Service Quality in Healthcare

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Service quality is defined as a focused evaluation that reflects the customer’s perception of elements of service such as interaction quality, physical environment quality and outcome quality (Brady and Cronin, 2001). Also measurement of delivery of services matches with the customer’s expectations (Abbas, 2012).

Service quality is evaluated by six quality dimensions:

Safety, Effectiveness, Patient centreless care, Timeliness, Efficiency and equity.

1. Safety: Safety is an important part in healthcare system. Safety reduces the risk of hazards. Safety food and environment can improve the health of residents in our XYZ organisation.
2. Effectiveness: Effectiveness can help in reducing the risk of errors. It mainly depends on matching of science with heath care services. Example: As per science if any drug used to cure specific disease than we cannot use alternative medicine to cure that particular disease.
3. Patient centreless care: In healthcare system decisions should be taken by putting patient in centre. Patient should be given power and authority to take decisions regarding their own health.
4. Timeliness: In XYZ health care timeliness should be more emphasized because if any nurse or healthcare Assistant will be late then he will reach late in patient room. Sometimes it might affect patient health in serious conditions. If you are late you might forget to give medicines, meal to patient and this can create risk with patient health.
5. Efficiency: Efficiency means reducing staff wasting stuff. It is very important to reduce the gap between input and output results (Donald, 2008).

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SERVQUAL model: (Nitin & Deshmukh, 2004)

Customer

Marketer

GAP 1 – Management Perception Gap: This is the gap between high quality services provided to residents and high quality services observation by XYZ rest home management. This gap can occur due to communication failure to top management, more level of management, lack of research on residents demand (Daniel & Berinyuy, 2010).

In XYZ rest home some residents do not like meal in dinner. They always complain to nurse and health care assistant. They do not have direct contact with management. They are not getting meal based on their demand and taste.

Management: Maintain good relations with residents to know their needs, expectations and taste (Pulkit, 2013).

We can conduct survey to know residents expectations regarding food and any other services.

GAP 2 : Quality Specification Gap: This gap arises due to difference between management observation of what are customers’ expectations and the specified services provided and observed by management while detailing the quality services that are required. This gap occurs due to lack of goal setting, improper procedures planning, inadequate perception of viability, absence of results setting and Lack of promise to service quality (Daniel & Berinyuy, 2010).

In rest home resident do not want care assistant whole day but I realised that some residents require care partner while day for routine work.

Management: Management should make sure that residents are provided all the services as per their need (Pulkit, 2013).

GAP 3: Service Delivery Gap: This gap arise due to difference in service delivery standard required by management and the services provided by staff members. This gap arises due to insufficient staff, lack of team work and lack of knowledge in employee or insufficient technology (Daniel & Berinyuy, 2010).

As per current situation, sometimes new employees do not read protocol of patient and they could not provide proper services to residents.

Management: Management should arrange monthly meetings for feedback for their staff services delivery from residents (Pulkit, 2013).

GAP 4: Communication Gap: This the gap between service deliveries promised and actual services provided. This occurs due to high level promises and failure to reach till residents expectations (Daniel & Berinyuy, 2010).

Management: Management should promise only that things which they can fulfil (Pulkit, 2013).

GAP 5: Perceived Service Delivery Gap: This gap arises due to difference between resident expectations of services and services delivered by management and staff members. This gap occurs as a result of all other 4 gaps (Daniel & Berinyuy, 2010).

Management: This gap can be managed by filling all other gaps (Pulkit, 2013).

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The simple meaning of Kanban concept is first to look in to your work and visualize. Second is to limit your work which is in progress. Do not push your work but try to pull the work. Try to improve the quality of your work and minimise the waste (Hisham, 2010).

In XYZ organisation volunteer facility is provided. This concept is applied to XYZ rest home too. Volunteer coordinator are getting many email of students from different institutions to work as a volunteer in our rest home. Every 24 hour coordinator check her email and list out all volunteers. After finishing first step she call individual for interview during time interval. Out of all she short list some students and call them in orientation. In orientation she explain and introduce with XYZ rest home.

In whole process email checking process is work to do. Check all mail and call individual for interview is first part of work in progress. Call short listed students and orientation is second part of work in progress. After finishing whole process they always think to improve whole process. They always continue this process without laziness. If anyone coordinator is absence during this process even though they do not quit the process and another coordinator handle whole the process (Elizabeth Knox Home & Hospital, 2014).

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Lean is a resident centric method mainly focus on continuous identifying the development opportunities by removing wasteful activities and creating importance (Philips Healthcare, 2011).

XYZ rest home is getting many advantages by applying Lean principles.

• Waiting time: Reduce the waiting time of residents for beds, agreements and works for paper. After entering in organisation reduce the waiting time for meal and providing individual facilities.
• Time for processing: It is mainly concern about flow of work and reduce the needless processing steps.
• Extreme resources: This talks about more resources which can improve the cost for administration (Philips Healthcare, 2011).
• More admission of residents and they are provided higher quality of services.
• Due to lean process XYZ rest home getting more vacate spaces than before owing to decreased consumption of inventory. We need more space during event time for residents. This is convenient for residents to play games and do extra activities in vacate space.
• Streamlined approach for XYZ rest home and administration.
• Improve quality care services in patient rooms and reducing chances of errors.
• Cleanliness is main improvement after applying lean principles in rest home.
• Simplify all the processes (LEI Group Australia, 2014).
• Reducing office works in office.
• Meeting with staffing demands and same number of staff members are taking care of more residents.

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Principles:

• Context Awareness: Know your organisation and be adaptable. There is no unique way to manage your organisation processes. Do not apply same cookbook to all organisation. It all depends on organisation size, market conditions, available resources, strategies and types of processes.

In XYZ rest home we have different resources and strategies applied for patients than other rest homes. We can’t use same principles as like other rest homes and one strategy for the reason of change.

• Continuity: Organisation should have a set practice and reviewed regularly. It should not be one off change project. It is continuous gain in effectiveness and effectiveness.

In XYZ rest home we got new instruments for residents. Staff members should check them regularly for effect and efficiency of that instruments on resident life.

• Enablement: Participatory management should be capable for working in an organisation. We should focus on development of individual and organisation BPM capabilities.

As per my view in our organisation we should focus more on training of staff members rather than focusing on BPM tools.

• Holism: In XYZ rest home every department should be aware of their roles and responsibilities. There should not isolated focus. BPM should have some scopes.
• Institutionalization: Policies and procedures of organisation must not be changed on the spot unless crisis.
• In our rest home when new resident is admitted and he is not good at health then we do not need embed them to finish documentary work. Resident must be provided room immediately (vom Brocke, Schmiedel, Recker, Trkman, Mertens, & Viaene, 2014).
• Involvement: All staff members should be involved in decision making process. Their active participation is crucial in BPM process.

According to my experience we are involving all staff members for new improvement in organisation. Sometimes residents’ opinions are also crucial and beneficial.

• Joint Understanding: There should not any language barrier between staff members and residents. They should use universal language (English) for better understanding. If any resident does not know universal language then he or she should not be neglected.
• Purpose: It indicates the value of BPM process. There should some value of doing work not for sake of doing that work.

Staff members should not finish their work as a house hold work as a sake of doing that but they should do it properly and provide high quality services to residents.

• Simplicity: Residents should be provided high quality care services within minimum resources and with best cost.
• Technology Appropriation: It simply explain about partnership between man and technology (machine) to get best outcomes. Staff members also take care of residents without relying only on machine (vom Brocke, Schmiedel, Recker, Trkman, Mertens, & Viaene, 2014)