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«13TH INTERNATIONAL PUBLIC RELATIONS RESEARCH CONFERENCE “Ethical Issues for Public Relations Practice in a Multicultural World” Holiday Inn ...»

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Istanbul Göztepe Eğitim ve Araştırma Hastanesi (IGEAH), one of the biggest public owned and operated hospitals in Istanbul, took series steps and established Total Quality Management (TQM) and developed other major public relationship strategies to handle their internal problems, collect relevant data, implement solutions, provide efficient feedback to employees and expand hospital’s reputation by providing better service quality, warmer welcoming to their patients, etc. This process was unavoidable for this hospital as the health care industry presents a very dynamic, unexpected, ambiguous and uncertain environment in which “quality issues” have occupied a central position. Quality of care is related to all issues vital to health care reform-to the question of access and to the problems associated with ineffective and inappropriate care, patient preferences and patient choice, is inseparable from the issue of efficiency (Koeck, 1997);

825 therefore, concepts of total quality management (TQM) and continuous quality improvement (CQI) have taken a central role in the health care quality management (McLaughlin and Simpson, 1999). According to Lakhe and Mohanty (1994), TQM is a solution for improving quality of products in developing economies. By adopting the concepts of TQM or CQI, a health care institution can move away from an inspection-oriented quality improvement system to one that orients itself to a systematic transformation of an organizational culture thru a roll-out plan involving customer focus, key-process monitoring, data-driven tools and techniques, and team empowerment (Klein et al., 1998).

Hospital profile

S. B. Istanbul Göztepe Eğitim ve Araştırma Hastanesi, 660-bed highly equipped public hospital with its 100 doctors, 400 employees, and 10 operating rooms, was established in 1972 on 162 square meters area in the heart of Istanbul. Today, it boast of over 17 specialty departments with various walk thru clinics and a total staff of about 2,500 including 650 doctors specialized in various fields with a 800 bed capacity constantly expanding. The hospital offers a wide range of medical and surgical specialty areas including kidney transplantation, infection treatment facilities, etc. and also has obtained ISO certification and strives for continuous improvement based on TQM principles including committed leadership, customer focus and satisfaction, process improvement, service design, human resource management and social responsibility. They also provide internships for many graduated med students (http://www.sbgoztepehastanesi.gov.tr/).

Public relationship outcomes Cutlip, Center and Broom (1985, 4) defined public relations as “the management function that identifies, establishes and maintains mutually beneficial relationships between an organization and the various publics on whom its success or failure depends”.

Relationships are distinguishing public relations from marketing. Heath and Coombs (2006) state that today’s practice of public relations is helping organizations build relationships.

Grunig et al. (1992) propose that one characteristic of effective organizations is their ability to achieve their goals through the development of relationships with their publics. On the results of the excellence study, Grunig and Hung (2002) suggested that the quality of relationships determines reputation, that quality relationships and reputation result more from the behavior of organizations than from messages disseminated, and the value of relationships include the value of reputation. Bronn (2007) stated that it is important for an organization to work on relationships as the quality of the relationship impacts different stakeholders’ impression of the firm.

Grunig, Grunig and Ehling (1992) suggested that reciprocity, trust, credibility, mutual legitimacy, openness, mutual satisfaction and mutual understanding were the key elements of an organization-public relationship and recommend that researchers and practitioners use these concepts when measuring the quality of strategic relationships. Hon and Grunig (1999) developed a measure of organization-public relationships. They suggested that six relational

dimensions could measure the relationship perceptions between an organization and its publics:

826 trust, control mutuality, commitment, satisfaction, communal relationship, and exchange relationship.

Ledinham and Bruning (1998, 62) suggested that an ideal organization-public relationship is the “state exists between an organization and its key publics that provides economics, social, political, and/or cultural benefits to all parties involved and is characterized by mutual positive regard”.

Corporate reputation

Topalian explained (1984) “Corporate reputation refers to the expectations, attitudes and feelings that consumers have about the nature and underlying reality of the company as represented by its corporate identity.” According to Dowling (1986), reputation is the set of meanings by which a company is known and through which people describe, remember and relate to it.

Fombrun (1996) and Roberts and Dowling (2002) defined reputation as a perceptual representation of a company’s past action and future prospects that describe the firm’s overall appeal to all its key constituents when compared to other leading rivals. In other words, this definition suggests that corporate reputation is a general organizational attribute that reflects the extent to which external stakeholders see the firm as good and not bad. A company’s reputation can be not only the primary basis for a consumer’s purchasing decision but also everything from stock value of the company to employee satisfaction or attitude toward the brand or product itself.

A good reputation helps a company attract the people necessary for its success analysts, investors, customers, partners and employees (Chajet, 1989). Jones explains (2000) that a good reputation can serve to buffer a corporation from economic loss in specific types of crisis.

In literature, reputation is measured by different scales. There are a number of general measures of corporate reputation, many focusing on the ranking of corporation. The most widely known is from the business magazine, Fortune, which regularly polls business executives and analysts as to the reputation of leading companies. The Harris-Fombrun reputation quotient is a relatively new alternative to the most admired list. The quotient is calculated from a list of twenty attributes representing six dimensions and well used in many studies. In 2005, The Reputation Institute introduced “The Reputation Institute’s Rep Trak System” to track and analyzed corporate reputation. It tracks 23 key performance indicators grouped around seven core drivers that were created from qualitative and quantitative research conducted in six countries (Van Riel and Fombrun, 2007).

The link between public relationship outcomes and corporate reputation

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relations, social responsibility and community affairs, delicately handled crisis management strategies, that organization will be able to shape and influence the stakeholders’ attitudes towards itself positively and that organization will be credible, reliable, responsible and trustworthy in the eye of its public. As Van Riel and Fombrun once mentioned that all communications influence to some extent the perceptions of participants and observers about the organization and its activities and so affect the organization’s image, brand and reputation.

It is well established in the literature that by developing quality relationships with public, public relations can have long-term value to organizations (L. Grunig, J. Grunig and Dozier, 2002). As J. Grunig and Huang (2000, 35) mentioned before: “Corporate reputation is highly connected with behavioral relationships because reputation essentially consists of the corporate behaviors that publics remember”. If organizations have successful public relations, stakeholders will trust the corporation’s reputation. Fombrun (1996, 57) emphasized the role of organizationpublic relations as an important precursor of corporate reputation: “To acquire a reputation that is positive, enduring and resilient requires managers to invest heavily in building and maintaining good relationships with their company’s constituents”.

Summing up the above discussion and review of the literature, we suggest the following


Hypothesis 1: Public relations outcomes will have a positive impact on corporate reputation.

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Instrumentation The questionnaire used in this study was 2 pages long and included three sections.

Section one was the cover page explaining the purpose and the nature of the study, also assuring confidentiality of the subject. Section two included 45 items which consisted of the measures of public relations outcomes and corporate reputation. Section three included a six-item demographic questionnaire (asking for the participant’s age, gender, marital status, number of children, occupation, the frequency of hospital visitation). All the scales were translated from English to Turkish. All of the translated items of the survey were examined by two bilingual English Language instructors working at Istanbul Commerce University and the dissertation advisor for semantic and syntactic equivalence. These items were then back translated to see how the two versions compared. The wording of some items was changed according to daily uses of Turkish language. After all the necessary corrections were made, the questionnaire was finalized.

Data Collection The primary data in this study were collected via surveys in one hospital. Paper surveys were distributed during the period of November and December, 2009. The paper surveys were handed out to participants by the researchers and collected immediately.

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Participants completed the study’s instruments on a voluntary basis. The sample of this study included 176 patients; 100 female (56.8%) and 76 male (43.2 %). 61.6 % (N=108) of the participants were married and 38.4 % (N=68) were single. In terms of their visitation, 67.9 % of the participants (N=120) were regular patients who always prefer this hospital, whereas 32.1 % (N=56) of the participants have been coming occasionally. 16% of the participants were housewife, 8% of them were retired and the rest were full time employee such as teacher, banker, driver, etc.


Public Relations Outcomes was measured by twenty-six item Organization- Public Relations Outcomes Scale which was designed by Grunig and Hon (1999). Corporate Reputation was measured by nineteen-item Harris-Fombrun’s Corporate Reputation Quotient Scale (2004).

This study used Likert Scale illustrated as: 1= Strongly agree; 2= Agree; 3= Neither agree nor disagree; 4= Disagree; 5= Strongly disagree; for both variables.

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The first step of the analysis was to examine the correlation and it was found that there was no multi-collinearity problem regarding the variables. The mean and standard deviations of the variables of the sample size is depicted in Table 1.

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It was seen that public relations outcomes has a significant impact on corporate reputation with an explanatory power of 51% (Beta=,804; p=,000). The result of this analysis is presented in Table 2. This finding provides full support for Hypothesis 1.

Table 2: The Impact of Public Relations Outcomes on Corporate Reputation

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Organizations in the twenty-first century are faced with a major challenge of change in both internal and the external environment. For organizations to develop, they often must undergo significant change at various points in their development. In today’s complex structured and expensive health care system, there is no doubt that most people seek for trustworthy and reliable hospitals and health care givers that they can count on. At this point reputation of a hospital becomes the key variable for individuals.

Corporate reputation has always been one of the most popular subjects to be searched in literature as it carries an important and strategic meaning for all kind of organizations in all sectors. It is clear that there are many organizational and environmental antecedents affect a corporate reputation. In this study, public relationship outcomes were specifically chosen as an independent variable, as recently, health care sector including most of the hospitals, clinics and etc. have been under heavy construction in order to function more efficiently and effectively all around the world. In order to compete successfully and be more reputable, public relationships management for hospitals became more important than ever, as it is all about persuasiveness.

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organization; therefore, they form a reputation for the organization based on what they know and understand. Secondly, indirect/ reputational relationship with an organization; therefore, they form a reputation based solely on what individuals have read or heard from others. In our study all our participants partake in both groups mentioned above, as they were patients of this hospital and also listened the others’ experiences about this hospital and followed the news.

In her doctoral dissertation, Hagan (2003) explained how strategic public relations influence the behavior of an organization to improve relationships with the organization’s constituents and thus affect reputation. Her quantitative and qualitative research showed that in the automotive industry, organization’s relationships with its public influences the way publics assign a reputation. Similar to her study but in a different sector, our study also has demonstrated quantitatively support for a positive effect of public relationship outcomes on corporate reputation and suggest that organizations benefit when public relations practitioners develop successful programs and initiatives. In fact, seen from the background of conclusions found in several studies, the strength of the impact of public relations outcomes on reputation in this study merits some further comment.

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