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Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful implementation in the healthcare sector.

This paper reports a literature review exploring the major reasons for the failure of TQM programmes in healthcare organisations.

TQM implementation and its impact depend heavily on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in healthcare organisations can be attributed to the strongly departmentalised, bureaucratic and hierarchical structure, professional autonomy, tensions between managers and professionals and the difficulties involved in evaluating healthcare processes and outcomes. Other obstacles to TQM success include lack of consistent managers' and employees' commitment to and involvement in TQM implementation, poor leadership and management, lack of a quality‐oriented culture, insufficient training, and inadequate resources. The review was limited to empirical articles written in the English language during the past 30 years (1980‐2010).

The findings of this article provide policy makers and managers with a practical understanding of the factors that are likely to obstruct TQM implementation in the healthcare sector.

Understanding the factors that obstruct TQM implementation would enable managers to develop more effective strategies for implementing TQM successfully in healthcare organisations.

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

The purpose of this paper is to put forward a quality cost management model for healthcare organizations, which is based on the quality management systems proposed in ISO 9000 international standards.

The model suggested here arose from the individual study of quality in healthcare, quality management systems and quality cost theories; and the analysis of problems emerging when these tools are combined in practice.

The traditional quality cost model, usually implemented in manufacturing companies, can also be applied to healthcare organizations that manage their processes according to ISO 9000 quality management systems.

This document is a general description of the model proposed and, therefore, just presents overall guidelines to managing quality costs in healthcare organizations.

Since most healthcare organizations are still stuck in the quality assurance stage, there has been little research conducted on quality cost specifically focused on this industry.

This research aimed to create inventive principles in managing quality and innovation systems that can be used as a guide for the development of effective innovation projects in hospitals.

Total quality and innovation management in healthcare (TQIM-H) framework and theory of inventive problem-solving (TRIZ) were integrated with results from in-depth interviews with 30 healthcare experts, resulting in TQIM-H inventive principle. The developed inventive principle was validated using 50 effective innovation projects from one of the largest healthcare conglomerates in Southeast Asia.

The TQIM-H inventive principle consisted of 7 dimensions and 72 procedures for creating innovation in hospitals under the medical quality framework. The principle effectively helps innovators develop innovative solutions that still strictly comply with medical guidelines.

Innovation is recognized as a critical factor that helps organizations adapt to global changes and increases the potential for competition, especially in hospitals. However, creating innovation in hospitals has a lower success rate than in other industries because, in general, ineffective innovation development strategies are used and the created innovation is not aligned with regulations and restrictions regarding healthcare quality in the healthcare system.

The purpose of this paper is to conduct a dual-level (organizational and individual user) analysis of development related to the Internet of Medical Things (IoMT). It examines the organizational dynamics of IoMT and develops a conceptual model for quality of experience (QoE) in user acceptance.

This study uses the information systems success model of quality factor as an analytical framework and extends it beyond the individual user experience (UX) to include an organization-level perspective. Interviews are conducted with relevant stakeholders for sociotechnical inquiries; a survey identifies user factors in IoMT.

The sociotechnical analysis sheds light on how IoMT has been accepted and stabilized in the healthcare sector. It shows the complex interaction between the social and technical aspects of IoMT by highlighting the co-evolution, interaction, and interface of devices that constitute the next-generation network environment. The UX model conceptualizes QoE specific to medical informatics.

Given the sociotechnical nature of this investigation, another approach to adoption of IoMT innovations was worth investigating to determine effective integration.

IoMT needs to be meaningful if they are to be sustainable and they need to offer quality of services and QoE no matter the location or demographic in which they are used.

With a dual-level analysis, the study provides a comprehensive view of the IoMT development process by investigating the organizational dynamics, in addition to the UX, of IoMT. The results provide a basis for developing future IoMT services with QoE requirements, as well as for clarifying sociotechnical dynamics.

The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality improvement and patient safety education program focused on developing leaders to change the future of healthcare quality and safety.

The safety attitudes questionnaire (SAQ) short-form was used for measuring the culture of quality and safety among healthcare workers who were graduates of an academic medical center’s healthcare quality and safety program. A 53 percent response rate from program alumni resulted in 54 usable responses.

This study found that 42 (78 percent) of the respondents report that they are currently working in a healthcare quality and safety culture, with 25 (59 percent) reporting promotion into a leadership role after completion of the quality improvement education program. This compares favorably to AHRQ culture of safety survey results obtained by the same academic medical center within the year prior revealing only 63 percent of all inpatient employees surveyed reported working in a quality and safety culture.

The study design precluded knowing to what degree a quality and safety culture, as measured by the SAQ, existed prior to attending the healthcare quality and safety program.

This study has practical value for other organizations considering a quality and safety education program. For organizations seeking to build capacity in quality and safety, training future leaders through a robust curriculum is essential. This may be achieved through development of an internal training program or through attending an outside organization for education.

The purpose of this paper is to highlight the usefulness of financial information as a complementary tool for quality programs implemented in healthcare institutions and, subsequently, to introduce an approach to its systematic management.

This paper begins with a description of the current status of quality management in healthcare services, continues with a theoretical explanation of the importance of financial indicators for making decisions, and finishes with a practical example showing how to integrate financial data into healthcare quality programs.

Financial indicators play a key role in healthcare quality management systems (QMSs). These indicators can be managed jointly with traditional non-financial measures, through introducing minor adjustments to the ISO 9000 model.

The approach presented in the second part of this paper was built based on theoretical arguments and on its use in industries other than healthcare. Hence, further research is needed to provide evidence of its practical application.

First, this work integrates disciplines which are usually managed separately, such as quality and accounting. Furthermore, it focusses on an industry such as healthcare, where QMSs are not highly developed.

The purpose of this paper is to describe how clinical registers were designed and used to serve multiple purposes in three health systems, in order to contribute practical experience for building learning healthcare systems.

Case description and comparison of the development and use of clinical registries, drawing on participants’ experience and published and unpublished research.

Clinical registers and new software systems enable fact-based decisions by patients, clinicians, and managers about better care, as well as new and more economical research. Designing systems to present the data for users’ daily work appears to be the key to effective use of the potential afforded by digital data.

The case descriptions draw on the experience of the authors who were involved in the development of the registers, as well as on published and unpublished research. There is limited data about outcomes for patients or cost-effectiveness.

The cases show the significant investments which are needed to make effective use of clinical register data. There are limited skills to design and apply the digital systems to make the best use of the systems and to reduce their disadvantages. More use can be made of digital data for quality improvement, patient empowerment and support, and for research.

Patients can use their data combined with other data to self-manage their chronic conditions. There are challenges in designing and using systems so that those with lower health and computer literacy and incomes also benefit from these systems, otherwise the digital revolution may increase health inequalities.

The paper shows three real examples of clinical registers which have been developed as part of their host health systems’ strategies to develop learning healthcare systems. The paper gives a simple non-technical introduction and overview for clinicians, managers, policy-advisors and improvers of what is possible and the challenges, and highlights the need to shape the design and implementation of digital infrastructures in healthcare services to serve users.

The purpose of this paper is to examine the usability and potential of incorporating quality costs into an electronic adverse incident recording system within a healthcare sector.

The paper is a general review and a discussion of an electronic adverse incident‐recording system into the potential benefits and restrictions was undertaken. Articles containing both information systems and quality costs were reviewed in order to explore the potential of linking information against patient safety issues.

The paper finds that quality costs is a valid and useful approach for measuring the impact of individual adverse incidents or trends in order to support managers and clinicians to develop appropriate action plans to reduce levels of patient harm and thereby improve patient safety. The paper also shows that quality costs can be used to support managers and clinicians and are commercially designed to improve the detection, investigation and action planning to improve service quality and patient safety.

Quality costs can be used as a driver for identifying potential high impact quality and patient safety projects within a healthcare setting.

This paper provides useful information for designers of electronic adverse incident‐reporting systems to support managers and clinicians to utilise the benefits of quality costing in order to strengthen and re‐focus patient safety issues in healthcare.

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.

It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.