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The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.

A meta-synthesis focusing on the transitions between wards was conducted within a research project. The results from eight studies within that research project have been combined and analysed from a holistic view.

The findings are a model with a description of seven different categories consisting of the identified factors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation, (2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in a health care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.

The result of the completed meta-synthesis is based on studies conducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context to improve quality and efficiency in patient transfers by management and employees working based on the various factors.

This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research as well as for practical improvements.

Total quality management is a valuable approach to continuously improve the quality of organizations; however, scholars debate its applicability to services, which require specific best practices that are different from those related to manufacturing. Moreover, digitization is pervading all kinds of services, but little has been written about total quality service practices in digital-based companies. For this purpose, the authors provide a holistic model of total quality service that reflects the peculiarities of such companies, guided by the question: how do total quality service practices change in digital-based service organizations?

The authors conduct an illustrative case study on Healthware Group, a global integrated digital health organization, to evaluate theoretical assumptions about total quality service practices in the digital environment.

The findings allow to validate the model provided. In addition, the study enables them to observe the changes the authors are witnessing in service provision in the digital era and the consequent transformation of best practices. To be accurate, the authors cannot refer to a full transformation in digital-based companies but rather to the enrichment and extension of TQS practices. The best illustration of these conclusions has been summarized in a set of propositions corresponding to seven of the key levers of a TQS model.

The paper represents the first attempt to discuss the relationship between total quality service and digitalization, offering a set of propositions for academics and insights for practitioners. The model can be used as a tool to visualize the different levers that successful implementation of TQS in digital-based services companies can rely on.

The purpose of this paper is to present design principles for holistic design of online degree programmes (ODPs) in higher education (HE). The study adds to previous research on online programme design by examining how the digital competence and pedagogical strategy of a HE organisation can inform holistic ODP design.

This paper presents a case study placed in the context of a Finnish applied HE organisation. Design-based research (DBR) process is used to create holistic design principles for new ODPs. Theoretical framework for the study is digitally competent organisation (Kampylis et al., 2015) and pedagogical strategy is innovation pedagogy (Kettunen et al., 2013).

Design principles for pedagogically informed holistic design of ODPs are presented as a three-tiered model comprising organisational, pedagogical and ODP layers. Each layer includes various principles for holistic design to integrate an organisation's pedagogical strategy in a digitally competent context to create quality ODPs.

The paper presents a case study from a HE organisation in Finland, but results are applicable to a wider global audience.

As a contribution to practitioners, this paper presents a three-tiered holistic design of ODP in HE organisation, where the design principles are categorised in organisational, pedagogical and ODP design layers. In addition, suggestions to managers, instructional designers and educators are made for the holistic design of ODPs.

Building the sense of community in ODPs and offering continuous support in pedagogy and technology are valuable for the well-being of the staff, students and the wider society.

The paper draws relationships between holistic design of ODPs, digital competence and pedagogical strategy. The paper provides managerial and operational viewpoints to managers, administrators and educators of HE organisations that plan to create new ODPs with a holistic focus on the educational organisation, its pedagogical strategy and digital competence. Recommendations for further development, possible applications and research of ODP education are made.

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.

Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands.

41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory.

After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride.

Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

The authors of this study, who adopted a holistic view of the international organization for standardization (ISO) 9000 series of standards, aimed to evaluate the current status of the standards within the framework of the quality movement. Specifically, the evaluation covered two dimensions, i.e. the significance of the content included in the standards and the quality of the standards’ elaboration, which encompasses such issues as, for instance, their correctness, relevance to current trends in quality management, comprehensibility, etc.

The paper is based on a review of the scientific literature, analysis of the current and all previous versions of the international standards and the results of a survey, through which data were collected from 73 quality management experts from 17 different countries. To evaluate the results, an importance-performance analysis was performed.

As the results of the research demonstrated, experts in quality management have accepted the ISO 9000 standards series. However, this positive view refers mainly to the very idea of developing quality management standards and these standard’s content structure (components included in them). Study participants assigned a low rating to the quality of the standards’ elaboration. Therefore, improving the following aspects of the standards is essential: definitions, guidelines explaining the requirements for a quality management system, self-assessment tools and guidelines concerning quality management concerning chosen forms of activity.

The research described here in has both practical and social implications. First, it delineates the direction needed to improve standardizations, whose use need not be strictly limited to quality management but can be successfully used to improve the standards in other areas of management. Therefore, the conclusions of this research directly contribute to increasing both the effectiveness and the quality of the standard organizations. The significant consequences of this research for managers are the identification of ISO 9000 components which they will find are the most useful.

The research described herein has both practical and social implications. First, it delineates the direction needed to improve standardizations, whose use need not be strictly limited to quality management. However, it can be successfully used to improve the standards in other areas of management. Therefore, the conclusions of this research directly contribute to increasing both the effectiveness and the quality of the standard organizations. The significant consequences of this research for managers are the identification of ISO 9000 components, which they will find are the most useful.

Most research treats ISO 9000 standards as a benchmark for their studies on quality management systems implemented in organizations. The standards themselves are rarely the subject of a study, and so this paper fills a gap in the research and provides insights into desired directions for standards improvement.

The purpose of the paper is to present a service design (SD)-based methodology developed to help small and medium enterprises (SMEs) undertake organisational change.

This research used the design science research methodology, which enabled the creation of the Service Design for Organisational Change (SD4OCh) methodology. A real case study of a small service company specialised in neuropsychological disorders was used for the definition and validation of SD4OCh.

The main outcome of this study is the SD4OCh methodology, which is based on three key stages: diagnosis (knowing where to begin by detecting the organisation's strengths and weaknesses), innovation (improving the structure/processes and designing/redesigning services by employing a customer-centric approach), and implementation (enabling the definition of the route towards organisational change). There is also a transversal evaluation stage, which quantifies the organisational changes.

This study adds valuable knowledge to the service science research field and contributes to the awareness of the usefulness of SD theory within companies, especially those which are small and medium-sized, since those companies lack the tools and methods required to tackle organisational change, signifying that the challenges the companies confront are different to those of larger companies.

Although this is a SD-based research, the SD4OCh methodology was developed in order to enable companies to make holistic changes, namely, to innovate their services, structure, and processes, thus supporting and guiding organisational change.