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This research takes Taijiang National Park (TNP) tourists as the study population while gathering the survey data via an online questionnaire. For the data analyses, it uses the importance–performance analysis (IPA) and the Kano two-dimensional quality model to evaluate the tourist satisfaction of TNP. Specifically, it considers the importance of service quality, classifies its service quality attributes, and suggests the priority for service improvement, rendering the TNP valuable reference points to realign service strategies. The study shows that the service quality attributes related to service personnel are the priority item to be improved, which could eventually enhance tourist satisfaction. In addition, brand differentiation could be achieved by improving the attractive quality items identified in this study to enhance tourist loyalty.

This paper aims to unearth the essential components of Six Sigma for successful deployment and sustainment of service quality in four different organizations in the United Arab Emirates (UAE). More specifically, the paper is intended to determine the motivation to apply Six Sigma, Voice of Customer, Key Performance Indicators (KPIs), Critical-to-Quality (CTQ), readiness factors, Critical Success Factors, sustainment measures, tools and techniques used, challenges/barriers and performance impact on the company.

An exploratory research methodology with multiple case study analyses was adopted to determine the answers to the research objectives. Four case studies from different service processes of four companies were analyzed. The case studies were collated from these companies via a case study protocol with pre-defined criteria.

The analysis shows that service operation improvement projects are primarily dependent on the voice of the internal customer, with return on investment in savings as the KPI of the process. Most organizations prefer cycle time and errors as the CTQs in the Six Sigma projects. Even novice users can effectively apply the Six Sigma methodology with external experts’ assistance, mentoring and interventions. Across the case studies, it is observed that the projects were successfully deployed due to the support of top management leadership, effective communication and cross-functional teams. Employee resistance to change is the common barrier observed during the case study analysis. Eventually, in all the four case studies, Six Sigma is executed with standard tools and techniques within the define, measure, analyze, improve, control (DMAIC) approach.

The present study’s findings cannot be generalized due to the limited number of case study analyses in different ecosystems in the UAE. The authors would like to analyse and report more case studies in service quality improvement through the Six Sigma methodology to comprehend and develop a generic roadmap for the deployment of Six Sigma in the UAE service industry.

The study’s findings provide insights into commonalities and differences between the essential factors of Six Sigma deployment and sustainability in UAE companies.

The study results might help the policymakers and key decision makers in UAE and other countries understand the effectiveness of Six Sigma in service quality improvement with its essential factors for deployment.

Meeting the patients' requirements as customers of the health care sector is crucially important as a social responsibility. According to the resource constraints, only an efficient utilisation of health services can provide that purpose. This study aims to develop a quantitative assessment framework for radiology centres as a vital section in healthcare to translate the patients' requirements into service quality specifications. This would help to achieve quality improvement by emphasising the voice of customers.

A literature review is conducted to specify the service quality criteria and the patients' requirements related to healthcare and hospitals. Based on the experts' opinions, these criteria and requirements are later customised for the radiology centres. Moreover, the requirements are categorised into five dimensions of SERVQUAL. The interrelations between service elements are also determined through expert group consensus using Pearson correlation. Afterwards, by applying the QFD method, the relations between the requirements and criteria are explored. Additionally, a customer satisfaction survey is executed in Tehran public hospitals to prioritise these requirements and provide an importance-satisfaction analysis.

Based on the result of the case study, service elements are prioritised for improvement, and practical suggestions are provided using the Delphi technique for quality improvement. In addition, a cause-and-effect diagram is presented to highlight the improvement area and provide enhancement suggestions.

This study is the first empirical attempt to benefit from the VOC in evaluating and enhancing the quality of service delivered to radiology patients. In doing so, the study applies a hybrid approach of QFD and SERVQUAL as well as other tools to highlight the improvement area and provide enhancement suggestions. The findings can be readily used by the practitioners.

Several studies have examined the relationship between service quality and willingness to pay in many industries. However, this relationship has not been explored through the lens of customer perceived value and their willingness to pay for improving and sustaining water service. This study aims to examine the impact of technical and functional service quality dimensions on customer perceived value and assess the influence of customer perceived value and socio-economic factors on customers' willingness to pay for improving and sustaining the water service.

Technical service quality includes core water service such as water delivery and maintenance, while functional service quality refers to the appearance of facilities, employees’ dress, and communication. SERVQUAL questionnaire responses were collected from 333 Palestinian household customers. Cronbach’s alpha was conducted to measure internal consistency and convergent validity. Path analysis was utilized to evaluate a causal diagram by examining the relationships among the constructs.

The results showed that technical and functional service quality and relative price explain 52% of the customer perceived value variation. Additionally, the results revealed that customer perceived value, technical service quality, and relative price significantly impact the customer’s willingness to pay for improving and sustaining service. In contrast, the functional service quality and socio-economic factors have insignificant effects. These predictors explain 60% of the customer’s willingness to pay for improving and sustaining service.

The study suggests that water providers should prioritize improving and sustaining technical service quality to increase customer willingness to pay. Furthermore, they should be aware that other factors, such as employee appearance and politeness, are less influential in driving customers’ willingness to pay.

The study presents a water service improvement model that utilizes data from a developing country to assess the influence of perceived customer value, along with its dimensions, on the willingness to pay for improving and sustaining water service quality.

The paper extends the discussion on the merit of using a net promoter score (NPS) to enhance the service design of organisations and to facilitate quality monitoring and improvement. NPS is a basic measure to assess the likelihood of a customer recommending an organisation to somebody else. This paper aims to show that this metric can be effective in monitoring and improving the quality of workplace training.

Investigating the merit of using NPS to improve organisational training involved a longitudinal study of training provided by IBM. Data is analysed using panel regression and partial correlation methods. Workplace training delivery is the unit of analysis in which an NPS and conventional customer satisfaction score evaluations were conducted at the end of the delivery. The efficacy of these measures to improve quality are compared and insights derived from analysing NPS are investigated.

The findings indicate that, although NPS is not necessarily related to the results or success of a business, from a corporate perspective it can provide a solid basis from which to make business decisions that benefit a company. The authors found that NPS was associated with improved satisfaction with training, although significant regional variations were observed. Building on the data, a service business model is proposed advocating NPS as a tool for continuous improvement.

The contribution to practice includes a clearer understanding of NPS as a quality and service improvement indicator and also as a driver for a service business design. In addition, it is indicated that enterprises operating in multiple regions should consider regional variations in NPS.

By analysis of IBM’s training data, the authors gain an understanding of an industry in which quality and the use of NPS has not been extensively studied. The data also offers a rich dimension in the examination of the factors that should be considered to effectively implement an NPS service improvement plan.

The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.

Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.

The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.

The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.

Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.

The purpose of this study is to examine the impact of educational service quality (ESQ) on student academic performance via the mediating role of student satisfaction.

To serve the study’s purpose, the study adopted a quantitative research approach. Three public universities representing 30% of the ten public universities located in the Southern part of Ethiopia participated in the study. Questionnaires were the main tools for gathering data. The adapted questionnaire, consisting of 116 items was administered to 400 randomly selected regular undergraduate graduating class students. The quantitative data collected via questionnaire were analyzed using descriptive and advanced inferential statistics.

The quantitative findings revealed that there is a statistically positive association between overall education service quality and students’ satisfaction (r = 0.712). The findings proved that the facets of education service quality accounted for 71.2% of the variations in students’ satisfaction in the universities. The quantitative findings further showed that the education service quality has a statistically indirect effect on students’ academic performance via the mediating role of students’ satisfaction (test statistic = 31.5311573, std. error = 0.00122536 and p-value = 0). The findings further confirmed that the overall education service quality accounted for 12.7% of the variations in students’ academic performance via student satisfaction in the universities.

The present study was conducted in public universities located in the Southern part of Ethiopia. The findings and conclusions of the study may not be generalizable to all Ethiopian public universities. Future researchers and scholars should conduct their study in all Ethiopian public universities by taking a representative sample from the Ethiopian public universities.

The present finding suggests that an improvement in ESQ leads to students’ satisfaction and that could contribute to boosting their academic performance. The findings of the present may help the practitioners who measure higher education service quality by providing how the provision of ESQ indirectly influences the student’s academic performance in the universities.

The findings of this study confirmed that the facets of ESQ are associated with students’ satisfaction and this, in turn, indirectly influences their academic performance. Student academic performance is one of the key indicators of quality education, and it has its influences on the social, political and economic development of a country. The findings of the present research provide valuable insights to higher education management bodies, higher quality assurance agencies and the Federal Ministry of Education to learn the indirect effect of ESQ on students’ academic performance and take necessary measures to improve the Ethiopian higher education quality.

The contributions of ESQ in the higher education sector are enormous. However, the existing service quality literature in higher education mainly focuses on the interrelation among service quality, student satisfaction, loyalty and behavioral intentions. Little is known about the indirect influence of ESQ on student academic performance (one of the key indicators of quality education), principally in Ethiopian higher education, the place of current research. The present study showed the indirect impact of ESQ on student academic performance in Ethiopian public universities. The study, therefore, suggests that university management bodies should actively monitor the quality of their services and commit themselves to boosting students’ learning outcomes.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

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.

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.

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.

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.

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.

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.