Introduction - High volatility (Vergidis, Tiwari & Majeed, 2006) and uncertainty (Eisenhardt, 2002) have increased the unpredictability and competitiveness for all types of businesses (Magal & Word, 2009). As a result, optimisation has become a common practice in the commercial and manufacturing sectors (Rowlands, Antony & Knowles, 2000) to maximally utilise the existing processes and ensure a sustainable and scalable competitive advantage (Antony, 2005). Optimisation’s benefits, however, have not yet been applied to the same extent in the service sector (Vergidis, Turner & Tiwari, 2008b). Deregulation, excess of available staff and rising dental prices have exposed the Swedish public dental sector to increased competition and diminishing customer satisfaction (Edelholm, 2011). To remain competitive the public providers need to comprehensively redesign and optimise its service processes.Purpose - The purpose of this thesis is to understand how optimisation and continuous service process improvement can be enabled in Swedish public dental care clinics.

Theoretical Framework and Research Method - The European Framework for Quality Management has been applied via three stages of action research strategy. The research objectives have been analysed through a combination of empirical data gathered from semi-structured interviews, workshops and observations at two public dental clinics.

Findings - Optimisation efforts are already present at the public dental care clinics, however, the application is re-active in nature due to lack of external market analysis and key performance indicators. As a result, continuous improvement is not present. The main internal support factors for successful optimisation efforts in public dental care are flat organisational structure, thorough and timely strategy, and cross-functional collaboration and commitment. The main obstacles for optimisation and continuous improvement in public dental care are strict internal hierarchies, restricted flexibility of roles and responsibilities, and misconception and lack of understanding of the optimisation and continuous improvement philosophy.