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The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

This study is focused to support an ongoing development project of the case company's current state and the challenges of the order-to-cash (O2C) process. The O2C process is the most visible process to the customer, and therefore, its punctual and fluent order management is vital. It is observed that the high degree of manual work in the O2C process causes mistakes, delays and rework in the process. The purpose of this article is therefore to analyze the case company's current state of the O2C process as well as to identify the areas of development in this process by deploying the means of Lean Six Sigma tools such as value stream mapping (VSM).

The study was conducted as a mix of quantitative and qualitative analysis. Based on both the quantitative and qualitative data, a workshop on VSM was organized to analyze the current state of the O2C process of a case company, engaged in the energy and environment sector in Finland.

The results found that excessive manual work was highly connected to inadequate or incorrect data in pricing and invoicing activities, which resulted in canceled invoices. Canceled invoices are visible to the customer and have a negative impact on the customer experience. This study found that by improving the performance of the O2C process activities and improving communication among the internal and external stakeholders, the whole O2C process can perform more effectively and provide better customer value.

The O2C process is the most visible process to the customer and therefore its punctual and fluent order management is vital. To ensure that the O2C process is operating as desired, suitable process performance metrics need to be aligned and followed. The results gathered from the case company's data, questionnaire interviews, and the VSM workshop are all highlighted in this study. The main practical and managerial implications were to understand the real-time O2C process performance, which is necessary to ensure strong performance and enhance continuous improvement of the O2C process that leads to operational excellence and commercial competitiveness of the studied case company.