It is all abour poor situation of Bangladeshi public hospitals

1. Providing Great Service: The Gaps Model
Gaps Model of Service Quality
Expected Service
Perceived
Service
CUSTOMER
COMPANY
Customer
Gap
Gap 1
Gap 3
Gap 2
External
Communications to
Gap 4 Customers
Service
Delivery
Customer-Driven Service
Designs and Standards
Company Perceptions of
Consumer Expectations
The Five Key Service Dimensions
Tangibles: Appearance of physical facilities, equipment, personnel, and
communication materials.
Reliability: Ability to perform the promised service dependably and accurately.
Responsiveness: Willingness to help customers and provide prompt service.
Assurance: Knowledge and courtesy of employees and their ability to inspire
trust and confidence.
Empathy: Caring, individualized attention the firm provides its customers.

2. Determinants of Perceived Service
Quality
Dimensions of Service Quality
1. Access
2. Communication
3. Competence
4. Courtesy
5. Credibility
6. Reliability
7. Responsiveness
8. Security
9. Tangibles
10. Understanding/Knowing the
Customer
Expected
Service
Service
Quality
Gap
Perceived
Service
Perceived
Service
Quality
Word of
Mouth
Personal
Needs
Past
Experience
External
Communication
to Customers
13
Figure 5.1
Customer Perceptions of Quality and Customer
Satisfaction

3. there are 4 types of providers gaps are there.they are:
 Provider Gap 1: Not knowing what customers expect
 Provider Gap 2: Not selecting the right service designs and standards
 Provider Gap 3: Not delivering to service standards
 Provider Gap 4: Not matching performance to promises
Certainly, providing great service is not easy, and it requires a diligent effort to
analyze the service process piece by piece in order to improve it. We now
examine what is known as the Gaps Model, which is designed to highlight those
areas where customers believe they are getting less or poorer service than they
should (the gaps) and how these gaps can be closed.
Bangladesh is a over populated country.There are many problems in
Bnagladesh.one of the major problem is is health service problem.thousands of
people are suffring for proper health service in Bangladesh.
The Customer Gap
Expected
service
Customer Gap
Perceived
service
Consumer expectation and service providers gap is huge in public health
service.So we are gong to discuss about public health service gaps perticularly
about BONGOBONDHU SHEIKH MUJIB MEDICAL COLLAGE
UNIVERSITY

4. 1.THE LISTENING GAP
WHAT IS LISTENING GAP
Gap between consumer expectation and management perception: This gap arises
when the management or service provider does not correctly perceive what the
customer wants or needs. For instance – hotel administrators may think guests
want better food or in-house restaurant facilities, but guests may be more
concerned with the responsiveness of the staff or the cleanliness of their rooms.

5.  Inadequate marketing research orientation
includes 3 key points
1.Insufficient marketing research
2.Research not focused on service quality
3.Inadequate use of market research
From the perspective of the BSMMU they don’t have any market research team
who can research the market and can focus on service quality.
 Lack of upward communication
1.Lack of interaction between management and customers
2.Insufficient communication between contact employees and managers
3.Too many layers between contact personnel and top management
In the BSMMU it is really hard to found any upper management that they are
communicating with the customers .so there is huge gap between customers
and top management.
There are also too many layers between contact personnel and top
management.so it is really hard for the patients or the customer to
communicate with them.
 Insufficient relationship focus
1.Lack of market segmentation
2.Focus on transactions rather than relationships

6. 3.Focus on new customers rather than relationship customers
In BSMMU or any public hospitals in Bangladesh they don’t really care about
any relationship with the customers.Actually they don’t believe in it.they only
focus on the transaction with the customers.nothing else.
 Inadequate service recovery
1.Lack of encouragement to listen to customer complaints
2.Failure to make amends when things go wrong
3.No appropriate recovery mechanisms in place for service failures
In the BSMMU there is no system for complaining. there is nobody to listen the
complaints. Patients go here and there to complain but no body listens and take
appropriate action. Patients also gets harassed if they went to complain against
some body.
There is no appropriate recovery mechanisms in place for service failures.

7. 2.SERVICE DESIGN AND STANDARD GAPS
Key Factors Leading to Provider Gap 2
Customer-Driven Service
Designs and Standards
 Poor service design
Unsystematic new service development process
Vague, undefined service designs
Failure to connect service design to service positioning
 Absence of customer-driven standards
Lack of customer-driven service standards
Absence of process management to focus on customer
requirements
Absence of formal process for setting service quality goals
 Inappropriate physical evidence and servicescape
Failure to develop tangibles in line with customer expectations
Servicescape design that does not meet customer and
employee needs
Inadequate maintenance and updating of the servicescape
Management Perceptions of
Customer Expectations
Gap
2
© 2006 The McGraw-Hill Companies, Inc. McGraw-Hill/Irwin All rights reserved.
WHAT IS SERVICE DESIGN AND STANDARD
GAPS
Gap between management perception and service quality specification: This is
when the management or service provider might correctly perceive what the
customer wants, but may not set a performance standard. An example here

8. would be that hospital administrators may tell the nurse to respond to a request
‘fast', but may not specify ‘how fast'.
 Poor service design
1. Unsystematic new service development process
2. Vague, undefined service designs
3. Failure to connect service design to service positioning
In the public hospital like BSMMU there is no system or research prgramme
to identify the customer needs.so there are no process going on when they
are designing the a new service.
After that for vogue and undefined service customers or the patients actually
have no clue that how can get the survive and what is the procedure.
 Absence of customer-driven standards
1. Lack of customer-driven service standards
2. Absence of formal process for setting service quality goals
In BSMMU there are no minimum standard maintain by its authority.They don’t
really aware of the customer needs.they don’t have the quality work force to
provide the best service quality.they don’t have the quality doctors who can
give the better treatment towards its patients.

9.  Inappropriate physical evidence and
servicescape
1. Failure to develop tangibles in line with customer expectations
2. Services cape design that does not meet customer and employee
needs
3. Inadequate maintenance and updating of the servicescape
BSMMU have really poor back dated servise design. Beside that there are back
dated lack of medicl equipment are present.
Modern treatment facility are nt over there. So the patients can get the proper
treatment over there.

10. 3.THE SERVICE PERFORMANCE GAP

11. Key Factors Leading to Provider Gap 3
Customer-Driven Service
Designs and Standards
 Deficiencies in human resource policies
Ineffective recruitment
Role ambiguity and role conflict
Poor employee-technology job fit
Inappropriate evaluation and compensation systems
Lack of empowerment, perceived control, and teamwork
 Customers who do not fulfill roles
Customers who lack knowledge of their roles and responsibilities
Customers who negatively impact each other
 Problems with service intermediaries
Channel conflict over objectives and performance
Difficulty controlling quality and consistency
Tension between empowerment and control
 Failure to match supply and demand
Failure to smooth peaks and valleys of demand
Inappropriate customer mix
Overreliance on price to smooth demand
Service Delivery
Gap
3
© 2006 The McGraw-Hill Companies, Inc. McGraw-Hill/Irwin All rights reserved.
THE SERVICE PERFORMANCE GAP
Gap between service quality specification and service delivery: This gap
may arise in situations pertaining to the service personnel. It could
happen due to poor training, incapability or unwillingness to meet the
set service standard. An example would be when a doctor's office has
very specific standards of hygiene communicated but the hired staff
may have been poorly trained on the need to follow these strict
protocols.

12.  Deficiencies in human resource policies
a. Ineffective recruitment
b. Role ambiguity and role conflict
c. Inappropriate evaluation and compensation systems
d. Lack of empowerment, perceived control, and teamwork
First problem we have noticed that in BSSMU is that Ineffective recruitment.
There is corruption every where. If any one want to get a job in the BSMMU
then he have to spend money. People get recruited basis of power and money
not basis of the quality.
There is also a conflict going on to employees of the political parties.Every one is
concentrated to get the power ad money.no one is concentrated to provide
quality service.
 Customers who do not fulfill roles
1. Customers who lack knowledge of their roles and responsibilities
2. Customers who negatively impact each other
AS the employees get their job basis on the money not on the
knowledge andand the quality they don’t have the knowledge that
how to provide the appropriate service to the patients or the
customers.

13.  Problems with service intermediaries
1. Channel conflict over objectives and performance
2. Difficulty controlling quality and consistency
3. Tension between empowerment and control
common complaints against public hospitals include the apathy of doctors
and nurses regarding their job and negligent attitude towards the patients.
There are allegations of negligence, absence in the workplaces, misbehaving
with patients, utter disregard for accountability, tendency to ask for
'commission' and general corruption.
In the BSMMU brokers are every where.if you have the money then you will get
every thing. that is the unsystematic system going over there.
There is no chain of command who can control the quality and consistency of
the service.
 Failure to match supply and demand
Failure to smooth peaks and valleys of demand
Capacity of the BSMMU is too low towards its high volume of the customers.

14. Beds of the BSMMU is really limited towards its huge demand. other
pathological equipment are also limited. for that reason patients have to wait
for the longtime to get a service.
4.THE COMMUNICATION GAP

15. Key Factors Leading to Provider Gap 4
Service Delivery
 Lack of integrated services marketing communications
Tendency to view each external communication as independent
Not including interactive marketing in communications plan
Absence of strong internal marketing program
 Ineffective management of customer expectations
Absence of customer expectation management through all forms of
communication
Lack of adequate education for customers
 Overpromising
Overpromising in advertising
Overpromising in personal selling
Overpromising through physical evidence cues
 Inadequate horizontal communications
Insufficient communication between sales and operations
Insufficient communication between advertising and operations
Differences in policies and procedures across branches or units
External Communications to
Customers
Gap
4
© 2006 The McGraw-Hill Companies, Inc. McGraw-Hill/Irwin All rights reserved.
WHAT IS THE COMMUNICATION GAP
Gap between service delivery and external communication: Consumer
expectations are highly influenced by statements made by company
representatives and advertisements. The gap arises when these
assumed expectations are not fulfilled at the time of delivery of the
service. For example – a hospital printed on its brochure may have
clean and furnished rooms but in reality, it may be poorly maintained –
in this case the patient's expectations are

16.  Lack of integrated services marketing
communications
1. Tendency to view each external communication as independent
2. Absence of strong internal marketing program
IT is a matter of regret that there is no internal or external marketing
program in the BSMMU.As there is no marketing team there is no
marketing programme is going on there or it is really hard to found
any marketing statement.
 Ineffective management of customer
expectations
1. Absence of customer expectation management through all forms of
communication
2. Lack of adequate education for customers
 Overpromising
1. Overpromising in advertising
2. Overpromising in personal selling
3. Overpromising through physical evidence cues
AS it si the Govt. organization govt. always overpromises when they
get s the power.but end of the day every thing remais same.nothing is
changed.mis management every where happening over and over.
 Inadequate horizontal communications
Insufficient communication between sales and operations

17. Insufficient communication between advertising and operations
Differences in policies and procedures across branches or units