4.4 Service-Oriented Quality Models

Taking into account the definition of service and its resulting three elements of service, the Model of Meyer will reflect the double-sided nature of service. The influence of the customer towards gained quality will be represented. Meyer wants to show the whole progress of service and its developing quality, but he also wants to define subqualities in order to obtain clear areas for creating quality. The importance of each area of subquality will depend on the kind of service. [MM87p.191]

Here, the Model of Meyer will be developed in steps, modifying the Model of Donabedian and making the necessary changes and additions. Although this might be in contradiction to Meyer, this will be didactic and guarantee easy understanding . Moreover, this approach takes into account current quality assurance. The Model of Donabedian is most commonly used in medicine. Physicians can build on their existing knowledge of quality understanding. Starting with this model, making changes and additions, will implicitly unfurl the needed improvements. Besides, it outlines the parts in common of both models. Today's implemented quality assurance programs in medicine can then be seen, as partial actions of the more widely developed Model. On the other hand, developing Total Quality Management for specific tasks and situations in medicine, one might then consciously simplify the Model of Meyer.

first step: potential quality instead of structure quality
Donabedian defines the subquality structure quality. He implies that somehow structure quality will cause process quality and finally influence the outcome quality. In practice this definition has been misleading. As already mentioned, best equipment does not necessarily improve the outcome. Defining this subquality, structure quality, separating it from the process quality, leads to the belief that structure quality could be for its own sake. In contrast to process quality (which will also be lived by the customer), a given structure never produces a quality in itself. Structure can only serve to create better process quality and better outcome; to determine what kind of structure will actually bring better process and outcome quality, one has to look the whole service from behind. Changing the structure, buying better equipment, will at first lower quality, it might then improve the quality. Structure must always be seen in a view of process, the weakest part determines the strength of the whole. New equipment in a structure with poorly skilled staff will most probably be of no benefit. If the staff is in agood condition, missing equipment can be the bottleneck. The elements of structure, that is to say, the quality of human resources, technical equipment and organisational structure, should not be counterbalanced. Referring to quality (not quantity) they cannot compensate one another.