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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 service…

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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/approachIn 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. FindingsIn 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 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 processes…

1336

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

Article
Publication date: 26 February 2024

Mohit Datt, Ajay Gupta, Sushendra Kumar Misra and Mahesh Gupta

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a…

Abstract

Purpose

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

Design/methodology/approach

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

Findings

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

Originality/value

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

Details

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

Keywords

Article
Publication date: 21 July 2023

Javed Ali, Ahmad Jusoh, Norhalimah Idris and Khalil Md Nor

The current study aims at developing a conceptual framework containing original dimensions of SERVQUAL and adding two modified dimensions: patient safety and medical…

Abstract

Purpose

The current study aims at developing a conceptual framework containing original dimensions of SERVQUAL and adding two modified dimensions: patient safety and medical professionalism in healthcare service quality (HSQ) model.

Design/methodology/approach

An extensive review of HSQ literature pertaining to its dimensions and models with respect to content analysis and bibliometric studies of service quality in healthcare and SERVQUAL in healthcare were performed on 47 relevant studies, 4,689 and 529 documents after applying inclusion and exclusion criteria. Google Scholar and Scopus were the primary sources to find the relevant documents.

Findings

The content analysis was conducted to group HSQ dimensions into seven themes. Co-occurrence analysis of author keywords was performed in VOSviewer to find the links between service quality, SERVQUAL and proposed dimensions. Organization and analysis of different HSQ models and dimensions emerged from the literature result in a comprehensive conceptual framework comprising modified dimensions of healthcare service quality – medical professionalism and patient safety.

Originality/value

SERVQUAL is a widely accepted, tested and validated model in perceiving HSQ from the lenses of patients. But it does not cover the complex nature of healthcare service, thus requiring modification and the addition of new contextual dimensions. Therefore, a comprehensive conceptual framework is developed to validate and test quantitatively.

Details

International Journal of Quality & Reliability Management, vol. 41 no. 2
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 14 July 2023

Karthik Padamata and Rama Devi Vangapandu

The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between…

Abstract

Purpose

The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.

Design/methodology/approach

Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.

Findings

Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.

Practical implications

This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.

Originality/value

To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 1 April 2000

John Øvretveit

Total quality management (TQM) promises much for service industries yet it has been little used in European healthcare. Of those hospitals and services which have implemented TQM…

8053

Abstract

Total quality management (TQM) promises much for service industries yet it has been little used in European healthcare. Of those hospitals and services which have implemented TQM, few have had great success and many have found difficulties sustaining their programmes. This paper defines TQM in healthcare and considers examples and results of TQM in European healthcare. It distinguishes between team projects using TQM methods and organization‐wide TQM programmes, and finds more evidence for the success of projects than for programmes. The paper discusses whether the differences between healthcare and many other industries explain the mixed results, and considers the prospects for future TQM programmes in European healthcare.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 2
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 systems in

4683

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.

Article
Publication date: 4 September 2017

Asma Shabbir, Shahab Alam Malik and Saquib Yusaf Janjua

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare

1864

Abstract

Purpose

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare service quality were compared by carrying out a GAP analysis to equate perceived and expected services and examined differences in the service quality.

Design/methodology/approach

The study sample comprises 310 inpatients of public and private healthcare service providers. Self-administered questionnaires were used along a five-point Likert scale and analyzed through the Statistical Package for Social Sciences. GAP analysis was used to observe the difference between expectations and perceived service quality.

Findings

A cross-sectional study revealed significant quality gaps between the expected and perceived services of public and private healthcare service providers; conversely patients’ expectations are not fully met in both types of hospitals. Private hospitals surpassed in terms of overall perceived service quality from their counterparts. Perceived services were found better in terms of physician medical services in public sector hospitals, while rooms and housekeeping services were found better in terms of private sector hospitals.

Practical implications

The result can be used by both public and private healthcare service providers to restructure their quality management practices which could only be possible through effective management commitment, regular patients’ feedback and translucent complaint procedures.

Originality/value

The study conceptualizes the expected and perceived hospital service quality dimensions as an eight-dimensional framework. A comparison between public and private sector hospitals is made to get a better understanding about the differences in the perceived healthcare services among two sectors. Consequences of the study will aid hospital managers and policy makers to get a fuller picture of healthcare services in order to contrive enhancement practices.

Details

International Journal of Quality & Reliability Management, vol. 34 no. 8
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 2 October 2007

Alexander Komashie, Ali Mousavi and Justin Gore

The purpose of this paper is to review the historical development of quality assessment methods in manufacturing industry and healthcare. It examines the gap between methods…

4558

Abstract

Purpose

The purpose of this paper is to review the historical development of quality assessment methods in manufacturing industry and healthcare. It examines the gap between methods across the two sectors, as well as the extent to which industrial techniques have been successfully adopted in healthcare. Finally, a proposal for a new approach is presented.

Design/methodology/approach

Firstly, a review of the evolution of quality assessment was conducted, based on books written by prominent experts in the field. Secondly, a study of the current approaches in healthcare was undertaken. Publications from varied sources, including worldwide operations research and healthcare sources were selected according to criteria and reviewed.

Findings

While, the concept of quality has a long history, quality management in healthcare is not as advanced as in industry. There are a number of reasons for this, such as differences in concerns and processes across the two sectors. Further, quality researchers have differing views towards the best approaches. It was deduced that the way forward in healthcare quality is the enhancement of staff ownership and pride in a way akin to the era of the craftsmen, but with the use of new technology.

Practical implications

The findings provide a picture of how far quality management has advanced in industry and healthcare. There is a note of caution for the use of industrial techniques in healthcare, which may provide useful direction for further research and implementation.

Originality/value

This work uniquely examines the origins of the concern for quality, and follows the changes in demand and supply in industry and healthcare. It argues that understanding this historical review, and the nature of processes across both areas, is key to the future of healthcare quality. Finally, a new approach based on discrete event simulation is proposed.

Details

Journal of Management History, vol. 13 no. 4
Type: Research Article
ISSN: 1751-1348

Keywords

Article
Publication date: 21 March 2019

Sue S. Feldman, Scott Buchalter, Dawn Zink, Donna J. Slovensky and Leslie Wynn Hayes

The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality

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Abstract

Purpose

The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality improvement and patient safety education program focused on developing leaders to change the future of healthcare quality and safety.

Design/methodology/approach

The safety attitudes questionnaire (SAQ) short-form was used for measuring the culture of quality and safety among healthcare workers who were graduates of an academic medical center’s healthcare quality and safety program. A 53 percent response rate from program alumni resulted in 54 usable responses.

Findings

This study found that 42 (78 percent) of the respondents report that they are currently working in a healthcare quality and safety culture, with 25 (59 percent) reporting promotion into a leadership role after completion of the quality improvement education program. This compares favorably to AHRQ culture of safety survey results obtained by the same academic medical center within the year prior revealing only 63 percent of all inpatient employees surveyed reported working in a quality and safety culture.

Research limitations/implications

The study design precluded knowing to what degree a quality and safety culture, as measured by the SAQ, existed prior to attending the healthcare quality and safety program.

Originality/value

This study has practical value for other organizations considering a quality and safety education program. For organizations seeking to build capacity in quality and safety, training future leaders through a robust curriculum is essential. This may be achieved through development of an internal training program or through attending an outside organization for education.

Details

Leadership in Health Services, vol. 32 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

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