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Augmenting Management Systems in Health Care: Auditing, Integration, and Assessment Open Access


Other title
Process Auditing
Customer satisfaction
ISO 10002
Integrated Management Systems
ISO 19011
Financial Statements
ISO 10003
Type of item
Degree grantor
University of Alberta
Author or creator
Fernandez Ruiz, Enrique
Supervisor and department
Karapetrovic, Stanislav (Mechanical Engineering)
Examining committee member and department
Ma, Yongsheng (Mechanical Engineering)
Tian, Zhigang (Mechanical Engineering)
Doucette, John (Mechanical Engineering)
Reay, Trish (Business)
Gotzamani, Katerina (University of Macedonia)
Karapetrovic, Stanislav (Mechanical Engineering)
Department of Mechanical Engineering
Engineering Management
Date accepted
Graduation date
2017-06:Spring 2017
Doctor of Philosophy
Degree level
The lack of literature reporting on the use of customer-satisfaction-augmenting Management System Standards (MSS) in health care provided an opportunity to explore the use of one such augmenting (AUG) MSS, namely ISO 10002, for managing feedback in a Canadian provincial health care organization (i.e., the Case Study Organization, CSO) and to identify subsequent research components, one of which was the development of an interdepartmental process audit. After examining literature on interdepartmental audits, and determining the opportunity to develop a method that would enable the auditing of interdepartmental processes through a focus on ‘interactions’, the “Boundary Audit Method” (BAM) was developed, verified and validated. Lastly, exploratory research was undertaken regarding the potential use of Financial Statements (FS) and Financial Ratio Analysis (FRA) with MSSs. The anticipated academic value of this research includes: a) The study was the first to examine the use of an AUG MSS such as ISO 10002 (2014) in a provincial health care organization for handling not only concerns but also commendations and suggestions. b) To my knowledge, the BAM is the first method for auditing interdepartmental processes through a focus on interactions. The designation “1.5-party audit” (first-and-a-half or one-and-a-half party audit) is another contribution, used to reflect the examination of a department’s own involvement in a process in addition to that of any other process partners. c) A novel model was proposed for structuring and integrating MSSs requirements. The model is the result of abstracting the Income Statement and Balance Sheet components and their interrelationships and using such a framework to organize (and integrate when multiple) MSSs requirements. d) A novel assessment technique was proposed for examining SMS-component interrelationships. The assessment technique adapts FRA and substitutes the numbers in the ratios with the juxtaposed SMS components, questions are then prepared to examine how SMS-components interrelate amongst each other, answers to the questions are found by examining documentation, interviewing personnel or observing the SMS, and recommendations for improvement are ultimately provided to management of the organization.
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
Fernandez, E., Karapetrovic, S., and Brooks, P. M. (2010), "ISO 10002 in Health Care: Update on a Case Study", Proceedings of the 14th International Conference on ISO and TQM (ICIT).

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