Service Excellence – Health Care  In United States healthcare, service excellence is the ability of the provider to consistently meet and manage patient expectations. Clinical excellence must be the priority for any health care system. However, the best healthcare systems combine professional (clinical) service excellence with outstanding personal service. Although health care in the United States is touted as the “world’s largest service industry,” the quality of the service is infrequently discussed in medical literature. Thus, many questions regarding service excellence in healthcare largely remain unanswered. Service excellence in healthcare is difficult to define and better described as a “I know when I receive it, or perhaps more frequently, I know when I have not.” According to Robert Johnson (Institute of Customer Service), service excellence has four key elements: delivering the promise of quality healthcare, providing a personal touch, doing a more than adequate job and resolving problems well. In order to achieve these elements, healthcare institutions, in particular, must be concerned with reducing the drivers of dissatisfaction, and providing exceptional healthcare. According to the federal Agency for Healthcare Research and Quality (AHRQ), exceptional healthcare is defined as “doing the right thing, at the right time, for the right person, and having the best quality result [outcome].” During the past decade, healthcare has been receiving increased attention not only because of unsustainable costs, but also because of an emphasis on quality of care improvement. Institutions are now attempting to measure and compare quality outcomes, as well as report them in both the consumer press and peer reviews literature to the delight of some and the consternation of others. Managers of healthcare delivery systems endeavor to provide the highest possible care achievable. Inherent to this goal is the need for evaluation of the quality of the health services provided. Measuring patient satisfaction is an indirect measure of quality, and can pose some difficult challenges to individuals attempting to assess quality. One difficulty is that in healthcare it is difficult to assess a patient's outcome after receiving care compared to the outcome they would have had with a different provider. The most important problem is establishing a definition of “satisfaction.” Because the definition of satisfaction can vary from patient to patient, many institutions have created surveys asking patients to rate the quality of the services they have received. This method of evaluation is extremely subjective, and many factors unrelated to the quality of care (the topic of interest) can affect the results. For example, a review of 37 studies addressing different methods of satisfaction evaluation found that phone interview increased the response rate by 30%.