Search results

Total quality management (TQM) promises much for service industries yet it has been little used in European healthcare. Of those hospitals and services which have implemented TQM, few have had great success and many have found difficulties sustaining their programmes. This paper defines TQM in healthcare and considers examples and results of TQM in European healthcare. It distinguishes between team projects using TQM methods and organization‐wide TQM programmes, and finds more evidence for the success of projects than for programmes. The paper discusses whether the differences between healthcare and many other industries explain the mixed results, and considers the prospects for future TQM programmes in European healthcare.

Defining quality of healthcare and determining how to improve organisational performance in developed countries is still an unresolved issue among healthcare professionals. However, given that it is an important area of responsibility and accountability it is no longer acceptable to view the issue as discretionary. An increasingly acceptable operative option for achieving continuous improvement and excellence seems to be the self‐assessment of an organisation, based on the principles of knowledge management and total quality management (TQM). This article provides an explanation of a two‐level self‐assessment approach for implementing TQM within the Spanish healthcare system. The first level integrates a client‐centred approach using classical healthcare accreditation criteria along with ISO 9000 standards, the aim being to establish quality assurance systems in the whole organisation. The second level uses the European Foundation for Quality Management Excellence Model as a road map for self‐assessment and continuous improvement towards excellence.

Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.

The purpose of this paper is to propose a new conceptual framework for big data analytics (BDA) in the healthcare sector for the European Mediterranean region. The objective of this new conceptual framework is to improve the health conditions in a dynamic region characterized by the appearance of new diseases.

This study presents a new conceptual framework that could be employed in the European Mediterranean healthcare sector. Practically, this study can enhance medical services, taking smart decisions based on accurate data for healthcare and, finally, reducing the medical treatment costs, thanks to data quality control.

This research proposes a new conceptual framework for BDA in the healthcare sector that could be integrated in the European Mediterranean region. This framework introduces the big data quality (BDQ) module to filter and clean data that are provided from different European data sources. The BDQ module acts in a loop mode where bad data are redirected to their data source (e.g. European Centre for Disease Prevention and Control, university hospitals) to be corrected to improve the overall data quality in the proposed framework. Finally, clean data are directed to the BDA to take quick efficient decisions involving all the concerned stakeholders.

This study proposes a new conceptual framework for executives in the healthcare sector to improve the decision-making process, decrease operational costs, enhance management performance and save human lives.

This study focused on big data management and BDQ in the European Mediterranean healthcare sector as a broadly considered fundamental condition for the quality of medical services and conditions.

This study aims to explore the downstream pharmaceutical supply chain (PSC) and provides insight to the delivery process of medicines and associated operational inefficiencies.

An exploratory, qualitative approach was adopted to examine PSC inefficiency within two European contexts, namely, the UK and Greece. Data was gathered through interviews and a thematic analysis conducted to analyse the data and identify challenges faced by both supply chains(SCs).

The medicines delivery system needs to be enhanced in terms of quality, visibility, speed and cost to perform effectively. The findings demonstrated that although the healthcare SCs in the two European contexts have different operational structures, the results are in concordance with each other. Financial, communication, waste and complexity issues were the major concerns.

To the knowledge this is the first study to examine aspects of the medicines SC via a cross-case analysis in the UK and Greece and extends the body of knowledge. A broader sample of responses is warranted to further validate these findings.

The study outputs can inform pharmacies’ strategic to instigate targeted improvement interventions. The implications of which may be extrapolated further to other European healthcare organisations.

This research contributes to the academic literature by adding further theoretical insights to SC strategy development, especially those that have been characterised as highly complex. The study identifies four key areas of intervention needed within this SC (in both countries) to promote higher level efficiencies and effectiveness.

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare‐sector players and whether specific rules are needed regarding competition between healthcare undertakings.

Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.

The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non‐price characteristics.

Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.

Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.

This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.

The purpose of this paper is to account for a ten-year experience with the European Foundation for Quality Management (EFQM) Excellence Model implemented in the Trento Healthcare Trust.

Since 2000, the EFQM Excellence Model provided an overarching framework to streamline business process governance, to support and improve its enablers and results. From 2000 to 2009, staff performed four internal (self) and four external EFQM-based assessments that provided guidance for an integrated management system. Over the years, key controls and assurances improved service quality through business planning, learning and practice cycles.

Rising assessment ratings and improving results characterized the journey. The average self-assessment score (on a 1,000 points scale) was 290 in 2001, which increased to 610 in 2008. Since 2006, the Trust has been Recognized for Excellence (four stars). The organization improved significantly on customer satisfaction, people results and key service delivery and outcomes.

The EFQM Model can act as an effective tool to meet governance demands and promote system-level results. The approach to integrated governance discussed here may support similar change processes in comparable organizations.

The paper describes a unique experience when implementing EFQM within a large Italian healthcare system, which had a broader reach and lasted longer than any experience in Italian healthcare.

The main purpose of this study is to investigate Ishikawa’s statement that “95% of problems in processes can be accomplished using the 7 Quality Control (QC) tools” and explore its validity within the health-care sector. The study will analyze the usage of the 7 QC tools in the health-care service sector and the benefits, challenges and critical success factors (CSFs) for the application of the 7 QC tools in this sector.

In order to evaluate Ishikawa’s statement and how valid his statement is for the health-care sector, an online survey instrument was developed, and data collection was performed utilizing a stratified random sampling strategy. The main strata/clusters were formed by health-care professionals working in all aspects of health-care organizations and functions. A total of 168 participants from European health-care facilities responded to the survey.

The main finding of this study is that 62% of respondents were trained in the 7 QC tools. Only 3% of participants in the health-care sector perceived that the seven tools of QC can solve above 90% of quality problems as originally claimed by Dr Ishikawa. Another relevant finding presented in this paper is that Histograms, Cause and Effect diagrams and check sheets are the most used tools in the health-care sector. The least used tools are Stratification and Scatter diagrams. This paper also revealed that the 7 QC tools proposed by Dr Ishikawa were most used in hospital wards and in administration functions. This work also presents a list of CSFs required for the proper application of the 7 QC tools in healthcare.

This research was carried out in European health-care facilities – and there is an opportunity to expand the study across global health-care facilities. There is also an opportunity to study the use of the tools and their impact on hospital performance using the Action Research methodology in a health-care organization.

To the best of the authors’ knowledge, this is the very first research within the health-care sector that focused on investigating the usage of all the 7 basic tools and challenging Dr Ishikawa’s statement: “95% of problems in processes can be accomplished using the 7 Quality Control (QC) tools” from his book “What is Quality Control?” The results of this study represent an important first step toward a full understanding of the applicability of these tools in the health-care sector.

The purpose of this paper is to investigate the effects of Lean Six Sigma (LSS) and workforce management on the quality performance of Malaysian hospitals. This paper also investigates the direct and indirect relationships between top management commitment and quality performance of the healthcare organisations in Malaysia.

This study applied stratified random sampling to collect data from 15 different hospitals in Peninsular Malaysia. The self-administered survey questionnaires were distributed among 673 hospital staff (i.e. doctors, nurses, pharmacists, and medical laboratory technologists) to obtain 335 useful responses with a 49.47 per cent valid response rate. The research data were analysed based on confirmatory factor analysis and structural equation modelling by using AMOS version 23 software.

The research findings indicated that LSS and workforce management have a significant impact on quality performance of the Malaysian hospitals, whereas senior management commitment was found to have an insignificant relationship with quality performance. The research findings indicate that senior management commitment has no direct significant relationship with quality performance, but it has an indirect significant relationship with quality performance through the mediating effects of LSS and workforce management.

This research focussed solely on healthcare organisations in Malaysia and thus the results might not be applicable for other countries as well as other service organisations.

This research provides theoretical, methodological, and practical contributions for the LSS approach and the research findings are expected to provide guidelines to enhance the level of quality performance in healthcare organisations in Malaysia as well as other countries.