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Purpose – This research analyzes and describes the implementation of the North Aceh Regency education budget policy for improving the quality of education in relationship to the impact of the special autonomy budget.

Design/Methodology/Approach – This research uses qualitative research, descriptive-qualitative analysis methods, and qualitative explorative methods.

Findings – The results show that the implementation of the special autonomy education budget policy of North Aceh Regency to improve the education quality has not run optimally. The main obstacle is the inadequate human resource issue, including the leadership problems of regional heads who should prioritize the development. Based on field data of the actors involved in the formulation of the education quality improvement program in Aceh Utara District, especially the legislative branch (namely BAPPEDA), the education office and members of the Aceh legislative team, the post-conflict Aceh representation of the legislature at the provincial level, the DPRA and DPRK at the district level / in the field of political will produced. The resulting program does not focus on the pattern of improving the quality of education, the policy is more rhetorical, and the program implementation is often adapted to the wishes of political actors.

Research Limitations/Implications – Given the fundamental differences in the root causes of primary and secondary education in Aceh, further research is needed to determine whether similar results will be obtained in other parts of Aceh.

Originality/Value – Identifies factors that lead to the low quality of educators and the unequal distribution of teachers in the Aceh Regency.

Paper Type – Research paper

This study aimed to bridge the gap between the financial measurement of process improvement ideas and Lean Six Sigma measurements. It was required to increase employee engagement in process improvement initiatives.

Through both a practical and theoretical application of the Design for Lean Six Sigma methodology, the researcher was able to design a process and a benefit measuring methodology that was acceptable by finance and aligns with the benefits expected from the elimination of the Lean wastes.

The project found that benefit measurement methodology is not understood by most employees, which leads to a lack of engagement in working on improvements. The result of the study was a model for employees to identify and quantify these benefits. This has resulted in a model for cost-benefit analysis aligning financial costs with non-value add waste costs and cost of poor-quality costs resulting in increased process improvement ideas and activity.

While this study was limited to one company, applying this methodology could benefit any company experiencing the same difficulties.

This is one of the first studies to try and cost the benefits of LSS projects both from an organisational and generic viewpoint.

The purpose of this paper is to extend the understanding of Six Sigma (SS) and the underlying dimensions of its critical success factors (CSF) via an analysis of the effects of top management support (TMS), implementation strategy (IS), and collaborative team (CT) on project performance (PP) in Mexican manufacturing companies.

Based on a SS literature review, a survey was conducted to capture practitioners’ viewpoints about CSFs for SS implementation and their impact on performance in manufacturing companies. A factor analysis and structural equation modeling were conducted in order to identify and analyze causal relationships.

The results suggest that CSFs grouped in the constructs TMS, IS, and CT have a positive impact on PP as measured by cost reduction, variation reduction, and quality improvement.

Although the empirical data collected supported the proposed model, results might differ among organizations in different countries. In addition, the study did not analyze a unique performance metric; instead, general PP dimensions were used.

Boosting the TMS, IS, and CT enhances positive PP of SS in manufacturing companies.

IS as a construct has not been studied exhaustively; this work contributes to a better understanding of it and its impact on PP. Additionally, studies of SS in Latin America are limited, so this study gives a complementary vision to practitioners and researchers about it.

In this paper, we contribute to the theorizing of patient involvement in organizational improvement by exploring concepts of “learning from patients” as mechanisms of organizational change. Using the concept of metaphor as a theoretical bridge, we analyse interview data (n = 20) from participants in patient engagement activities from two case study organizations in Ontario, Canada. Inspired by classic organizational scholars, we ask “what is the organization that it might learn from patients?”

Patient involvement activities are used as part of quality improvement efforts in healthcare organizations worldwide. One fundamental assumption underpinning this activity is the notion that organizations must “learn from patients” in order to enact positive organizational change. Despite this emphasis on learning, there is a paucity of research that theorizes learning or connects concepts of learning to organizational change within the domain of patient involvement.

Through our analysis, we interpret a range of metaphors of the organization, including organizations as (1) power and politics, (2) systems and (3) narratives. Through these metaphors, we display a range of possibilities for interpreting how organizations might learn from patients and associated implications for organizational change.

This analysis has implications for how the framing of the organization matters for concepts of learning in patient engagement activities and how misalignments might stymie engagement efforts. We argue that the concept and commitment to “learning from patients” would be enriched by further engagement with the sociology of knowledge and critical concepts from theories of organizational learning.

The purpose of this paper is to assess causal relations between the implementation of the 5S approach and the reduction of patients’ waiting time at out patient departments (OPDs) of hospitals in Tanzania.

Patients’ waiting time was measured under the cluster randomized control trial (c-RCT). In all, 16 hospitals were chosen and divided into treatment and control groups using block randomization. Before the intervention, a baseline study was conducted at OPDs in all 16 hospitals. After one year of the intervention, the end-line study was carried out in both the groups. A comparison of the average waiting time reduction and Difference-in-Difference (DID) analysis was carried out to see the effect of the 5S approach on the reduction of patients’ waiting time.

Statistical significance in reduction of patients’ waiting time was seen in the medical records sections (p=0.002) and consultation rooms (p=0.020) in the intervention group. The same trend was also seen using DID analysis (−15.66 min in medical record, −41.90 min in consultation rooms).

This study has the following limitations in terms of the data. The data were collected for only three days at the time of baseline survey, and again for three days at the time of the end-line survey from 16 hospitals. Moreover, piloted areas for the implementation of the 5S approach vary from hospital to hospital. There might be a bias in the measurement of a patient’s waiting time. Caveats are therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing quality improvement programs in Tanzania and in other African countries for improvement of time factors.

This study used c-RCT, and has proven the effectiveness of the 5S approach in improving the working environment and reducing patients’ waiting time at OPDs in several hospitals at district level in Tanzania.

Background: Most children in low-income countries complete their elementary education with low competency in essential reading, writing, and arithmetic skills. Besides, about 250 million students are not learning the basics, most of whom have spent at least four years in school, and this failure is coined the global learning crisis. This study aimed to examine educational quality management practices perceived by secondary school teachers.

Methods: The study employed a multilevel mixed-method design. Employing a simple random sampling technique, the researcher selected 251 teachers from 10 secondary schools in the research regions. He collected data through a researcher-designed questionnaire, school standards, and student achievement records from November 2018 to March 2019. He analyzed data from a questionnaire using frequency, percentage, mean, Pearson correlation, and exploratory factor analysis. The document review concerning quality management was analyzed using content analysis to triangulate the quantitative findings.

Results: At the school level, the study revealed the impracticality of laboratories. Besides, incompetent and unmotivated teachers and students ran the education business from the input side. At the same level, principals' management practices on staff development and encouraging parents to support their schools were low. The principals' management practices in the teaching-learning process were also undesirable at the classroom level. Overall, the study revealed incredibly insufficient input, process, and output management in the study context.

Conclusion: Hence, the study concluded that it is difficult to achieve the very objectives of producing creative, critical, and problem-solving individuals through this type of educational provision and its management. Due to this, it is not easy to achieve quality education for all goals.

The purpose of this paper is to reflect on research evidence and practice experience of transforming primary care to a more integrated and holistic model.

It is based on a scoping review which has been guided by primary care stakeholders and synthesises research evidence and practice experience from ten international case studies.

Adopting an inter-professional, community-orientated and population-based primary care model requires a fundamental transformation of thinking about professional roles, relationships and responsibilities. Team-based approaches can replicate existing power dynamics unless medical clinicians are willing to embrace less authoritarian leadership styles. Engagement of patients and communities is often limited due to a lack of capacity and belief that will make an impact. Internal (relationships, cultures, experience of improvement) and external (incentives, policy intentions, community pressure) contexts can encourage or derail transformation efforts.

Transformation requires a co-ordinated programme that incorporates the following elements – external facilitation of change; developing clinical and non-clinical leaders; learning through training and reflection; engaging community and professional stakeholders; transitional funding; and formative and summative evaluation.

This paper combines research evidence and international practice experience to guide future programmes to transform primary care.

This work analyses quality management (through the European Foundation for Quality Management-EFQM-model) and transformational leadership in hotels in Spain.

The study analyses 102 5-star and 5-star large luxury hotels that answer a questionnaire on transformational leadership and the EFQM model. It analyses the degree of importance of quality and transformational leadership in hotels, the significant differences between groups of hotels (according to stars, size, modality and type of product) and the association between transformational leadership and quality.

The results show the levels of quality and transformational leadership, minor significant differences between groups and an association between the two variables. In general, chain-affiliated hotels have a higher level of leadership and a more advanced employee and process management than independent hotels. Also, those hotels that focus on a vacational product show a lower attention to the strategy dimension in the EFQM model. The number of employees is not an important factor to adopt quality. Finally, transformational leadership allows hotels to advance in the development of quality management.

Although there are studies on quality management that show the importance of leadership for quality, there are few studies that examine transformational leadership and quality in the same study, mainly in the tourism industry, and especially in the case of the hotel industry.

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

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.