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I. Introduction
a. Background of the Company

De Ocampo Memorial Hospital started as a business venture in partnership with the

De Ocampo Memorial College. The brief history of this company started in 1913 when
the Memorial College was still (originally) named Colegio Dental del Liceo de Manila.
The college was used to be located at Dalumbayan Street (near Rizal Rizal Avenue)
Manila with just a few medical students. After a year, it was then again renamed as
Philippine Dental College, making it the first dental college recognized by the
Philippines government and authorized to confer the degree of Doctor od Dental
Surgery on 1916, and then the degree of Doctor Dental Medicine in 1932. After the
great success of the De Ocampo Memorial College, the owners thought of helping the
students put into actual practice their medical expertise, theories, and principles.
Which gave birth to the De Ocampo Memorial Hospital.

Now, De Ocampo Memorial Hospital is a Level 2 hospital private hospital, with a

maximum of 20-bed capacity. The healthcare facility is situated at 2921 Nagtahan
Road Corner Magsaysay Boulevard 1016 Manila, Philippines. They offer proven
healthcare experience and the ability to support the necessary changes that enable
healthcare operations to realize their full potential. The hospital has worked with their
affiliated physicians, regulators, and government agencies, all while maintaining a
reputation of trust and high integrity which affirms their credibility in the healthcare
industry.

Today, the corporation is on its fourth generation of family management, the hospital
is now headed by its new president, Dr. Vicente Antonio De Ocampo, and ably
supported by his sister, vice president Dr. Maria Victoria Lantin. At the helm of the
finances of the company is treasurer Zenaida De Ocampo. The future as envisioned
by the De Ocampos will not only usher in a stronger college but will also be a fulfillment

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of enhancing and improving the present hospital, which has been an essential partner
in helping students put into actual practice the theories and principles they have
learned, particularly in the College of Nursing, Dentistry and Optometry.
Under a more youthful leadership, focus is thereby leveled at courses that are more
suitable to the needs of the students aiming for a better future and consequently
helping our country sustain economic gains. With this view, the De Ocampo Memorial
College currently dedicates its resources and concentrates on the following programs:
Dentistry, Nursing, Medical Technology, B.S. Hotel and Restaurant Management,
Midwifery, Dental Hygiene, Dental Laboratory Technician, Health Aide, and Caregiver.

Photo Credits: David Montasco

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De Ocampo Memorial Hospital situated at Nagtahan Road Corner Magsaysay
Boulevard. The healthcare facility is located on an accessible location, which provides
convenience to its loyal patients and affiliated physicians and healthcare service
providers. The facility is equipped with CCTVs which tightens the security in the
hospital. Spacious and secured parking spaces is available in front and at the back of
the hospital, both being monitored by a security guard to maintain the safety of
patients and doctors vehicle.

The commute to the hospital is very easy since public transportations like; jeepneys,
tricycle, and pedicabs are readily available in the vicinity of the hospital. The
healthcare facility is air conditioned, and has a back up generator in case of power
failure.

Upon entry to the hospital, the customer service representative will guide you on the
process of your visit. The hospital is equipped with enough guide posters on how to
properly locate the office or location of the service the patient would like to avail.
Hospital personnel are also very generous in assisting their patients need and
concerns. Stairs and elevators are available for easy access to higher floors of the
building.

De Ocampo Memorial Medical Center aims to inform its patients of its impressive
credentials. The use of HMOs, Philihealth, SSS, PCSO funds, and other NGO
healthcare funding assistance is very welcome in this healthcare facility, because
their focus is on the betterment of their patients.

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De Ocampo Memorial Medical Center Vision and Mission

De Ocampo Memorial Medical Center Organizational Chart

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 De Ocampo Memorial Medical Center Medical Department

Location:

De Ocampo Memorial Medical Center, 2921 Nagtahan Street, Santa Mesa,

Manila, Santa Mesa, Manila, Metro Manila
Contact Number: 715 1891
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 b. Background of the Study
According to World Health Organization (WHO), a well-functioning healthcare
system provides equitable access to quality care regardless of the patients capacity to
pay while protecting them against the financial consequence of ill health. This definition
clearly does not apply to the current situation of the healthcare in our country; Philippines.
During the speech of Department of Health (DOH) Secretary Dr. Enrique Ona during the
2010 World Population Day Celebration, he stated that, There is unfair and inequitable
access to health care that leaves the poor behind; low overall government spending on
health; high out-of-pocket spending that impoverishes thousands of Filipino families;
persisting high maternal and newborn deaths that are among the highest in the Southeast
Asian region; high fertility rates among the poorest Filipino women; the continuing
challenge of infectious diseases like TB, dengue and malaria; emerging diseases like
HIV/AIDS and the interlocking crisis of non-communicable diseases; shortage in human
resources for health, particularly doctors

The way a healthcare system is financed and organized has a major influence on
a populations health and wellbeing. In a 2012 review, the WHO described the countrys
health financing system as fragmented with insufficient government investment,
inappropriate incentives for providers, weak social protection and high inequity.
The National Demographic and Health Survey revealed that the majority of patients
confined in both public and private hospitals pay out-of-pocket, using their salary or
income and dipping into their savings. Out-of-pocket payments were significantly higher
among patients confined in government hospitals.
Citing PhilHealths limited population and service coverage resulting in high out-of-pocket
payments, the WHO review concluded that
[pq]in general, the Philippine health financing system does not provide a safety net from
the financial consequences of illness. Because PhilHealth is unable to provide full
insurance coverage, Filipinos who get sick can easily slide into poverty.

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 According to a 2007 report by the Asian Development Bank (ADB), higher-income
Filipinos prefer private health facilities, which they considered as providing better-quality
services. Lower-income Filipinos usually go to public health facilities such as rural health
units and village health stations, which are generally perceived to provide low-quality
health services.

About 40% of hospitals in the country are public. Of the over 700 public hospitals,
around 10% are managed by the DOH while the rest are managed by local government
units (LGUs) and other national government agencies. The DOH categorizes both public
and private hospitals based on their service capabilities, from Level 1 (primary), Level 2
(secondary), to Levels 3 and 4 (tertiary). Level 1 hospitals, which have very limited
capacity comparable only to infirmaries, account for more than half of the total number of
hospitals in the country.

Private hospitals outnumber government hospitals in all categories. The disparity is

most glaring in tertiary hospitals where the number of private hospitals is four times that
of government hospitals. Level 1 and Level 2 hospitals are relatively well distributed
across the country. However, Level 3 and Level 4 hospitals are highly concentrated in
Central Luzon and Metro Manila. Of the countrys 17 regions, only four meet the WHO
recommendation of 20 hospital beds per 1,000 population.

c. Case Study Problem Definition

De Ocampo Memorial Hospital offers different type of medical services to its
customers, who are particularly consisting mostly of regular families of different
generations. The researchers have used the data from the ServQual Survey from 15
respondents who were randomly chosen. The problems were as follows:

1. A rating of (1.40) in the tangibles dimension, which denotes that this hospital
fails to exceed customers expectations on the physical aspects of the
company, such as its facilities and equipment.
2. A rating of (1.20) in the empathy dimension, which denotes that this hospital
fails to exceed customers expectations in terms of its staff giving individual
attention and care to their patients.

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 d. Objectives of the Study

This study aims to identify the following:

To analyze the current process of De Ocampo Memorial Medical Center
To identify the problem from which the dilemma arise
To improve the service of De Ocampo Memorial Medical Center
To propose a possible solution on how to improve De Ocampo Memorial Medical
Centers services about attending to health needs of patients

e. Importance and Relevance of the Study

The researchers will be able to better understand published works, learn to

balance collaborative and individual work, and this can even spark their interest involving
the subject matter. They will be able to hone both their data gathering and analyzing skills
in the process of identifying the problem and its solutions. Since this research is done in
a group, they will be able to learn how to work better with other people as well as keep
tract of their individual workloads. From this study, it may also be possible that they may
be interested in the subject matter and pursue a career involving healthcare. Readers will
be able to become aware of the operations of De Ocampo Memorial Medical Center and
might be able to use this research work as a guide to doing their own. Reading this
research paper can also create mental stimulation and this has many benefits.

The study will benefit the researchers, readers, and future researchers taking up
this course, Healthcare Systems, taking into consideration that health is the most vital
aspect of a well-being. This research will help them to understand the importance of
healthcare system in the Philippines as well as the role of hospitals in society. Also, to
address the worth of common health issues of a patient and how the De Ocampo
Memorial Medical Center attends to their needs as of what the current process implies.

De Ocampo Memorial Medical Center holds a big responsibility on their patients needs
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since it is the required undertaking of all hospitals in the Philippines. Thus, addressing
challenges and issues would help our country as well.

f. Potential Impact of the Study

This study will influence all as it gives awareness of how valuable a healthcare
system is and to raise awareness about what roles would it stand in a patients life.
Also, applying the knowledge from school into practice and be able to recommend
possible solutions to the dilemma by improving the service of De Ocampo
Memorial Medical Center.

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 II. Research Methodology

Analysis on the
Interview and Gap Analysis
Interview
ServQual Survey Why-Why Analysis
ServQual Survey
Service Process How-How Analysis
Map

Figure 1 Methodology

The researchers aim to identify the different challenges that De Ocampo Memorial
Medical Center encounters. A set of questions were prepared by the researchers based
on the studys objectives for the interview with Mr. Enrico Colas, a ServQual Survey to be
distributed to 15 respondents who were randomly asked. These are followed by making
an analysis based on the interview and ServQual Survey, and creating a service process
map.
Furthermore, Gap Analysis, Why-Why Analysis and How-How Analysis are being
used by the researchers in this study to provide recommendations for the companys
areas for improvement based on a deeper understanding of its situation.

Data collection

The interview was conducted by the researchers at De Ocampo Memorial College,

where Mr. Enrico Colas, a former employee of the said hospital, is currently working. He
worked for 18 years at De Ocampo Memorial Medical Center, and was the head of
information before he left.

The ServQual Survey tool was used in this study in order for the researcher to
identify and assess the different perceptions of the customers towards the company. This
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tool would also help the healthcare providers to understand not only the perceptions, but
also what the customers expect from the companys services. Furthermore, this tool
would provide better understanding for the researchers and the company on what areas
are in need of quality improvements. This tool consists of 22 statements to ascertain the
general expectation of customers and 22 matching statements to measure customers
assessment of a specific organization within the service industry. The response to these
statements was elicited by way of a 7-point Likert Scale.
The reliability and validity of these 22 items and 5 dimensions was confirmed thereafter.
These 5 dimensions are:
1. Tangibles this pertains to the physical facilities, equipment, staff appearance,
etc.
2. Reliability this refers to the ability to perform service independently and

accurately.

3. Responsiveness this refers to willingness to help and respond to customers

need.
4. Assurance this pertains to the ability of staff to inspire confidence and trust in
customers.
5. Empathy this pertains to the extent to which caring individual service is given.

The researchers obtained 10 sets of answered questionnaires out of the 30 sets

supposed to be answered. This is due to the privacy of the patients and restrictions set
by the De Ocampo Memorial Medical Center.

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The table below shows the result of ServQual Survey Results:

Dimension Statement Expectation Perception Gap Average for

Score Score Score Dimension
Tangibles 1
5.70 4.00 -1.70 -1.40
2
5.80 3.73 -2.07
3
6.60 5.27 -1.33
4
5.30 4.82 -0.48
Reliability 5
6.40 5.73 -0.67 -0.81
6
6.20 5.64 -0.56
7
6.60 5.18 -1.42
8
6.40 5.36 -1.04
9
6.44 6.09 -0.35
Responsiveness 10
6.50 5.82 -0.68 -0.49
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6.60 6.18 -0.42
12
6.60 6.18 -0.42
13
6.90 6.45 -0.45
Assurance 14
6.50 5.91 -0.59 -0.70
15
6.60 6.18 -0.42
16
6.60 5.91 -0.69
17
6.90 5.82 -1.08
Empathy 18
6.80 5.45 -1.35 -1.20
19
6.70 5.73 -0.97
20
6.40 5.36 -1.04
21
6.60 5.18 -1.42
22
6.60 5.36 -1.24
Table 1 ServQual Survey Result

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Tangibles has the lowest rating among the five dimensions, which means that the De
Ocampo Memorial Medical Center should focus on improving this area. Empathy should
also be given focus if the company wants to create a positive impact on the customers.

A service process map is created by the researchers to identify failure point/s of the
companys service delivery and identify areas that are in need of improvement. However,
based on limitations, the service process map to be presented is focused on patients
experiencing severe stomach pain, diarrhea, or high fever.

Process Man Material Machine

Enter the
Emergency Patient
Room

Assess the
Blood Pressure
patient (ask in
Monitor, Oxygen
depth
Nurse Evaluation Paper Concentrator (if
questions)
applicable)
Initial Emergent
Stabilization

Call for
appropriate Nurse
doctor

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 Check the
results of Doctor Evaluation Paper
assessment

Identify if
theres a need
to Doctor
admit/discharge
the patient

If a treatment is
needed, there
will be an order
Doctor
for laboratory
test, X-ray,
bloodwork etc.

Transport
patient to Wheelchair/
designated Nurse Wheeled
room (ex. X- Stretcher/ Bed
ray)

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 Perform X-ray X-ray machine
Radiologist
exam

Nurse
If the patient is Evaluation Paper Dextrose machine
admitted,
he/she will be
transferred to
the room,
Inject dextrose
(if applicable)
Doctor
Advise for
discharge
Patient, Cashier
Pay bills Payment, Receipt Computer
Personnel

If the patient
may be
Patient, Cashier
discharged, the Payment, Receipt Computer
Personnel
bills are being
given

Table 2 Service Process Map

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Data analysis
Gap Analysis

Service Quality Gaps Model

Word of Mouth
Personal Needs Past experience
Communications

Expected Service

Gap 5

Consumer Gap 6 Perceived Service

Provider Service delivery External

Gap 4
(including pre- communications
Gap 1 and post contacts) to customers

Gap 3

Employee Translation of
perceptions of perceptions into
consumer service quality
expectation specifications

Gap 7 Gap 2
Management
perceptions of
consumer
expectations

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Gap 6: Customers Expectations versus Employee Perceptions of Customer
Expectation
Problems: Causes:
De Ocampo Memorial The front-line
Medical Center fails employee is pre-
to inform patients occupied with other
and/or the people tasks, therefore failed
accompanying to communicate
patients of the properly with the
different policies that customers
they need to comply
The employee is not
knowledgeable in
answering different
questions of the
customers
Table 3 Service Quality Gap
Closing the Gap:
Either increase front-
line employee or
improve job rotation
Evaluate employees
performances from
time to time, (conduct
surveys if possible),
and conduct trainings
regularly
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Why-Why Analysis

Only regular Potential

customers tend to customers tend to
go for check-ups go at the nearest
and treatments hospital
Lack of equipment
(ex. MRI and CT Insufficient funds
Scan)
A rating of (1.40)
Delayed payments
for the tangibles
by the patients
dimension
It is only accredited
Lack of hospital
by the PHIC to
beds
provide 20 beds

Only
Potential
regular
customers
customers
tend to go
Staff cannot tend to go
Patients Wrong at the
accommodat for check-
fail to ratio of nearest
A rating of e each ups and
receive the staff to hospital
(1.20) for patient treatments
care and Lack of number of Insufficient
the intensively
attention staff patients funds
empathy and
they they can
dimension communicate
expect to accommoc Delayed
for longer
receive ate payments
period of time
by the
patients

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Given the survey, the researchers were able to identify a problem regarding the hospital's
tangibles. The root cause of this was then traced with the interview and data. Unexpected
delays in payments can have a catastrophic affect on any businesses that have little or
no cash reserves or credit to rely on and this is the case for De Ocampo Memorial Medical
Center. Payment delays can also cost the hospital more money since operations need to
be supported and if there are insufficient funds, the hospital might borrow money from
someone else and of course, borrowed money has interest.

The following are the data obtained from the De Ocampo Memorial Medical Center
supporting the delayed payments as the root cause as to why the hospital obtained a
rating of (1.40) for the tangibles dimension and a rating of (1.20) for the empathy
dimension

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The following are the data supporting that the De Ocampo Memorial Medical Center
lacks hospital beds to accommodate patients needed to be admitted:

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How-How Analysis

Only accept promissory note, when

secured by a mortgage or by a
guarantee of a co-maker, who will be
jointly and severally liable with the
patient for the unpaid obligation

Improve payment process

Improve screening and verification

processes before admission

With the why-why analysis, the issue to be resolved must be the delayed payments of the
patients. De Ocampo Memorial Medical Center is one of the few hospitals that allow a
patient to be discharged without the full payment and the researchers believe that this is
also a reason why the delays happen, because the customers are not in a hurry to pay.
To answer the problem at hand, the hospital should revise its payment terms and prioritize
the assessment of its clients.

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 III. Case Study Analysis

The gap on Customers Expectations versus Employee Perceptions of Customer

Expectation, which is the sixth gap, indicates that De Ocampo Memorial Medical Center
fails to inform patients and/or the people accompanying patients of the different policies
that they need to comply. There were two solutions being proposed by the researchers,
those are that the company should increase front-line employee or improve job rotation,
and evaluate the employees properly if there is a need to further train them or even
replace them.

The researchers have obtained from the Why-Why Analysis that the delays in
payments of the patients hospital bills contribute the most as to why De Ocampo
Memorial Medical Center failed to understand and provide aspects in the tangibles
dimension, such as the lack of equipment. A solution for the absence of ambulance, is
that hospital currently hires a third-party company which provides ambulance who can
either pick up patients from their locations or send patients from De Ocampo Memorial
Medical Center to another hospital. For the empathy dimension, the same cause, which
is the delays in payments occurs. The researchers neglected that the two dimensions
received the lowest ratings because of the reason that potential customers tend to go to
the nearest hospital, because of mainly, the researchers ought to mind that every second
counts when saving lives, therefore a patient must be brought to the nearest hospital for
immediate action.

Based on the How-How Analysis, Republic Act No. 9439 Section 2 indicating laws
regarding bills, promissory notes etc. should be followed both by the hospital and the
patients and other stakeholders involved. Furthermore, thorough screening and
verification of different health cards should also be practiced to avoid misunderstanding
and losses.

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IV. Conclusions

The researchers have initially aimed to identify the following:

a) To analyze the current process of De Ocampo Memorial Medical Center
b) To identify the problem from which the dilemma arises
c) To improve the service of De Ocampo Memorial Medical Center
d) To propose a possible solution on how to improve De Ocampo Memorial Medical
Centers services about attending to health needs of patients

This study, based on the interview and data collected (ServQual Survey) from the
De Ocampo Memorial Hospital, have attained the previous objectives. The information
and data from the said data collection method have been used by the researchers to
create an analysis in terms of their current service process, and further propose an
action to resolve the issues that the company is experiencing. In addition to that Gap
Analysis was made by the researchers upon having a better understanding on the
hospitals process. However, due to the limited data and information given by our
interviewee, Mr. Colas, the service process map on this study focused on a situation
wherein a patient is taken into the emergency room at the De Ocampo Memorial
Hospital.

The results of the different tools used have resulted to the following:
a) A rating of (1.40) in the tangibles dimension and (1.20) in the empathy dimension
due to the lack of sufficient funds of the hospital, which is then further analysed
by the researchers that the reason for having insufficient funds is because of the
delays in payment of the patients bills
b) To further improve ratings, the hospital must strictly implement policies in terms
of payment method and in terms of how they verify the health cards of the
patients and screening for admission (if applicable)

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 V. Alternative Courses of Action

Given the analysis, the researchers were able to conclude that the lack of
quality service is due to insufficient fund and the following could be possible solutions:
Only accept promissory note, when secured by a mortgage or by a guarantee
of a co-maker, who will be jointly and severally liable with the patient for the
unpaid obligation
Improve screening and verification processes before admission
Ask for a credit card if possible
Acquire funding through gaining more investors
Make operations more efficient

To further discuss the alternative courses of action, accepting promissory

notes when secured by a mortgage will make sure that the patient will still be liable
and cannot run away from their charges and bills. Improving the screening and
verification process before admission also helps their assessment on the patient if
they were to able pay for their bills and charges.

Asking for credit cards also helps to secure that they are able to pay in case
of emergency through credit card. In acquiring fund through gaining investors they
need to further more advertise the hospital so that they could attract investors. Lastly,
by making the operations more efficient they will be able to improve the system to
avoid patients escape from their liabilities.

Among the alternatives, this is the one that assures the payment will be
received at a certain time but this is also a harsh way to collect payment from clients
since it is like you are forcing the client to pay up front, plus if the medical bill was
charged through credit card and the client was not able to pay his bills, there is added
interest and sometimes additional charges and this can lead to the client going further
in debt.

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 VI. Recommendations

The researchers recommend to go with the solution to only accept promissory note,
when secured by a mortgage or by a guarantee of a co-maker, who will be jointly and
severally liable with the patient for the unpaid obligation to answer the problem involving
delay of payment since this is the root cause of the insufficient funding and clients should
be able to pay their debts. This is the least aggressive way to collect payment and
hospitals seeking to improve collections have to be careful since overly-aggressive debt
collection practices are regulated and given an emergency, they cannot require a patient
to pay up front or ask for the patients credit card before delivering a service.

For future areas of study, the researchers recommend having bigger size respondents
when conducting surveys (ex: ServQual Survey). It is also ideal to conduct an interview
with the different departments to provide thorough analysis on the service process and
further create better recommendation.

To avoid delayed payments, here is the proposed billing system for the De Ocampo
Memorial Medical Center:

Actor Process
1.0 Patient/Representative Ask for hospital bill
2.0 Cashier Provide hospital bill
3.0 Patient/Representative Check the details of hospital bill
3.1.a Patient/Representative Can give complete payment
3.1.b Patient/Representative Cannot give complete payment
4.0.a Patient/Representative Give full payment
4.0.b Patient/Representative Give partial payment
5.0.a Cashier Give receipt to patient who gave full
payment

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5.0.b Cashier Discuss payment details to patient who will
pay partially
6.0 Patient/Representative Agree with payment details
7.0 Cashier Ask for at least two valid IDs and contact
numbers and other requirements
8.0 Patient/Representative Provide all requirements
9.0 Patient/Representative Pay on the agreed date

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 VII. Appendices:

ServQual Survey Part 1 (Expectation)

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ServQual Survey Part 2 (Perception)

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