Despite much interest in service quality and various other service quality measures, scholars appear to have overlooked the overall concept of quality. More specifically, previous research has yet to integrate the effect of the customer network and customer knowledge into the measurement of quality. In this work, it is posited that the evaluation of quality is based on both the delivered value from the provider as well as the value developed from the relationships among customers and between customers and providers. This research examines quality as a broad and complex issue, and uses the “Big Quality” concept within the context of routine healthcare service. The last few decades have witnessed interest and activities surrounding the subject of quality and value co-creation. These are core features of Service-Dominant (S-D) logic theory. In this theory, the customer is a collaborative partner who co-creates value with the firm. Customers create value through the strength of their relations and network, and they take a central role in value actualization as value co-creator. I propose to examine the relationship between quality and the constructs of value co-creation. As well, due to the pivotal role of the decision-making process in customer satisfaction, I will also operationalize the value co-creation construct. Building upon the “Big Quality” concept, this study suggests a new approach by extending the quality concept to include the value-creation concept in Service Dominant Logic. This study identifies the associated constructs and determinants of Big Quality in routine healthcare management service, and examines the relationship among the associated quality constructs, customer satisfaction, and customer commitment. This study employed an online survey methodology to collect data. In data analysis, I used the variance-based structural equation modeling (PLS-SEM) approach to confirm the factor structure, proposed model, and test the research hypotheses. The results show that the customer’s participation in in-role and extra-role behaviors are positively associated with their perceived quality, satisfaction, and commitment level. The major contribution of this study to decision sciences and the service quality literature is the development of a comprehensive framework explaining the importance of value co-creation within the context of healthcare quality. Finally, this work examines perceived service quality as a key factor of customer satisfaction and the relationship of Big Quality with commitment level in healthcare service management.