Service Quality Improvement through Integrated Demand Management in the Ethiopian Healthcare Sector
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Date
2016-01
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Addis Ababa University
Abstract
Quality is a basic differentiator for manufactured products and for services provided. The
Service sector constitutes a considerable part of the country’s economy. Besides its economic
contribution, the service sector such as the healthcare is an inseparable part of human life. The
healthcare service needs to be accomplished with great care and speed to save lives and promote
happiness by eradicating diseases and alleviating human suffering.
Efforts have been exerted by the Government, to improve the quality of life in the country
through the expansion and development of manufacturing industries. Compared to
manufacturing industries, the quality of service sectors has not advanced adequately. This is
partly due to the fast rate of population growth. Much is expected to improve the service quality
with the resources available. The complexity and wide coverage of the service sector do not
make improvements to be achieved easily. Among the efforts worthy of mentioning to improve
service quality in the sector is the implementation of Business Process Re-Engineering (BPR)
and the Kaizen philosophy and principles especially in hospitals, though the results gained has
not yet reached the standard expected. Owing to this, complaints in the health sector still persist
and it is obligatory to find ways and means to deal with them. Therefore, the main objective of
this research is to assess the existing problems by undertaking an in-depth study of different
healthcare departments. To this end, it is necessary to develop an integrated demand
management model. It is believed that this will be helpful in managing the demand within the
sector and achieve an integrated method of channeling healthy delivery services in an efficient
and effective manner.
To realize the dissertation’s objectives, an in-depth literature review was conducted. The
concepts and terms related to quality, supply chain and demand management in healthcare as
well as different models and options were investigated with the help of mathematical and
statistical tools to study quality improvement approaches. As a result, existing gaps were
identified and further examined by using a combination of primary and secondary sources,qualitative and quantitative data and with information gathered from focus group discussions to
deal with improvements and approaches for the identified problems. By using the data obtained,
a Fuzzy-AHP approach was selected and the necessary measures were prioritized for the purpose
of implementation. The prioritization was also supported by sensitivity analysis. As a result,
both emergency and referral cases in relation to inpatient and out-patient needs, as well as
pharmaceutical distribution were examined in different sections.
In the assessment of the existing working situation in the selected areas of the sector, waiting
time data were analyzed and the working procedures were also investigated. Core problems
were selected and the patient flow of the existing system was studied with the help of system
dynamics stock-flow diagrams. Pharmaceutical distribution networks were re-designed to
minimize the delay of services.
Finally, an integrated demand management model which is aimed at improving the service
quality in the sector to enhance the degree of responsiveness to patients’ needs that would do
away with delays was developed by using system dynamics and consultation of experts for the
choice of parameters for application. The workability of the new model is theoretically validated
and supported by experts in the area.
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Keywords
Service quality, Healthcare, Integrated demand management, System dynamics, Ethiopia