Industrial and Management Systems Engineering


Date of this Version

Summer 8-2011


A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Master of Science, Major: Industrial and Management System Engineering, Under the supervision of Professor Ram Bishu. Lincoln, Nebraska: August, 2011

Copyright 2011 Vijaya Krishna Musunuru


In the recent years, healthcare organizations have realized that quality in providing service is critical for their survival in this competitive world. This increased attention to service quality has forced many health care providers to reevaluate their systems to stay in business. The main purpose of this study is to test the hypothesis “Process Quality predicts the Product quality (patient satisfaction) in the healthcare domain”. The objective of this study was three- fold. The first objective is to analyze historical data both on patient satisfaction and on provider attributes to yield process parameters for a particular area in a hospital. The second objective is to demonstrate and validate the concept that Process quality predicts product quality in health care domains. The third objective is to use a survey tool which yields significant process parameters and demonstrating the method to improve them using lean six sigma methodologies.

Three data sets consisting of responses to patient, employee and physician questionnaires were taken. The ANOVA and Regression Analysis were performed on raw data to enumerate the relation between final outcome measures and their respective attributes. The Regression Analysis was repeated using the combined quantitative composites derived from each of the 3 data sets independently via dimension reduction by factor analysis. The analyses identified several potential key dimensions that were used to develop a generic survey for the patients, physicians and nurses. A preliminary analysis was done to validate the model by partnering with a health care facility.

The ANOVA performed on the generic survey data have shown that the category of the respondent as the most important variable. The multiple regression analysis on the raw data and attributes has shown that the hospital security and adequate medication provided by the providers is significantly affecting the dependent variable: Recommending hospital to others. Moreover from the linear regression analysis, the variables ‘treating each other with courtesy and respect’, ‘feel safe & secure’ ‘flexibility in scheduling work hours’ and ‘balancing of family life and work’ had the highest coefficients which are at 0.001 level. It concludes that dimensions also contribute the most to the variation in health outcomes.

Advisor: Ram R. Bishu