Monitoring and reducing patient dissatisfaction: a case study of an Iranian public hospital

O. Rasouli, M.H. Zarei

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)
170 Downloads (Pure)


Patients' dissatisfaction with hospital services is a major indicator for the assessment of healthcare quality. This paper proposes an innovative framework to measure and decrease patient dissatisfaction with hospital services. First, a validated and verified SERVQUAL-based questionnaire is proposed to be distributed among patients. Then, according to the collected data, the level of dissatisfaction is monitored by deploying a p-chart and a Demerit chart. Finally, in order to identify long-term improvement opportunities, an improvement index and Pareto chart have been exploited. The usefulness of the proposed framework is illustrated by the application on a case study in a public hospital of Iran. The results revealed that both the Demerit chart and p-chart are quite competent in monitoring patients’ dissatisfaction and alarming out-of-control situations. In the studied hospital, food service was found to be the critical challenge that required both immediate and long-term improvements. Nurses’ criteria should receive immediate improvement while long-term efforts should be devoted to hospital environment and facilities.
Original languageEnglish
Pages (from-to)531-559
Number of pages29
JournalTotal Quality Management and Business Excellence
Issue number5-6
Early online date17 Mar 2015
Publication statusPublished - 2016
Externally publishedYes

Bibliographical note

This is an Accepted Manuscript of an article published by Taylor & Francis in The Language Learning Journal on 17/03/2015 available online:

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.


  • patient dissatisfaction
  • SERVQUAL questionnaire,
  • public hospital service
  • control chart
  • p-chart
  • Demerit chart
  • Pareto chart
  • improvement index


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