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The study aims to test the framework that proposes the role of resources (intellectual capital) in mobilizing entrepreneurial orientation that influences the competitiveness improvement of micro-small-medium enterprises (MSMEs) under the lens of resource orchestration theory.

In this study, 347 respondents from the MSMEs participated through a structured questionnaire. For the data analysis purpose, the structural equation modeling technique was employed using SmartPLS software.

The results suggest human, structural, and relational capital are significant antecedents of entrepreneurial orientation, which leads to competitiveness improvement. The findings also indicate the mediation role of entrepreneurial orientation between intellectual capital and competitiveness improvement.

The current study presumably will supplement the promising research effort to progress the research orchestration theory and also could be a strategic guideline for the managers/owners of the MSMEs.

This study is possibly a novel attempt to divulge the association between intellectual capital (tripartite model) and competitiveness improvement of firms under the lens of resource orchestration theory.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

Strategic ambitions can function as drivers of improvement in organizations. Continuous improvement is driven by strategic ambitions to: design quality into the structure of the organization; plan and control improvements; assure improvements; set and realize improvement goals; position the organization in the market as a “high quality” organization; and create value in interaction with stakeholders. An analytical framework based on these drivers is described. A research project is carried out in the organization of DaimlerChrysler Netherlands. The improvement processes in this organization are analyzed with the framework. The research project indicates that the improvement processes are driven by the strategic ambitions of the organization.

This paper outlines a model for assessing the sustainability of shop floor based process improvement programmes. The model was developed as part of a larger research programme, investigating the inhibitors and enablers for process improvement. The model is based on the SMMT (Society of Motor Manufacturers and Traders) Industry Forum MasterClass Process Improvement activity, but can be applied to any intensive shop floor based process improvement programme. The model’s purpose is to identify the level of sustainability achieved by process improvement programmes and consists of two elements. The first element identifies five different levels of sustainability at cell level. The second element operates at factory level and examines the degree to which the tools and techniques have been spread between cells.

The purpose of this paper is to describe a business management system that addresses the following issue: Lean Six Sigma, total quality management, and other process improvement efforts center on the execution of process improvement projects; however, often these projects (e.g. Lean Six Sigma Black Belt projects) are identified in silos and do not benefit the business as a whole, e.g. $125 million is reported saved, but nobody can find the money.

The paper “Where process‐improvement projects go wrong,” Wall Street Journal, January 25, 2010 (www.smartersolutions.com/blog/forrestbreyfogle/?p=2726) elaborates on the shortcomings of typical process improvement efforts by building an analog between process improvement programs and a spring's stress‐strain curve – stretching, yielding, and failing. To address the described issues, process improvement efforts need to be part of an overall enhanced business management system in order to have long‐lasting success. This structured organizational framework should integrate predictive scorecards with targeted strategies creation that blends analytics with innovation, which lead to the establishment of functional performance goals that pull for the creation of enterprise‐as‐a‐whole‐beneficial improvement projects, which positively impacts these target objectives.

The described nine‐step Integrated Enterprise Excellence (IEE) business management system provides the framework for achievement of these above‐described needs. The IEE system, for example, blends analytics with theory of constraints, competitive assessments, and economic environment so that created project work efforts have a whole‐system‐performance measurement benefit.

In Lean Six Sigma and Lean kaizen event programs, improvement projects are often selected from a brainstorming‐list of potential opportunities. Initial gains when starting such a deployment can be achieved; however, this effort typically stalls out and the process improvement teams are laid‐off when times get tough. The reason for this rough‐time downsizing is that the previous team process improvement project efforts were not, in the eyes of executives, expended in areas so that a significant overall enterprise benefit was achieved. IEE provides a business management system for addresses these issues so that business improvement efforts have a whole‐organization benefit.

The IEE system can be used by management to address the business management problems of the day, e.g. management issues that led to the financial crisis and the problems that Toyota is now experiencing.

Many who have studied the IEE system have said that this system provides a framework for how business should be run and should be taught in business schools.

This paper presents a methodology to nominate and select improvement projects that are perceived as adding value to customers (both internal and external). The structure of the methodology can be explained in three “stages”. First, the methodology suggests a new way of categorizing improvement opportunities, i.e. reactive‐proactive, to “upgrade” the little Q ‐ big Q categorisation. Then, it develops a roadmap that links performance indicators and improvement projects for both reactive and proactive improvements. Finally, it suggests an algorithm to select the improvement project, where the assessment of to what extent the nominated improvement projects add value to customers relies on the comparison between Overall Perceived Benefits (OPB) and Overall Perceived Efforts (OPE). The improvement project perceived as having the largest impact on adding value to customers receives the highest priority.

The purpose of this article is to describe how the training of healthcare professionals in improvement work can be performed, and evaluate potential changes in attitude as a result of the initiative.

The study was carried out at a University Hospital in Sweden. There were 443 participants in the study. The response rate before the intervention was 55 per cent (242 respondents) and six months later, it was 43 per cent (190 respondents). A two-day training program about quality improvement was performed on seven different occasions and after the training had been concluded, participants were encouraged to translate their newly acquired knowledge into improvement projects. Surveys on attitudes toward improvement work were completed by the participants right before the training and six months afterwards. The results were analyzed using a Mann-Whitney test.

The analysis showed some statistically significant changes in attitude among the participants. There were also differences between groups of participants based on their profession and the number of years in their current position.

A limitation of the study is that it was solely based on attitudes expressed during the survey and did not include any observed changes in behavior. Another limitation is that attitudes after the intervention were only measured once.

It is possible to use training to change attitudes toward improvement work. The result differs among groups of participants, which raises the question as to whether training should be tailored to better suit the needs of different groups to create positive change. Further research is needed regarding how to reach and fully implement a quality improvement mindset.

Executives of a multinational company were looking for ways to spread improvements made at one location to other locations throughout the world. Their initial approach of sharing examples and case studies had proven ineffective. In addition, the localized improvements were having little impact on the worldwide corporate business measures. The principles of quality management and change management added little insight. Frustration with their lack of success had given way to an interest in an approach developed by the Institute for Health Care Improvement (IHI) for the health care industry (Kilo, 1998). The concept of an “improvement collaborative” provided the framework for developing their global improvement initiatives.

The purpose of this paper is to explore some of the key factors that trigger and drive improvement in the NHS and in health care more widely, and to suggest what practical steps can be taken to speed it up.

The paper outlines the varied improvement drivers that impact on health care organisations today – establishing a basic understanding of the different motivating factors behind each. Building on this, the paper explores the shared attributes of successful health care improvement practice and highlights the processes and tools that are helping many frontline NHS organisations achieve faster and better improvement locally.

There are many reasons that trigger improvement efforts in the health service and most have a valid role to play. But underpinning them all are four fundamental skill and knowledge sets: leadership; performance and metrics; the right tools and processes; and relationships. One important way to unlock the potential for faster improvement in patient care is for organisations and individuals to understand the profound relevance of these four areas to their own improvement work, and to know about the tools and techniques that are proven to help.

This paper helps address the broad and recognised need across the NHS and wider health service to build service improvement capacity, capability and will. It clarifies the priority areas where organisations, clinicians, health care professionals and improvers at all levels need to develop, and it offers practical steps to help ensure this happens.

Reports the main findings of a study carried out into the quality improvement structure of six different companies. Among the findings is that an infrastructure in terms of TQM Steering Committee and improvements facilitators is necessary at the introduction and during the development stages of an improvement process, but this infrastructure will change as a company’s quality improvement activities mature. In setting up this structure, care must be taken that it does not duplicate the existing management structure. The improvement structure becomes less important when people in all functions take responsibility for their own personal improvement but it takes some time for this to happen. Also points out that the improvement infrastructure needs to be reviewed on a regular basis and assessed to evaluate its effectiveness.