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Purpose Healthcare providers are increasing their focus on patient satisfaction and patient-oriented services as they play a significant role in managing rising costs, elevating service quality and establishing sustainable quality improvement strategies. In recent years, the Kano model has gained popularity in the healthcare industry and has been employed to improve patient satisfaction. The purpose of this paper is to illustrate how the Kano model can be deployed to identify a wide range of complex patient needs and convey its potential usefulness in the continuous improvement of the healthcare sector. Design/methodology/approach This paper provides a case study of implementing the Kano model to identify diverse patient needs and aims to eliminate the gaps identified in prior research, which include generically applying the Kano model to all service units of the healthcare system and using a predetermined service quality scale. This study emphasizes the importance of scale development and individual attention to each healthcare service unit in determining intricate patient needs. A cross-sectional study was conducted at the Student Health Services (SHS) of Missouri University of Science and Technology where the data were collected using the Kano survey. The respondents included undergraduate and graduate students that have utilized the healthcare services offered. A total of 138 patients were surveyed using a Kano model-based questionnaire that included demographics and treatment as well as service expectations. Findings Of the 21 quality attributes evaluated by the patients, 16 were categorized as one-dimensional, 3 as indifferent, and 2 as attractive attributes using the Kano model. None of the quality attributes showed a dominant must-be feature. The students considered the availability of appropriately qualified medical staff within 10 minutes of the check-in process and provision of after-hours care as attractive attributes that create greater satisfaction. Research limitations/implications The research was conducted at a university SHS center. Therefore, respondents in the survey are in a younger age group, which may affect patient expectations. In addition, expectations of an SHS center may be different than expectations of visiting a primary care physician and other healthcare units. Originality/value This study contributes to a better understanding of the identification of healthcare needs using the Kano model and advocates focusing on shifts in the categories over time and changes in the demographic environment.

Purpose In order to provide access to care in a timely manner, it is necessary to effectively manage the allocation of limited resources. such as beds. Bed management is a key to the effective delivery of high quality and low-cost healthcare. The purpose of this paper is to develop a discrete event simulation to assist in planning and staff scheduling decisions. Design/methodology/approach A discrete event simulation model was developed for a hospital system to analyze admissions, patient transfer, length of stay (LOS), waiting time and queue time. The hospital system contained 50 beds and four departments. The data used to construct the model were from five years of patient records and contained information on 23,019 patients. Each department’s performance measures were taken into consideration separately to understand and quantify the behavior of departments individually, and the hospital system as a whole. Several scenarios were analyzed to determine the impact on reducing the number of patients waiting in queue, waiting time and LOS of patients. Findings Using the simulation model, it was determined that reducing the bed turnover time by 1 h resulted in a statistically significant reduction in patient wait time in queue. Further, reducing the average LOS by 10 h results in statistically significant reductions in the average patient wait time and average patient queue. A comparative analysis of department also showed considerable improvements in average wait time, average number of patients in queue and average LOS with the addition of two beds. Originality/value This research highlights the applicability of simulation in healthcare. Through data that are often readily available in bed management tracking systems, the operational behavior of a hospital can be modeled, which enables hospital management to test the impact of changes without cost and risk.

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