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Attempts to show that, while ISO 9000 is part of total quality management, the organizational culture that is suited to ISO 9000 is not suited to the other aspects that make up total quality. Total quality is a balance between these factors such that, if the pull in one direction is too strong, the balance will be lost. Finally, contends that it is the inherent strength or inflexibility of the registration that has contributed to the failure of so many total quality initiatives.

Proposes that the type of staff (flexible, creative, individualistic) responsible for IT successes of the 1980s may not be happy in the industry of the 1990s which will require tighter management. Discusses the delegation dilemma and the factors affecting managers′ willingness to relinquish control. Examines the difference between “responsibility” and “accountability” and where these should lie in a management structure.

Many different definitions exist of TQM. These either focus on supporting one or more of either product, process, people and customer management initiatives. Most tend to describe TQM in absolute terms, suggesting following a particular route is appropriate for all companies. In reality different approaches are successful for different companies. Redefines TQM and then looks at the integration of the decision on what approach to take with changes in the marketplace and corporate culture.

Effective delegation often fails, due to a misunderstanding about the difference between responsibility and accountability. Added to this many of the key management processes actively discourage delegation, causing internal conflict and resulting in inefficient and ineffective organisations. However, companies such as the BOC Group show what can result when delegation is successful.

For organisations to attract and retain top quality staff in the 1990s they will need radically to change their thinking towards benefits offered to such staff. It is suggested that a targeted approach, reducing rather than increasing the traditional benefits offered, could pay dividends for organisations competing for scarce human resources.

Quality managers must be seen to support directly the primary aims of the business. This means that they can no longer impose change plans on the business, but rather they have to persuade and facilitate change. This requires skills that are inherent in the consulting process. Identifies the key skills in this process which are based on the seven‐stage consulting process model. Briefly discusses this model and concludes by including a contact address for anyone who wishes to develop the skills highlighted in the process.

Outlines a new training programme for quality managers, to help them develop consultancy skills. The programme focuses on implementation of a quality plan within an organization.

Looks at the nature of the consultant‐client encounter with regard to the introduction of quality assurance systems. Notes that while the encounter itself is a dynamic one wherein prescription of quality‐assured behaviours is an impossibility, the static processes which surround the encounter can be effectively assured to auditable standards. Suggests that demand for a flexible approach will lead to an audit approach which focuses on process examination and less so on normative content.

Pre- and post-immigration trauma and stress make refugees a particularly vulnerable group in terms of mental health and well-being. The purpose of this paper is to describe a listening project undertaken in Plymouth, UK, which sought the views of 17 service users (n=12) and staff (n=5) from four local support organisations, for people with refugee and asylum seeker status and those with diverse cultural backgrounds. Aims of the project were to expand Western-centric understandings regarding beneficial support and the promotion of good mental health and well-being in this population.

Responses were subjected to thematic analysis, co-conducted with a service user. Participants were asked about their personal understandings of mental health and well-being and what supports or hinders well-being.

The findings enabled the development of a model incorporating 10 threads which support and 9 holes that can hinder well-being.

The relatively small numbers of participants compared with the numbers of asylum seekers and refugees in Plymouth may not be fully representative of the general population in Plymouth and the UK.

Despite increasing cultural diversity within the UK population, available mental health services exist mainly as developed from a Western psychological model of mental distress and treatment. This research provides services with a more informed understanding of mental health for asylum seekers and refugees. As such it is of value towards future service design in Plymouth and the UK. Findings also contributed to a successful funding bid to set up a peer-led support project in the city.

The purpose of this paper is to analyze the context of the emergence of a skin infection outbreak in the aftermath of Hurricane Matthew in Haiti and detail the role of community-based participatory research in mobilizing local action in a country with low state capacity.

While implementing a post-disaster study that combined a survey of 984 households and 69 community leaders with 23 focus groups, 60 ethnographic interviews and community mapping, a skin infection outbreak was detected. Using study results, the research team in partnership with different stakeholders responded to the outbreak with a health intervention.

The findings illustrate how pre-existing conditions shape local communities' vulnerability to health crises in the aftermath of disasters and the critical role research can play in informing the recovery processes. Community-based approaches to emergency health reinforced by multi-stakeholder partnerships with local government can strengthen post-disaster response and governance structures setting the groundwork for the development of local resilience.

The health intervention was implemented as a result of the study. Patients served were not derived from the study sample but were self-selected based on their need for skin-related medical treatment.

This article highlights the integral role research can play in identifying the health impacts of disaster events in vulnerable, hard-to-reach communities and strengthening government involvement in disaster governance.