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Examining the role of service climate in health care: An empirical study of emergency departments

Claudia Steinke (Faculty of Business, University of Victoria, Victoria, Canada)

International Journal of Service Industry Management

ISSN: 0956-4233

Article publication date: 25 April 2008




Using a modified version of the service profit chain, the purpose of this paper is to examine the mediating role of service climate (SC) by exploring predictors of SC (i.e. service training (ST), managerial practices (MP), physical design (PD), and job design ( JD), job satisfaction ( JS), and employee empowerment) on service quality (SQ), client satisfaction (CS) with service, and client empowerment (CE). The larger proposition being that certain structural variables, through their impact on SC have the potential to positively influence outcomes in health care.


Registered nurses (N=180) from emergency departments across one province in Canada provided information about internal SQ (i.e. ST, MP, PD, and JD), JS, feelings of empowerment, and SC. Furthermore, these nurses provided information on external SQ, CS with service, and CE by responding to questions from the vantage point of the client. The data were analyzed using statistical package for the social sciences; structural equation modelling (SEM) was implemented using LISREL.


SEM analyses showed that JS and empowerment only partially mediated the relationship between MP, PD, and JD and SC. In addition, SQ, CS with service, and CE were fully mediated by SC.

Research limitations/implications

A limitation of this study is that the researcher used only employee (nurses) data rather than employee and client data simultaneously in the research model. Future research should be done on the service profit chain theory to incorporate both viewpoints. In addition, research could be carried out in other service occupations and organizations to test the invariance of the research model.

Practical implications

The results should lead health care managers to consider the importance of emphasizing internal SQ features that facilitate SC in health care.


This contribution of this research is apply the service profit chain framework in exploring the role of SC in health care. In addition, emphasize the importance of the PD of emergency department to creating a climate for service in health care.



Steinke, C. (2008), "Examining the role of service climate in health care: An empirical study of emergency departments", International Journal of Service Industry Management, Vol. 19 No. 2, pp. 188-209.



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

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