A community hospital system realized that approximately 2,000 patients were leaving its emergency department (ED) each year without receiving medical attention. This hospital system realized that majority of these patients who did not receive medical attention had minor ailments and conditions which could be treated by a primary care physician. However, the patients who were leaving without medical treatment was negatively affecting the ratings of the hospital system so they hired you as a Public Health Administrator to help improve service delivery at the ED. In your first month in as the Administrator, you realized that 500 patients left the ED without receiving medical attention, which was higher than the 200 reported for the same month last year. To help understand why these patients were leaving without receiving medical care, you reach out to a few of them. You then realized that the main issue that these patients who did not receive care and other patient who even received care complained about the was the rudeness and unprofessionalism of the staff at this hospital. From the perspective of the staff, majority of them attributed the issue to overcrowding in the emergency department. Knowing that overcrowding can definitely influence how staff worked at the ED, you implemented a mandatory training program in good customer service practices for all the 50 staff working at the ED in your third month of employment. You made all staff complete a Customer Relationship Management (CRM) Questionnaire before and after the mandatory training program. The scores range from 0 (poor customer relation) to 100% (excellent customer relation) with a positive change of 7.5% considered as improvement in good customer relationship. Information for the staff at the ED are available in the lesson page under dataset folder called "Emergency Department data". Please use this data (whenever applicable) to answer the following questions. Provide data from your SPSS output to support your answers whenever possible (copy and paste them into this document). Ensure that you provide confidence intervals in your outputs wherevers applicable.

1. Perform a paired t test to test whether the training program resulted in a change in customer relation scores in staff before and after the program. Provide relevant information from your SPSS output here

Did the training program bring change in customer relationscores before the training program and the customer relation after the training program? Support your answer with statements (ideally a short paragraph) based on data from your SPSS output.