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Examines the developing importance of the quality issue in the service sector and highlights common barriers to the successful implementation of total quality management principles (TQM). Such information provides managers in complex service organizations such as the National Health Service (NHS) with valuable lessons for improving quality standards. Illustrates how TQM principles could and in a few cases are already being applied to the NHS in the light of the 1989 Government proposals for reform. Such efforts are in the early stages of development and therefore guidelines are proposed to assist management in sensitive areas for implementing change.

The labour market experience of graduates and diplomates is a subject currently being explored in the United Kingdom. Reports on the findings of a study undertaken in Northern Ireland with special reference to the hospitality industry. Examines graduate and diplomate opinions on the preparatory value of hospitality management courses and their perception of job quality. Found that graduates in particular feel overqualified because of a lack of opportunity to implement their knowledge and skills acquired and developed in higher education. Part of the problem appears to lie with the conflicting expectations of graduates and employers in the hospitality industry and argues that this could be overcome by forging greater links between the educators and employers. As one of the major challenges of the 1990s is the recruiting and retaining of graduates, hospitality employers must offer training which builds on the foundation laid in higher education.

Discusses the service quality matrix as one strategy in attaining and maintaining service excellence in relation to Northern Ireland’s hospitality record. Presents a set of guidelines based on the ideals and concepts of total quality management as a means to establishing Northern Ireland as a quality tourism destination to prospective travellers.

Using the Occupational Stress Indicator, the results from this study provided a comparative overview of Australian and UK hospital workers’ perceived responses to organizational sources of pressure, use of coping strategies plus outcomes of job satisfaction, mental and physical ill health. The broad picture that emerged was that the Australian hospital workers appeared to have a more favourable working environment as their organization presented fewer sources of pressure. Despite lower levels of contributory pressure, it was apparent that Australian hospital workers perceived similar long‐term outcomes to organizational sources of pressure as the UK hospital worker sample. The Australian hospital workers reported significantly higher perceived physical ill health, and second, similar levels of mental ill health and job satisfaction when compared to the UK hospital workers. In addition, the Australian hospital workers reported increased use of coping strategies. The discussion takes into consideration the context and time frame of the two operating environments.

Improving quality of life for older people calls for public policy initiatives that have a positive impact on the determinants of quality of life. This paper presents a review of current social welfare, housing and health policy in the Republic of Ireland relevant to older people and policy areas that are of particular relevance to the determinants of quality of life identified in the literature. The state pension, on which older people are heavily reliant, constitutes the main focus of social welfare cash payments. However, a general practice of marginal increments that fail to take adequate account of inflation and costs of living can leave older people living on the margins of society. In relation to housing policy, there is a need for improved policy implementation regarding housing maintenance and facilitating home comfort in the older population. Overall, greater consideration for the housing needs of older people in general and social housing needs in particular are required. Since 1988 a preference for community over institutional care has persisted throughout Ireland's health policy documents, although gaps between policy aspiration and implementation measures continue to be highlighted. Future policy needs to focus on the creation of enabling environments for social participation and in the optimising of opportunities for physical, social and mental well‐being. The review underscored the absence of a rights‐based approach in policy‐making to date and the need for substantial capacity building to be undertaken among older people themselves.

The international demand for products and services no longer happens automatically; it has to be created. Consumers are increasingly becoming more sophisticated in the standards which they expect and more vocal about products and services which do not meet their requirements in terms of choice and quality. This applies to a whole range of products and services including those provided by the hospitality industry. Managements are constantly striving to meet customer requirements and in an effort to fulfil this objective have turned to a wide continuum of theories and practices such as quality circles, etc. Total quality is one of the latest concepts to have found favour in the world of management as a means to maintain, increase and consolidate market share. Examines the importance of the quality issue in the service sector of the economy. Commences with an exposition of the main principles of quality management and goes on to discuss two examples of particular importance to the hospitality industry in Northern Ireland by focusing on two cases located in different sectors of the industry.

Focuses on particular aspects of a healthy life style, diet and eating behaviours. Specifically considers the role which catering managers play in the provision of healthy food, the main proposition of the discussion being that this group has an important contribution to make in the establishment and maintenance of a healthy diet. Commences with a consideration of the responsibilities of catering managers and the factors which influence food selection. Then proceeds to examine the results of a recent research programme which surveyed attitudes, knowledge and behaviour of final year hospitality management students. These students are likely to find employment in the hospitality industry, many as food and beverage managers and, as such will be involved in planning menus and providing meals for the population across a wide variety of sectors.

The purpose of this paper is to determine the particular competencies demonstrated by effective physician leaders. Changing organizational and environmental dynamics present unique challenges to leaders in the field of healthcare. An accelerated emphasis on increasing the quality of health care delivery, containing costs, and restructuring the delivery of health care itself are redefining the very nature of healthcare and the roles of physicians as leaders. Given this context, the authors propose to identify the essential competencies for twenty-first century physician leadership.

In all, 53 critical incident interviews from 28 physicians identified as emerging leaders at the Cleveland Clinic, a top-rated US academic healthcare institution, were examined in two ways: an existing leadership competency model was applied to each critical incident and inductively derived themes were identified through thematic analysis of the incidents.

The predominant distinguishing leadership competencies demonstrated by the physician leaders included: Empathy, Initiative, Emotional Self-Awareness and Organizational Awareness. Communicating deliberately, getting buy-in from colleagues, focussing on the mission of the organization and showing respect for others were also discovered through thematic analysis to be essential practices of these effective physician leaders. Over 90 percent of the critical incident stories dealt with colleague-to-colleague interactions.

The research was conducted in one academic healthcare organization, thus limiting the generalizability of the results. Additional research testing these results in a variety of healthcare institutions is warranted.

This study identified specific competencies that distinguish effective physician leaders. These leaders actively sought to work with colleagues to obtain their input and consensus in order to enact organizational change and improve health care delivery in their institution. Importantly, their intentions were neither self-focussed nor self-promoting but strongly mission driven. The identification of physician leader competencies will assist incumbent and emerging physician leaders in their ability to be effective leaders, as well as inform the design of training and development programs for physicians.