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1 – 10 of over 28000
Article
Publication date: 1 November 2006

Pui‐Mun Lee, PohWah Khong and Dhanjoo N. Ghista

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of…

4087

Abstract

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of service quality. To measure this impact, the potential loss of customers due to poor quality service is measured. A potential customer loss model is proposed. To address the competitive and financially driven healthcare delivery business, a three‐pillar approach, termed the Excellent Healthcare Service Model (EHSM), is introduced. This approach advocates that the healthcare industry should use a system view to deliver quality healthcare by taking into account quality, cost, and efficiency factors in a holistic manner. Design/methodology/approach – In this paper a survey questionnaire was used to gather data necessary to compute impact of deficient healthcare service. The questionnaire was administered to a sample of 400 people and the survey method used was intercept interview. Customer loss and potential customer loss due to deficient service were computed. Findings – In this paper, findings from the research indicated that, in the healthcare industry, for every 100 customers that experienced deficient service, about 70 customers would be unlikely to patronize the same organization again. In addition, for the same 100 customers who have experienced deficient service, about 75 of them will go on to tell on average nine family members and friends about their experiences. Through word of mouth from these 75 dissatisfied customers, there will eventually be about 465 persons who might have been potential customers but will probably not patronize the organization at all based on what the dissatisfied customers have told them. Practical implications – The ideas presented in this paper provide a new way of looking at service quality performance, through the impact of deficient service. With this knowledge, economic impacts of poor service quality could easily be quantified, and such economic‐based results are usually a better motivator for managers and workers to deploy quality improvement initiatives. Originality/value – The results and ideas presented in this paper are valuable for the healthcare industry. It provides an alternative approach to quantify service quality performance. The paper also proposes a system‐based approach to enhance service process performance.

Details

The TQM Magazine, vol. 18 no. 6
Type: Research Article
ISSN: 0954-478X

Keywords

Article
Publication date: 1 March 2004

Adam Fadlalla and Nilmini Wickramasinghe

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is…

1360

Abstract

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also under a stringent timeline to become compliant with the health insurance, portability and accountability act (HIPAA) regulatory requirements. Robust healthcare information systems (HCIS) become critical to enabling healthcare organizations address these challenges. Hence, it becomes an imperative need that the information that is captured, generated and disseminated by these HCIS be of the highest possible integrity and quality as well as compliant with regulatory requirements. This paper addresses this need by proposing an integrative framework for HIPAA compliant, I*IQ HCIS. It bases this framework on an integration of the requirements for HIPAA compliance, the principles of information integrity, as well as the healthcare quality aims set forth by the Committee on the Quality of Healthcare in America.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 November 2001

Slavica A. Ritonja and Zvonko Hocevar

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare

1308

Abstract

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes classification”. The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare.

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Open Access
Article
Publication date: 27 September 2022

Olusegun Emmanuel Akinwale and Olusoji James George

The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare

Abstract

Purpose

The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in underdeveloped nation. This study investigated the rationale behind medical workers' brain-drain syndrome and the quality healthcare delivery in the Nigerian public healthcare sector.

Design/methodology/approach

To stimulate an understanding of the effect of the phenomenon called brain drain, the study adopted a diagnostic research design to survey the public healthcare personnel in government hospitals. The study administered a battery of adapted research scales of different measures to confirm the variables of interest of this study on a probability sampling strategy. The study surveyed 450 public healthcare sector employees from four government hospitals to gather pertinent data. The study used a structural equation model (SEM) and artificial neural networks (ANNs) to analyse the collected data from the medical personnel of government hospitals.

Findings

The findings of this study are significant as postulated. The study discovered that poor quality worklife experienced by Nigerian medical personnel was attributed to the brain-drain effect and poor healthcare delivery. The study further demonstrated that job dissatisfaction suffered among the public healthcare workforce forced the workforce to migrate to the international labour market, and this same factor is a reason for poor healthcare delivery. Lastly, the study discovered that inadequate remuneration and pay discouraged Nigerian professionals and allied healthcare workers from being productive and ultimately pushed them to the global market.

Originality/value

Practically, this study has shown three major elements that caused the mass movement of Nigerian healthcare personnel to other countries of the world and that seems novel given the peculiarity of the Nigerian labour market. The study is original and novel as much study has not been put forward in the public healthcare sector in Nigeria concerning this phenomenon.

Details

Arab Gulf Journal of Scientific Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1985-9899

Keywords

Article
Publication date: 2 June 2022

Javed Ali, Ahmad Jusoh, Norhalimah Idris, Khalil Md Nor, Yulin Wan, Alhamzah F. Abbas and Ahmed H. Alsharif

The purpose of this study is to explore the literature of healthcare service quality for identifying and analyzing the healthcare service quality models and dimensions and…

Abstract

Purpose

The purpose of this study is to explore the literature of healthcare service quality for identifying and analyzing the healthcare service quality models and dimensions and to present future research insights pertaining to the applications of these models and dimensions.

Design/methodology/approach

A literature review of healthcare service quality has been performed on 59 relevant studies after applying inclusion and exclusion criteria. Google Scholar and Scopus are the primary sources to find the relevant documents. Search was limited to keywords of “service quality,” “healthcare,” “models” and “dimensions.”

Findings

The results revealed that different models and dimensions have been evolved and developed after SERVQUAL in healthcare service quality literature. There is still a need to develop new models, add new contextual dimensions and items in existing models on different aspects of healthcare services. There is also a need to incorporate the perspective of service providers as respondents. Moreover, healthcare service quality models can be devolved or narrowed down at department and individual levels.

Originality/value

This study presents valuable research insights for the researchers and practitioners in ways that healthcare service quality models and dimensions can be developed, modified and tested further in different research contexts and settings. Besides, the literature on healthcare services can be enhanced and enriched.

Details

The TQM Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 8 March 2022

Nitin Gupta, Prem Vrat and Ravindra Ojha

The Healthcare sector is one of the important sectors of the Service Industry. It is believed that in this sector, the customer server relationship is very critical, and…

Abstract

Purpose

The Healthcare sector is one of the important sectors of the Service Industry. It is believed that in this sector, the customer server relationship is very critical, and even the slightest gap in the people quality may have a huge impact on the delivered service quality. Some of these enablers are doctors, nursing staff and support staff. Furthermore, the nonpeople quality enablers such as diagnostic services, facilities, hygiene levels and so on are also likely to impact the delivered service quality. It was also felt that the degree of impact each enabler has on the service quality could vary. Therefore there is a need for structured and deep analysis. The paper attempts to identify, analyze and prioritize the enablers that impact the delivered service quality.

Design/methodology/approach

The enablers have been identified through literature review and inputs from experts in the healthcare fraternity. The authors have explored different decision-making tools such as analytic hierarchy process (AHP), analytic network process (ANP), stepwise weight assessment ratio analysis, Hybrid Model and DEMATEL (Decision-Making Trial and Evaluation Laboratory) for the analysis of data in this paper. Based on the strengths of the approach and careful considerations by focus group discussions, DEMATEL was chosen as the best option. It is simple, unique, sparingly used in the healthcare sector, effective in prioritizing and gives meaningful insights on importance, cause and effect factors. DEMATEL approach converts the complex problem with interrelated factors into a clear structure that makes simple interrelationships among factors in the form of cause and effects digraph, and hence, the authors chose to use it. A case study in one of the hospitals has also been conducted to demonstrate the applicability of the developed index. The case study very strongly validates the developed index.

Findings

This research paper has found that there are people quality enablers such as the doctor, nursing staff, support staff and nonpeople quality enablers such as facilities, diagnostic services and hygiene levels maintenance, which impact the delivered service quality. It also concludes that the delivered service quality depends not only on the quality but also on the availability of these enablers. The inputs received from the experts have been run through the DEMATEL methodology and importance computed for each. The top five priority enablers are Quality of Doctor, Availability of Doctor, Quality of Support Staff, Quality of Nursing Staff and Availability of Support Staff.

Research limitations/implications

The weights of the enablers have been obtained using the DEMATEL tool. These weights have been calculated using the inputs from 22 experts, which meets the statistical requirement (Skulmoski, 2007). However, a larger group of experts can be reached, and based on the inputs received from them, the tool can be revalidated for repeatability and reproducibility. Using Fuzzy DEMATEL can also be explored for further analysis.

Practical implications

The proposed framework to assess the service quality level of a healthcare organization is based on a sound approach of DEMATEL. The service index arrived, thereafter, can be used to rate the delivered service quality by any healthcare organization. It can be used to compare the similar type of healthcare organizations across locations. This Index can facilitate improvements in the healthcare organization through internal and external benchmarking. It also helps the organization to know the gaps, understand the root cause, improve upon them and become the best in class. This Index uses the inputs from the end customers to calculate the rating, which makes it more reliable and accurate. The overall scores obtained from the Index can provide the ranking to the healthcare providing organizations and options to customers to choose from best. The service quality index can be used by an organization to continuously monitor their delivered service quality scores and improve them to become the best in class. The research paper highlights the significant role played by the people quality and its strong impact/contribution on the delivered service quality. Hence, it is believed that it will encourage the healthcare organizations to prioritize the improvement and upgrade of the people quality over the nonpeople quality aspect.

Originality/value

Putting people and nonpeople quality enablers in one single model and assigning weights to them using the DEMATEL approach is a new application in healthcare. Developing an Index to measure the delivered service quality in the healthcare sector is also different and new.

Details

Journal of Health Organization and Management, vol. 36 no. 5
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 30 December 2021

Shahidul Islam, Nazlida Muhamad and Vai Shiem Leong

Transformative service research (TSR) has received considerable attention from researchers and marketers in recent years and becomes a research priority in health care. In…

Abstract

Purpose

Transformative service research (TSR) has received considerable attention from researchers and marketers in recent years and becomes a research priority in health care. In response, this paper adapts the TSR entities and wellbeing framework to systematically review healthcare quality research on Muslim consumers. The purpose of this paper is to identify research gaps and provide directions for future research, aligning healthcare studies with the TSR framework.

Design/methodology/approach

The authors of this paper reviewed empirical papers in healthcare quality research on Muslim patients between the years 2000 and 2020. The recorded journal articles were synthesized using insights from the TSR framework. Several literature gaps were identified and future research directions were provided using the TCCM framework, in which T stands for theory, C for context, C for characteristics and M for methodology.

Findings

This paper finds studies that encompass several domains of the TSR framework including cultural and religious dimensions, service interaction and customer engagement dimensions and customer service wellbeing. Findings also reveal subject matters related to the TSR framework, which receive less attention in the healthcare literature. A number of potential avenues for theoretical extension in health care are also discussed.

Social implications

The implications of this paper are highly relevant to Muslim healthcare consumers, the healthcare system and society in general. The findings suggest inspiring changes in the healthcare ecosystem that yields a greater quality of life (health and wellbeing) for individuals and their respective communities.

Originality/value

This paper advances the current state of healthcare research by identifying and organizing components of TSR entities and wellbeing framework, using Muslim patients as the context. It enhances some pioneering approaches within the domain of TSR and quality dynamics and provides a holistic perspective as guidance and systematic thinking to further advancement in the field of services marketing and Islamic marketing.

Details

Journal of Islamic Marketing, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1759-0833

Keywords

Article
Publication date: 29 April 2021

Prachi Verma, Satinder Kumar and Sanjeev K. Sharma

This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting…

Abstract

Purpose

This article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality.

Design/methodology/approach

Questionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21.

Findings

The outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. “Overall objectivity” and “technical objectivity” defined the quality of object. The quality of process of e-Healthcare services was characterized by “functionality,” “timeliness” and “responsiveness.” Quality of infrastructure was defined by “technical infrastructure,” “physical infrastructure,” “manpower skills” and “organizational infrastructure.” “Manner of interaction” and “timely interaction” defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction.

Research limitations/implications

Theoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumer

Practical implications

The outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers.

Originality/value

In this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality.

Details

Benchmarking: An International Journal, vol. 29 no. 1
Type: Research Article
ISSN: 1463-5771

Keywords

Open Access
Article
Publication date: 7 May 2021

Malin Knutsen Glette and Siri Wiig

The purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these…

1616

Abstract

Purpose

The purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these trade-offs potentially affect clinical quality dimensions.

Design/methodology/approach

The paper is a thematic synthesis of the literature concerning health personnel working in clinical, somatic healthcare services, organizational factors and clinical quality.

Findings

Identified organizational factors imposing trade-offs were high workload, time limits, inappropriate staffing and limited resources. The trade-offs done by health personnel were often trade-offs weighing thoroughness (e.g. providing extra handovers or working additional hours) in an environment weighing efficiency (e.g. ward routines of having one single handover and work-hour regulations limiting physicians' work hours). In this context, the health personnel functioned as regulators, balancing efficiency and thoroughness and ensuring patient safety and patient centeredness. However, sometimes organizational factors limited health personnel's flexibility in weighing these aspects, leading to breached medication rules, skipped opportunities for safety debriefings and patients being excluded from medication reviews.

Originality/value

Balancing resources and healthcare demands while maintaining healthcare quality is a large part of health personnel's daily work, and organizational factors are suspected to affect this balancing act. Yet, there is limited research on this subject. With the expected aging of the population and the subsequent pressure on healthcare services' resources, the balancing between efficiency and thoroughness will become crucial in handling increased healthcare demands, while maintaining high-quality care.

Details

International Journal of Health Governance, vol. 26 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 8 June 2012

Diego Fornaciari and Stefaan Callens

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation…

973

Abstract

Purpose

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare‐sector players and whether specific rules are needed regarding competition between healthcare undertakings.

Design/methodology/approach

Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.

Findings

The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non‐price characteristics.

Research limitations/implications

Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.

Practical implications

Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.

Originality/value

This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 28000