Analysis of the Determinants of Health Protocol Behavior among Healthcare Workers in the Post-Pandemic Era

Abstract

This qualitative study examined how Emergency Department (ED) nursing service quality, conceptualized using the SERVQUAL model, shapes patient satisfaction in routine post-pandemic care. An explanatory single-site case study design was selected to capture service processes and clarify mechanisms linking perceived quality to satisfaction. The study was conducted in a metropolitan public hospital ED in Jakarta, Indonesia. Fourteen informants (eight patients/family caregivers and six ED nurses and unit leaders) were purposively recruited to represent variation in acuity, shift exposure, and roles, enabling rich comparison of experiences across the care pathway. Semi-structured interviews and brief non-participant observations were analyzed thematically using a SERVQUAL-informed coding frame. Findings show that responsiveness (timely updates, visible attention, and prompt responses) and reliability (consistent information and follow-through) most strongly influenced satisfaction, particularly during crowding and long waits. Assurance and empathy increased satisfaction when nurses provided clear explanations, advocated for comfort, and maintained respectful interactions, while tangibles (privacy, cleanliness, signage) shaped comfort but rarely offset perceived delays. The study recommends structured communication routines, peak-hour staffing and role clarity, and targeted environment-of-care improvements to strengthen perceived quality and
patient satisfaction.