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Using an adapted approach to the Kano model to identify patient needs from various patient roles

Susanne Gustavsson (Skaraborg Hospital, Skövde, Sweden)
Ida Gremyr (Department of Technology Management and Economics, Chalmers University of Technology, Göteborg, Sweden)
Elisabeth Kenne Sarenmalm (Skaraborg Hospital, Skövde, Sweden)

The TQM Journal

ISSN: 1754-2731

Article publication date: 11 January 2016




The purpose of this paper is to study how an account of multiple patient roles when using the Kano model in healthcare improvements can support identification of a wide range of patients’ needs.


The study presented in this paper was part of a longitudinal action research study. The empirical material was collected by various methods (interviews, a focus group, participative observations, and a survey) over a two-month period within the Children’s and Women’s Healthcare department in a Swedish hospital. The respondents included the management team, healthcare professionals, patients, and the patients’ partners.


The study shows that incorporating a view of multiple patient roles into application of the Kano model, and using input on customer needs obtained from patients, relatives, and healthcare professionals, helps to identify a wide range of patients’ needs.


The view on patients within healthcare is being transformed from one based on servility to that of patients as customers. This paper elaborates on a hands-on way of applying the Kano model based on a view of multiple patient roles as a means to support this new patient view. The application builds on input from various groups (such as patients and healthcare professionals), and, by using input from various stakeholders. This approach appears to overcome a gap, identified in earlier research, of either relying solely on patients, or solely on healthcare professionals, when identifying patients’ need. Rather input from several groups – patients, relatives, and professionals – are suggested to be used in combination.



The authors are grateful to the management team at the Children ' s and Women ' s Healthcare department at the Skaraborg Hospital in Sweden for their contribution of empirical material and reflective dialogues, as well as their willingness to improve care for newborns and their mothers (and partners). The authors extend special thanks to Sonja Kvint, the manager of the division. This work was supported by the Research and Development Centre, Skaraborg Hospital; and Vinnvård through the Centre for Healthcare Improvements (CHI) (, which is gratefully acknowledged.


Gustavsson, S., Gremyr, I. and Kenne Sarenmalm, E. (2016), "Using an adapted approach to the Kano model to identify patient needs from various patient roles", The TQM Journal, Vol. 28 No. 1, pp. 151-162.



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