Question 4

Analyze Shouldices performance and processes on the five dimensions of service quality: reliability,
responsiveness, empathy, assurance, and tangibles. How does each dimension contribute to Shouldices
overall image or position in the marketplace?

To answer above question we used HOSQUAL model developed by Joshi, Basher and Mamta in Research
Paper Adapting the SERVQUAL scale to hospital services: An empirical investigation of patients
perception of Service Quality.

Figure 4.1

HOSQUAL at Shouldice Hospital:

1. TANGIBLES Shouldice Hospital is very rich in terms of tangibles whether its 17000 square foot
premises or location. Its centrally located at Ontario, Toronto Canada. Its very near to Ontario
Airport and connected with roadways which makes it very convenient to reach Shouldice
Hospital. Shouldice Hospital consists 6 Examination Rooms, 5 Operation Theatres, nearly 45
Patient rooms (shared by 2), 1 Laboratory, Post-operative rooms and Dinning area. Apart from

these Hospital projects its physical presence with Medical Information Questionnaires, Patient
Brochure and Employees appearance. Interiors are designed as per patients convenience
whether its handrails at aisle, carpets and ambience.

2. RELIABILITY Success rate at Shouldice hospital is 99% and chances of reoccurrence are as low
as 1% as compared to 10% of competitors, complication rate is approximately 0.5%. Doctors are
specially trained before they start operating at Shouldice. Patients are informed about each
every detail. Annual follow checkups are also provided. A natural and unique technique is used
for operation which gives Shouldice core competency in Hernia operation. All this factors peak
reliability of Shouldice.
3. RESPONSIVENESS - Shouldice employs 34 full time nurses out of which 6 are available all the
time, nurses provide counselling to patients other staff also helps patients in. After operation
doctor offer help to patients to walk to post-operative rooms. Patients who come out of Canada
are offered one visit solution, they are given privilege to go through examination and operation
in single visit.
4. EMPATHY Interaction with patients starts prior appointment, they are sent a medical
information questionnaire and are briefed about entire procedure. After patients reach
Shouldice, nurses walk with them to their rooms. No bed-pans are provided here to motivate
patients to socialize and be active. Shouldice also organizes annual Alumni meets.
5. PROCESS Shouldice gives great emphasis on customer defined standards, in terms of facility
handrails at aisle, carpets to avoid slips, optimized staircase and ambience. Standard times are
fixed and capacity is optimally utilized. A normal surgery is completed in 45 minutes, checkup is
completed in 25 minutes. Medical history is sent to concerned doctors are going to examine
patients. Annual follow checkup are provided to keep track of reoccurrence.

6. POLICY Policies are formulated in best interest of patients. Parents accompanying childrens
for treatment arent charged any extra. No television and telephone is provide in patient rooms
to push socializing and keep patient active. Shouldice also has No firing policy in instance when
an employee was found guilty of theft, he was sent for counselling.

A Conceptual model of service quality (Source: Parasuraman et al.,1985)

Figure 4.2
Shouldice enjoys positive word of mouth by its patients and it is major source of incoming patient. So,
patients expectations are in sync with Shouldices perception of customer expectation. Shouldice is
super specialty hospital which performs only Hernia treatment. Its segmentation and positioning very
pointed which helps it fill all GAPS.