Quality assessment of a private university dental hospital in Karachi: case study using European Foundation for quality management (EFQM) excellence model

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Background Defining and measuring quality is a challenging task. It can be defined and measured in many ways: All depends on who is defining the quality i.e. purpose of definition and which tool, model or framework was used to measure it. An extensive mushrooming of the dental institutions in Pakistan has raised concern about their quality. The quality of dental teaching institutes, like any other teaching institutes, may be evaluated on the basis of infrastructure, curriculum, qualification and skills of teaching faculty, selection criteria of the students, and financial considerations. The European Foundation for Quality Management (EFQM) Excellence Model can be used as a way to benchmark with other organizations, on the basis for common vocabulary and a way of thinking, and a structure for the organization's management system EFQM has also been extensively used as a self assessment tool for organizations to help in their efforts to make a quality diagnosis and assessment, and to stimulate its continuous improvement. The model is based on eight fundamental concepts, which forms the foundations over which organizations could build their excellence. These concepts are: 1) Results orientation, 2) Customer focus, 3) Leadership and constancy of purpose, 4) Management by processes and facts, 5) People development and involvement, 6) Continuous learning, innovation and improvement, 7) Partnership development, and 8) Corporate social responsibility Objective This study assesses the quality of an academic dental hospital across its core activities using conceptual framework derived from EFQM Excellence model and finally to outlinethe strengths, gaps and areas for improvement. Methodology The study was conducted at Hamdard University Dental Hospital from July to September 2007. The hospital holds a large market share of dental services among the private sector dental hospitals in Karachi, and it is considered as one of the finest platform for students' supervised dental clinical training in Karachi. The hospital provides dental services and consultation in various specialties such as Periodontology, Restorative Dentistry, Prosthodontics, Oral and Maxillofacial, Surgery and Orthodontics, catering to nearly hundred to hundred and twenty patients daily, under the supervision of forty four faculty members on board. It was a facility based case-study, in which all components of the EFQM model were assessed qualitatively. In-depth interviews were carried out using a semi- structured interview guidelines which covered all the key aspects of quality pointed out in the EFQM model. A total of fourteen in depth interviews were conducted ensuring inclusion of all the internal stake holders. Nine participants were from the management, three from the faculty and two represented the students. Study findings Study participants responded in the light of the eight fundamental concepts of the EFQM excellence model. The majority of the concepts were even though present, if not been practiced. An efficient and a well-defined system for assessing the needs of patients existed and they work in a system where students are accountable. The structure for assessing the needs of the management and the faculty and a tool to measure patient satisfaction was missing. Participants could not recall sighting or hearing the vision of their institute and expressed concern over lack of involvement of faculty and other stakeholders in decision making at all levels. Most of the interdependent and interrelated activities were clearly defined. Responsibilities were assigned without giving proper authority. The participants valued and reflected positively on the concepts of continuous learning and improvement, partnership development and the social responsibilities of the organization. Conclusion Finally through the analysis of the in interviews and applying the EFQM excellence model, the results exhibited are not merely based on technical issues of gaining the excellence but a complex relationship between the head of the institution, the management staff, the faculty, and the students was observed. Proper division of job responsibilities and powers to the staff at all cadres is an essential and efficient mean to achieve the excellence in spite of the resource constraint. It is also essential to develop the processes that are built through consensus based on broader participation among the management, faculty and the higher officials. Thus in order to chase a quality journey, concepts of leadership and constancy of purpose, people development and involvement, management by processes and facts and results orientation are needed to be strengthened.

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