D. Yannacopoulos Study of employee satisfaction in

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A.2. Economy Session Chair: U. Aftakhova - V. Brinia - A. Vozikis - D. Yannacopoulos Study of employee satisfaction in the public sector :the case of Tax Offices Eleni Tountorake -MSc International Business Management-TEI of Piraeus D.Yannacopoulos-Department of Business Administration,TEI of Piraeus,PhD Abstract The main purpose of this study is to define the job satisfaction of employees into the Greek public sector and especially in the Tax Offices of Athens. The research was done in order to investigate the attitudes and perceptions of employees about their work and the satisfaction they receive from it. The sample was 130 individuals from the Tax Offices of Athens who were asked about four dimensions of job satisfaction in order to draw conclusions about their overall job satisfaction. The four satisfaction criteria in order to measure job satisfaction were: professional development ,job benefits, working environment as well as colleagues relations. The analysis was performed with the system MUSA (Multicriteria Satisfaction Analysis) that calculates total and partial satisfaction indices, and the relative importance of each satisfaction criterion. The findings showed that: Overall, only 47% of the respondents were job satisfied whereas 53% were dissatisfied. Work development and benefits are those criteria for which 72% of the respondents were dissatisfied by their career development, whereas 62% of the respondents were dissatisfied by their work extra benefits. On the contrary, 89% of the respondents were satisfied by their relation to the colleagues, whereas 69% of the respondents were satisfied by their working environment. Based on the research findings, it is suggested a significant improvement to external factors such as salaries and other work benefits, which will contribute to further productivity of civil servants. 1. Introduction The term of public administration generally describes the set of instruments and actions designed to satisfy the general interest of the citizens of a State. Public Administration make up the State in the strict sense, and a large number of public institutions to whom the law has assigned the pursuit of objectives of general social interest (Spiliotopoulos, 2002) We could say that the public administration is the administrative aspect of a government. Economic and social policy is implemented, it becomes an act of the public administration, i.e. all the services and agencies that operate under direct government supervision. Services that can be characterized as public are ministries, regions, municipalities, tax offices, public universities, public hospitals etc. This research will focus on the study of employee satisfaction in the Tax Offices, because of the interest they present, due to their complexity, the sheer volume of work and the many different objects they manage, the composition of workers that make them up, and whose views on job satisfaction are of great interest, as they serve such a crucial and topical today field, the collection of public revenue. ISSN - 1791 - 1133

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International Scientific Conference eRA-7 The main research objective is the study of the attitudes and perceptions of employees towards the job they offer. More specifically, in order to study the global job satisfaction of the employees in the Tax Offices, it will be investigated their opinion on 1) Professional development 2) Job benefits 3) Colleagues’ relations 4) Working environment 2. Literature review 2.1Main theoretical approaches According to the definition given by Locke, the sense of professional satisfaction is a pleasant feeling which arises from the fact that the work of a person fulfills important labor values. The main purpose of an employee's job, is to produce, therefore, it is very important that employees are satisfied by their work, otherwise, among the consequences that may occur could be even a reduction of the profitability of a company. There are several areas of professional satisfaction, the most important of which are the following: -satisfaction from company and administration -satisfaction from colleagues -satisfaction from benefits -satisfaction from the working conditions -satisfaction from the work itself -satisfaction from promotion opportunities The job satisfaction is a complex concept, with many individual elements. A distinction that is made is that of satisfaction from intrinsic and extrinsic factors. The intrinsic satisfaction is directly related to the content of the work itself, such as the freedom given to options with regard to the implementation of the project, the degree of responsibility, variety of activities, skills and more. The extrinsic satisfaction is associated with the work environment: the working conditions, administration, timetable, security, benefits, etc. This separation is associated with Maslow’s hierarchy of needs and Herzbergs’ two factor theory ,of motivation and hygiene factors. Maslow first introduces the concept of hierarchy of needs. This hierarchy, displayed as a pyramid, suggests that people are motivated to fulfill basic needs before moving on to other, more advanced needs. The lowest levels of the pyramid are made up of the most basic needs, while the more complex ones, are located at the top. At the bottom of the pyramid, are basic, physiological needs (thirst, hunger, sleep).Following, the needs of safety and security, such as the desire of steady employment, health insurance, shelter, needs the individual activates only if physiological needs are fully ensured. The next level consists of social needs (the needs of love and belonging), which are fulfilled with involvement in social groups and community. After these three categories of needs have been satisfied, esteem needs become very important to the individual, for example self esteem, personal worth, social accomplishment and recognition. At the top of the pyramid are self actualizing needs, which refers to personal growth and fulfilling one’s potential. According to Maslow, in the workplace, the greater incentive for job satisfaction is the self-realization, as long as you have fulfilled all other requirements. ISSN - 1791 - 1133

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International Scientific Conference eRA-7 On the other hand, Herzerg argues that nowadays, lower situated needs have been satisfied one way or another, and what really matters to the employee is the satisfaction of the top level needs. He classifies the factors of job satisfaction in two categories: a)motivators , that give positive satisfaction and motivate to higher performance; are arising from intrinsic conditions of the job itself, such as recognition, responsibility, achievement or personal growth b)hygiene factors, that do not give positive satisfaction, though dissatisfaction results from their absence; these are extrinsic to the work itself, and include aspects such as working environment, company policies, salary, security, etc The fact is that job is not an object of a single behavior, therefore, the satisfaction derived from the profession is in essence, the degree of satisfaction resulting from different dimensions of the same job. According to another theory, that of Alderfer , professional satisfaction is directly related to satisfying three types of needs: existence, relatedness, and growth (ERG). An employee , will fulfill the needs of existence through salary, additional benefits and a safe working environment. To meet the needs of the relatedness will develop contacts with colleagues, which should be distinguished from emotional support, respect, recognition and a sense of "belonging". Finally, growth needs are covered when there is creativity and independence at work, that provides challenges and leads to personal development. The needs are perceived as a range rather than a hierarchy. An individual can work on growth needs, even if existence or relatedness needs remain unsatisfied. 2.2 Study of job satisfaction Most of the research for the study of professional satisfaction was conducted by organizational psychologists whose primary interest was the efficient operation of the company .In this context, the first organized efforts that focused on career satisfaction study, started in the 1930s, given the assumption that professional satisfaction can lead to greater employee productivity. After the 1930s, many studies have been conducted on this subject, while recently professional satisfaction was associated with the quality of life , for which there is particularly heightened interest. The professional satisfaction is a measure for companies’ quality of life , and it is very important to be understood and increased by the administration ,whether it is linked to productivity or not. Until the 1970s, under the influence of the human relations theories, there was an intense interest in job satisfaction, while, from the 1980s onwards, interest begins to decline, because the relation of professional satisfaction with other factors at work was more complex than that researchers initially assumed. Job satisfaction in the public sector has not been studied extensively, and these studies are mainly comparisons with the private sector. Survey results showed greater satisfaction from intrinsic factors (development of the employee, achievement), rather than from extrinsic factors (salary, security).The employees who seem to be more satisfied with their work are those with high levels of organizational commitment and devotion to their institution. 2.3. Satisfaction survey design

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International Scientific Conference eRA-7 The design of a survey of satisfaction, according to Kessler (1996) must include the following: -defining research objectives -defining satisfaction dimensions -setting survey sample and research process -development and testing of the questionnaire 2.4. Defining satisfaction dimensions The definition of the dimensions of satisfaction is one of the most important steps in a customer satisfaction survey. The term "satisfaction" is often referred to as a characteristic measure of effectiveness, or criterion. The MUSA method, which will be applied in this research requires defining a scale of satisfaction, which constitute a coherent family of standards. 2.5. Defining survey sample The sampling is all of the information that is collected from a certain number of people, in order to extend it to the whole population. To determine the size of the sample are usually taken into consideration some factors, such as the accuracy of the results, the number of respondents, the desired geographic coverage and the number of people who must be included in the sample.(Petrakis, M., 2006). The sampling method used was taking a convenience sample, from the Tax Offices of Athens. This method was chosen because it was not possible to obtain a representative sample of the Tax Offices across the country. In addition, this sample gives us the opportunity to have a first insight into the research topic, in a cheap and fast way. The results of the search cannot be generalized yet, but form a basis of what happens to the object being studied. 2.6 Questionnaire development The research for this study was performed with the structured questionnaire according to the MUSA method of measuring and analyzing customer satisfaction. For checking the validity of the questionnaire we had first a pilot survey in 15 respondents to see if there are any problems in understanding. Extra content validity was conducted as the questionnaire was sent to 5 employees of the service in order to evaluate whether it meets the objectives of the research and if they needed anything else to add. 3. The MUSA method The survey was conducted with descriptive statistics and the MUSA method (Multi Criteria Analysis Satisfaction). The descriptive statistics was used to fix the answers of respondents via frequencies and percentages of each answer chosen. The MUSA method is a multicriteria preference disaggregation approach, which provides quantitative measures of customer satisfaction considering the qualitative form of customers’ judgment, proposed by Grigoroudis and Siskos (2001).

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The main objective of the MUSA method is the aggregation of individual judgments into a collective value function, assuming that client’s global satisfaction depends on a set of n criteria or variables representing service characteristic dimensions. The required information is collected via a simple questionnaire in which the customers evaluate provided service, i.e. they are asked to express their judgments, namely their global satisfaction and their satisfaction with regard to the set of criteria. Combining weights and average satisfaction indices, a series of action diagrams can be developed. These diagrams indicate the strong and the weak points of customer satisfaction, and define the required improvement efforts. Each diagram is divided into quadrants, according to performance (average satisfaction indices) and importance (weights), that may be used to classify actions, and thus, set priorities: -action opportunity (low performance/high importance): these are the areas that need attention and must be improved in order to increase the global customer satisfaction level -leverage opportunity (high performance/high importance) : these areas can be used as advantage against competition -status quo (low performance/ low importance): generally, no action is required, since these satisfaction dimensions are not considered as important by the customers right now -transfer resources (high performance/low importance): company’s resources may be better used elsewhere. The bottom right quadrant is obviously the first priority, for the attributes are important to customers but company’s performance is rated moderately low. The second priority may be given to the satisfaction criteria in the top right quadrant, especially if there is room for improvement. The third priority issues are indicated in the bottom left quadrant; although these issues are not terribly pertinent at the time of the analysis, they may be more important in the future, and company’s performance is certainly not good. Finally, last priority for improvement should be given to the criteria in the top left quadrant because this category is the least important and company’s performance is relatively good.

Action diagram

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The action diagrams can indicate which satisfaction dimensions should be improved, but they cannot determine the output or the extent of the improvement efforts. For this reason, combining the average improvement and demanding indices, a series of improvement diagrams can be developed. Each diagram is divided into quadrants according to demanding (high/low) and effectiveness (high/low) that may be used to rank improvement priorities: -first priority: this area indicates direct improvement actions since these dimensions are highly effective and customers are not demanding. -second priority: it includes satisfaction dimensions that have either a low demanding index or a high improvement index. -the third priority of a company refers to satisfaction dimensions that need great effort but are of low effectiveness.

Improvement diagram

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The main advantages of the MUSA method are: - the MUSA method was developed especially to evaluate customers’ satisfaction level, and analyzes in depth the satisfaction for each of the characteristics of the provided service -evaluates both global and partial satisfaction -developing action and improvement diagrams, not only indicates the strong and the weak points of customer satisfaction, but define and rank the improvement efforts as well -the results of this method can be used to continuously improve the quality system The phrase of W. Edwards Deming , «It is not enough to do your best; you must know what to do, and then do your best», expresses the main advantage of the method, that not only indicates the weak points of a company, but proposes ways of improvement as well.

4.Application 4.1. Sample determination and research process This research is based on the collection of quantitative data from the target audiences located in large population samples, using a structured questionnaire. The objective of the quantitative research is to extract statistical findings which relate to the total population in order to explain its behavior. The respondents were 130 employees of the Athens Tax Offices (which in their entirety, are 65), while an attempt was made so as the sample would be as much as possible correctly distributed in terms of demographic characteristics, taking into account as a key factor that the investigation requires civil servants and precisely employees in Tax Offices. ISSN - 1791 - 1133

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4.2 Defining research criteria The criteria used are the following: 1)professional development: this criterion includes characteristics such as promotion opportunities ,work recognition, work-promotion relation, training opportunities 2)benefits :satisfaction from current salary, from the extra benefits, comparison of additional benefits to those of other companies 3)collaboration with colleagues :satisfaction from working with colleagues , from the human relations developed at work and outside work relations 4)environment and function of the institution :satisfaction from the working environment, from technical support and service efficiency

4.3 Questionnaire development The questionnaire, that consists of two parts, begins with an introduction, which assures the confidentiality of the responses and that the information will be used only for the purposes of this paper. The first part relates to demographics of respondents in order to gather data on gender, age, marital status, level of education, duration of working in the service, and their position in the Tax Office. The second part, consists of questions that measure the global satisfaction, but also the individual dimensions, and is divided into four parts, which are the criteria for job satisfaction. All the questions are open-ended and some of them make use of the Likert scale. 4.4.Research methodology For the purpose of this survey, which took place in October 2011,it has been done a quantitative research, using a questionnaire which was distributed to 130 employees at the Tax Offices of Athens. For reasons of confidentiality and validity, the completion of questionnaires was anonymous. 5. Research results 5.1 Demographic characteristics The sample analysis showed that the majority of employees in the Tax Offices of Athens is formed by women, 69,2%, while the proportion of men is 19.1%. 57.7% are aged from 41 to 50 years old, 26.2% are over 50 years old, 15.4% are from 31 to 40 years and 0.8% is from 25 to 30 years. In addition, 44.6% of employees working in the service of 21 to 30 years, the 27.7% from 11 to 20 years, 19.2% over 30 years and 8.5% from 3 to 10 years. As to the level of education, the majority are graduates of AEI or TEI, with 45.4% and 14.6%

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International Scientific Conference eRA-7 respectively. Percentage of 3.8% hold a master's degree, while 35.4% are high school graduates. The 74.6% have a post of employee in the tax offices, 20.8% are heads and the remaining 4.6% are managers or assistant managers. With regard to the family situation, the majority of workers in offices is married, 66.2%, 15.4% single, 15.4% are divorced and the remaining 3.1% widowed.

5.2 Global satisfaction of the employees at the Tax Offices of Athens As far as the global satisfaction of the employees in the Tax Offices of Athens is concerned , 52,31 % are unsatisfied, 33,85% satisfied, and 13,08 % very satisfied As regards to the partial satisfaction criteria: 1.concerning the professional development, 71.53% of the employees are unsatisfied, and 28,47% satisfied. 2.concerning the benefits, 61,54% of the employees are unsatisfied and 39,46% satisfied . 3.concerning the collaboration with colleagues, 10,77% of the employees are unsatisfied and 89,33% satisfied. 4.concerning the environment and the function of the institution 30,77% of the employees are unsatisfied and 69,33% satisfied.

In the next graph we see the weights of the criteria for the global satisfaction of the tax offices employees. The “professional development” criterion is the most important one, with a significant weight of 30,28% followed by “environment and operation of the institution” with 28,6%, “benefits” (24,15%) and “collaboration and colleagues” (16,97%).

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5.3. Action diagram Combining weights and satisfaction indices, the action diagram can be formulated as shown below. 1. Action opportunity (low performance/high importance): in this diagram the professional development appears in the bottom right quadrant, as a critical satisfaction dimension, requiring immediate improvement efforts. It has the lowest average satisfaction index compared to the rest of the criteria, while it is considered as the most important criterion by the employees. 2. Leverage opportunity (high performance/high importance): environment and function of the institution appears in the top right quadrant, as one of the strongest points, the competitive advantage of the Tax Offices 3. Status quo (low performance /low importance): in this area, the benefits criterion is not considered yet critical but may result important in the future 4. Transfer resources (high performance/low importance):this area consists of the collaboration with colleagues criterion, which may be better used elsewhere, for example to improve dimensions of the action opportunity area.

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5.4. The improvement diagram The action diagram indicates that the satisfaction dimension that should be improved is the professional development, by they cannot determine the output or the extent of the improvement efforts. That’s why we use the improvement diagrams, that combine average improvement and demanding indices. The improvement diagram, shown below, reveals that there is no particularly critical priority to be set (the bottom right quadrant).However, the improvement priorities should focus as following: - in the areas of high improvement index (professional development and benefits ) or low demanding index (environment and operation of the institution), which we notice in the right upper quadrant; this should be the priority of a tax office, because is highly effective, but involves great effort on the part of the service -the last priority refers to satisfaction dimensions that have a small improvement margin and need substantial effort, like collaboration with colleagues(low effectiveness , high demanding, in the top left quadrant)

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6.Conclusions 6.1. Conclusions on research results The environment and the operation of the institution are located in the leverage opportunity area, of high performance and great importance. These are the competitive advantages of Tax Offices in comparison with other services on the topic of employee satisfaction. In the current situation, we notice that benefits, are a weak point of the service, though it is not considered the most important criterion by the employees, which is professional development. In the transfer resources area, there is the criterion of collaboration, while in the action opportunity area, there is the professional development criterion, because it is of high importance to the employees, but of low performance on behalf of the Tax Offices. Generally, employees seem to be very satisfied from colleagues and collaboration, and quiet satisfied from environment and operation of the institution. However, there are improvement margins. As far as benefits and professional development are concerned, the satisfaction level is rather low. Employees are quite demanding with these criteria, so improvement actions should focus there. They are more satisfied according to the less important criterion, and less satisfied on dimensions that are important to them. 6.2.Practical application of the results To achieve job satisfaction of the employees in the tax offices, there should be implemented specific strategies, that can be summarised as follows: 1.the institution, even if the benefit criterion couldn’t be improved, should provide the employees with more work motivation , and the feeling that they are useful and their ISSN - 1791 - 1133

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International Scientific Conference eRA-7 work is being recognized; professional development should be promoted and employees should advance according to objective criteria 2. in order to transport resources from a low priority sector, as that of collaboration, some of the time an employee spends with colleagues at work or outside, should be dedicated to training, and generally, personal advancement 3.adopt strategies that aim to developing, strengthening and training of the employees through systematic, lifelong learning. 4.improve the technological infrastructure. 5.create new working conditions, that would recognize and use the skills and abilities of the employees( and thus improve the critical criterion of professional development) 6.managers should communicate with the employees their personal goals and responsibilities, and determine exactly what they are expected to do, and at the same time advise and guide, so as to improve the professional development criterion

6.3 Research limitations The main research limitations of this survey are the follows: 1.difficulty in collecting information from the Tax Offices of Athens, due to their number (65), and their geographic dispersion 2.difficulty in collecting the questionnaire, because usually Tax Offices are very crowded 3. the research was conducted in Athens, so province were not taken into account 4. the impact of the economic crisis was not evaluated, there haven’t been examined factors like the new salary cuts, changes in insurance and health care , the imminent structural changes of the Public Services, as merger and closing Tax Offices

7. References Greek 1. Γρηγορούδης Β.,Σίσκος Γ.(2005), Ποιότητα Υπηρεσιών και Μέτρηση Ικανοποίησης του Πελάτη,Αθήνα:Εκδόσεις Νέων Τεχνολογιών. 2..Κάντας, Α. (1996). Το σύνδρομο της επαγγελματικής εξουθένωσης στους εκπαιδευτικούς και στους εργαζόμενους σε επαγγέλματα υγείας και πρόνοιας. Ψυχολογία, σελ. 71-85. 3.Κάντας, Α. (1995). Οργανωτική – Βιομηχανική ψυχολογία. Μέρος 3ο. Διεργασίες ομάδας – Σύγκρουση, ανάπτυξη και αλλαγή – Κουλτούρα – Επαγγελματικό άγχος. Αθήνα: Ελληνικά Γράμματα. 4.Κάντας, Αριστοτέλης (1998). Οργανωτική – Βιομηχανική Ψυχολογία: Κίνητρα – Επαγγελματική Ικανοποίηση – Ηγεσία (Μέρος 1ο). Αθήνα: Ελληνικά Γράμματα. 5.Κυριαζόπουλος Π., Σαμαντά Ε.(2011), Μεθοδολογία Έρευνας Εκπόνησης Διπλωματικών Εργασιών, Αθήνα: Σύγχρονη Εκδοτική 6.Πετράκης , Μ.(2006), Έρευνα Marketing, Αθήνα: Σταμούλης. 7.Πόρισμα της Επιτροπής για την αναδιοργάνωση των Φορολογικών Περιφερειακών Υπηρεσιών του Υπουργείου Οικονομικών (Αθήνα, Μάιος 2011) 8.Σπηλιωτόπουλος,Ε.(2002).Εγχειρίδιο Διοικητικού Δικαίου.Αθήνα:Εκδόσεις Σάκκουλα 9.Στρατηγικό Σχέδιο 2011-2015 για την Ελληνική Φορολογική Διοίκηση (Υπουργείο Οικονομιών, Αύγουστος 2011) English ISSN - 1791 - 1133

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International Scientific Conference eRA-7 1.Arnold, J. Cooper, C. L. (1998). Understanding human behavior in the workplace. Work Psychology. 2. Bartlett, K.R. (2001), The relationship between training and organizational commitment: A study in the Health Care field. Human Resource Development Quarterly, Vol.12, No.4,pp.335-352 3.Coleman, F.D., Irving, P.G., & Cooper, L.C. (1999). Another look at the locus of control - organizational commitment relationship: it depends on the form of commitment. Journal of Organizational Behavior, Vol. 20,No 3, p.p. 995-1001. 4.Cooper, C. L., Cooper, R. D. and Eaker, L. H. (1988). Living with stress. Harmonds -worth: Penguin 5.DeMato, D.S., et. al. (2004). Job Satisfaction of Elementary School Counselors: A New Look. Professional School Counseling Vol. 7, No. 4, pp. 236-245. 6.Fisher D. Cynthia (2000). Mood and Emotions while working: missing pieces of job Satisfaction? Journal of Organizational Behavior Vol. 21,No2, p.p. 185-202. 7.Hackman, J. R., & Oldham, G. R. (1975). Development of the Job Diagnostic Survey. Journal of Applied Psychology Vol. 60, No 2, p.p. 159-170. 8.Herzberg, F., Mausner, R., Peterson, O. and Capwell, D.F. (1957). Job attitudes: review of research and opinion. Pittsburgh: Psychological service of Pittsburgh. 9.Herzberg, F. (1966). Work and the nature of man. Cleveland: World Publishing Co. 10.Herzberg, Mausner & Snyderman (1959). The motivation to work. New York: John Wiley and Sons Inc. 11.Hoppock, R. (1957). Occupational Information. New York: Mc Grow- Hill. 12.Howell, William C. and Dipboye, Robert L. (1986). Essentials of Industrial Organizational Psychology ,Chicago: The Dorsey Press. 13.Jewell, L.N. & Siegall, M (1990). Contemporary industrial and organizational psychology, West Publishing Company. 14.Johns, G. (1996). Organizational behavior: Understanding and managing life at work, Harper Collins College Publishers. 15.Lawler, E.E. III, & Porter, L. W. (1967). The effect of performance on job satisfaction. Industrial Relations, Vol. 8,No 2, p.p. 20 – 28. 16.Lawson, Robert B. and Shen, Zheng (1998). Organizational Psychology: Foundations and Applications. New York: Oxford University Press. 17.Locke, E. A. (1976). The nature and the causes of job satisfaction (στο M. D. Dunnette (Ed.)). Handbook of Industrial and Organizational Psychology. Chicago: Rand Mc Nally. 18.Mathieu, E.J., & Zajac, M.D. (1990). A review and Meta-Analysis of the Antecedents, Correlates, and Consequences of Organizational Commitment. Psychological Bulletin, Vol.108, No.2, p.p. 171-194. 19.Mayo, E. (1945). The social problems of an industrial civilization. Boston: Harvard University, Graduate School of Business Administration. 20.Maslach, C. (1993). Burnout: a multidimensional perspective (στο W. B. Shaufeli, C. 21.Maslach & Marek ). Professional Burnout. Recent developments in theory and research. London: Taylor & Francis. 22.McCormick, Ernest J. and Ilgen Daniel (1985). Industrial and Organizational Psychology New Jersey: Englewood Cliffs. 23.Noe, R. A., Hollenbeck, J. R., Gerhart, B., & Wright, P. M. (2000). Human Resource Management: Gaining a Competitive Advantage. United States of America: McGraw Hill Companies, Inc. ISSN - 1791 - 1133

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International Scientific Conference eRA-7 24.Pavlov, I. P. (1927). Conditioned Reflexes. Στο Γ. Ποταμιάνος (1998). Θεωρίες προσωπικότητας και κλινική πρακτική. Αθήνα: Ελληνικά Γράμματα 25.Rice, R. W., Gentile, D.A., & McFarlin, D. B. (1991). Facet importance and job satisfaction. In R. E. Riggio. (2003). Introduction to Industrial / Organizational Psychology. New Jersey: Prentice Ηall. 26.Spector, Paul E. (1997). Job Satisfaction: Application, Assessment, Cause, and Consequences. London: Sage Publications. 27.Spector, Paul E. (2000). Industrial & Organizational Psychology: Research and Practice.New York: John Wiley & Sons, Inc. 28.Riggio, Ronald E. (1999). Introduction to Industrial / Organizational Psychology New Jersey: Prentice Hall. 29.Vroom Victor H. (1964). Work and Motivation. New York: John Wiley and Sons, Inc. 30.Weiss, et al. (1967). Manual for the Minnesota Satisfaction Questionnaire. In R. E. Riggio. (2003). Introduction to Industrial/Organizational Psychology. New Jersey: Prentice Ηall. 31.Weiss, H. M., Suckow, K., & Rakestraw, Jr., T. L. (1999). Influence of modeling on selfset goals: Direct and mediated effects. In R. E. Riggio. (2003). Introduction to Industrial / Organizational Psychology. New Jersey: Prentice Ηall. Websites -www.unipi.gr/faculty/ysiskos/files/paper4.pdf,11/9/2012 -www.dss.dpem.tuc.gr/pdf/113Grigoroudis.pdf,10/9/2012 -wwws.dpem.tuc.gr/pdf/Preference disaggregation for measuring and analysing customer satisfaction - The MUSA method.pdf 10/9/2012 -www.epikaira.gr , 3/12/2011 -www.k-tipos.gr/ktipos ,.13/11/2011

Tourism cluster. Achieving competitive advantage through synergies. Case study: The Leading Tourism Cluster S.A. N. Klada M.B.A. Tourism Management University of Piraeus – Greece Tel: +30 6932645242, E-mail: nikol_klada@hotmail.com

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International Scientific Conference eRA-7 N. Theocharis Lecturer, A.S.T.E. of Rhodes – Greece Tel: +30 6977746042, E-Mail: ntheoharis@aster.edu.gr 1 Abstract 2 This paper attempts to fill one of the research gaps in the business networking. In such a global economical turmoil, the need for synergy among businesses aiming a competitive advantage and economies of scale, has led to a worldwide spread of business clusters. 3 A tourism cluster is a group of important tourist destinations in a specific geographic region, in which high quality services are provided. The relations between enterprises and institutions and a tourism cluster can be understood in two ways, horizontal by the creation of strategic alliances, or vertical by the creation of strategic nets. A tourism cluster is one of the strongest tools for promoting innovation and enhancing the competitiveness of enterprises and economies. 4 In Greece, the tourism cluster particularly is considered necessary during the economic crisis. This paper is an attempt to present the framework in which clusters develop, and focuses on the first tourism cluster, the Leading Tourism Cluster S.A. (L.T.C). L.T.C. is the first synergy of joint procurement in order to achieve bulk purchase prices. Finally, the results of a survey in hotels - cluster members are presented. The survey was held in order to determine how important and efficient is for a hotel to be a member of the cluster. 5 6 Keywords: Tourism Cluster, synergies, network, strategic alliances, competitive advantage, economies of scale.

Introduction 7 This paper is divided into four sections. In the first section a theoretical approach to a tourism cluster is described. The second section refers to the cluster organization in European countries, while the third section analyzes the current situation in Greece and the necessity of a cluster. Finally, in the fourth section is presented in detail the first cluster in Greece, the Leading Tourism Cluster S.A. as well as the survey that was conducted in a questionnaire sent to 10 hotel units - cluster members in Greece.

8 1. Tourism cluster 1.1 The concept of the tourism Cluster A complex group of different elements, including services carried out by tourism companies or business (lodging, restoration, travel agencies, aquatic and theme parks, etc…); richness provided by tourist holiday experiences; multidimensional gathering of interrelated companies and industries; communication and transportation infrastructures; complementary activities (commercial allotment, holiday traditions, etc.); supporting services (formation and information, etc); and natural resources and institutional policies (Montfort, 2000, p. 46). While Montfort highlights a cluster as characteristics and components, Beni highlights the cohesion between agents and cooperation by creating company nets when defining cluster thus: Tourism cluster is a group of highlighted tourism ISSN - 1791 - 1133

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International Scientific Conference eRA-7 attractions within a limited geographic space provided with high quality equipment and services, social and political cohesion, linkage between productive chain and associative culture, and excellent management in company nets that bring about comparative and competitive strategic advantages. (Beni, 2003, p. 74) The relations between enterprises and institutions and a tourism cluster can be understood in two ways (Rodrigues, 2001, p. 307): Horizontal – by the creation of strategic alliances, where agreements can be of two kinds: on one side, the agreements between enterprises that have the same principal activity, i.e. among enterprises that deal with lodging, entertainment, transport and catering. On the other side, the agreements between enterprises working with the same group of customer satisfaction, but offering different product components to the customers (tourism service); Vertical – by the creation of strategic nets, where there is the establishment of a unilateral supplier-customer relation among the partners in such a way that the object activities of the agreement are fulfilled by one of the parts, which gives its output to the other in exchange for a payment. A tourism cluster is a group of companies and institutions bound up to a tourism product or group of products. Such companies and institutions are spatially concentrated and have vertical (within the tourism productive chain) and horizontal relationships (involving factor, jurisdiction and information exchange between similar agents dealing with a tourism product offer). They show an intern configuration that generally includes: a) A set of tourist attractions that draw non-resident attention; b) The concentration of tourism service companies: restaurants, accommodation, transport services, crafts, travel agencies etc; c) Sectors providing support to tourism services; d) Suitable and low-cost infrastructure (roads, energy, sanitation, health services, etc.); e) Companies and institutions that provide specialized qualification, information and financial capital; f) Intern agents organized into class associations; g) Government agencies and other regulating bodies that impact tourism agglomerations. The advantages of cooperation nets in tourism activities allow for the effective exploitation of the collective efficiencies and/or the development of external companies from the enterprises (entrepreneurial cooperation, work productive specialization, collective infrastructure, service specialization etc.) and also makes it possible to benefit from the increased ability to negotiate collectively with suppliers of inputs and components. In addition to these advantages, cooperation nets facilitate the development of new models, production processes and organization, the exchange of technical and market information, consortiums for buying and selling goods and services, as well as joint marketing campaigns. Interaction and synergy arising from joint actions have competitive advantages over the isolated actions of companies (Nordin, 2003, p. 19). Although collaboration is a cluster-supporting basis, competition is performed vigorously. Even when cooperation is the cluster’s main element, rivalry is also necessary for its development and survival. Without competition, companies are doomed to be unsuccessful, especially when it comes to the dynamic innovation process.

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International Scientific Conference eRA-7 Due to the characteristics of the tourism cluster, local development programs consider it as a local strategy for combating regional disparities and social inequality. Porter (1999, p. 230) emphasizes that tourism does not depend only on the appeal of the main attraction (beaches or historical sites), but also on the comfort and service of hotels, restaurants, souvenir shops, airports, other modes of transport and so on. As the example shows, the parts of the agglomerate are generally effectively dependent on each other. A bad performance of one may compromise the success of the others.

Figure 1: Tourism cluster representation Source: Sieglinde Kindl da Cunha & Joao Carlos da Cunha, 2005: 52 Not all regions are adequately equipped in the same way to develop tourism activities. A region that is suitable for the development of tourism should have cultural, physical-natural and social characteristics that define its identity, accessibility to infrastructure, supra-structure (accommodation, restaurants., transport, etc.) to guarantee high quality tourism, strategic location near places where tourists come from, enough tourist attractions to draw tourists and sustainable economic activity. There should also be good tourism marketing strategies in order to divulge an attractive, unique and competitive image of its tourism product (Smith, 1989). However, the economic, social, environmental and cultural sustainability of the tourism cluster will only occur if the tourism product is based on public policies and strategic planning to determine its conditions for sustainability and multi-scale insertion (regional, domestic and global). 1.2 Tourism cluster Sustainability The function of tourism causes direct impacts that affect both the territorial system and the production of tourism itself. The environmental spoiling of a beach does not mean only the deterioration of the territorial system but also competitiveness of the function of tourism in the region (Ivars, 2004, p. 25-26). Sustainability is a fundamental concept when reassessing the role of tourism in contemporary society. The World Tourism Organization defines sustainable tourism in this way: Sustainable tourism is understood as the kind that satisfies the present needs of tourists as well as preserving the destination regions while incrementing future opportunities. It has to be conceived in a way to guide management of all available resources in order to meet economic, social and aesthetic demands, ISSN - 1791 - 1133

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International Scientific Conference eRA-7 maintaining cultural integrity of essential ecological processes, biological diversity and life supporting systems (OMT, 1998, p. 21). The local development model based on sustainable tourism involves very complex relationships and can only be accomplished if the dimension reality of a certain region or territory is taken into consideration. Ruschmann (2001) emphasizes the need to consider the following dimensions when seeking to plan sustainable local development:  Ecological and environmental sustainability: this refers to a physical basis development process that aims to preserve and use rationally the natural resources incorporated into tourism activities, as well as supporting capacity of the associated ecosystem to absorb or recover from anthropocentric aggressions.  Economic sustainability: this is the search for economic growth/development through the efficient allocation and management of resources and constant public and private investments to guarantee not only profitability at the microeconomic level, but also economic efficacy at the macro-social level in the present and future.  Socio-cultural sustainability: this is the need to maintain cultural diversity, values and practices currently existing in a region and building individual citizenship and complete social integration within a culture comprising rights and duties.  Political-institutional sustainability: strengthening democratic mechanisms aimed at designing and implementing public policies, institutional arrangements and political-social representative organisms that have already taken sustainable criteria into consideration. 2. Organizing cluster within the European countries The cluster is one of the most significant tools for promoting innovation and enhancing innovations of businesses and economies. The E.U. supports intensively their creation. The framework has many activities which address to clusters. The E.U. formed a team of experts, which created the European cluster Memorandum and developed an European observatory. Countries with high developed economies pioneer and develop actions which support clusters. Within Europe clusters exist in Portugal, Malta, Sweden, Greece, Cyprus, etc. In these economies the public sector gets directly involved in the tourism cluster. The tourism sector and especially the creations of clusters within Europe has augmented the working positions. 3. Greece In Greece clusters are considered essential during economic crisis. Especially nowadays, since the general crisis creates turmoil in business survival, any kind of business activity, reducing cost and high quality is the main goal. Today, Greek tourism and commerce come through an intensive and long crisis, hence these goal terms into a deep need. During economic instability the chances for synergies highly increase. Their aim is to lead in reducing operating cost without diminishing the quality, rising profits and developing in due time.

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International Scientific Conference eRA-7 In early 2000 there was an announcement for cluster creation in the 2nd Community Support, but the results was not encouraging. The 3rd Community Support which included a cluster development within industry and tourism, three proposals concerning industry where submitted and all three got approved. Moreover, four proposals concerning tourism were approved. 1. The first consisted of conferences planning, workshops, exhibitions, etc, and for businesses took part in it. 2. The second considered cruises with the participation one travel agency and six yachting companies. 3. There was also a suggestion involving logistics services και information technology with the participation of one IT company, two travel agencies, and two hotels. 4. Finally, a cluster of Cretan medium sized companies was suggested. These are the four clusters sponsored by the 3rd Community Support. In addition to that non-funded clusters were also developed in Greece. These were formed by companies, enterprises and organizations in favor of coopetition (competition + cooperation). This term suggests that cluster – members do not necessary collaborate but can also compete. Examples of this within the country exist in various sectors such as research, technology, alteration, environment, tourism, etc. 4. Leading Tourism Cluster (L.T.C.) S.A. – The Company L.T.C. is the first synergy of joint procurement in order to achieve bulk purchases prices with tourism. It is the first Greek cluster under the name L.T.C. which was founded October of 2006 from ten hotel chains and individual hotel units (www.ltc.gr) Airotel group, Aldemar Hotels & Spa, Atrium Palace Thalasso Spa Resort & Villas, Capsis Convention Centers & Resort Hotels, Blue Gr Mamidakis Hotels, Caravia Beach, Kontokali Bay, Marbella Corfu Hotel & Bungalows, Nana Beach και Lindos Royal. Leading Tourism Cluster (L.T.C.) capacity presented in Table 1: Hotel units Airotel Alexandros Hotel Airotel Stratos Vassilikos Hotel Airotel Parthenon Hotel Airotel Malaconda Beach, Eretria Airotel Achaia Beach, Patras AIROTEL GROUP Paradise Royal Mare Paradise Village Knossos Royal Village Royal Mare Village Cretan Village Olympian Village Epohes ALDEMAR HOTELS Minos Beach Art Hotel ISSN - 1791 - 1133

No of Rooms. 93 88 79 152 85 615 200 413 435 322 560 22 129 20

International Scientific Conference eRA-7 Candia Park Village Miramare Wonderland Life Gallery Athens BLUE GR MAMIDAKIS Kontokali Bay Hotel Kontokali Bay Hotel Sofitel Capsis Hotel Rhodes Sofitel Capsis Palace & Capsis Beach Hotel CAPSIS HOTELS Marbella Beach MARBELLA BEACH HOTELS Caravia Beach CARAVIA BEACH HOTEL Lindos Royal LINDOS ROYAL HOTEL Νana Βeach NANA BEACH HOTEL Atrium Palace Atrium Prestige ATRIUM Sunshine Corfu Sunshine Crete Sunshine Rhodes SUNSHINE HOTELS

222 175 30 243 694 660 384 300 270 266 316 300 322 329 374

Table 1: L.T.C. Capacity Source: L.T.C. 4.1 Business activity 4.1.1 Purchases L.T.C. offers significant benefits to every Vendor by giving them access to important touristic and similar clientele, increasing the sales volume, simplifying the commercial procedures, announcing to members new services and information in real time. The approved vendors guarantee that L.T.C. can offer goods and services in a vast variety. L.T.C has achieved today very important synergies with lots of companies, such as PepsiCo - Ivi, Creta Farm, Hellenic Fine Oil, Credin, Johnson Diversey and many others. The companies also cover a vast variety of region were L.T.C. members are based (Crete, Kos, Rhodes, Corfu, Athens, Patras, Pirgos, and Eretria) (www.ltc.gr). 4.1.2 Negotiations

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International Scientific Conference eRA-7 L.T.C. using the know–how and its members size plans on their behalf the negotiations of various purchases. The main goal is to create strong collaborations among the members by achieving better prices and quality (www.ltc.gr).

4.1.3 Quality check L.T.C. ensures the quality of purchasing of the members. This is guaranteed by visiting the vendor plants and the hotel members. Furthermore, some of the products go through quality inspections within L.T.C. headquarter. In order to achieve high quality L.T.C. includes the following criteria, which are strictly taken under consideration and checked (www.ltc.gr):  Credibility and certification of approved Vendors.  High standards of goods.  Firm timetable of purchases. 4.1.4 Electronic Ordering System (E.O.S.) L.T.C. is trying to use every technology in favor of its members. The E.O.S. helps them ammelidate the productivity of the purchasing department and the logistics. A complete electronic negotiating and ordering system through the web assuring communication channels (www.ltc.gr). E.O.S offers to the L.T.C. members:  Vast variety of goods and collaborators.  Trust worthy transactions between members and vendors.  Purchasing templates.  Secured delivery of purchases (time and quality).  Reduced operational costs, and others. E.O.S. is a flexible system that constantly is enriched giving the members new potential. 4.1.5 Consulting L.T.C. offers consulting services in managing Food & Beverage from supplying to producing (www.ltc.gr). 4.1.6 Education One of the company’s concerns is the constant and organized education human resource of L.T.C members. 4.2 Economic figures of Leading Tourism Cluster S.A. During its first year Leading Tourism Cluster S.A. mainly focused on Food and Beverage purchasing on its nine members, which consisted of 15.000 beds. L.T.C.’s sales reached 10.500.000€. In 2008 the company negotiated 10.600.000€ in Food and Beverage on behalf of its members which resulted in achieving a benefit ranging from 5-30% for its 30 hotels (17.500 beds).

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International Scientific Conference eRA-7 L.T.C. presents constant increase for its first operational year in 2006 until 2010. The first year the increase 16,9%, the second year was 9% and the third year 15,9% as it is shows in the grand total assets in Table 2. Moreover continuing the analysis of Table 2 is concluded by the performance of fixed assets, the company after the purchase of capital equipment during the initial use is not made some additional important market. As for the current assets is observed for the first year a remarkable increase of 46%, mainly due to increased cash at Bank and in Hand and in the next years also 9% and 11% respectively, mainly from the increase in Debtors. On the total capital and reserves of the company there is a continuous increase, due to the results of accounting periods 2007 - 2010. On the total creditors of the company from 2007 to 2010 did not initially observe any significant variation except for the year 2010. 2010 we see an increase in current liabilities (probably on borrowing) in combination with the high increase in debtors shows potential lending fresh start.

ASSETS FORMATION EXPENSES FIXED ASSETS Tangible Assets Long Term claims Total Fixed Assets CURRENT ASSETS Stocks Debtors Cash at Bank & in Hand Total Current Assets GRAND TOTAL ASSETS LIABILITIES CAPITAL & RESERCES Share Capital Reserves Results carried forward TOTAL CAPITAL & RESERVES CREDITORS Current Liabilities Total Creditors GRAND TOTAL LIABILITIES

2007 22.271,05

2008 0,41

2009 0,41

2010 12.219,27

27.460,41 2.833,00 30.293,41

0,98 2.833,00 2.833,98

1,11 2.833,00 2.834,11

1.314,74 2.833,00 4.147,74

0,00 75.397,57 121.776,58 197.174,15 394.348,30

174,07 102.733,22 186.407,29 289.140,51 578.455,09

167,89 151.556,83 163.869,42 315.426,25 631.020,39

134.537,50 302.351,96 50.405,03 352.756,99 840.051,48

206.159,00 0,00 -44.192,16 161.966,84

206.159,00 731,22 13.893,17 220.783,39

206.159,00 1.300,69 0,72 229.695,41

228.394,00 1.370,20 1.267,74 231.031,94

87.771,77 71.690,60 88.733,25 272.629,56 87.771,77 71.690,60 88.733,25 272.629,56 249.738,61 292.473,99 318.428,66 503.661,50

Table 2: Historical data L.T.C. for accounting period 2007 - 2010 Source: L.T.C.

4.3 Survey The survey was held in order to determine how important and efficient is for a company to be a member of a cluster. The goal of this survey is to determine how

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International Scientific Conference eRA-7 important the clusters are as far as the competiveness increase is concerned the achievement of economies of scales and improvement of the provided services. The survey was held in 10 hotel units across Greece, divided in geographical regions, while the choice of number of hotels was chosen on the basis on their membership on L.T.C. In a question that was raised conservy the opinion the specific hotel units had before joining the cluster, three of them had very positive opinion, three held positive opinion, one had neither positive nor negative and one held negative opinion (Figure 2).

Figure 2: Figure before participating in a cluster

The given results demonstrate the hotels tendency to assure a high percentage of satisfaction from participating in a cluster. The majority of hotel members (7 hotel members) are very satisfied with percentages reaching 70% - 100%. However, there is a small amount of hotel members (1 hotel member) that supports an average satisfaction (40%) (Figure 3).

Figure 3: Satisfaction with participation in cluster

Α large amount of hotel members (75%) considered the creation of a tourism cluster a developing and efficient investment for its members with long and strong term benefits. The remaining 25% supports that the benefits are mostly short term (Figure 4).

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Figure 4: Benefits to participants’ cluster (Hotels - members cluster)

Old surveys have reached to the conclusion that the most important benefits for a cluster member are the following:  Quality upgrade of provided service.  Organization improvement.  Introduction new technologies.  Economies of scales.  Total Quality Management (TQM).  Logistics. The majority (29%) considers that the most significant benefit is economies of scale. In this context, we can mark a high potential develop economies of scale and economies of scope due to the possibility common use of plants in a specific area. Some support (18%) that they would be provided with direct and effective information as far as technology and market changes and technical quality criteria are concerned. A less significant percentage (12%) considers quality and provided service upgrade equal important. Finally, some (6%) think of Logistics as the most significant benefit (Figure 5).

Figure 5: Benefits for a cluster member

All the hotel members of a tourism cluster (100%) agree in expanding the collaboration in various sectors which could give competitive advantages, six out of eight hotel members believe that the sector which involves the Quality assurance systems could also take into consideration an expanding of the synergy, since there is a direct relation with the main cluster sector purchases. Being a member of a cluster gives the company the advantage of having their employees trained by experienced personnel. Therefore a large amount of the survey participants (83%) consider this ISSN - 1791 - 1133

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International Scientific Conference eRA-7 goal as major. Technology and quality check are also areas that can provide competitive advantages (figure 6).

Figure 6: Collaboration sectors

The results of Figure 7 demonstrate the business tendency towards developing and applying new technology in their companies. Technology is present in every activity that adds value in a product (Georgopoulos, 2006: 158). The vast majority of hotel members appear satisfied by the Electronic Ordering System in purchasing department. More specifically, 37% of the participants seem completely satisfied from E.O.S. every day use and 38% seem very satisfied. Nonetheless there is a small percentage of participants appearing relatively satisfied (25%) from its use. New technologies and the internet offer modern and valuable opportunities to the hotel manager, such as constant information availability, transaction and communication 24/7, adjusted to the need of its hotels.

Figure 7: Satisfaction of use Electronic Ordering System

Conclusions Tourism cluster is a business and organization group collaborating and competing each other aiming at designing and delivering the tourist product. These synergies concern tourism destinations, referring to either the whole country of specific destinations. In Greece, clusters are considered essential during this general economic crisis. Today, Greek tourism and commerce come through an intensive and long crisis, hence these goal terms into a deep need. During economic instability the chances for synergies highly increase. Their aim is to lead in reducing operating cost without diminishing the quality, rising profits and developing in due time. In these specific survey Leading Tourism Cluster S.A. (L.T.C. S.A.), the first successful tourism cluster in Greece, was analyzed. This cluster consists of ten hotels, representing more than 10.000 rooms, which collaborated in order to achieve better ISSN - 1791 - 1133

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International Scientific Conference eRA-7 prices due to larger number of purchases. These clusters goal is supplying Food and Beverage in larger quantities show as to achieve lower prices. According to the survey results there is a high percentage of satisfaction among the participants from joining a cluster. This vast majority of the hotel members consider themselves highly satisfied heraeus a small percentage shows average satisfactions. This satisfaction derives from the short and long-term benefits potential. Hence, it is a developing and effective investment. All the hotel members agree in expanding the synergy in various sectors that could provide competitive advantages. The main cluster area which also received the highest percentage of all responses was Quality Assurance Systems. Having access to experienced personnel, training employees, technology and quality check are equally important areas. Finally, most of the hotel members consider themselves greatly satisfied with the Electronic Ordering System. To conclude in these days, that Greek tourism and commerce are going through a rough an intense crisis, the goal of cluster turns into a necessity. During periods of crisis synergy opportunity increase. The main goal of these synergies is to eventually lead into reducing operation cost but also maintain quality, increase profits and development in due time. References [1] Artikis G., (2002), Financial Management - Investment Decisions. Athens: Publications Interbooks. [2] Artikis G., (2002), Financial Management - Funding Decisions. Athens: Publications Interbooks. [3] Georgopoulos, Ν. (2006), Strategic Management. Athens: Publications G. Benou.

[4] Beni M. C. (2003), Globalização do turismo: megatendências do setor e a realidade brasileira. São Paulo: Aleph. [5] Da Cunha S. K., Da Cunha J. C. (2005), Tourism Cluster Competitiveness and Sustainability: Proposal for a Systemic Model to Measure the Impact of Tourism on Local Development. [6] Porter M. E. (1999), Competição, (2nd edition), Rio de Janeiro: Campus. [7] Ivars J.A. (2003), Planificación turística de los espacios regionales en España, Madrid: Síntesis. [8] Lagos D.G., Papathanassiou, Zuhrt D., Triantafyllou G. (2008), Wine Tourism Networks and Business Clusters in the Greek Tourism Industry. [9] Monfort M., V.M. (2000), Competitividad y factores criticos de exito en la ‘‘hoteleria de litoral’’ experiencia de los destinos turisticos Benidorm y Peniscola. (Doctoral Dissertation, Universidad de Valência, Espanha, 2000). Retrieved September 2, 2003, from http:// www.cervantes.com/fichaobra.htlm?Ret=2619. [10] Nordin S., (2003), Tourism clustering and innovation: path to economic growth and development. European tourism research institute. MID – Sweden University. Osternsund: Sweden. [11] Rodrigues A. B. (Org) (2001), Turismo rural. São Paulo: Contexto. [12] Ruschmann D. V. M. (2001), Turismo e planejamento sustentável: a proteção do meio ambiente. (7thed.). Campinas: Papirus. [13] Smith, S. (1989), Tourism analysis. A handbook. New York/London: Longman. [14] World Tourism Organization – WTO (2004), Turismo y desarrollo local sostenible: elemento para un debate. In: Noticias Delnet – Centro Internacional de Formacion de la OIT. n. 24. 2004. Retrieved October 11, 2004, from http://www.world-tourism.org. [15] www.ltc.gr ISSN - 1791 - 1133

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International Scientific Conference eRA-7 [16] www.ltcnews.gr

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Evaluation of providing health services in patients in General Hospital of Piraeus “TZANEIO” Α. Stamatopoulou1, D. Yannacopoulos 2 1. Τ.Ε Management & Economics, MSc(c) International Business Administration 2. Department of Business Administration, TEI of Piraeus, PhD. Introduction The last ten years consumer’s satisfaction of service users, has gained wide recognition as a measure of quality to many services of public sector. Besides the management of the NHS should control performance of health services, in line with expectations and patients’ perceptions. Consumer assessment is a key aspect of quality assurance and its use in the NHS. Additionally, effective communication between healthcare providers and patients is one of the most important elements to improve satisfaction over the results of their health (Steelea , 1992). Health is a social good and adequate health care is a right of every modern society citizen. Therefore, the evaluation of services is a prerequisite for the rational handling of the multiple and often unavoidable problems in this area. Purpose The purpose of this proposal is divided into three parts: The first one is the literature review and the identification of satisfaction criteria of health care services within the principles of total quality . Secondly the investigation of prerequisites and conditions through the assessment of patients’ satisfaction from providers of health care services. Last but not least is the investigation and evaluation of patients’ satisfaction, based on provided services, as well as the investigation of the factors affecting the quality of health care services, provided in G.H .P “Tzaneio”. LITERATURE REVIEW The meaning of providing health services Definition of providing health services: The definition «providing health services» includes the provided services from health care providers, medical staff, hospitals etc (Kuriopoylos et al, 1999). The meaning of patient-consumer Definition of patient-consumer: In the area of health care, words such as «patient», «user» and «consumer», are used as similar. A patient becomes consumer when he or she looks for health services as far as he or she collects useful information, to make the best choice (Shackley & Ryan 1994). The meaning of patient’s satisfaction While reviewing the literature on satisfaction, the first thing that is noticed is the wide variety of definitions that have been proposed in relation to that meaning. Definition of patients’ satisfaction. According to Hunt (1977) satisfaction is considered an evaluation of feelings of an experience. From literature review patients’ satisfaction is considered a quality indicator of care from the side of patients (Ward , 1990). According to Oliver (1997) a sentence that summarizes all the questions that may arise is: "Everyone knows what satisfaction is, until they are asked to give one definition. Then it seems that no one knows. " In order to avoid this problem, many researchers have developed their own theories about how the 'meaning of satisfaction is defined. "Nevertheless it seems that all agree that the level of ISSN - 1791 - 1133

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International Scientific Conference eRA-7 satisfaction is considered as assessment of consumption, a fact that varies from unfavorable to favorable. The meaning of quality The meaning of quality is multidimensional and its multifaceted approach is suitable for what is related to the definition of and to the measurement. In most cases it is defined in relation to the receptor (either consumer or user is) of a product or service. The common perception of quality is more important in services and it is defined into five different categories:  Based on the procedure or completeness: that is meant as the compliance with the demands  Based on value: that is meant as the relationship of cost to producer and price to the consumer  Based on product: that is defined as similar as how well a product is being prepared or a service is functioned  Based on customers: that is defined as the demands for customers’ satisfaction  Transcendent : Quality is defined as innate superiority Models which are referred to factors of service quality It is not possible for the quality of service or product to be reassured without having established the quality factors. According to Grönroos (1978) service quality is consisted of three dimensions:  The technical quality of the result  The functional quality of the institution  The vision of cooperation Researches (Parasuraman et al, 1985) have shown that consumers use criteria for the evaluation of services which are divided into 10 categories:

One of the well-known models which are referred to the quality of service is the model «Servqual» (service quality), which is proposed by Berry L., Parasuraman A., Zeithaml V. A, (1988) and which measures consumer perception of service quality. According to 'model Servqual' the level of quality of a provided service is defined by the expectations of consumers. Furthermore, the «gap model» which was proposed from Parasuraman A., et al (1985), it is referred into 5 gaps:  the gap between the expectations customer & administration’s perception  the gap of specialization in service quality  the gap in providing services  the gap in external communication ISSN - 1791 - 1133

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International Scientific Conference eRA-7  the gap between expected and perceived service Finally, according to Kano model (1984), as higher as are the demands of customer for the quality of product or of the service, so higher is his/her satisfaction for the quality of product or of the service & conversely (Grigoroudis & Spyridaki, 2003). Theory of reassurance of quality of health services According to Donabedian theory (1992) the reassurance of quality of health services aims to the distraction of information from the patients about the function of (structure, procedure, result), so as to be succeed the highest profit with the lowest cost for the patient. Justification of research suggestion Nowdays that the demands of citizens are increasing many other aspects of services are crucial for the reformation of patient's opinion about the quality of health care services (Fitzpatrick, 1991). The evaluation of management contribution must include assessments for the patients’ opinion about the issues that form the public opinion, to promote the media & the policy makers to criticize. The present study aims to investigate patients’ opinion for the level of the provided health care services. Factors causing problems in the quality of providing health services It is supported that hospitals offer a limited range of services and they have lack of ability to deal with complicated problems (Greenwald et al, 2006). Also quality problems are attributed to lack of information from health professionals and it is the main cause of this quality problem, according to perceptions of patients (Chassin, 1998). Deficiencies, (gaps in security, medical errors, quality shortcomings and deficiencies in care), are key factors in the failure of hospital care (Woolf, 2004). Finally, the misuse of health services is responsible for the failure of many hospitals to adopt information about technology, to reduce medical errors and it leads to various forms of improper care by creating problem in service quality (Waguih, 2002). Consequences of satisfaction from providing health services The consequences are criteria of satisfaction of consumers of health services. These are: The probability for prolonged pain, patients’ dissatisfaction for long waiting & the retard of ambulances in certain areas (Derlet, 2000). Moreover, the commercialization of health, which is a central idea of administrative care. As a result, price, cost, quality, availability and sharing of health care is getting closer to the function of a competitive market. The commercialization affects the relation therapy between health professionals and their patients (Pellegrino, 1999). Reference to an International study In a research of OECD that was conducted in 17 countries the average percentage of people who state to be satisfied from health system is seen on the below table. Also, the table shows that Mediterranean countries and USA are in the lowest position.

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Sourc es: European Countries, Euro barometer (1998), USA & Canada, Harvard School of public Health (2000)

Method research For the scientific information gathering, it will be used quantitive method, and numeral information will be collected under the conditions of remarkable control & it will follow a statistical analysis. Furthermore, a structured close questionnaire, that includes questions of Likert category will be used. It is mentioned that the research is on progress. Restrictions of research They are found in the usage of criteria (internal and external validity, reliability, objectivity) and these are:   

The limitations in types of questions of research The probable failure of the application of methodological techniques or instruments The choice of sample & the way of being interviewed in the hospital is an issue that can cause distortions in final results, due to difficulties in the

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

gathering of information from interviews, from focus teams, recordings or another qualitive method The sample is not represantive, the result cannot be generalized

Conclusions The recording of opinions of hospitalized patients is considered to be the main method of assessment, related to the degree of satisfaction of health services. The evaluation is usually confused with quality assurance and these concepts, which are often combined. Based on the literature review that is related to the theoretical background the following concepts were analyzed: a) providing health services, b) patient-consumer, c) patient’s satisfaction, and d) quality. Subsequently the models that are referred to the factors that lead to quality health services and theories relating to the management-ensuring quality. It is expected that this study will result in the recording, investigation and assessment of the degree of patient satisfaction from health care services and also will identify factors that contribute to the improvement of services.

REFERENCES 1) Chassin, M.R., (1998), “Is Health Care Ready for Six Sigma Quality?”, The Milbank Quarterly, Vol. 76, No 4, pp 565-591. 2) Derlet, R.W., Richards, J.R., (2000), “Overcrowding in the nation’s emergency departments: complex causes and disturbing effects”, Annals of Emergency Medicine, Vol. 35, No 1, pp 63-68. 3) Donabedian, A., (1992), “Quality assurance in health care: consumers' role”, Quality in Health Care, Vol. 1, pp 247-251. 4) Fitzpatrick, R., (1991), “Surveys of patient satisfaction: Important general considerations”, BMJ, Vol. 302, pp 887-889. 5) Greenwald, L et al., (2006), “Specialty Versus Community Hospitals: Referrals, Quality, And Community Benefits”, Health Affairs, Vol. 25, No 1, pp 106-118. 6) Grigoroudis, E., Spyridaki, O., (2003), “Derived vs. Stated Importance in Customer Satisfaction Surveys”, Operational Research, Vol .3, NO 3, pp 229-247. 7) Grönroos, C., (1978), “A Service Oriented Approach to Marketing of Service”, European Journal of Marketing, Vol. 12 No. 8 pp 588-601. 8) Hunt, H.K., (1977), “CS/D Overview and Future Research Direction: In Conceptualization & Measurement of Consumer Satisfaction and Dissatisfaction”, ed Cambridge, England. 9) Kuriopoulos J et al., (1999). “Financial of health from A –Z ”, Public Exantas, Athens. 10) Mano, H., Oliver, R. L., (1993), “Assessing the Dimensionality and Structure of the Consumption Experience: Evaluation, Feeling and satisfaction”, Journal of Consumer Research Vol. 20, pp 451-466. 11) Parasuraman, A., Zeithaml, V.A., Berry, L.L., (1985), “A Conceptual Model of Service Quality and its Implications for Future Research”, Journal of Marketing, Vol. 49, pp 41-50. 12) Pellegrino, E.D., (1999), “The commodification of medical & health care: The moral consequences of a paradigm shift from a Professional to a Market Ethic”, Journal of Medicine & Philosophy, Vol. 24, NO 3, pp 243-266. ISSN - 1791 - 1133

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International Scientific Conference eRA-7 13) Shackley, P., Ryan, M., (1994), “ What is the Role of the Consumer in Health Care?, Journal of Social Policy, Vol. 23, pp 517-541. 14) Steelea, K., (1992), “Patients as experts: Consumer appraisal of health services”. Public Money & Management, Vol. 12, Νο 4, pp 31-37. 15) Waguih, W.I., (2002), “Outcome Measurment in Psychiatry: A Critical Review”, American Psyciatric Publishing, USA. 16) Ward, R.A., (1990), “Age and patients of HMO satisfaction”, Journal of Aging and Health. 17) Woolf, S.H., (2004), “Patient Safety Is Not Enough: Targeting Quality Improvements To Optimize the Health of the Population”, Annals of Internal Medicine, Vol. 140, No 1, pp 33-36.

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Educational policy against Social Exclusion in the context of Financial Crisis: The case of Greek Second Chance Schools Brinia Vassiliki1, Tziafetas Konstantinos2 1

Athens University of Economics and Business vbrinia@aueb.gr 2 Adult Education M.ed., Hellenic Open University Kon.tziaf@gmail.com

Abstract This paper presents part of the results of research conducted in Second Chance Schools (SCS) of Greece in May 2012. Main purpose of the survey was to map the dimensions of social exclusion of SCS students and examine the effectiveness of applied educational policy against social exclusion in the context created by the current economic crisis. Due to the extensive geographical dispersion and the increased heterogeneity of the sample a quantitative investigation of the issue was implemented. Data was collected by a structured questionnaire that was constructed solely for the purpose of research. The survey took place in 13 schools. The results paint a very difficult situation for trainees that is characterized by high unemployment, financial hardship and social degradation. Inductive data analysis does not constitute a clear relationship between the prospect of continuing education to better address these difficulties. Thus, considerable doubts emerge on the effectiveness of present educational policy against social exclusion.

Introduction For modern societies, the restraint of inequalities and the assurance that everyone can have equivalent access of all the opportunities constitute not only a matter of democracy and justice but also an essential parameter of social and economic growth (Ευρωπαϊκό Συμβούλιο, 2004∙ Φωτόπουλος, 2008∙ Ευρωπαϊκή Επιτροπή, 2010). In order to set the foundations for the achievement of these objectives, European Union announced its commitment for direct and coordinated confrontation of poverty and social exclusion and implemented flexible, compensatory, ALM1 policies that are suitably adjusted to the particularities of each member country (European Council, 2000∙ Bradshaw & Mayhew, 2010). Given the central importance of education in the reproduction of discriminations and inequalities these policies include inter alia educational regulations that aim to create the conditions for emancipation of the excluded from the social providence and the social transfers (European Council, 1995· Κογκίδου κ.συν., 1997· Σπανού, 1999· Brandsma, 2000· Φραγκουδάκη, 2001· Carrera & Geyer, 2009∙ Doherty, 2011). Second Chance Schools2 (SCS) are a key part of these regulations seeking the rehabilitation in the employment and the society of adult individuals that did not complete the obligatory education (European Commission, 1999∙ Oster, Linna, Jansen & Carvalho, 2000∙ Γ.Γ.Δ.Β.Μ., 2010). The repercussions of present economic situation in combination with the consequent social policy and the deep recession which Greece has entered the last three-year period compose legitimate questions about the degree in which the promoted educational policy is capable toaddress effectively the problem of social exclusion under the conditions created by the current economic crisis (Ευρωπαϊκή Επιτροπή, 2011a·Gulson & Fataar, 2011∙ Μπαλούρδος, 2011). As a primary institution of adult education, SCS are additionally invited to alleviate the impact of 1

Active Labor Market For information about the institutional frame and the legislation that concerns the conditions under which SCS (Σ.Δ.Ε.) operate in Greece check Law 2525/1997 (Official Journal Of the Hellenic Republic 188/23/9/1997, t. [A]΄, article 5, [par].1 and the Ministerial Decisions [Y].[A]. 2373/2003, article 1, [par].2 and [Y].[A]. 260/2008) 2

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International Scientific Conference eRA-7 the economic crisis. Providing opportunities for improvement of dexterities and adaptability of individuals with low qualifications so that they would be able to correspond effectively in the new requirements of employment, SCS are expected to facilitate the reduction of unemployment rates (G.H.K., 2011β). However, in order to achieve, this target they must firstovercome the difficulties caused by the underfunding and the disorganization that characterizes the design and organization of LL3 in Greece (K.AN.E.Π. - Γ.Σ.Ε.Ε., χ.χ.∙ Κουράκης, 2011). On this basis it was decided to conduct a research on the degree of social exclusion that are faced by the educated people at SCS, as well as on the general effectiveness of current educational policy against the social exclusion in Greece (Μουσούρου,1998). This paper presents part of the results of this research relating to the effectiveness of SCS in the interconnection of their students with the labor market and the extent to which they manage to motivate them to participate in LL, especially under the circumstances that rise under the present economic crisis.

The field of the research The importance of the present research is based on the central position that social exclusion possesses for social and economic growth in combination with the negative repercussions of present economic situation that are expected to affect negatively the effort to change the situation and evade the crisis (Eurostat, 2010· European Commission, χ.χ.∙ European Commission, 2010a∙ Matsaganis & Leventi, 2011). Even if there is not an explicit and well accepted definition of social exclusion among the scientific community, the latter is comprehended as a multidimensional, dynamic activity of “detachment” from the social web that renders the individuals incompetent for equivalent participation in economic, social, political and cultural life of the society in which they belong (Sen, 1992∙ Levitas, 1999∙ Gallier & Paugam, 2002∙ Byrne, 2005∙ Καβουνίδη, 2005∙ Μπαλούρδος, 2006). This process has significant psychological, social and economic impacts on both the individuals and the society as a whole (Papadopoulos & Tsakloglou, 2005∙ Shepey, 2005∙ Twenge et al., 2007· Williams, 2007∙ Oaten, Williams, Jones & Zadro, 2008∙ Σδράλη και Καραμέτου, 2008∙ Παπάνης, Γιαβρίμης & Βίκη 2009). The failure of the objectives of strategy “2010: European Year for Combating Poverty and Social Exclusion” and the important increase of the number of European citizens who face the danger of poverty and exclusion demonstrate the inefficiency of European social policy round this issue despite the repeated engagement of EU for its confrontation (European Council, 2000∙ Ι.Κ.Κ., 2004· Bradshaw et al., 2010a, 2010b· European Commission, 2010b· Eurostat, 2010). The strategy “Europe 2020” constitutes the latest effort of EU for a model of growth with inclusive social character seeking the convergence of European states in matters of social protection and integration, education and ALMP (European Commission, 2011· European Commission, 2010c). In this way social, educational and labor policies are interlinked and LL is upgraded in order to constitute the dominant channel for employment integration and social incorporation (Μαυρογιώργος, 1999∙ Χρυσάκης, 2005∙ Šefčovič, 2009∙ Ευρωπαϊκή Επιτροπή, 2011b). However, despite the growing concern of social issues in the EU and the developing discourse round the social exclusion, EU’s main economic orientation and strong political desire to become the dominant global 'knowledge economy' compose doubts for the social character of the applied regulations (European Council, 2000· 3

Lifelong Learning

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International Scientific Conference eRA-7 Aust, Daguerre & Gooby, 2002· Ρέππας, 2002· EurLex, 2004). The economic weakening of several European educational systems and their subsequent disability to moderate the effects of economic crisis strengthen these doubts, considering particularly the more general divergence between the official statements of the confrontation of social problems (as the exclusion) and the consequent economic and political choices (Buffandi as cited in Σπανού, 1999 Ε.Ι., 2009∙ Ο.Λ.Μ.Ε., 2012). Under an alternative prospect, the educational measures against social exclusion can, therefore, be seen as an attempt to balance the dominant discourse on the knowledge economy with the traditional argumentation that looks upon education as a vehicle of democratization and means of establishing equal opportunities (Βελισσαρίου, 2005a, 2005b). Specifically regarding Greece, the underfunding of education (diachronically lower than the average in EU and without meeting the specific criteria that the latter places for its members) contributes largely to the poor performance of the Greek educational system in international competitions (like P.I.S.A.) and it composes significant doubts regarding the ability of Greek education to contribute to the prevention of social exclusion, especially under the present conditions (Meghir, Vayanos and Vettas, 2010). The SCS as one of the established measures for the confrontation of social exclusion and the moderation of effects of economic crisis are appropriate for the investigation of tripartite relation between educational policy, social exclusion and economic crisis. The lack of previous surveys in Greece concerning the special characteristics of social exclusion of SCS students which obscures the problems faced by those who do not possess the qualifications necessary for satisfactory access to the labor market strengthened the particular choice.

Purpose of the research The main aim of this research was to investigate the effectiveness of educational policy against social exclusion in the context created by the economic crisis. Towards this direction it was chosen to specify the living conditions of the SCS students and consequently to examine the extent, to which the SCS, as an institution entrusted with this role, manage to guide their learners to LL and link them with employment achieving the improvement of prospects of their social re-integration. On this basis, the research questions of this thesis were formulated as follows: • What impact has the current economic crisis on the living conditions of trainees in Second Chance Schools? • Is the current educational policy against social exclusion effective, as implemented in SCS?

Methodology The focus of this research in testing specific hypotheses and the investigation of each case exclusively in relation with the parameters of the research highlighted as appropriate methodological approach aquantitative inquiry of the issue by using a structured questionnaire for data collection (Κυριαζή, 2009∙ Τσιώλης, 2011). The high heterogeneity and the extensive geographical dispersion of the sample, the multidimensional nature of the investigated subject and the personal nature of the questions, reinforced this choice. It can adequately cover the range of different cases by gathering data from a large population with low cost, in a short time, minimizing validity issues (Παρασκευόπουλος, 1993· Δημητρόπουλος, 2001).

The questionnaire ISSN - 1791 - 1133

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International Scientific Conference eRA-7 The questionnaire used is improvised and prepared in accordance with the requirements of the specific research, following the general rules of questionnaire configuration (Cohen & Manion, 1997· Bird et al., 1999· Κατερέλος, 2008· Κυριαζή, 2009) and using cues from previous relevant studies ( Ι.Κ.Κ., 2004· Μπαλούρδος, 2006· Ρετινιώτη & Μάντζιου, 2010· Eurostat, 2011). The wording, scope and content of the questionnaire are adapted to the characteristics of the sample. The questions are divided into three sections that they examine at line, demographic elements, information regarding the welfare of the participants and the participants’ degree of agreement with suggestions for the improvement of their social and economical status. To facilitate the process the questionnaire was also posted on the Internet. A short preliminary investigation to a small number of trainees lead to appropriate modifications prior to its use increasing its validity for the purposes of the survey.

Data collection process Data collection was delayed due to problems encountered in the process of adopting the necessary license from the I.NE.DI.BI.M.4 and finally took place in May of 2012. The process, in most cases included the researcher's (or appropriately informed collaborator’s) visit to the field and the collection of the data, on a voluntary basis after a short briefing on the purpose of the research and the details of the procedure. The completion of the questionnaire was held usually in the presence of the researcher and the educator of the class for the specific teaching period. Due to the high geographic dispersion of the sample, in cases where it was impossible for the researcher (or his colleagues) to be present, it was decided, with the directors’ consensus, to collect the data either by posting the questionnaire to the school or by completing it on line. Councils of these schools and ICT teachers helped in order to complete the process without any problems. Out of the total number of 600 questionnaires that were given out, 432 were returned completed. After the necessary checking remained 409 questionnaires that had a sufficient number of responses, percentage that makes roughly 68%. The data contained in these were digitized using the program Open Office Calc v. 3.2.1., and encoded by applying consequently coding rules in the data set. The final matrix was imported in SPSS v. 17.0, where the data were analyzed statistically.

Validity The utilization of data from previous, similar researches for the construction of the questionnaire supported its criterion validity and its conceptual design. The particularities of sample, however, led to the reduction of examined dimensions of social exclusion to the most essential in relation to the population, a fact which limited the questionnaire’s content validity. The support of the participants during the collection of data contributed, also, in the validity of the whole process.

Reliability The external checking of the consistency was impossible due to time constraints and methodological limitations. Regarding the internal consistency of the research instrument, Cronbachs alpha was used to check the homogeneity of using the different sets of questions. The results show a sufficient degree of internal reliability (Ζαφειρόπουλος, 2005). Specifically: 4

Institute of Youth and Life Long Learning (Ινστιτούτο Νεολαίας και Δια Βίου Μάθησης).

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International Scientific Conference eRA-7 Table 1. Internal consistency of the questionnaire

Scale Reasons for returning to SCS Every-day problems Events worsening economic situation Housing problems Region of residence Proposals and perspectives

Cronbach’s alpha 0,711 0,763 0,803 0,661 0,842 0,774

Results The analysis of the results shows that the majority of respondents are married women who are in their first year of their studies and are in the fourth decade of life. They have stopped school, mainly for economic reasons and usually live in urban areas, in families with two to five members and have returned to the SCS mainly in order to upgrade their education level, but also to gain credentials and skills required by the labor market. Unemployment is a severe problem among participants of whom 47% declare to be workers, 41% unemployed, 6% housewives and 4% pensioners. Remunerated work is the main source of income for only 45% of trainees out of which about one in two is fully employed and nearly one in three does more than one job. The 67% of respondents stated that the unemployment is a severe problem in their living region (hardly 6% think the contrary) while the 54% are having more than one unemployed person in their family. Equivalently important is also the problem of poverty, with the 55% considering its rate high in their region.For nearly three in four respondents the frequency of confrontation of economic difficulties was increased due to the economic crisis. 33% of the respondents live in houses with important deteriorations which they are unable to repair due to their financial status depending on help from relatives and friends or social welfare benefits for their survival. The important economic decline of the last three years has a preponderant role in this situation. Only 2% states that lives comfortably with their income, while seven out of ten consider it insufficient to meet their needs. As a result, the students of SCS face a grid of acute difficulties which compose a generalized and multidimensional difficulty in meeting basic financial obligations. Applying the non-parametric test based on Spearman's ρ was found that such problems (e.g. difficulties in paying bills) strengthen responents’ claim to find permanent work (a = 0,002, cc = 0,164) and orients them to look for a job after graduation (a = 0,007, cc = 0,169). About six in ten students expect their graduation to contribute significantly in the improvement of their living conditions. They feel that dropping out of school led to increased difficulties and state that they intend to continue their studies. Even though 53% of the respondents correlate explicitly this choice with the improvement of their life, the statistical analysis of the results shows that there is no such significant relationship between the examined variables. Applying non parametric testing based on Spearman’s ρ we found that willingness to continue studies is associated with the existence of employment centers in the region of residence (a = 0,049, cc = 0,134) and the positive expectation of attendance of SCS (a