This case is designed to give students an opportunity to consider
ways that a service organization, speciﬁcally a hospital, might
seem different from manufacturing because service is not as easy
to measure as the dimension of a part. However, as students begin
to think about the dimensions of a hospital’s service, they may see
ways that service can be measured. The answers to this case
are based in part on a similar case in M.A. Vonderembse and
G. P. White’s Operations Management: Concept, Methods, and
Strategies(Eagan, Minn.: West Publishing Company, 1988).
1. Why is it important to get the patient’s assessment of health
care quality? Does the patient have the expertise to judge the
health care he or she receives?
The patient is the customer. If the patient “perceives” that the
health care received is inadequate, then he or she may go elsewhere the next time these services are needed. Although
patients may not have the expertise to judge some aspects of
health care, they can judge appearances of competence, improvements in the way they feel, how they are treated, the cleanliness and comfort of the environment, and timely responses to
2. How might a hospital measure quality?
Measuring quality in a service setting such as a hospital can
sometimes be difﬁcult. One obvious way is to keep track of the
number of patient complaints—or even lawsuits. Some other
measures that could be used include, but are not limited to, the
■ Average time for nurses to respond to a patients’ call
■ Average time spent by patients in intensive care
■ Average recovery time after surgery
■ Average condition of patients upon discharge
■ Change in patient condition between admission and discharge
■ Number patients per staff member
3. Using the steps in the table in the case discuss how each might
apply to FCGH.
To answer this question, one must remember that the product
provided by FCGH is health care. However, it must also be remembered that the hospital’s staff (nurses, physicians, lab technicians, etc.) are the suppliers of that service. Thus, quality of
service will depend a great deal on the staff—their motivation,
attention to details, morale, level of caring, etc.
Quality to the Customer:
■ Is conformance of the service provided compared to established quality standards? Is quality of the hospital’s health
care service compared with that of competitors?
■ Have the costs of quality been measured and have possible
areas for cost savings been identiﬁed?
■ Do procedures exist to review patient treatment for quality?
Are these procedures being carried out?
■ Have procedures been established and followed to qualify
new treatments before they are used on patients?
■ Has each treatment been scrutinized regarding safety and are
appropriate records kept? Does a written plan exist for dealing with major problems regarding patient?
■ Has the effectiveness and risk of each treatment been measured, and is that information used in selecting treatments?
■ Is incoming material inspected? Are staff members evaluated
before being hired? Are records of these evaluations kept?
■ Are suppliers and staff members made aware of their quality
responsibilities? Are records kept on nonconformance?
■ Has the hospital developed policies for controlling treatments and lab tests? Have employees been trained to follow
Inspection and Test Planning:
■ Do inspection and test plans exist for all services provided
and are records maintained on the results? Are all test procedures and equipment regularly checked for accuracy?
Quality Performance Indicators:
■ Are quality performance indicators regularly published