Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL

An integrated approach for healthcare services risk assessment and quality enhancement

Purpose

The purpose of this paper is to introduce an integrated approach using failure modes and effects analysis (FMEA), multiple-criteria decision making (MCDM), mathematical modeling and quality function deployment (QFD) techniques, for risk assessment and service quality enhancement in coronary artery bypass grafting (CABG) as a treatment for cardiovascular diseases (CVDs).

Design/methodology/approach

First, the disruptions in the CABG process are identified and prioritized following FMEA instructions, using two MCDM techniques, called analytic hierarchy process (AHP) and TOPSIS. Consequently, several corrective activities are identified and weighted on the basis of QFD. Finally, a mathematical model is established to determine the most cost-effective activities for implementation. The approach is developed in a fuzzy environment to reflect the uncertainty and ambiguity of human reasoning.

Findings

Regarding the CABG process disruption, a total of 30 failure modes in four main categories were identified and prioritized. Moreover, eight corrective activities were devised and ranked according to their impact on the failure modes. Finally, considering a limited amount of budget, a sensitivity analysis on the mathematical model’s objective function indicated that using 30 percent of the total budget, required to implement all corrective activities, was enough to cover more than 70 percent of the effects of corrective activities on the failure modes.

Originality/value

This paper contributes to the quality risk assessment knowledge by introducing an integrated approach to evaluate and improve healthcare services quality. Also, the case study conducted on the CABG process has not been done by other related studies in the literature.

Participant satisfaction with the vocational rehabilitation process: a micro perspective of relationship dimensions

This article is the last in a series of two that examines participant satisfaction with the vocational rehabilitation (VR) process. Disabled individuals face formidable challenges when entering the workforce. The VR process involves a complex series of interactions and relationships among participants, counselors, training professionals, ancillary service providers, and employers to help participants prepare for and find employment. In the first article, we identified six relationship dimensions that influence overall satisfaction with vocational training services and presented a highly reliable survey instrument. In part two, we look at the items within each dimension and identify those with the greatest impact on participant satisfaction. The findings show that the level of caring or concern demonstrated by the counselor, an element of the interpersonal social bond dimension, has the greatest affect on participant satisfaction with the entire VR process.