Leading Change for Patient and Service Improvement Module about service quality: Service quality concept in the current literature

The developed countries have given a significant importance to the service sector of the country. With every passing day the segment of employment is growing and increasing very rapidly. This ultimately gives the members of the society a life with high quality and setting high standards for the members to a live a good life. Service sector contributes as a major portion of the country and without it other sectors cannot also develop. It also faces competition with global world as the world has become global all the way. The main point of this competition is to bring free circulation of the services and products. Getting confidence of the consumers is an essential part and while facing competition they need to provide the best services in order to sustain in the market. The quality of the services being provided is also to be measured and the service is then chosen to analyze and research the quality of the service. There are various methods to measure the service quality. Those methods are statistical methods, benchmarking, servperf and etc. However, to measure the service quality SERVQUAL method has been used in this research (Brown, Churchill, & Peter, 1993; Cronin & Taylor, 1992; Parasuraman, Zeithaml, & Berry, 1985). The basic reason to use this method is because it is most frequently used and is preferable among others (Buyukozkan, 2011).

The factor which distinguishes the similar products and services is the service quality. It differentiates it from other product and services. So, the companies need to focus on the quality of service they are providing in order to be different and competitive in the market. The service quality has gathered a lot of significance in today's era. However, the service quality of healthcare sector may vary as the health of human may be fluctuating. The health of the individuals is very important and that is why healthcare department is given so much importance. It is also expected that services provided by healthcare should be meeting the expectations of the patients. This sector is taken for implementation in Turkey as it is a growing country with increasing population. The major purpose of this study is to find out the factors which provide quality service by the healthcare sector and then those factors are considered to measure and evaluate the performance of the home healthcare staff (Buyukozkan, 2011).

It is difficult to measure the quality of the services as they are intangible, inseparable and heterogeneous. It cannot be measured easily because there is no proper concrete way to describe its quality. The evaluation is done by the analysis of the evaluator of the linguistic variable so it should be performed in an environment o uncertainty and fuzziness. The fuzzy set theory (Zadeh, 1965) is used in the measurement of performance to prevail over the issue. This theory helps in going through the uncertainty and indistinct perspective of the concepts which are connected with subjective finding of the human being. These days' fields like management sciences have been using fuzzy set theory for decision making (Hsu, Chen, & Tzeng, 2007; Huang, Chu, & Chiang, 2008; Kahraman, Buyukozkan, & Ates, 2007; Liu & Lai, 2009) but it is also mentioned that this is used in a limited way in the grounds of the service quality (Bilsel, Buyukozkan, & Ruan, 2006; Tsaur, Chang, & Yen, 2002; Tseng, 2009a, 2009b).

The measurement for the service quality is essential and for this identification and criteria for prioritizing is used and this combines as a systematic process. This also leads to decision making and becomes more useful. Moreover, there are different theories which are used in the process of service quality measurement including AHP (analytic hierarchy process), a MCDM (multiple criteria decision making) a theory projected by Saaty in 1980.

Service concept

The meaning of service concept is a basic portion of the tactical gain hunting processes of service design, service innovation and service development (Goldstein, Johnston, Duffy, & Rao, 2002; Stuart & Tax, 2004). Due to its difference from material objects, it is very tricky to classify service. There are many types of services; ranging from that given in a beauty parlour to that given by an insurance firm. Another reason for the difficulty in classifying service is that there are a wide range of activities being performed. In spite of these difficulties, some researchers are still able to define service (Devebakan, 2005).

Unlike goods, services are in-tangible products that are there to satisfy the...

In terms of economics, the term service can be explained as an economic activity which provides time, place, shape and comforts at a psychological level. Accordingly, Edvardsson and Olsson (1996) have classified service concept as what needs to be done to satisfy the client and how to perform those tasks. Goestch and Davis (1998) on the other hand describe service as any activity performed for someone else, while Collier agrees on the fact that service could be a performance or an event that is created and utilized at the same time (as cited in Uyguc (1998). However the statement takes a different path when he describes it as a work which links the customer with the service provider (Tar-m, 2000). It is observed by Goldstein (et al., 2002) as a combination of material and non-material objects put together to develop a service package. Liu, Bishu and Najjar (2005) concur that service is whatever the customer requires. There are so many definitions available that can help managers in grasping what service concept is (Buyukozkan, 2011).
The service of good healthcare is necessary to the society because of two main reasons; reprieve from diseases and enhanced health for humans (Bowers & Kiefe, 2002). Nevertheless, the healthcare system has been undergoing some extreme difficulties since the 90s. Express progress towards a method of controlled healthcare and incorporated delivery systems has seen healthcare suppliers to acknowledge a contest. One can only survive in this cut-throat environment when the healthcare supplied is beyond the client's expectations (Lee, Delene, Bunda & Kim, 2000). In order to provide economical healthcare to the customers, the hospitals need to study the major factors of service quality (Li, 1997).

One change that is very much visible in Turkey is that customers are becoming more and more involved with the whole process. They are demanding for precise services which they require. They then study the services available which means healthcare suppliers needs to keep a track of how they are being assessed by the customer. Consequently, hospitals along with caring for the customers and keeping apparently competent service need to look at healthcare as well. Behind all this, the service quality is now an important factor for healthcare suppliers (Dagger, Sweeney, & Johnson, 2007).

Healthcare has been observed in a number of ways in the regions of conventional healthcare research. Quality was explained by Donadedian, 1988 as the capability to reach the wanted goals by fair means only, here the wanted goals means an attainable position of health. However in the same way it is observed as the similar way to attain better and good outcomes of health (Dagger & Sweeney, 2006; Marshall, Ron, & Rebecca, 1996; O'Connor, Shewchuk, & Carney, 1994). If we look at it from a completely different perspective it can be observed as a way to increase patronage, long-term profitability and competitive advantage (Brown & Swartz, 1989; Headley & Miller, 1993).

Healthcare is a very different service industry than other services. The main difference is that the patient does not have the choice to choose a doctor among those who offer low prices or who have better and upgraded technology. Things are different in healthcare industry. Here the doctor is undoubtedly chosen by the patient himself but those choices are based on the opinions of the doctor's existing patients or from the doctor's health organization or from friends and acquaintances. The services provided to service recipients' is very important as it is the sole base of enhancing the quality of healthcare industry (Lee et al., 2000).

Healthcare institute, if they want to flourish, should evaluate the quality of their service as well as grasp on the service delivery charter. Proper strategies and tactics should be implemented in the healthcare however a suitable and legitimate measure should be present in order to evaluate the strategies and tactics that are implemented. The most popular service quality measure that is being applied is the SERVQUAL. Many studies have been measure against this standard in the past such as Babakus and Mangold (1992), Bakar, Akgun, and Al Assaf (2008), Bowers and Kiefe (2002), Dean (1999), Devebakan (2005), Devebakan and Aksarayl? (2003), Lee and Yom (2007), Lee et al. (2000), Li (1997), Ramsaran-Fowdar (2008).

A number of conceptual frameworks have been developed for assessing the offered care qualities hence drawing attention to the literature of healthcare. Li (1997) assessed the performance of the quality in terms of clinical quality and also included patient satisfaction, response to patient requests and patient complaints. Lee…