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Quality Assurance and Improvement Program (QAIP) is defined as “an ongoing and periodic assessment of the entire spectrum of audit and consulting work performed by the internal audit (IA) activity”. QAIP is an important component of internal auditors’ commitment to improve internal audit (IA) quality. The pressure towards improvement is urgent for central banks, in light of the vulnerabilities of their IA functions identified by the International Monetary Fund. The authors analyse the professional standards and the literature on IA and QAIP, aiming to propose general considerations to enhance IA quality and to develop and maintain a QAIP, with reference to central banks, also shedding light on the synergies among IA, QAIP and total quality management (TQM).

This paper reviews the most relevant professional standards in light of the professional and academic literature regarding IA quality, QAIP and their relationship with TQM. The analysis of these sources represents an important step to identify general measures to improve IA quality and develop effective QAIP in central banks.

This analysis shows that it is important to understand the rationale behind the development of an IA function and its theoretical and practical foundation, especially for complex organisations such as central banks. In addition, the authors show that QAIP represents an important tool to exploit the synergies between TQM and IA. These synergies could result in higher levels of quality for the IA function and more effective implementation of TQM within the whole organisation. Lastly, the authors provide practical suggestions to support the implementation of an effective QAIP in central banks and to spread TQM philosophy within the organisation.

The authors contribute to the scant literature on IA quality and QAIP by focusing on central banks and shedding light on the relationship with TQM. Regardless of their importance, these topics have been largely neglected by the extant literature.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

World Health Organizations (WHO) (2023) states that governments and employers have a responsibility to uphold that right by providing work that simultaneously prevents workers from experiencing excessive stress and mental health risks. The business environment continues to produce a lot of stress on workers, which includes internal pressures to achieve results and employees suffer the consequences. Some companies have turned to mindfulness as a technique that helps mitigate these consequences and have joined Kaizen as a process improvement technique in the work environment. Therefore, this study has a research purpose: “to comprehend the possible linkage between Kaizen philosophy from an individual perspective, with Mindfulness ZEN Buddhism technique to understand the individual benefit (well-being) of each employee in organizations.” The answer to this represents the research gap in this article. The research questions governing this study are as follows: RQ1: Does Mindfulness is used as Kaizen technique of personal-individual improvement in 21st-century organizations? RQ2: What elements and characteristics of Kaizen and mindfulness can be found working together? And RQ3: Which qualitative impact of mindfulness and Kaizen in the workplace outcome (well-being, performance of the job (process)) and relationships with other employees)?

This research used a qualitative approach due to the recent phenomenon studied. In a certain way, it was used a mixed-method (combination of qualitative data – web search secondary data analysis and qualitative research-Convergence Model). First, it was done an intensive web search with the aim to identify companies' corporate mindfulness programs, along with companies which have applied mindfulness and Kaizen programs. It was identified a group of big companies with global and international presence (“famous” for their products and services) in diverse industrial and service sectors, country of origin and business locations; with the purpose of getting a holistic vision of all organizations which have practice Kaizen and mindfulness. Therefore, this study explored secondary data related to both practices, analyzing reports or briefings published in management magazines and official WEB pages and/or business magazines.

As a result of the triangulation of the data with its secondary data convergence model and qualitative research, a theoretical framework was reached that shows the benefits of the two combined twin techniques of Kaizen and mindfulness. The worker experiences a path that goes from concentrating on the execution of their processes, following their operating standards (Standardize, Do, Check, Act [SDCA] cycle), going through the evolution to continuous improvement or Plan-Do-Check-Act (PDCA) cycle, experiencing work with concentration-awareness and reducing your daily stress, maintaining high sensitivity to the work process and your environment and finally, discovering an essential life purpose. Finally, worker experiences benefit when there is wide application of both with the SDCA and PDCA cycles such as high motivation, constant learning from your mistakes, day-to-day learning and the Munen Musso (not using the mind).

The main limitation is the qualitative methodological bias and secondary data research. In addition, to have a theoretical sample. However, the richness of the data helps to overcome this limitation. On the other hand, the qualitative research interviews are for a certain geographical area, therefore, the results cannot be generalized.

The results of this research can shed light on operations managers in the use of techniques for continuous improvement and improvement of people's quality of life, such as mindfulness. In Mexico, they are beginning to be used jointly (twin techniques) to comply with Regulation 035 of psychosocial risk, the researchers are sure that in other countries it will be used in the same way to comply with regulations. However, the research findings show the benefits that can be provided to workers in organizations by applying Kaizen and Mindfulness together.

To the best of the authors’ knowledge, according to the literature review, this is the first article that explores the relationship between Kaizen and Mindfulness as twin techniques that help improve the individual quality of life of employees in organizations.

Existing conceptual, empirical and case studies evidence suggests that manufacturing industries find the joint implementation of Kaizen philosophy initiatives. However, the existing practices rarely demonstrated in a single framework and implementation procedure in a structure nature. This paper, therefore, aims to develop, validate and practically test a framework and implementation procedure for the implementation of integrated Kaizen in manufacturing industries to attain long-term improvement of operational, innovation, business (financial and marketing) processes, performance and competitiveness.

The study primarily described the problem, extensively reviewed the current state-of-the-art literature and then identified a gap. Based on it, generic and comprehensive integrated framework and implementation procedure is developed. Besides, the study used managers, consultants and academics from various fields to validate a framework and implementation procedure for addressing business concerns. In this case, the primary data was collected through self-administered questionnaire, and 244 valid questionnaires were received and were analyzed. Furthermore, the research verified the practicability of the framework by empirically exploring the current scenario of selected manufacturing companies.

The research discovered innovative framework and six-phase implementation procedure to fill the existing conceptual gap. Furthermore, the survey-based and exploratory empirical analysis of the research demonstrated that the practice of the proposed framework based on structured procedure is valued and companies attain the middling improvements of productivity, delivery time, quality, 5S practice, waste and accident rate by 61.03, 44, 52.53, 95.19, 80.12, and 70.55% respectively. Additionally, the companies saved a total of 14933446 ETH Birr and 5,658 M² free spaces. Even though, the practices and improvements vary from company to company, and even companies unable to practice some of the unique techniques of the identified CI initiatives considered in the proposed framework.

All data collected in the survey came from professionals working for Ethiopian manufacturing companies, universities and government. It is important to highlight that n = 244 is high sample size, which is adequate for a preliminary survey but reinforcing still needs further survey in terms of generalization of the results since there are hundreds of manufacturing companies, consultants and academicians implementing and consulting Kaizen. Therefore, a further study on a wider Ethiopian manufacturing companies, consultants and academic scale would be informative.

This work is very important for Kaizen professionals in the manufacturing industry, academic and government but in particular for senior management and leadership teams. Aside from the main findings on framework development, there is some strong evidence that practice of Kaizen resulted in achieving quantitative (monetary and non-monetary) and qualitative results. Thus, senior management teams should use this research out to practice and analyze the effect of Kaizen on their own organizations. Within the academic community, this study is one of the first focusing on development, validating and practically testing and should aid further study, research and understanding of Kaizen in manufacturing industries.

So far, it is rare to find preceding studies proposed, validated and practically test an integrated Kaizen framework with the context of manufacturing industries. Thus, authors understand that this is the very first research focused on the development of the framework for manufacturing industries continuously to be competitive and could help managers, institutions, practitioners and academicians in Kaizen practice.

The industrial revolution changed the market landscape significantly in all industrial sectors. It has a noteworthy impact on enhancing the quality of goods and services. The quality aspect is of utmost concern and determines the success or failure of any product. Therefore, the presented study analyses the key barriers and solutions of Quality 4.0.

Twenty barriers and fifteen solutions were identified using a literature review and investigated using a hybrid approach. Barrier weights were evaluated with the help of the fuzzy AHP method. Furthermore, the computed weights were used to perform computations in the next step using fuzzy-TOPSIS to prioritize the ranking of identified solutions.

The research results show that “Lack of applying advanced analytics to uncover Quality 4.0 initiatives” and “Lack of integrating data from various sources across the organization” are the topmost barriers. Furthermore, “Implement a leadership development program focused on Quality 4.0” and “Cross-departmental peer learning environment” are the topmost solutions.

Managers and industrialists can benefit from Quality 4.0 through improved decision-making, process efficiency, supply chain collaboration, agile quality management, enhanced customer experience and a culture of continuous improvement. This results in better quality, operational effectiveness and a competitive edge.

The solutions need to be mapped with barriers to adopting Quality 4.0. Furthermore, the research results involve novelty by prioritizing the solutions to overcome the anticipated barriers.

Companies should enhance their market position and competitiveness by improving staff effectiveness, skills, resource commitment, and applying relevant managerial methods. This study aims to examine the impact of knowledge management (KM) and total quality management (TQM) on employee effectiveness (EE) and supply chain performance (SCP) in emerging economies.

The used methodology consists on conducting a survey within Tunisian companies, where the authors gathered 206 responses. Collected data was analyzed using statistical package for the social sciences (SPSS) software, enabling the authors to establish a conceptual model. This model was further examined through structural equation modeling, using analysis of moment structures (AMOS) software for hypothesis validation. Additionally, the authors’ research aimed to enhance SCP and boost EE while minimizing costs through a nonlinear mathematical model and the quality function deployment method.

The results indicate that TQM and KM positively impact EE, and KM and EE positively impact SCP. However, the significance of employee performance on SCP varies depending on company location and industry sector studied.

This work emphasized the involvement of small- and medium-sized enterprise managers from emerging economies in the studied concepts and confirmed the effects of KM and TQM practices on EE and SCP.

This study investigates the effects of top management commitment (TMC) and Kaizen on quality management practices (QMP) and how the latter influence the performance of Jordanian public hospitals in the aftermath of COVID-19.

A survey-based questionnaire was employed to collect data from 222 practitioners and professionals working in public hospitals in Jordan. Partial least squares structural equation modeling (PLS-SEM) was undertaken to analyze data.

Significant and positive effects of TMC and Kaizen (continuous improvement) on QMP are highlighted by the results. The findings also show that QMP has a positive and significant impact on public hospitals' performance. Furthermore, the effects of TMC and Kaizen on performance were also found to be significant.

Practitioners and researchers will gain a greater understanding of how implementing QMP can enhance the performance of public hospitals in the context of the COVID-19 outbreak. The results underline the important role of Kaizen and TMC in the success of QMP and their effect on performance. This research is a cross-sectional study, and there is a need to conduct further empirical investigation based on secondary data or objective measurement of performance.

This research is one of the first studies to investigate the effects of QMP on public hospitals' performance following the COVID-19 outbreak. This study is one of the empirical examinations of QMP and Kaizen in developing countries by investigating Jordanian public hospitals.

Although the debate about the interplay between quality management and organizational culture is long established, extant knowledge about their link is not consistent. This article attempts to fill such a gap by integrating current perspectives and insights through a literature review.

A domain-based literature review has been conducted, which followed the Scientific Procedures and Rationales for Systematic Literature Reviews. The knowledge core consisted of 76 items, which were analysed through bibliographic coupling and co-citation analysis. An interpretive approach was taken to articulate the study findings.

The current scholarly debate unfolds through four research streams, which emphasize the need for joint optimizing quality management and organizational culture embracing a longitudinal perspective. Similarly, the theoretical roots inspiring reviewed contributions are distributed in four clusters, which rely on the assumption that organizational excellence derives from the harmonization of quality management and organizational culture.

Quality management necessitates a supportive organizational culture to set the ground for excellence. At the same time, it modifies the inner traits of the organizational culture. Such cultural changes should be carefully handled to ensure a dependable quality orientation. Achieving organizational excellence involves mastering the interplay between quality management and organizational culture.

This article delivers an unprecedented systematization of the scientific literature. It identifies the main research streams through which the debate on quality management and culture evolves, shedding light on the main conceptual roots inspiring recent scholarly advancements. Alongside overcoming the fragmentation of the extant debate, this review enables the envisioning of an agenda for further developments.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.