Voices from Within: Analyzing Employee Perceptions of Service Quality and Quality ‎Improvement Practices in The Indian Healthcare Sector

  • Authors

    • Dr. Seep Sonali Assistant Professor, MYAS-GNDU Department of Sports Science and ‎Medicine, Guru Nanak Dev University, Amritsar, (Punjab), India
    • Dr. Shweta Shenoy Professor, MYAS-GNDU Department of Sports Science and Medicine, Guru Nanak Dev ‎ University, Amritsar, (Punjab), India
    https://doi.org/10.14419/pxf9tq84

    Received date: July 22, 2025

    Accepted date: August 29, 2025

    Published date: October 20, 2025

  • Service Quality (SQ)’ Employee Perceptions; Quality Improvement (QI); Quality Initiatives; ‎SERVQUAL; Hospitals

  • Abstract

    Background: Understanding service quality from the perspective of healthcare employees is ‎vital for redesigning effective and sustainable healthcare systems. While patient expectations ‎and perceptions are well-researched in the literature, employee perceptions remain ‎underexplored, particularly in resource-constrained settings such as India’s healthcare sector.

    Methods: A cross-sectional quantitative study was conducted with 500 employees across 23 ‎charitable and private hospitals in the state of Punjab, India. The questionnaire was designed, ‎including the generic SERVQUAL items, quality improvement (QI) practices, and ‎organizational assessment items. Reliability was confirmed via Cronbach’s alpha; factor validity ‎was assessed through EFA. Independent t-tests and ANOVA explored demographic variations.

    Results: Reliability (M=3.72) and Responsiveness (M=3.68) were the most positively rated ‎service quality domains, whereas Empathy (M=3.19) and Tangibles (M=3.47) scored lowest. ‎There were mixed perceptions regarding activities related to quality improvement, while ‎training rates were moderate, and employee engagement remained low. Technicians reported ‎the lowest satisfaction levels across all job roles (p<0.001). EFA confirmed existing variable ‎structures with a significant Bartlett’s Test (p < .001), and KMO of 0.757.

    Conclusion: Hospital employees perceive themselves as responsive and reliable but face ‎emotional fatigue, poor infrastructure, and fragmented QI engagement. Technicians in require targeted interventions. Empowering staff voices in quality strategies is ‎essential for meaningful and lasting healthcare reform‎.

  • References

    1. Camilleri, D., & O’Callaghan, M. (1998). Comparing public and private hospital care service quality. International Journal of Health Care Quality Assurance, 11(4), 127–133. https://doi.org/10.1108/09526869810216052.
    2. Cheema, H. S. (n.d.). Budget 2025-26. Punjab Govt. (Last Accessed on 26th March, 2025).
    3. Chen, S.-H. and Chen, M.-C. (2014), “Improving employee satisfaction priority through performance control matrix”, International Journal of Supply and Operations Management, Vol. 1 No. 3, pp. 314-327.
    4. Comm, C.L. & Dennis, F.X. (2000). “Assessing employee satisfaction in service firms: An example in higher education”, Journal of Business and Economic Studies, 6(1), p. 43 – 53.
    5. Elizalde, J., Lumibao, J., & Lizarondo, L. (2024). Barriers and facilitators to health professionals' engagement in quality improvement initiatives: a mixed-methods systematic review. International journal for quality in health care: journal of the International Society for Quality in Health Care, 36(2), mzae041. https://doi.org/10.1093/intqhc/mzae041.
    6. Gremler, D. D., Gwinner, K. P., & Brown, S. W. (2001). Generating positive word-of-mouth communication through customer-employee relation-ships. International Journal of Service Industry Management, 12(1), 44–59. https://doi.org/10.1108/09564230110382763
    7. Hasin, M. A. A., Seeluangsawat, R., & Shareef, M. A. (2001). Statistical measures of customer satisfaction for health care quality assurance: A case study. International Journal of Health Care Quality Assurance, 14(1), 6–13. https://doi.org/10.1108/09526860110366214.
    8. IBEF, Ministry of commerce and Industry, GOI Retrieved on 25-06-2025 Healthcare System in India, Healthcare India - IBEF.
    9. Joseph, J., D, H. S., & Nambiar, D. (2021). Empanelment of health care facilities under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in India. PLoS ONE, 16(5), e0251814. https://doi.org/10.1371/journal.pone.0251814.
    10. Kaiser, H.F. (1974), “An index of factorial simplicity”, Psychometrika, Vol. 39 No. 1, pp. 31-36. https://doi.org/10.1007/BF02291575.
    11. Mosadeghrad, Ali. (2013). Healthcare service quality: Towards a broad definition. International journal of health care quality assurance. 26. 203-19. 10.1108/09526861311311409. https://doi.org/10.1108/09526861311311409.
    12. Nagendrappa, Prakash & Nandini, Arjunan. (2023). Workforce sustainability and quality of service in accredited hospitals in India: Mediating role of job engagement. Problems and Perspectives in Management. 22. 25-33. https://doi.org/10.21511/ppm.22(1).2024.03.
    13. Nashrath, M., Akkaddechanunt, T. & Chontawan, R. (2011). Perceived nursing SQ in a tertiary care hospital, Maldives. Nursing and Health Sciences, 13(4): 495-501. https://doi.org/10.1111/j.1442-2018.2011.00648.x.
    14. Parasuraman A, Zeithaml VA, Berry LL. Servqual: a multiple-item scale for measuring consumer perc. J Retailing 1988; 64:12
    15. Sexton, J. B., Thomas, E. J., & Helmreich, R. L. (2006). Error, stress, and teamwork in medicine and aviation: Cross sectional surveys. BMJ, 320(7237), 745–749. https://doi.org/10.1136/bmj.320.7237.745
    16. Srivastava, S., & Prakash, G. (2019). Internal service quality: Insights from the healthcare sector. Journal of Health Management, 21(2). https://doi.org/10.1177/0972063419835127.
    17. Torres-Moraga, E., Barra, C., Vasquez-Parraga, A.Z. and Farıas, A. (2013), “The effects of service quality on customer trust and satisfaction in inter-net banking”, Estudios de Administracion, Vol. 20 No. 1, pp. 1-36. https://doi.org/10.5354/0719-0816.2013.56388
    18. Tsai, W.-C., & Huang, Y.-M. (2002). Mechanisms linking employee effective delivery and customer behavioral intentions. Journal of Service Re-search, 5(2), 156–169. https://doi.org/10.1037//0021-9010.87.5.1001.
    19. Vieira, V. A. (2005). An extended theoretical model of customer experience. Journal of Service Theory and Practice, 15(4), 339–352.

  • Downloads

  • How to Cite

    Sonali , D. S. ., & Shenoy , D. S. . (2025). Voices from Within: Analyzing Employee Perceptions of Service Quality and Quality ‎Improvement Practices in The Indian Healthcare Sector. International Journal of Basic and Applied Sciences, 14(6), 435-443. https://doi.org/10.14419/pxf9tq84