9: Service Quality

Chapter 9

Service Quality


This chapter aims to stress the importance of service elements in the delivery of quality care in everyday practice and to review the popular service-quality models which apply to dental practice.


Having read this chapter, the reader should have a better understanding of what constitutes service quality.


Organisations survive and prosper through meeting the needs of customers. High service standards contribute much to this success and, according to David Garvin of Harvard Business School it means: “Pleasing customers, not just protecting them from annoyance.”

John Tschohl, described by Time magazine as the guru of customer service and now president of the Service Quality Institute, states that: “Providing exceptional customer service” should be “at the top of your list of corporate goals. While quality, price, and speed are important to customers, service is the icing on the cake. It will give you a competitive edge and keep your customers coming back to you.”

Abrams et al (1986) compared dentist and patient assessments of dental restoration quality. They concluded that: “Simply practising dentistry with a high degree of technical expertise will not necessarily convince the patient that he has received high-quality dental care. Other less technical aspects of dental care are recognised as being barometers of quality of dental treatment. Practitioners should not lose sight of the human and psychological aspects of care, and keep in mind that they are integral components of quality in dental treatment.” Many of these aspects relate to service quality.

There has been a stream of research into aspects of service quality and it has been conceptualised in two different ways:

  1. The Nordic perspective, as articulated by Grönroos (1984), defines the dimensions of service quality as consisting of functional aspects (e.g. intangible benefits) and technical ones (e.g. the delivery of the service). These dimensions are viewed as the main properties of perceived service quality.

  2. The second concept is the American one, as exemplified by the work of Parasuraman et al (1988), and revolves around the SERVQUAL model which defines service quality as the outcome of effective service delivery which occurs when customers receive service that is superior to their expectations.

According to these authors, service quality is an attitude formed by customers by comparing prior expectations of the service and their perceptions of the actual service performance. In other words, perceptions of service quality are based on the evaluation of service delivery in comparison to pre-consumption expectations, i.e. the disconfirmation model.

Details of these two approaches are presented later in this chapter.


Service quality can be defined in many ways. It is the difference between the patients’ expectations for service performance prior to the encounter and their perceptions of the service actually received.

Other perspectives on service quality include:

  • Service quality is superiority or excellence as perceived by the customer (Peters and Austin, 1985).

  • The delivery of excellent or superior service relative to customer expectations (Zeithaml and Bitner, 1996).

  • Quality is behaviour – an attitude – that says you will never settle for anything less than the best in service for your stakeholders, whether they are customers, the community, your stockholders or colleagues with whom you work every day (Harvey, 1995).

  • (Quality is) providing a better service than the customer expects (Lewis, 1989).

Elements of Service Quality

Dr Michael Kendrick is a well known international consultant and the former Director of the Institute for Leadership and Community Development in the US. He has identified 30 elements of service quality (Table 9-1), which “taken together … should enhance the probability that a service actually benefits the people it was intended to serve.”

Table 9-1 Kendrick’s 30 elements of service quality
Kendrick’s 30 elements
  1. The regard and value the agency extends to consumers.

  2. The loyalty and fidelity held by service providers to those served.

  3. The degree of understanding present by those served.

  4. The extent to which consumers are understood in terms of their needs.

  5. The extent to which the agency individualises services.

  6. The level of consumer participation and guidance in regards to what is happening with and for them.

  7. The relevance of service practices to people’s needs and preferences.

  8. The extent to which the service respects and strengthens the person’s autonomy and self determination.

  9. The extent to which the person is assisted in maintaining or strengthening their community.

  10. The extent to which the person is supported in having and managing personal relationships.

  11. The provision to consumers of just the right amount and intensity of support.

  12. The extent to which the agency addresses the person’s development, growth, and competencies.

  13. The presence of appropriate protection and safeguards for the person’s vital needs.

  14. The extent to which the agency preserves and nurtures the person’s natural and informal supports.

  15. Respect for the rights of the person and support for the person to exercise these rights.

  16. The extent to which the service and agency processes are understood and meaningful to the consumer.

  17. The service should be affordable.

  18. The service should adapt as individual needs change.

  19. The person is not stigmatised through association with the service.

  20. The service should be coordinated with other aspects of the person’s life.

  21. The level of appropriate acknowledgment and support for the existential, emotional and spiritual struggles of the person served.

  22. Adequate levels of structure, consistency and dependability of service.

  23. When supervision is needed, it should be properly targeted, enhancing, and empowering for the person.

  24. The extent to which consumers’ lives are encouraged to be as normal as possible.

  25. That the interests and needs of the person served are not supplanted by the interests of the caregiver or the agency.

  26. Consumers should not be subjected to involuntary interruptions in their home and work life.

  27. The person should have e/>

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Jan 5, 2015 | Posted by in General Dentistry | Comments Off on 9: Service Quality
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