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An ISO 10000-based Patient Satisfaction Framework Open Access


Other title
Patient satisfaction measurement
Emergency Department
ISO 10001
ISO 10004
Patient centered
Contunuum of care
Integrated care
ISO 10002
Customer satisfaction
Inpatients care
Type of item
Degree grantor
University of Alberta
Author or creator
Khan, Mohammad A
Supervisor and department
Dr. Stanislav Karapetrovic, Department of Mechanical Engineering
Examining committee member and department
Dr. Fotis Vouzas, Department of Business Administration, University of Macedonia
Dr. John Doucette, Department of Mechanical Engineering
Dr. Yongsheng Ma, Department of Mechanical Engineering
Dr. Amit Kumar, Department of Mechanical Engineering
Dr. Linda Carroll, School of Public Health, University of Alberta
Department of Mechanical Engineering
Engineering Management
Date accepted
Graduation date
Doctor of Philosophy
Degree level
Health care systems focus on fulfilling patient expectation and needs. However, the wide differences among various health care services make the understanding and use of patient satisfaction information challenging. Patient satisfaction can systematically be studied and analyzed through methods based on the ISO 10000 series of quality standards, a research area that is still unexplored. This research presents a study of three specific aspects of patient satisfaction through the application of ISO 10000 standards and various quality management principles and techniques. Unlike the traditional, provider-centered health care delivery systems, integrated health care, a relatively recent strategy, offers a patient-focused system that integrates the diverse resources and services with the objective of attaining a high quality of care and patient satisfaction. However, research on patient satisfaction in integrated care systems is still rare. The ISO 10000-based methods developed in this thesis address this void, demonstrating the focus on patient experience along the health care process. The thesis demonstrates a systematic construction of patient satisfaction promises, unsolicited handling of patient feedback and measurement of patient satisfaction by applying ISO 10001, 10002 and 10004, respectively. A promise and its supporting processes were designed, developed and implemented in the inpatients care of a Canadian hospital. The feedback-handling and patient satisfaction measurement systems were designed and developed by focusing on the Emergency Department (ED) and inpatients care continuum, which was assumed as an integrated care case. To design and develop the three components that this research focuses on, i.e., patient satisfaction promises, a feedback-handling system and a patient satisfaction measurement system, interviews with the research participants, which including health care professionals (e.g., nurses and unit managers) and feedback-handling experts involved in health care performance measurement, were performed. A promise was implemented in an inpatients care unit, including performance measurement processes with collection and use of solicited and unsolicited patient feedbacks using a patient survey and a feedback handling process, respectively. A feedback handling system was developed for the unit-level handling of feedbacks by focusing on the ED and inpatients care continuum. For the measurement of patient satisfaction, a survey encompassing patient experience along the continuum of care was developed and verified through interviews with the research participants. The survey also included items related to promise and feedback-handling system performances. Based on the results, the usefulness and applicability of the standardized systems were analyzed. The most significant contribution of this research comes from the connections demonstrated among promises, feedback-handling and patient satisfaction measurement, which helped in conceptualizing a patient satisfaction framework for integrated care. The use of ISO 10001 presented a fresh approach to the systematic design, development and implementation of promises in health care. The integrated application of the three ISO 10000 standards in health care is presented for the first time, the feasibility of the approach and synergy attained being evident in the work presented. Through the focus on a care continuum, the ISO 10002 and ISO 10004-based feedback-handling and patient satisfaction measurement systems enriched the research in integrated care. The research learning can not only be replicated in other health care areas, and but can also serve as a baseline in other industries and sectors in investigating customer satisfaction effectively and efficiently.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Khan, M.A.R. and Karapetrovic, S. (2015), “Establishing an ISO 10001-based promise in inpatients care”, International Journal of Health Care Quality Assurance, Vol. 28 Issue 2, pp. 100-14Khan, M.A.R. and Karapetrovic, S. (2013), "Implementing an ISO 10001-based promise in inpatients care", International Journal for Quality Research, Vol. 7 No. 3, pp. 335-46Khan, M.A.R. and Karapetrovic, S. (2014), “ISO 10002:2004-based feedback handling system for emergency and inpatients care”, European Accounting and Management Review, Vol. 1 Issue 1, pp. 25-43Khan, M.A.R., Karapetrovic, S. & Liss, K. (2010), "A Methodology for an ISO/TS 10004 Application in Integrated Health Care", Proceedings of The 14th International Conference on ISO 9000 & TQM, Scranton, Pennsylvania, April 5-7, 2010, Paper 2-3, pp. 1-8.

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