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The purpose of this paper is to describe how quality function deployment (QFD) methodology was employed for translating customer needs and expectations into the quality characteristics in a private healthcare setting. This case study illustrates how an existing approach of SERVQUAL and QFD integration can be applied for quality improvement.

Integrating SERVQUAL into QFD to set the success factors to improve quality in the healthcare industry is the main aim of this paper. A privately‐held university hospital, within the city of Istanbul in Turkey, was selected as the sampling frame. A SERVQUAL‐type of questionnaire was used and a total of 250 questionnaires were distributed and 210 of them were received. Usable responses were 170, comprising a response rate of 68 percent.

From the results of the QFD application it is seen that behavior and attitude of staff has the highest weight score, meaning that when behavior and attitude of staff is improved there will be almost 25 per cent of improvement in the hospital. Another finding was that there is strong relationship among skills of physician, behavior and attitude of staff, and having enough modern equipment.

QFD technique is able to provide hospitals with a better understanding of customers' expectations to translate these expectations into appropriate service specifications and perform existing process assessment.

The case study was a first attempt to apply this integrative approach to a service sector and thus offers practical and applied information useful to both academicians and practitioners.

The purpose of this paper is to examine the role of perceived service attributes in the development of overall customer satisfaction (OCS) and customer loyalty (CL) in a health-care setting. This paper also sheds light on the role of hospitalist physicians (HPs) and offers suggestions to improve patient satisfaction and loyalty.

A telephone survey was used to collect data from recently hospitalized patients with respect to their HP. Structural equations modeling (SEM) was used to confirm the overall relationships between perceived service quality (PSQ), OCS and CL. The sample was then divided into customer relationship groups (CRGs) based on satisfaction and loyalty measures. Discriminant analysis was used to determine which attributes differentiated most between high and low satisfaction and loyalty groups.

Overall relationships among PSQ, OCS and CL were in conformity with the conceptual model. Findings also revealed that service attributes played an important role in distinguishing between high and low satisfaction and loyalty groups, although some attributes were more important than others and different attributes emerged as being key influencers for satisfaction and loyalty.

The conceptual model used is a fairly straight forward model, and we have not considered the impact of individual factors such as expectations and value perceptions or involvement levels and demographic characteristics on service quality and overall satisfaction. The data for this study were provided by a major health maintenance organization (HMO), and there is room for improvement in the manner in which certain constructs were measured. For example, OCS, recommendation and retention all used single item measures, and it might have been preferable to use multiple item measures for these constructs.

The study shows that organizations can benefit by identifying and focusing on critical attributes as part of their customer relationship management program.

The SEM results provide strong support for the overall model linking service quality, OCS and CL in a health-care setting. As one would expect, PSQ has a strong impact on OCS, which, in turn, has a fairly strong impact on CL. However, there is also a significant direct linkage between PSQ and CL. This linkage shows that at least a certain portion of CL could evolve independent of the satisfaction level with the HP. This shows that, in addition to trying to improve satisfaction, organizations should also explore influencing loyalty directly, perhaps by the strategic use of service attribute perceptions.

The study shows that customer perceptions at the service attribute level can often be the key to the generation and management of customer satisfaction and loyalty. It also has significance for how satisfaction and loyalty with HPs can be improved in a hospital setting.