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The purpose of this paper is to systematically investigate the patient flow and waiting time problems in hospital emergency departments (EDs) from an integrated voice of customer (VOC) and voice of process (VOP) perspective and to propose a new lean framework for ED process.

A survey was conducted to better understand patients' perceptions of ED services, lean tools such as process mapping and A3 problem-solving sheets were used to identify hidden process wastes and root-cause analysis was performed to determine the reasons of long waiting time in ED.

The results indicate that long waiting times in ED are major concerns for patients and affect the quality of ED services. It was revealed that limited bed capacity, unavailability of necessary staff, layout of ED, lack of understanding among patients about the nature of emergency services are main causes of delay. Addressing these issues using lean tools, integrated with the VOC and VOP perspectives can lead to improved patient flow, higher patient satisfaction and improvement in ED capacity. A future value stream map is proposed to streamline the ED activities and minimize waiting times.

The research involves a relatively small sample from a single case study. The proposed approach will enable the ED administrators to avoid the ED overcrowding and streamline the entire ED process.

This research identified ED quality issues from the integration of VOC and VOP perspective and suggested appropriate lean tools to overcome these problems. This process improvement approach will enable the ED administrators to improve productivity and performance of hospitals.

The purpose of this paper is to assist organizations in understanding the nature of quality management from a resource‐based perspective by investigating the relationship between strategies needed to drive quality enhancement, and resources being allocated to support effective strategy implementation. The resource‐based view of TQM elements led this case study research to deal with quality management from a strategic viewpoint, or what is known as Strategic Quality Management (SQM).

The paper employs the analytic network process (ANP) to model the interactions between eight SQM strategies and the three types of resources (human, organisational and technological) needed for effective strategy implementation. The paper then formulates a goal programming (GP) model in order to identify the extent to which each single strategy is inhibited by a lack of (or overloaded by) resources. Using a case study approach, the hybrid ANP‐GP methodology is employed to illustrate the application in the context of enhancing quality in the food‐processing industry.

The ANP analysis quantitatively differentiates between the amount of resource support each strategy receives and the support it needs. The GP model offers insight on how to re‐allocate resources to minimize identified discrepancies related to how the company utilizes their resources.

This paper argued that practicing QM with the consideration of the firm's strategic need for resources provides better understanding of why quality gurus still disagree on whether soft or hard TQM is more connected to organizational performance. Therefore, rather than focusing on “generalizing” the TQM model, as has traditionally been done in previous attempts, the main contribution of this paper is to propose a methodology that assesses a firm's utilization of resources considering its strategic need for these resources.