In this study, we examined the effects of healthcare staffs` perceived service quality(E-PSQ) on patients` perceived service quality(P-PSQ) leading to patients` satisfaction(P-CS) and the effects on guardians` perceived service quality(G-PSQ) also leading to guardians` satisfaction(G-CS). To investigate the causalities of the factors, we collected national wide samples of 144 hospitals, 721 healthcare staffs, 1456 patients, and 1455 guardians of the patients. Followed were contributions of this study. First, healthcare staffs and patients were commonly related by service quality, which meant the increase of healthcare staffs` perceived service quality led to increase of patients` perceived service quality. Second, healthcare staffs and guardians of patients were also related by perceived service quality. Third, patients` perceived service quality would lead to service satisfaction of patients, Fourth, guardians` perceived service quality would also lead to service satisfaction of guardians. The findings implied service managers of hospital settings should pay attention to healthcare staffs` perception of service quality as well as those of patients and guardians. With such strategy, hospitals could survive the drastically changing environments of current healthcare service area.