THE EFFECTS OF BUSINESS EXCELLENCE TO INTERNAL AND EXTERNAL CUSTOMER OPINIONS IN HEALTHCARE

Year 2021, Volume: 6 Issue: 3, 564 - 578, 26.11.2021

İpek Aydın Özkan Tütüncü

Abstract

Aim: Hospitals can determine the strengths of organization and improvement strategies by implementing business excellence models to increase customer satisfaction. The aim of the study is to evaluate the effects of business excellence dimensions on internal and external customer opinions.
Methods: The universe of the study is public hospitals in Izmir urban area. Four hospitals included in the study and 488 healthcare workers agreed to participate to study. Survey was developed from the Malcolm Baldrige National Excellence Award Healthcare Criteria.
Findings: Factor analysis revealed six business excellence dimensions: strategic planning; workforce focus; process management; customer focus; leadership; and measurement, analysis, knowledge management. Correlation analysis showed that business excellence dimensions have strong relations between each other and internal and external customer opinions. According to regression analysis,customer focus, process management and measurement, analysis, knowledge management effect to the external customer. Workforce focus, process management and leadership effect to the internal customer. Conclusion: In order to improve the internal and external customer opinions in healthcare organizations, hospital managerial teams have to focus on processes and workforce, give importance to be more patient centered and plan their strategies according to customers’ opinions. This study helps the hospitals, in which areas should be focused on primarily when developing policies and strategies; and preparing plans for future developments.

Keywords

Business Excellence, Internal Customer, External Customer, Hospital, Healthcare

References

• Amin, M. & Nasharuddin, S.Z. (2013). Hospital service quality and its effects on patient satisfaction and behavioral intention. Clinical Governance: An International Journal, 18(3), 238-254.
• Badri, M.A., Selim, H., Alshare, K., et al. (2006). The Baldrige education criteria for performance excellence framework. Empirical test and validation. Int J Qual Reliab Manag. 23, 1118–57.
• Berkowitz, B. (2016). The Patient Experience and Patient Satisfaction: Measurement of a Complex Dynamic. OJIN. 21, 1, pp. 1.
• Bloom, G., Standing, H. & Lloyd, R. (2008). Markets, information asymmetry and health care: Towards new social contracts. Soc Sci Med, 66, 2076-2087.
• Bou-Llusar, J.C., Escrig AB, Roca V, et al. (2005). To what extent do enablers explain results in the EFQM Excellence Model? An empirical study. Int J Qual Reliab Manag, 22, 337–53.
• Buttigieg, S,C., Dey P,K. & Cassar, M.R. (2016). Combined quality function deployment and the logical framework approach to improve quality of emergency care in Malta. Int J Health Care Qual Assur, 29(2), 123–40.
• Caffyn, S. (1999). Development of a continuous improvement self-assessment tool. Int J Oper Prod Man, 19, 1138–53.
• Castilla, M.J.I. & Ruiz, O.R. (2008). EFQM model: knowledge governance and competitive advantage. Journal of Intellectual Capital. 9, 133–56.
• Chahal. H. & Kumari, N. (2010). Development of multidimensional scale for health care service quality (HCSQ) in Indian context. Journal of Indian Business Research, 2, 4, 230-255.
• Chai, K.H., Ding, Y. & Xing, Y. (2009). Quality and customer satisfaction spillovers in the mobile phone industry. Serv Sci, 1(2), 93-106.
• Cohen, J., Cohen, P., West, S.G. & Aiken, L.S. (2003). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, 3rd ed., Mahwah, NJ, Lawrence Erlbaum.
• Corredor, P. & Goñi, S. (2010). Quality awards and performance: Is there a relationship? The TQM Journal, 22, 529–38.
• Davies, J. (2008). Integration: Is it the key to effective implementation of the EFQM excellence model? Int J Qual Reliab Manag, 25, 383–99.
• Eskildsen, J.K, (1998). Identifying the vital few using the European Foundation for Quality Management Model. Total Qual Manage, 9, 92–5.
• Eskildsen, J.K. & Dahlgaard, J.J, (2000). A causal model for employee satisfaction. Total Qual Manage, 11, 1081–94.
• Ghosh, S., Handfield, R.B., Kannan, V.R., et al. (2003). A structural model analysis of the Malcolm Baldrige National Quality Award framework. Int J Manag Decis, 4, 289–311.
• Goldstein, S.M & Schweikhart, S.B. (2002). Empirical support for the Baldrige Award Framework in U.S. hospitals. Health Care Manage R, 27, 62–75.
• Gómez, J.G., Costa, M.M. & Lorente, Á.R.M. (2017). EFQM Excellence Model and TQM: an empirical comparison. Total Qual Manag Bus, 28(1-2), 88-103.
• Haas-Wilson, D. (2001). Arrow and the information market failure in health care: the changing content and sources of health care information. J Health Polit Policy Law, 26, 1031-1044.
• Hair, J.F, Black, B., Babin B, et al. (2007).Multivariate Data Analysis, 6th ed., Pearson Education Inc, New Jersey, USA.
• Hartley, J. & Benington, J. (2010). .Leadership for healthcare. Policy Press, Bristol.
• Hillman, G.P. (1994). Making self-assessment successful”, The TQM Magazine, 6, 29–31. Hines, P.A. & Yu, K.M. (2009). The changing reimbursement landscape: Nurses’ role in quality and operational excellence. Nurs Econ, 27 (1), 7-14.
• Horn, J.L. (1965). A Rationale and test for the number of factors in factor analysis. Psychometrika, 30(2), 179–185.
• Jabnoun, N. & Rasasi, A.J.A.L. (2005). Transformational leadership and service quality in UAE hospitals. Manag Serv Qual, Vol. 15, No. 1, pp. 70-81.
• Kim, D.Y., Kumar, V. & Murphy, S.A. (2010). European Foundation for Quality Management Business Excellence Model: an integrative review and research agenda. Int. J Qual Reliab Manag. 27,684–701.
• Koura, K. (2009). Comparative study of core values of excellence models vis-a-vis human values. Measuring Business Excellence, 13(4), 34–46.
• Kupfer, J. & Bond, E. (2012). Patient satisfaction and patient-centered care: Necessary but not equal. JAMA. 308(2), 139-140. doi:10.1001/jama.2012.7381.
• Lee, P, M. & Quazi, H,A. (2001). A methodology for developing a self-assessment tool to measure quality performance in organizations. Int J Qual Reliab Manag, 18,118–41.
• Lee, S.M., Rho, B.H. & Lee, S.G. (2003). Impact of Malcolm Baldrige National Quality Award criteria on organizational quality performance. Int J Prod Res, 41, 2003–21.
• Mackerron, G, C., Mason, R. & McGlynn, M. (2003). Self-assessment: Use at operational level to promote continuous improvement. Prod Plan Control, 14, 82–89.
• Miljkovic, S. (2007). Motivation of employees and behavior modification in health care organizations. Acta Medica Medianae. 46, 53-62.
• Nabitz, U.W. & Klazinga, N.S. (1999). EFQM approach and the Dutch Quality Award. Int J Health Care Qual Assur, 12, 65–70.
• Naidu, A. (2009). Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur, 22(4), 366-381.
• NIST. (2008). Health Care Criteria for Performance Excellence 2008. available at: http://www.quality.nist.gov/PDF_files/2009_2010_HealthCareCriteria.pdf. (accessed May 26, 2010).
• NIST. (2013). 2013-2014 Baldrige Health Care Criteria for Performance Excellence. available at: http://www.nist.gov/baldrige/publications/upload/Category_and_Item_Commentary_HC.p df (accessed August 16, 2016).
• Nunnally. J.C. (1967). Psychometric Theory, McGraw Hill, New York.
• Pannirselvam, G.P. & Ferguson, L.A. (2001). A study of the relationships between the Baldrige categories. Int J Qual Reliab Manag, 18, 14–34.
• Peters J. (2000). A quality philosophy. Measuring Business Excellence. 4(4), 6.
• Price, R., Elliott, M., Cleary, P., et al. (2014). Should health care providers be accountable for patients’ care experiences? J Gen Intern Med.;30(2), 253-256. doi:10.1007/s11606-014- 3111-7.
• Pruckner, G.J. (2010). Health economics demand for health capita. available at: http://www.econ.jku.at/members/pruckner/files/lehre/health/demand.pdf. (accessed August 16 2016).
• Rad, A.M.M. & Yarmohammadian, M.H. (2006). A study of relationship between managers' leadership style and employees' job satisfaction. Leadership in Health Services, 19(2), 11- 28. https://doi.org/10.1108/13660750610665008.
• Ritchie, L. & Dale, B.G. (2000). Self-assessment using the business excellence model: A study of practice and process. Int J Prod Econ. 66, 241–54.
• Samuelsson, P.& Nilsson, L.E. (2002). Self-assessment practices in large organisations. Int J Qual Reliab Manag, 19, 10–23.
• Tutuncu, O. & Kucukusta, D. (2007). Relationship between organizational commitment and EFQM Business Excellence Model: A study on Turkish award winners. Total Qual Manag Bus. 18,1083–96.
• Tutuncu, O., Cobaner, A.A., Guzelgoz, O. et al. (2014). The effects of health transformation program on patient–healthcare personnel communication and interaction in Turkey. Qual Quant, 48, 3433-3446.
• Vahey, D., Aiken, L., Sloane, D., et. al. (2004). Nurse burnout and patient satisfaction. Med Care. 42(2), 57-66.
• Velicer, W.F. (1976). Determining the number of components from the matrix of partial correlations. Psychometrika. 41(3), 321–327.
• Zink, K.J. & Schmidt, A. (1998). Practice and implementation of self-assessment. Int Journal of Quality Science, 3, 147–70.