Improving the quality of hospital services using the QFD approach and integration with kano analysis under budget constraint

Document Type : Research Paper


Industrial Engineering Department, Faculty of Engineering, Semnan University, Semnan, Iran



Background and Objectives: One of the main concerns of hospital managers is their ability in improving their organization's performance. The use of quality management and decision-making techniques facilitates managers to achieve this goal. In this research, the corrective activities to increase the quality of hospital services are determined and selected using an integration of the QFD method with the kano analysis and knapsack problem mathematical model (KPMM). This approach is implemented in a private hospital in Iran.
Methods: First, the customers’ wants are identified. The corrective activities are then identified to meet these want, and the relationship between each corrective activity and each want is determined. Next, the types of the wants are identified based on the kano analysis, and their weights are determined using their degree of importance and type. Then, the final weight of each corrective activities is obtained based on the wants’ weights and the relationship matrix. Finally, KPMM is used to select the optimum list of corrective activities under budget constraint.
Findings: This study identifies 30 customers’ wants among them “Professional and experienced doctors and nurses" and " Healthy and sufficient consumables" obtained the highest weights. Results show that there are 2 “Attractive” customer wants, 15 “One-dimensional” customer wants and 13 “Must-be” customers’ wants. Finally, 30 corrective activities were identified which are placed at house of quality. The corrective activities "Training of physicians and nurses" and "Increasing staff sense of responsibility" obtained the highest weights.
Conclusions: Utilizing the kano analysis for determining the weight of customers’ wants in the house of quality approach causes the organization's strategies taken in to account in prioritizing corrective activities. Moreover, KPMM leads to an optimum selection of corrective activities.


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