, R (2019) state that one of the primary issues in the study of
organizational behavior and the practice of human resource management is the contentment of
staff members. Employee satisfaction results from job interaction and organizational commitment.

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Employee involvement in their work leads to satisfaction. Organizational commitment and job
involvement have been significant determinants of employee satisfaction. Several studies suggest
that employee happiness influences employee motivation, goal achievement, and a healthy work
environment. In a field like healthcare, where the focus is on the client, employee unhappiness can
be the starting point for significant issues within an organization. Satisfied employees contribute
to client satisfaction.

Surveys of employee happiness are frequently used to gauge employee contentment and evaluate
various facets of the workplace. These questionnaires ask about work-life balance,
communication, leadership, career growth opportunities, and job satisfaction. Gallup, for instance,
provides the Employee Satisfaction Survey (Gallup, n.d.), which offers a thorough evaluation of
employee satisfaction levels and points out potential growth areas. The Employee Engagement
Survey, which assesses employee happiness and engagement, is also provided by the Society for
Human Resource Management (SHRM) (SHRM, n.d.).

Employee dedication and emotional investment in their work and the organization are measured
by employee engagement. A collection of questions is used in indices like the Gallup Q12 Index
to evaluate many facets of engagement, including recognition, feedback, chances for professional
growth, and alignment with organizational objectives. Organizations can gauge their workforce's
contentment and motivation by assessing employee engagement. The Q12 Index has been widely
utilized by Gallup to evaluate employee engagement across multiple industries (Harter et al.,
2002).

Employee loyalty and their propensity to recommend the company as a place to work are measured
using the NPS metric. Organizations can identify promoters (those likely to recommend), passives
(those unlikely to recommend), and critics (those unlikely to recommend) by asking employees to
rate their likelihood of referring the company on a scale of 0–10. NPS offers a straightforward and
practical way to gauge overall employee loyalty and satisfaction. NPS has been successfully used
by a number of companies, including Apple and American Express, to gauge employee happiness
(Reichheld, 2003).

Pulse surveys are quick, routine polls that continuously record the attitudes and levels of
satisfaction of employees. These surveys offer real-time feedback and enable firms to spot new
problems or developments that have an impact on employee happiness.

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 Figure 3: Pulse Survey Mechanisms (Qualtrics, 2015)

They are especially helpful for gauging worker satisfaction in circumstances that are constantly
changing or dynamic. To periodically gauge employee satisfaction and track trends, many firms,
including IBM, have introduced pulse surveys (Davenport et al., 2018).

While stay interviews are conducted with current workers, exit interviews are conducted after
people depart the company. These interviews offer insightful information about the perceptions of
company culture, reasons for leaving or staying, employee happiness, and suggestions for change.
Exit interviews are used by companies like Microsoft to collect feedback and raise employee
satisfaction (Seldman, 2004). Similar to this, businesses like Google have started using stay
interviews to learn more about their staff's requirements and address any potential problems that
can lower satisfaction (Lipman, 2015).

Focus groups, interviews, and open-ended survey questions are examples of qualitative research
techniques that allow for in-depth examination of employee happiness. These techniques enable
staff to communicate their experiences, viewpoints, and recommendations in a more nuanced way.
Organizations can discover specific areas for development and obtain a greater understanding of
the elements affecting employee happiness by using qualitative methodologies. Employing
qualitative techniques like focus groups, companies like Zappos have shaped their organizational
cultures and gained insights into employee satisfaction (Hsieh, 2010).

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 Chapter 3

Theoretical Framework

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3.0 THEORETICAL FRAMEWORK
Based on the frameworks we found that are currently in use, we came up with our own iteration
of evaluation framework for Padma Diagnostic Center Ltd. - PDCL’s employee performance and
satisfaction.

3.1 PERFORMANCE EVALUATION: HEALTHCARE BALANCED SCORECARD

In 2000, Stewart et al. noted that there was a lack of useful frameworks for evaluating and
improving performance in the healthcare sector because the majority of the performance
management literature at the time was centered on industrial companies. The particular qualities
of healthcare settings, such as their varied orientations, values, and stakeholders' and shareholders'
expectations, are blamed for this shortage. Therefore, creating a thorough performance assessment
system that records past performance and directs future improvements presents formidable
hurdles. Following Stewart and Bestor's finding, a number of academics have worked to create
frameworks designed expressly to evaluate hospital performance.

Patient
Perspective

Learning & PDCL

Growth Financial
Perspective Perspective

PDCL
Performance

Internal Quality of
Environment Care
Perspective Perspective

Figure 4: Proposed BCS Framework for PDCL Performance Evaluation

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The Balanced Scorecard (BSC), which Kaplan and Norton launched in 1992, is a well-known
strategy that has had a significant impact on organizations' ability to design multidimensional
performance evaluation systems and accomplish strategic goals. Numerous academics and
professionals in the healthcare field have attested to the BSC's appropriateness as a tool for gauging
and influencing performance in hospitals and healthcare organizations. Nevertheless, despite these
initiatives, there is still a need for comprehensive performance measurement frameworks that are
scientifically tested and tailored to the unique needs of hospital executives in order to evaluate and
enhance hospital performance in order to achieve strategic goals.

The healthcare balanced scorecard is not something that we can do through a survey, it is a
continuous process that we want to run on PDCL. Based on the 5 parameters, we want to propose
a model through which the performance of PDCL’s employee and the organization as a whole will
be measured.

3.2 SATISFACTION EVALUATION: PERIODICAL PULSE SURVEY

To evaluate the employee satisfaction we are proposing a periodical pulse survey with the
employees of PDCL. Initially we will be doing a survey of our own, the survey structure are as
follows.

The survey will be conducted in a confidential basis, and no data will be shared with PDCL or any
other personnel unless it is voluntarily expressed by the participant. The survey will take a look at
5 key areas of the employee’s contribution:

 Patient Centered climate

 Pointing out others’ error
 Frequency of medication errors
 Comfort reporting own errors
 Care provider job satisfaction

The model for our proposed framework for the satisfaction evaluation – periodical pulse survey is
drawn in the next page:

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 Patient-
centered
climate

Care
Pointing
provider
out others’
job
errors
satisfaction
Employee
Satisfaction

Frequency
Comfort
of
reporting
medication
own errors
errors

Figure 5: Proposed Framework for Satisfaction Evaluation: Periodical Pulse Survey

Few of these questionnaire will be used to score in our Performance evaluation scorecard, and it
will give a holistic overview of the relationship between PDCL’s employee satisfaction vs
employee performance.

The questions are based on a 5 point likert scale. The full questionnaire and the responses from the
participants is attached in the appendix part of the report.

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 Chapter 4

Research Methodology

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4.0 RESEARCH METHODOLOGY
The research approach is evaluated using a variety of factors. We have designed a suggested model
here based on the ideas that have been discussed. Both constructions and certain types of variables
are things we have constructed.

For our performance evaluation research, we used a balanced scorecard template which contained
5 perspectives. Here is the details of each of the perspectives.

Patient Perspective: The patient perspective examines how PDCL is meeting their healthcare
needs. The key strategic goal here will be to increase patient satisfaction.

PDCL Financial Perspective: This perspective will analyze how their share and stakeholders are
profiting from their business and if the annual goals are being met or not. These data will be
collected from the annual reports and scored on the basis of year to year performance in accordance
with the management expectations.

Quality of Care Perspective: This perspective deals with the infrastructure and medical care
efficiency of PDCL. If they have sufficient equipment to conduct the research and tests the patients
want, they will score highly in this sector. Another factor we will consider is the expertise of the
technicians and the service quality of the nurses and other medical persons.

Internal Environment Perspective: This perspective captures opportunities to improve work

condition and how comfortable are the employees to work at PDCL.

Learning & Growth Perspective: The scores for this perspective will predominantly come from
the questionnaire we will make to measure the employee satisfaction. In that they will be asked to
rate their growth and learning curve.

The detailed measurements we used to calculate each of this perspectives are shared in the table
in the next page. We have also shared the actual snap of our excel sheet template to calculate
performance of PDCL in the Appendix A.

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 Table 1: Performance Evaluation Perspectives & Measurements

Perspectives Measurements
Patient Perspective
Financial Perspective
Quality of Care
Perspective
Internal Environment
Perspective
Learning & Growth
Perspective
 Medical care complaints (per annum)
 Recurring visits percentage
 Behavioral complaints of officials (per annum)
 Yearly turnover
 Number of patients served per month
 Redundancy of tests and diagnostic reports
 Error ratio in diagnostic report
 Report Accuracy
 Report delivery on time ratio
 No. of test conducted vs request received
 Comfort Reporting Own Error
 Comfort Reporting Other's Error
 Nurse-patient care ratio
 Proper documentation for patient condition
 On the job training received
 Likely to recommend to others
 Level of Job Satisfaction

4.1 SUBJECT & DATA COLLECTION

The primary focus of this study is the PDCL workforce as the analytical unit. Within this
workforce, we targeted a diverse group of employees, including staff nurses supervised by the
Senior Nursing Supervisor, laboratory technicians, lab assistants, technicians, and Assistant
Professors from various departments. Additionally, we conducted interviews with the
Administrative team. By including multiple departments, we aim to ensure the collection of
comprehensive and reliable data for more robust results in this study.

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4.2 DESIGNING THE MEASUREMENT INSTRUMENT

Data for the variables listed in this study was collected through a survey questionnaire. The
measurement items used in the questionnaire were derived from existing literature, ensuring
content validity. The questionnaire was distributed to approximately 140 individuals who were all
citizens of Bangladesh, ensuring clarity, uniformity, and coverage in the sample. The questionnaire
consisted of five distinct sections, each corresponding to one of the variables, and a five-point
Likert scale was used to evaluate each component.

Section 1 of the questionnaire sought confidential information about the respondents. In Section
2, data regarding the patient-centered environment was collected to determine patient satisfaction
ratings, ranging from 1 (agree) to 5 (disagree). Section 3 aimed to identify further errors and
measure the workforce's level of comfort, using a scale ranging from 1 (agree) to 5 (disagree).
Section 4 focused on identifying medication errors within PDCL, with responses ranging from 1
(rarely) to 5 (usually).

In Section 5, the questionnaire aimed to measure employees' comfort levels in accepting

responsibilities for their own mistakes, using a scale ranging from 1 (quite comfortable) to 5 (not
comfortable). Finally, Section 6 assessed the job satisfaction level of PDCL employees using two
different measurement modes, ranging from 1 to 5. The modes included a scale from "absolutely
never" to "satisfied" and a scale from "dissatisfied" to "satisfied".

By utilizing this survey questionnaire, the study aimed to collect comprehensive data on the
variables of interest, enabling a thorough analysis of PDCL's performance and providing valuable
insights for organizational improvement.

4.3 DATA COLLECTION PROCEDURE & SAMPLE

Out of the 140 individuals who were contacted, the response rate for the survey was approximately
64%. The sample workforce entities were instructed to complete the questionnaire based on
specific criteria related to their designations. The questionnaire was primarily administered online,
and 89 respondents provided their responses using the scale incorporated in the questionnaire for
measuring the variables.

Here are the constructs that were used for the research:

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 Table 2: Research Constructs & Definitions

Constructs Definitions

Patient-centered climate
Pointing out others’ errors
Frequency of medication errors
Comfort reporting own errors
Care provider job satisfaction
All decisions and indicators regarding the quality of health
care are determined by the distinctive medical requirements
and desired health outcomes of an individual.
Understanding a Patient-centred climate helps to know
about individual demand and satisfaction.
Pointing out others' errors is The process of criticizing
mistakes. Or, to put it another way, perpetual criticism,
usually over different kinds of things.
The frequency of medications measures the inappropriate
use of medications which may cause a harmful impact on
patient health. If the frequency is low we can assume that
the structure of the institution is well structured.
Reporting their own errors is the comfort with which
individuals can acknowledge and admit the errors that
they've committed. Which could convince them to take their
profession more diligently.
Job satisfaction means how pleased employees are with their
jobs, including whether they appreciate each component of
their work or just some parts, such as the task itself or the
supervision.

There are some items under every construct. The items under the constructs which are selected for
making the questionnaire are shown in the next page:

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 Table 3: Research Constructs & Items

Constructs Items

Patient-centered 1. I feel nurses are able to spend enough time with each patient.
climate 2. I know patients well enough to provide the care they need.
3. I think there is an adequate nurse-to-patient ratio for safe care at
PDCL.
4. I think there are enough qualified/experienced nurses for the
workload in PDCL.
5. I think I am given a complete understanding of patient health
conditions from PDCL.
Pointing out 1. I feel comfortable pointing out supervisor/management errors at
others’ errors PDCL.
2. I feel comfortable pointing out coworkers for errors.
3. I feel comfortable pointing out physician errors.
4. I feel comfortable pointing out technician errors with test reports.
Frequency of 1. I think there are no patients who receive the wrong medicines at
medication PDCL.
errors 2. I think there are no patients who received the wrong dosage of
medicines at PDCL.
3. I never received a mistaken test report.
4. I did not notice any unnecessary medicine prescribed by doctors.
Comfort 1. I feel comfortable reporting errors that did not result in harm.
reporting own 2. I feel comfortable reporting errors that resulted in harm.
errors 3. I feel comfortable reporting near-misses.
4. I feel comfortable reporting any errors regarding test interpretations.
Care provider 1. I would recommend PDCL as a good place to work.
job satisfaction 2. I would recommend PDCL to my friends/family for a job.
3. I am quite satisfied with my current job
4. I am quite satisfied with the equipment/supplies for my job.
5. I am quite satisfied with the on-the-job training for my works.

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 Chapter 5

Healthcare Industry

& PDCL at a Glance

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5.0 HEALTHCARE INDUSTRY & PDCL AT A GLANCE
The healthcare sector in Bangladesh is of paramount importance, as recognized by the
government's commitment to fostering a healthy and productive population. Notably, significant
progress has been made in improving life expectancy, reducing infectious diseases, as well as
infant and maternal mortality rates. To further propel the sector's growth, the government provides
favorable incentives, such as tax holidays, to new hospitals that fulfill specific criteria. The
healthcare industry encompasses various components, including hospitals, clinics, diagnostic
centers, clinical trials, outsourcing, telemedicine, and medical devices and equipment.

5.1 HEALTHCARE INDUSTRY HIGHLIGHTS

According to Bangladesh Investment Development Authority (BIDA)’s official report, it is stated

that, with a compound annual growth rate (CAGR) of 10.3% since 2010, the size of the healthcare
industry has reached USD 6.76 billion in 2018 in terms of healthcare expenditure. This represents
a doubling of its size in just eight years.

Notably, the private sector dominates the healthcare industry, experiencing significant growth in
tertiary hospitals and diagnostic centers. According to the Directorate General of Health Services
(DGHS), as of the end of 2019, there were 255 public hospitals, 5,054 private hospitals and clinics,
and 9,529 diagnostic centers registered in Bangladesh.

Public hospitals provided a total of 54,660 beds, while private hospitals and clinics accounted for
91,537 beds, resulting in a combined total of 143,394 beds available for healthcare services. In the
next table we will see some of the key parameters of our healthcare industry.

These statistics highlight the robustness and potential of the healthcare industry in Bangladesh,
reflecting the government's commitment to promoting quality healthcare services and
infrastructure. The growth of the private sector and the increasing number of diagnostic centers
emphasize the importance placed on advanced medical diagnostics and personalized patient care.
This industry overview sets the stage for further exploration into the performance and satisfaction
of employees within diagnostic centers, underscoring the significance of research in this area.

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5.2 DIAGNOSTIC CENTERS IN BANGLADESH

In recent years, Bangladesh's diagnostic center industry has experienced substantial expansion and
development and has become increasingly important to the nation's healthcare system. A
diagnostic center performs a wide range of diagnostic tests and procedures, including laboratory
investigations, medical imaging, pathology, and other diagnostic services. As a specialized
healthcare facility, it is outfitted with cutting-edge technologies and qualified professionals.

The diagnostic center market in Bangladesh has grown quickly in terms of size. Industry
projections estimate that the diagnostic center market will be worth USD 550 million in 2020,
having grown at a compound annual growth rate (CAGR) of almost 15% over the previous five
years. This expansion can be linked to a number of things, including greater disease prevalence,
improved healthcare infrastructure, and increased public knowledge of healthcare issues.

To meet the varied healthcare needs of the population, the business has seen the creation of
numerous diagnostic centers around the nation. These facilities range in size from little clinics
giving fundamental diagnostic services to huge, all-inclusive facilities providing a wide range of
specialized tests and operations.

Additionally, technological and equipment advances have been a feature of Bangladesh's

diagnostic center market. The use of contemporary diagnostic methods and instruments has
increased the precision and effectiveness of diagnostic processes. To improve their diagnostic
skills, diagnostic centers have made investments in cutting-edge machinery like MRI scanners, CT
scanners, ultrasound machines, and laboratory analyzers.

The Directorate General of Health Services (DGHS) and other regulatory organizations oversee
the diagnostic center sector in Bangladesh in line of the legal framework. To protect the wellbeing
of patients, these organizations make sure that quality standards, safety procedures, and ethical
norms are followed.

In conclusion, Bangladesh's diagnostic center sector has grown and developed remarkably, making
a substantial impact on the country's healthcare system. The sector continues to play a significant
role in disease diagnosis, treatment planning, and improving overall healthcare outcomes in
Bangladesh thanks to its growing market size, technological improvements, and focus on quality
and patient care.

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5.3 PADMA DIAGNOSTIC CENTER: THE 40-YEAR JOURNEY

Padma Diagnostic Centre Ltd. (PDCL) represents an exemplary establishment in the field of
diagnostic services, serving as an advanced and highly esteemed center in Bangladesh. With its
inception in 1986, PDCL has emerged as the largest provider of diagnostic services in the private
sector of the country. Being a pioneer in its domain, PDCL has introduced cutting-edge technology
and state-of-the-art medical equipment to ensure round-the-clock medical investigations and
consulting services.

As PDCL celebrates its 37th anniversary this year, it is noteworthy to acknowledge the remarkable
transformation the organization has undergone. From its humble beginnings in three rented rooms
with basic technology, PDCL has evolved into a sophisticated center that caters to hundreds of
thousands of patients annually. The legal status of Padma Diagnostic Centre Ltd. is that of a private
limited company, duly registered with the Ministry of Health & Family Welfare of the People's
Republic Government of Bangladesh, holding License No. 1235 & 638.

Figure 6: Padma Diagnostic Center Ltd. (PDCL)

5.3.1 PDCL AT A GLANCE

Padma Diagnostic Center Ltd. is a limited/service-oriented company that was founded in 1986.
Located at 245/2 New Circular Road, Malibagh, Dhaka-1217, the company is dedicated to
providing a range of imaging and diagnostic services. Led by Managing Director Samiul Islam
and Executive Director Sabbir Hossain, the company is guided by a team of directors including
Sazzad Hossain, Kaiyum Khan, and Mazharul Islam. Their product and service offerings include

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X-Ray, CR System, Ultrasound, CT, MRI, Bone-densitometer, mammography, as well as essential
clinical laboratory equipment such as ABG machines, Cell counters, Bio-chemistry analyzers, and
more. With a focus on patient-centered care, Padma Diagnostic Center emphasizes that their
patients are neighbors, not mere numbers. The company's revenue for 2022 amounted to ৳ 104.1
Crore, with a net income of ৳ 9.1 Crore.

5.3.2 THE JOURNEY OF PDCL

In 1986, Dr. Manirul Islam embarked on a visionary journey as the founder of Padma Diagnostic
Centre. With an initial capital of approximately 30 lac taka, he started the diagnostic center in a
short-term rented house located in Dhaka. At its inception, the center possessed essential
diagnostic equipment such as Colorimeter, Hot water oven, X-Ray, ECG, and Ultrasonogram. The
early days of PDCL saw the dedicated efforts of a team comprising five employees. Since then,
PDCL has experienced tremendous growth and expansion. Presently, the diagnostic center boasts
a workforce of more than 300 employees, exemplifying its commitment to providing
comprehensive healthcare services to the community.

In the next page, the key landmarks in the history of Padma Diagnostic Centre Ltd. (PDCL) will
be shown in figures.

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1988

• Introducing the most advanced technology at the time, Elisa Reader, which was the
first in Bangladesh. PDCL also opened a new branch in Mirpur-1 called "Padma Path
Lab" that offers the same services and employs renowned doctors for personal
consultations with patients.

1994

• Installation of a 316 K.V. powerful backup generator, one of the first among private
diagnostic centers at the time.

1995

• Introducing the first addition of the German ROCHE GmbH's Fully Automated
Biochemistry Analyzer Hitachi 911 in Bangladesh.

2001

• ETT machine, Sysmex Automated Blood Cell Counter, Blood Coagulation introduced.

2002

• Padma established its own fully equipped 100-bed hospital with the best surgeons
and doctors in the Panthapoth area of Dhaka.

2003

• CR technology and a self-contained PCR lab are established. This is also the first
COBAS AMPLICOR AUTOMATED PCR in the country.

2013

• Launch of the Hematology Analyzer XN-3000 was the first unit in Bangladesh.

2015

• A number of service information technologies, such the Apelem Stratos dR BMD

machine, were also introduced in this year. Nihon Kohden 1200 J/K EEG machine. The
first unit was an Automatic ESR Analyzer (Mechatronics; STARRSED) in Bangladesh.
Multi-slice CT scan using a Canon Alexion.

2017

• Introduced automatic Blood Culture System from DL. Resona 7 ultrasound device
with Mindray DC8 expert echocardiogram equipment. MRI scanner made by Toshiba,
1.5 Tesla Vantage Elan.

Figure 7: Key Landmarks in the history of PDCL

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5.3.3 ORGANIZATION STRUCTURE

Padma Diagnostic Centre Limited (PDCL) a reputed Diagnostic & Medical support company
which was initially governed by the laws of the People's Republic of Bangladesh's Ministry of
Health and Family Welfare. It is a private limited company. PDCL is dedicated to providing its
customers with exceptional medical care and services using available resources. PDCL's team of
dedicated professionals works in tandem with a wide network of Bangladeshi citizens to provide
its clients with convenient services both domestically and internationally.

In 1986, Padma Diagnostic Center Ltd set out on its maiden adventure. 50 percent of the shares in
PDCL is owned by the managing director and founder rest 50 percent shares owned by other
directors, it is a totally private limited company, shares are held privately by the shareholders; the
shares of the company are not publicly traded or enlisted in share market.

5.3.4 QUALITY POLICIES OF PDCL

These are the quality policies Padma Diagnostic Centre Limited (PDCL) uphold at every section
of its operation:

Figure 8: Quality Policies of PDCL

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Apart from that PDCL also boasts itself of superior qualities policies through these measures:

 Utilize a Quality Management System (QMS) to integrate organizational practices,

workflow, and resources.
 Implement electronic validation of samples through barcode machines and biometric
systems to eliminate errors.
 Prioritize the well-being, health, and safety of all employees.
 Treat guests at the laboratory with respect and prioritize their safety during their visit.
 Ensure timely, discreet, accurate, and clinically beneficial reporting and dissemination of
examination results to patients.
 Adhere to ethical principles and professional standards, demonstrating a commitment to
acting ethically.
 Comply with all applicable environmental laws related to medical practices.
 Subject reports to examination and quality assurance checks by relevant authorities and
staff before making them public.
 Safeguard patient clinical information to ensure confidentiality and protection.

5.3.5 HR POLICIES OF PDCL

The corporate work culture at PDCL embodies a harmonious blend of efficiency and equity,
aligning with our progressive business vision. We strongly believe in enhancing employee
productivity and fostering professional growth. To achieve this, we prioritize creating a conducive
environment that facilitates continuous learning and development for our employees. Our
recruitment process ensures that we hire individuals with the right skills and qualifications for the
appropriate roles at the right time.

At PDCL, we highly value productivity as the spontaneous contribution of our human resources.
Our HR department plays a pivotal role in our success, implementing strategic human resource
development programs. We recognize the significance of effective communication and transparent
inquiry handling in maintaining our position as a reliable and transparent industry leader.
Moreover, we believe in empowering our employees as true owners of their jobs, fostering
motivation, and a sense of pride.

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In PDCL, HRD represents a unique fusion of professionalism and a shared sense of responsibility
and success, akin to a closely-knit family. Each member of our organization possesses a deep
connection, genuine concern, and a sense of pride for our company. Our HR department plays a
crucial role in ensuring seamless operations, fostering spontaneous engagement, and aligning
organizational goals with employee satisfaction. We have maintained harmonious relationships
with labor unions, and as of the time of writing, no disputes or disturbances have been reported.
Our dedicated staff members genuinely care for PDCL as if it were their own family.

Employee-employer relations at PDCL are characterized by a friendly and supportive atmosphere.

Some of our current staff members have been with the company since its inception, while others
joined after their retirement, including family members and their own children. This familial bond
contributes to a sense of loyalty, commitment, and mutual support within our organization.

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 Chapter 6

Findings & Analysis

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6.0 FINDINGS & ANALYSIS
The findings is based on two models, one is for the proposed healthcare balanced scorecard to
measure employee performance, and another is the periodic pulse survey to measure employee
satisfaction at PDCL.

6.1 PERFORMANCE EVALUATION OF PDCL

6.1.1 HEALTHCARE BALANCED SCORECARD EXPLANATION

This scorecard is based on 5 key perspectives: Patient perspective, financial perspective, quality
of care perspective, internal environment perspective and learning and growth perspective.
Underneath all these perspectives, we have set some strategic goals to measure them. And each
perspective has specific measurement tools. These measurement tools were selected based on the
current healthcare balanced scorecard that are in use. The UoM depicts the Unit of Measurement
and it is mostly in percentage but some of it are in currency format. Among the 5 perspectives,
each of them have been assigned weight based on their necessity for PDCL organization as a
whole. The weight for each of the perspectives are as follows:

Table 4: Perspectives & Assigned Weights

Perspectives Assigned Weights Based on Necessity

Patient Perspective 20%
Financial Perspective 40%
Quality of Care Perspective 20%
Internal Environment Perspective 10%
Learning & Growth Perspective 10%
Total = 100%

Each measurements have their own weights as well. Based on the necessity of each measurements
to understand a specific perspective, we have dissected each perspective into 100% weights and
assigned them into each of the measurements. These percentages will be used to calculate the
fulfillment of the specific measurements.

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The next two columns are where the PDCL management needs to put values based on their scores.
The first one is the actual instances where they can write how many times that specific
measurement took place or how much is the specific measurement. It will be compared with the
total number of incidents or with the projected value to assign a score. For example, let us assume
that a total of 500 tests were conducted in a month. And amidst them 9 of them were erroneous,
that means the score for that particular measurement can be (491/500) in percentage, since 491 of
the test reports were error free. Therefore, the error ratio in diagnostic report for a total of 500
reports consisting 9 erroneous one is 98 out of 100. Of course the management has the authority
to reduce or increase the final score, if they think some of the mistakes are important or negligible.
Another example of scoring is the yearly revenue. Let us assume, the target yearly revenue was
500 crore and they managed to attain 420 crore, then the management can give a score based on
the percentage of target achieved.

Basically, the scoring section lies with the management of PDCL and since it is a yearlong process,
and we cannot do that in a short span of this thesis time allocated, we will be presenting last year’s
value to give a breakdown of PDCL’s overall performance.

6.1.2 CALCULATING PERFORMANCE

The formula used to calculate the fulfilments of a specific measurement is:

Fulfillment = Score (assigned by management) X Weight (of the specific measurement)

For example, the score of Medical care complaints for the year 2021-22 was 88 according to the
management, and the weight assigned to this measurement was 45%. So the fulfillment score of
Medical care complaints measurement was 39.6. Similarly we find the scores for Recurring visits
percentage & Behavioral complaints of officials were 4 and 32.55 respectively.

In order to calculate the total weighted average for a particular perspective, this is the formula:

Weighted Score = Sum of fulfillments X Weight (of the specific perspective)

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For example, the quality of care perspective is calculated by the 4 measurements it consists of. All
four measurements here contain exactly 25% weight and the perspective as a whole contain 20%
weight of the overall performance calculation. As we can see in the sample data for the year 2021-
22, the scores assigned for each of the measurements in this perspective is 91, 98, 93 and 92. The
final weighted score for this perspective is calculated by summing up these 4 scores and
multiplying it with its weight i.e. 20%. And that brings us to a weighted score of 18.7 for this
perspective – quality of care.

Finally, the formula to calculate the overall performance of the organization is:

Overall Performance = Sum of all weighted averages according to category

From the scores given to us by the management, we see that the scores for each five perspective is
as follows:

Table 5: Overall Performance Score

Perspectives Scores
Patient Perspective 15.23
Financial Perspective 31.50
Quality of Care Perspective 18.70
Internal Environment Perspective 8.645
Learning & Growth Perspective 8.26
Total = 82.335

The detailed view of the performance evaluation scorecard is shown in Appendix C, the excel link
is also embedded there in a google link.

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6.1.3 ANALYZING RESULTS

From the data provided to us by the management, we see that 3 measurements yielded 39.6, 4 and
32.55 fulfillment scores respectively, and finally resulted in a weighted score of 15.23 out of the
assigned 20 for this perspective. This indicates that, the performance score for this specific
perspective is more than 75%. Respectively, we see that the scores of financial and quality of care
perspective are 31.5 and 18.7 out of 40 and 20 respectively. The financial aspect is reeling a bit,
with especially low score in the yearly turnover, which can be attributed to the COVID 19 situation.
The quality of care however has a very high score with more than 90% of the assigned weight in
this aspect. The detailed snap of the result obtained from our excel sheet is given below:

Although the last two perspective were supposed to come from survey results, but it was assigned
by management for the fiscal year 2021-22, because there was no survey conducted to test the
employee satisfaction. The framework proposed by us will be in effect from this year onward, and
the first three perspective will be scored by management and the last two perspectives’ score will
come directly from the periodical pulse survey to assess PDCL’s employee satisfaction.

After taking all the scores in account, we come up with a final overall performance score of 82.335
out of 100. The primary lacking of the score in in the financial perspective since they were not
able to meet their financial goals for the fiscal year 2021-22. The best performing category is the
quality of care perspective, with all of its measurements scoring well above 90, the overall
weighted average for this perspective stands at 18.7 out of 20.

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6.2 EMPLOYEE SATISFACTION OF PDCL

6.2.1 PERIODICAL PULSE SURVEY RESULTS

The questionnaire we prepared for our survey is attached in the appendix section of this report.
The first section consists of questions relating to their workplace designation, department and
remuneration. All of them were optional, although most opted to respond to those questions. Here
are demography of our respondents:

From the above graph, it is clear that the respondents predominantly had a work experience
between 2 to 5 years. There were also 22 individuals out of the 87 respondents who had more than
5 years of work experience at PDCL.

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In order to make sure that the responses were as unbiased as possible, we sent out the questionnaire
to 9 separate departments of PDCL, and as we can see, the responses were almost equally divided
from each of them.

Finally, we also asked their monthly salary, and we can see the breakdown of that in the above
graph. The breakdown of male to female ratio for the survey was 61:39. In the next couple of
sections, we will show and explain in brief all the results we accumulated through our survey
questionnaire.

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Patient-centered Climate

After the demographic questions, we went straight into the satisfaction measuring questions for
the next 5 sections. The first section was Patient-centered climate with the likert scale being 1 =
Agree & 5 = Disagree.

59.6% of the respondents strongly agreed that nurses could spend enough time, and none of the
respondents had any disagreement over this statement.

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The follow-up question of whether the ratio of nurse to patient was enough had similar responses,
with 46.1% strongly agreeing that there were indeed enough nurses in PDCL.

Next, the question was, whether the nurses and doctors were qualified enough, and a staggering
61.8% strongly agreed with this notion, with another 30.3% agreeing. The overall notion of patient
centered climate seemed very positive, with almost 90% of the respondents replying in an
agreeable manner.

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The final question for this section was the documentation to properly treat patient, and this also
resulted in an overall positive response, with none leaning towards the disagree scale.

Pointing Out Others’ Errors

After this section, we shifted our focus to the comfort of pointing out others’ error at PDCL. The
likert scare for this section was 1 = Quite Comfortable 5 = Not Comfortable

The comfort of reporting errors surrounding management had an overall mixed response, although
the dominating response was quite comfortable.

Although there are some (13.5%) respondents who chose to stay neutral and even around 10%
more who expressed their discomfort, the overall consensus was the comfortableness towards
pointing out management errors.

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The next question was regarding the coworkers, and here we also got a mixed response, although
38.2% showed quite comfortableness towards this, which is 2.2% higher than the previous
management error pointing out comfortableness.

The comfort of pointing out physician’s error was also mixed, but primarily leaning towards 1.

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The final question of this section was comfort of pointing out technician error, and this had the
overall highest comfort with 46.1% saying they were quite comfortable. Another 32.6% said they
were comfortable which brings us to almost 90% comfort of the employees to point out
technician’s error at PDCL.

Frequency of Medication Errors

The next section was frequency of medication error at PDCL consisting of 4 questions, and all of
them were based on a likert scale where 1 = Rarely & 5 = Usually.

58.4% of the respondents said that there were rarely any issues with wrong medicines at PDCL.

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The following questions had similar responses as well with few to none of the respondents stating
any instances of wrong dosage or drugs at PDCL.

Again, 58.4% stated that wrong dose of drugs were not an issue at PDCL, with only 4 people
reporting usual mishaps.

For mistaken test reports, there were some cases of receiving it sometimes, but most of the
responses said that it was rare (57.3%).

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The final question of this section however, deviated from the rest of the responses.

Although, the dominant response is rarely, there are cases of unnecessary medicines being
prescribed by doctors in the survey, with 16 of them stating that this does tend to happen.

Comfort Reporting Own Errors

With this, we concluded section 3 of the questionnaire and moved onto section 4 which was
comfort of pointing out own errors. The likert scare for this section was 1 = Quite Comfortable 5
= Not Comfortable

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The first question showed almost 80% were comfortable reporting errors that were harmless. The
next question however showed that, when errors resulted in harm, it was a different case.

Almost 20% expressed their discomfort to error such mistakes that resulted in harm, and 18% said
that they were neutral of this notion. However, 37.1% said that they were quite comfortable
reporting such cases.

In cases of near misses, 39.3% expressed high comfort of reporting such incidents and only 4.5%
said they were uncomfortable sharing such incidents and another 14.6% remained neutral.

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The final question of section 4 had an overall mixed response, with almost 8% expressing their
discomfort in reporting test misinterpretations. But 37.1% said that they were comfortable with it.
And 9% of the respondents remained neutral.

Care Provider Job Satisfaction

The final section of our questionnaire was care provider’s job satisfaction, with a total of five
questions. The first 2 question had a likert scale of 1 = Absolutely and 5 = Never

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56.2% absolutely recommended PDCL as a good place to work, and only 2.2% said never. For the
next question, we asked whether they would recommend PDCL to their friends and family
members.

None of the respondents said never, and overall 91% gave positive responses to this question. 9%
remained neutral however. The next three questions were given to express their level of satisfaction
at PDCL, and the scale was 1 = Satisfied & 5 = Dissatisfied

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48.3% stated their satisfaction and 7.9% remained neutral with their job satisfaction. And only

5.6%, consisting of 5 respondents, stated they were not satisfied with their job.

The next question also received similar responses, with 47.2% saying they were completely
satisfied with their equipment on the job.

The final question of the survey had a somewhat mixed response, where almost 10% said they did
not receive proper training, but 48.3% said the opposite and were satisfied with the training they
received for their job.

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6.2.2 SURVEY RESULT ANALYSIS

The survey had an overall 89 respondents, and the demography was split in a 61:39 male to female
ratio. The survey was conducted in an online basis, where we shared the google form to all 9
departments at PDCL. The overall responses showed somewhat similar participation from all 9
departments, with the highest participants coming from pathology department (16.3%) and the
least participants coming from serology department (3.7%). The average participation rate from
each departments were somewhat close to 10%.

The survey responses regarding various aspects of employee satisfaction at PDCL revealed a
generally positive sentiment among the workforce. When it came to pointing out errors of others,
the responses were mixed, with a significant portion of respondents expressing neutrality.
However, the majority reported feeling quite comfortable with pointing out errors. The frequency
of medication errors at PDCL was perceived to be low by most respondents, except for a few cases
of prescribing unnecessary medicine that received a somewhat mixed response. In terms of
comfort reporting their own errors, the overall response was less positive, with only 39%
expressing high comfort. Notably, reporting errors resulting in harm received the least positive
response. On the other hand, the final section on job satisfaction showed an overwhelmingly
positive response, with more than 50% expressing high satisfaction with their work environment,
on-the-job training, and co-workers at PDCL. Overall, the survey indicated that employees at
PDCL are generally happy and satisfied with their job and organization.

The overall survey results showed a positive response with only the pointing out others’ error
section getting a somewhat mixed response. The first section, patient centered climate had only 2
respondents who disagreed with 2 out of the 4 statements. The overall consensus was leaning
towards the agreeableness, with an average of 54.8% respondents agreeing highly with all of the
statements.

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Chapter 7

Conclusion

50 | P a g e
7.0 CONCLUSION
The report was tried to be made as comprehensible as possible with over 2 months of work and
visiting PDCL multiple times for interviews and survey works. The key objective of designing a
performance and satisfaction framework for PDCL has been completed successfully. Along with
that, other objectives of getting a proper understanding of healthcare industry, testing out our
proposed framework and recommending it to them have also been done to the best of our capacity.

Based on the survey questionnaire conducted at PDCL, the findings of the report indicate that
overall employee satisfaction within the organization is high. The devised framework for employee
satisfaction was positively received by the upper management, who have expressed their
commitment to conducting this survey twice a year to consistently assess employee satisfaction
across the organization.

However, it is important to note that the performance evaluation framework relied on scores
provided by the management, which may have been based on assumptions. To address this
limitation, for the upcoming 2023-24 fiscal year, PDCL aims to provide unbiased and actual scores
in the framework model, enabling a more accurate assessment of overall performance. The survey
questionnaire for employee satisfaction will contribute to filling out the scores for the fourth and
fifth perspectives of the performance evaluation framework.

It is highly recommended to PDCL to start implementing these frameworks to their organization

as soon as possible, because without them, they will not be able to take any informative decisions
across their organization. Any and every help needed from our end will be provided to the best of
our abilities to ensure the frameworks are properly established at PDCL.

For future research, it would be valuable to consider the overall industry as a benchmark for
comparison. Incorporating a competitor perspective to evaluate organizational performance could
be an essential addition as the sixth perspective in the healthcare balanced scorecard. This
adjustment would provide a more comprehensive and holistic assessment of PDCL's performance
in relation to its industry peers.

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APPENDICES

APPENDIX A: PDCL PERFORMANCE EVALUATION SCORECARD

APPENDIX B: EMPLOYEE SATISFACTION SURVEY

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APPENDIX C: PDCL BALANCED SCORECARD (ASSUMED FOR YEAR 2021-22)

Google Drive link for the complete Excel Sheet:

https://docs.google.com/file/d/17hXt7JIzaiD96n45Vjd123rAoeSyOGBG/edit?usp=docslist_api&
filetype=msexcel

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APPENDIX D: SURVEY QUESTIONNAIRE

The following questions are intended solely for general analytical purposes. We assure complete
confidentiality for all information obtained through surveys, ensuring the privacy of individual
respondents. Our findings will not disclose any personal information. The quantitative data
collected will be used exclusively for analytical purposes.

Section 1: Confidential Information

Section Prompt: These questions are optional, if you feel uncomfortable answering any of them,
you can leave them blank.

Question 1.1: What is your current designation?

Answer: ……………………………………………………………………………………………

Question 1.2: How many years have you been working at PDCL?

 0 - 1 year
 1 - 2 years
 2 - 5 years
 5+ years

Question 1.3: What sector/division are you working in?

 Haematology
 Biochemistry
 Serology
 Pathology
 Cytology
 Microbiology
 Endocrinology
 ECG
 Administration

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Question 1.4: What is your approximate monthly salary?

 0 - 19,999 BDT
 20,000 BDT - 39,999 BDT
 40,000 BDT - 59,999 BDT
 60,000 BDT - 79,999 BDT
 80,000 BDT - 99,999 BDT
 100,000 or above

Section 2: Patient-centered climate

Section Prompt: Express the level of agreeableness for each of the following statements. Your
responses are fully confidential and will not be shared with the organization. Kindly give your
responses as candidly as possible. You are required to respond to each of the question.

Left Extreme: Agree

Right Extreme: Disagree

Question 2.1: Nurses can spend enough time per patient to provide necessary care

Question 2.2: You are given enough documentation of patient health conditions to give them
proper care

Question 2.3: There is an adequate nurse-to-patient ratio for patient safe care at PDCL

Question 2.4: There are enough qualified/experienced nurses or doctors or medical personnel for
workload in PDCL

Section 3: Pointing out others’ errors

Section Prompt: Your responses are fully confidential and will not be shared with the organization.
Kindly give your responses as candidly as possible. You are required to respond to each of the
question.

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Left Extreme: Quite Comfortable

Right Extreme: Not Comfortable

Question 3.1: How comfortable are you in pointing out supervisor/management errors at PDCL?

Question 3.2: How comfortable are you in pointing out errors of your coworkers?

Question 3.3: How comfortable are you in pointing out errors of physicians?

Question 3.4: How comfortable are you in pointing out technician errors with test reports?

Section 4: Frequency of medication errors

Section Prompt: Your responses are fully confidential and will not be shared with the organization.
Kindly give your responses as candidly as possible. You are required to respond to each of the
question.

Left Extreme: Rarely

Right Extreme: Usually

Question 4.1: Were there any patients that receive wrong medicines at PDCL?

Question 4.2: Were there any patients who received wrong dosage of medicines at PDCL?

Question 4.3: Have you ever received a mistaken test report?

Question 4.4: Have you ever noticed any unnecessary medicine prescribed by doctors?

Section 5: Comfort reporting own errors

Section Prompt: Your responses are fully confidential and will not be shared with the organization.
Kindly give your responses as candidly as possible. You are required to respond to each of the
question.

Left Extreme: Quite Comfortable

Right Extreme: Not Comfortable

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Question 5.1: How comfortable are you in reporting error that did not result in harm?

Question 5.2: How comfortable are you in reporting error that resulted in harm?

Question 5.3: How comfortable are you in reporting near-misses?

Question 5.4: How comfortable are you in reporting any errors regarding test interpretations?

Section 6: Care provider job satisfaction

Sub-Section Prompt: Your responses are fully confidential and will not be shared with the
organization. Kindly give your responses as candidly as possible. You are required to respond to
each of the question.

Left Extreme: Absolutely

Right Extreme: Never

Question 6.1: Would you recommend PDCL as a good place to work?

Question 6.2: Would you recommend PDCL to your friends/family for job?

Sub-Section Prompt: Your responses are fully confidential and will not be shared with the
organization. Kindly give your responses as candidly as possible. You are required to respond to
each of the question.

Left Extreme: Satisfied

Right Extreme: Dissatisfied

Question 6.3: Express the level of satisfaction with your current job:

Question 6.4: Express the level of satisfaction with equipment/supplies for your job:

Question 6.5: Express the level of satisfaction with the training you receive to get better at your
job:

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