Service Quality

Dimensions of Service Quality Reliability

◦ Perform promised service dependably and accurately. Examples: delivered home heating oil on schedule, correct diagnosis and treatment of a medical problem.

Responsiveness◦ Willingness to help customers promptly. Example: avoid keeping

customers waiting for no apparent reason. Assurance

◦ Knowledge and courtesy of employees. Ability to convey trust and confidence. Example: being polite and showing respect for customer.

Empathy◦ Providing caring, individualized attention to customers. Example:

being a good listener. Tangibles

◦ Physical facilities and facilitating goods. Example: cleanliness.

Perceived Service Quality

Word of mouth

Personal needs

Past experience

Expectedservice

Perceivedservice

Service Quality Dimensions

ReliabilityResponsiveness

AssuranceEmpathyTangibles

Service Quality Assessment1. Expectations exceeded ES<PS (Quality surprise)2. Expectations met ES~PS (Satisfactory quality)3. Expectations not met ES>PS (Unacceptable quality)

Service Quality Gap Analysis

Customer

Perceptions

Customer

Expectations

Service

Delivery

Service Standards

ManagementPerceptions of Customer Expectations

Managing the Evidence

Conformance Service Design

Understanding the Customer

Customer Satisfaction GAP 5

Customer / Marketing Research

GAP 1

Conformance GAP 3

Communication GAP 4

Design GAP 2

Quality Service by Design Quality in the Service Package

◦ Supporting facility◦ Facilitating goods◦ Information◦ Explicit services◦ Implicit services

Taguchi methods (robust design) Poka-yoke (fail-safing)

◦ Example: Height bar at amusement park

Quality Function Deployment◦ House of Quality

Walk-Through Audit

Quality Service by DesignExercise How can healthcare services be redesigned to jointly optimize safety, effectiveness,

and cost?

Currently, malpractice law is intended to ensure doctors provide appropriate care and incompetent doctors are weeded out. It has the unintended consequence of incentivizing doctors to "over-service" patients to minimize liability.

◦ Some statistics - over 90% of medical malpractice cases are decided in favor of the doctor, 20%-30% of tests and procedures are done primarily to minimize the doctor's liability risk, 15% of initial diagnoses are incorrect.

Issues to address:◦ What is the service concept (i.e., how is value being created for the patient)?

◦ Quality of care vs. quality of service◦ How does a gap analysis inform the healthcare services design process? (Patients are

good at assessing the quality of service but less so the quality of care.)◦ How can expectations be better managed?

Achieving Service QualityCost of Quality

Cost Categories (in order of cost increase)◦ Prevention (to prevent failures from occurring)◦ Detection (to determine the condition of a service and whether it

conforms to standards)◦ Internal Failure (costs incurred to correct problems prior to delivery to

the customer)◦ External Failure (costs incurred to correct problems after delivery to

the customer)

Tradeoff between prevention/detection and internal failure/external failure costs goal is to minimize sum of these costs

Examples in healthcare services?

Achieving Service QualityStatistical Process Control

Statistical process control (SPC) is implemented via control charts that are used to monitor the output of the process over time and indicate the presence of problems requiring further action.

A control chart consists of a centerline based on the process average and two control limits to indicate whether action needs to be taken. It is intended to reflect only common (random) causes of variation in order to detect special (assignable) causes of variation.

The control limits are set to strike a balance between the following competing priorities:◦ Usually detect when the process has gone out of control (narrow

control limits work better), but increases producer’s risk◦ Usually not overreact to random variation (wider control limits work

better), but increases consumer’s risk

Control Chart Example

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

Date

Aver

age

num

ber o

f err

ors

Sample Mean Low er Control Limit Upper Control Limit

Achieving Service QualityUnconditional Service Guarantee:Customer View

Unconditional (L.L. Bean)

Easy to understand and communicate (Bennigan’s)

Meaningful (Domino’s Pizza)

Easy to invoke (Cititravel)

Easy to collect (Bennigan’s and Domino’s)

Achieving Service QualityUnconditional Service Guarantee:Management View

Focuses on customers (British Airways)

Sets clear standards (FedEx)

Guarantees feedback (Manpower)

Promotes an understanding of the service delivery system (Bug Killer)

Builds customer loyalty by making expectations explicit

Approaches to Service Recovery Case-by-case addresses each customer’s complaint

individually but could lead to perception of unfairness. Systematic response uses a protocol to handle complaints but needs prior identification of critical failure points and continuous updating.

Early intervention attempts to fix problem before the customer is affected.

Substitute service allows rival firm to provide service but could lead to loss of customer.

Service Recovery Framework

PatronageLoyaltySatisfactionRetention

SeverityOf

Failure

PerceivedServiceQuality

Psychological-empathy

-apology

Tangible -fair fix-value add

Psychological-apology-show interest

Follow-upService

Recovery

Tangible-small token

ServiceRecoveryExpectations

ServiceRecovery

CustomerLoyalty

ServiceGuarantee

Speed of Recovery

FrontlineDiscretion

ServiceFailure Occurs

ProviderAware ofFailure

Fair Restitu-

tionPre-recoveryPhase

ImmediateRecovery Phase

Follow-UpPhase