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Service Quality
Dimensions of Service QualityReliability
◦ 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
Expected
service
Perceived
service
Service Quality
Dimensions
Reliability
Responsiveness
Assurance
Empathy
Tangibles
Service Quality Assessment
1. 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
Management
Perceptions
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 DesignQuality 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 Design
ExerciseHow 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 Quality
Cost 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 Quality
Statistical 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
1/1/2009
1/3/2009
1/5/2009
1/7/2009
1/9/2009
1/11/2009
1/13/2009
1/15/2009
1/17/2009
1/19/2009
1/21/2009
1/23/2009
1/25/2009
1/27/2009
1/29/2009
1/31/2009
Date
Averagenumberoferrors
Sample Mean Low er Control Limit Upper Control Limit
Achieving Service Quality
Unconditional 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 Quality
Unconditional 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
RecoveryCase-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
Patronage
Loyalty
Satisfaction
Retention
Severity
Of
Failure
Perceived
Service
Quality
Psychological
-empathy
-apology
Tangible
-fair fix
-value add
Psychological
-apology
-show interest
Follow-up
Service
Recovery
Tangible
-small token
Service
Recovery
Expectations
Service
Recovery
Customer
Loyalty
Service
Guarantee
Speed of
Recovery
Frontline
Discretion
Service
Failure
Occurs
Provider
Aware of
Failure
Fair
Restitu-
tionPre-recovery
Phase
Immediate
Recovery Phase
Follow-Up
Phase

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Service operation management 3

  • 2. Dimensions of Service QualityReliability ◦ 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.
  • 3. Perceived Service Quality Word of mouth Personal needs Past experience Expected service Perceived service Service Quality Dimensions Reliability Responsiveness Assurance Empathy Tangibles Service Quality Assessment 1. Expectations exceeded ES<PS (Quality surprise) 2. Expectations met ES~PS (Satisfactory quality) 3. Expectations not met ES>PS (Unacceptable quality)
  • 4. Service Quality Gap Analysis Customer Perceptions Customer Expectations Service Delivery Service Standards Management Perceptions 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
  • 5. Quality Service by DesignQuality 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
  • 6. Quality Service by Design ExerciseHow 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?
  • 7. Achieving Service Quality Cost 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?
  • 8. Achieving Service Quality Statistical 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
  • 10. Achieving Service Quality Unconditional 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)
  • 11. Achieving Service Quality Unconditional 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
  • 12. Approaches to Service RecoveryCase-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.
  • 13. Service Recovery Framework Patronage Loyalty Satisfaction Retention Severity Of Failure Perceived Service Quality Psychological -empathy -apology Tangible -fair fix -value add Psychological -apology -show interest Follow-up Service Recovery Tangible -small token Service Recovery Expectations Service Recovery Customer Loyalty Service Guarantee Speed of Recovery Frontline Discretion Service Failure Occurs Provider Aware of Failure Fair Restitu- tionPre-recovery Phase Immediate Recovery Phase Follow-Up Phase