Objective: The objective of this study was to examine a complex service environment—hospitals—to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively.
Subjects: In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage.
Methods: Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs).
Results: Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs.
Conclusions: Primary actors—ie, doctors—need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, “putting the customer first.” Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as “patient advocates.” Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.