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Puay Cheng Lim: Puay Cheng Lim is based at Leicester University Management Centre, Leicester, UK.
Nelson K.H. Tang: Nelson K.H. Tang is based at Leicester University Management Centre, Leicester, UK.
Peter M. Jackson: Peter M. Jackson is based at Leicester University Management Centre, Leicester, UK.
Introduction
Hospitals in Singapore are grappling with a variety of issues: the dynamics of regulation, market forces, quality and a cost-conscious environment. Perhaps the most significant of these issues is how to improve the quality of hospital services to meet and exceed customers' expectations. Hospitals, like all service companies, have problems in defining quality, providing and controlling the desired levels of performance.
Quality is an elusive and a multi-dimensional construct. Often mistaken for imprecise descriptions like "goodness or luxury, or shininess or weight" (Crosby, 1979), quality and its requirements are not easily articulated by consumers (Takeuchi and Quelch, 1983). Furthermore, the inherent characteristics of services exacerbate the efforts to improve service quality. It is therefore important to identify and understand the characteristics that differentiate services from traditional manufactured products. Amongst the most frequently mentioned are the intangibility, perishability, inseparability, simultaneity and heterogeneity of services (Zeithaml et al., 1990; Parasuraman et al., 1985; Rosander, 1991). Consequently, it is difficult for customers to identify and prioritise their expectations and for management to include these expectations in the service package. The direct participation of customers in the delivery process also introduces an uncontrollable element, which in turn affects the perception of quality.
With the growing consensus that customer satisfaction is an important indicator of health care quality, many hospitals in Singapore are searching for ways to change the delivery of patient care through total quality management (TQM). A widely accepted TQM principle is to know the customers and to meet or exceed their expectations (Tennor and DeToro, 1992). Ultimately, TQM strives to create a corporate structure that is guided by business strategy and driven by the expectations of customers. From this perspective, hospitals will have to focus on integrating their various processes in different levels that include quality management, human resource management etc. to meet and exceed customers' expectations and to achieve organisational excellence. Furthermore, hospitals provide the same type of service, but they do not provide the same quality of service. It...