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The purpose of this paper is to improve the mammography and ultrasound screening processes to increase the healthcare system quality and patients’ pleasantness while decreasing costs.

The data storage system is very insufficient so that data are collected from hospital staff and by personal observations. A lean management tool, value stream mapping is used to see the general view of the radiology department with its problems at a glance. Data and the map are used as a guide to conduct a quality house to make a prioritization between the problems, to decide which one to solve first, of patients at the hospital.

Problems of the radiology department related to mammography and ultrasound and suggestions to these problems according to the quality house conducted.

The paper consequently focuses on the value creation process and on how to revisit managing for quality in the systems perspective.

The purpose of this paper is to design a future value stream map of the system and patient pathway with lean health care application tools in terms of quality improvement (QI) in order to decrease the non-value-added activities for patients, doctors, and nurses for a radiology unit in a public hospital based in Istanbul, Turkey.

Data are collected from personal observations, information technologies unit, and authorized employees. In order to measure subprocesses, some qualitative data are transformed into quantitative data via authorized employees’ experiences. Moreover, data tracking and keeping systems are too poor for revealing the current situation.

The current value stream map of the system of the radiology department of a public education and research hospital was analyzed and the future value stream map of the system and patient pathway was redesigned with lean health care application tools in terms of QI.

The greatest limitation is the resistant to change and fear of talking on mistakes and low performances.

This paper states an example of a current and future value stream map showing step by step where the bottlenecks are and how these can be improved and what specific benefits will this analysis bring to the health care system. It will be useful for both academicians and practitioners on how to apply lean to health care.

The purpose of this paper is to employ quality function deployment (QFD) method for translating internal customer needs and expectations into appropriate service specifications to perform existing process assessments in relation to quality characteristics for increasing internal customer satisfaction.

The integration of SERVQUAL into QFD has been used to set the success factors to improve quality in the textile industry. One of the largest textile companies in Turkey provided the sample. A SERVQUAL-type of questionnaire was used and a total of 32,938 questionnaires were distributed both manually and online, 24,551 usable were received, comprising a response rate of 77.31 percent.

Findings of the QFD application suggest internal customer focus as having the highest weight score of almost 12 percent improvement. In addition, improvements in technical requirements of politeness and process communication have a 9 percent impact each on internal customer satisfaction criteria.

QFD technique is able to provide companies with a better understanding of internal customer expectations and translate these into appropriate service specifications and perform existing process assessment.

This paper is a first attempt that applies this integrative approach to a different type of industry, thus offering practical and applied information for professionals engaged in academia and as practitioners.

The aim of this research is to examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Istanbul evaluate quality of health care to be similar or different to that of the Kazakhstani, Egyptian and Jordanian patients.

A conceptual model including behavioural dimensions of patient‐physician relationships and patient satisfaction has been used for approach. As the empirical research setting, this study concerns people who are or were patients once in Istanbul hospitals.

The questionnaire was taken from another research regarding Egyptian and Jordanian medical clinics. The same research was also done by the authors in Kazakhstan in 2008. A total of 48 items (attributes) of the newly developed five quality dimensions (5Qs) by the second author were identified to be the most relevant.

The results of this study can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health care quality strategies.

A 5Qs model to measure the patients' satisfaction of medical care is proposed as for previous studies for Kazakhstanian, Egyptian and Jordanian hospitals. As mentioned previously the 5Qs model encompasses technical, functional, interaction, infrastructure and the atmosphere qualities and services. The results can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health care quality strategies.

This paper aims to explore the best strategy for Turkish SMEs to obtain world class manufacturing status.

A questionnaire was used as a reaserch tool. From the results of a questionnaire, a factor analysis is used to reduce 42 quality management practices into a smaller set of dimensions. The resulting dimensions (factors) were used as independent variables for multiple regression analysis, which is used to evaluate whether relationship(s) exist between company's exporting, being ISO 9000 certified, and the belief that ISO 9000 guarantees the quality of the product or service supplied.

The ten dimensions resulting from the factor analysis was information analysis, quality results, strategic planning, customer satisfaction, leadership, management process quality, business outcome comparative and human resource utilisation. The first finding from the multiple regression analysis identified a relationship between exporting and paying attention to quality results plus documenting technical quality of their product or service as compared to other companies. The second result was that the application of the quality management practices does not depend on being ISO 9000 certified. The third finding was proving the relationship between the belief of ISO 9000 guaranteeing the quality result and leadership. Finally, the paper concludes with the best strategy for the local SME's to become a world‐class manufacturer and this was found to be “six‐sigma benchmarking.”

The questionnaires was distributed to only Turkish SME's in the electric‐electronic industry. The number can be enlarged and also new industries can be added to the research.

A very useful guide for the companies who want to be a world‐class manufacturer.

This paper does not only give information on the industry but also shows the path towards being a world‐class manufacturer.

The purpose of this paper is to describe how quality function deployment (QFD) methodology was employed for translating customer needs and expectations into the quality characteristics in a private healthcare setting. This case study illustrates how an existing approach of SERVQUAL and QFD integration can be applied for quality improvement.

Integrating SERVQUAL into QFD to set the success factors to improve quality in the healthcare industry is the main aim of this paper. A privately‐held university hospital, within the city of Istanbul in Turkey, was selected as the sampling frame. A SERVQUAL‐type of questionnaire was used and a total of 250 questionnaires were distributed and 210 of them were received. Usable responses were 170, comprising a response rate of 68 percent.

From the results of the QFD application it is seen that behavior and attitude of staff has the highest weight score, meaning that when behavior and attitude of staff is improved there will be almost 25 per cent of improvement in the hospital. Another finding was that there is strong relationship among skills of physician, behavior and attitude of staff, and having enough modern equipment.

QFD technique is able to provide hospitals with a better understanding of customers' expectations to translate these expectations into appropriate service specifications and perform existing process assessment.

The case study was a first attempt to apply this integrative approach to a service sector and thus offers practical and applied information useful to both academicians and practitioners.

The aim of this paper is to investigate and define the competitive positioning of banks including state‐owned, domestic and foreign banks operating in Istanbul, Turkey. The aim is to check the competitive marketplace and to identify the major quality attributes, which bankers themselves and their customers used in determining the overall perception of a given bank and services offered.

The investigation was held in Istanbul, Turkey. In total, 30 banks were included in the research, which includes state‐owned, local and foreign‐owned banks. A total of 1,530 questionnaires were submitted, answers collected and analyzed. Reliability test and frequency analysis were used to analyze the data.

From the banks' customers' point of view, determinants relating to functional quality or how the customers wish to receive banking services became evident. It also became clear that customers of banks are not fully receiving what they want or need and their expectations, especially on the most important attributes of quality, are not being met.

The survey showed how the banks were selected and including their employees in relation to the other competitors' banks in the Turkish banking industry.

The paper demonstrates an integrated technology, use of staff talent and streamlined operations that respond to customer needs and encourage customers to use the whole range of banking products/services rather than only a few as the end game. The results were used by bank staff later on to reengineer and redesign creatively their positioning strategy and the future direction for creating more effective quality strategies.

This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan.

A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly‐developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data.

The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staff's concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer‐orientation strategy is recommended.

Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies.

Patients in three countries have similar concerns and quality perceptions.

The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change‐oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.