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The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

The purpose of this research is to provide an introduction into Hoshin Kanri and how it has been used with other methodologies and frameworks. Additionally, factors that impact successful Hoshin Kanri implementation and future research opportunities are explored.

A systematic literature review was conducted to determine the methodologies and frameworks that have previously been explored and identify factors that lead to successful Hoshin Kanri implementation as it relates in the Western world.

Even though Hoshin Kanri has been used to a limited extent for decades in the West, there is still relatively little published research on the topic. In the period reviewed most published research was performed in the UK or USA. In addition, most years had less than two publications (the exception being five in 2020).

This literature review was primarily focused on the manufacturing sector, publications from 1990–2021, and available in English.

Current practitioners may use the research in this review to improve their current Hoshin Kanri practices using the techniques mentioned as a means of continuous improvement or to build a new framework for their own needs.

This paper makes an important contribution to the study of Hoshin Kanri as it provides: (1) an updated literature review regarding the study and application of Hoshin Kanri, (2) a qualitative analysis of alternative methodologies and frameworks to traditional Hoshin Kanri and (3) success factors when considering implementation of Hoshin Kanri within an organization and researchers with potential ideas for future research.

Regarding human resource and labour relations management, academia focuses mainly on cities; however, rural areas are an integral part of China's economic structure. This study focuses on the movie projection industry in China's rural areas and explores how human resource practices (HRPs) are transformed and the labour process is reconstructed in digital transformation.

We adopt a case study of a rural movie projection company. The company's HRPs reconstructed the labour process of movie projection, and they have been promoted as national standards. Data were collected from in-depth interviews, files and observations.

Rural movie projection companies combine high-performance and paternalistic HRPs in the media industry's digital transformation. HRPs and digital technology jointly reconstruct the labour process. First, the HRPs direct labour process practices towards standardisation. Second, the digital supervision platform guides the control style from simple to technical, placing projectionists under pressure while increasing management efficiency. Third, rural movies made using digital technology have disenchanted rural residents. Accordingly, the conventional relationships between the “country and its citizens,” “individuals themselves,” and “models and individuals” have been removed, and a new relationship between “individuals themselves” is formed thanks to the novel HRPs.

This research plays a crucial role in exposing researchers to the labour process of rural movie projection, which is significant in China but often ignored by Western academia and advances the Chinese contextualisation of research on labour relations.

A sense of collective free-thinking with tangible goals makes co-creation an enlightening experience. Yet despite the freedom and organic flow of the methodology, there remain barriers to deploying co-creation in the real-world context. The aim was to understand the barriers and solutions to co-creation, reflect on applying co-creation in practice and co-create an applicable framework for co-creation.

These reflections and conceptual developments were completed using a Participatory Action Research Approach through the co-creation of the Erasmus+ funded Co-creating Welfare course.

Results presented are centric to the experiences in the United Kingdom but led to application at an international level. Problem formulation led to solutions devised about who should co-create, what co-creation aims to achieve, how to receive management buy-in, co-creating beyond the local face to face context and evaluation.

The Three Co’s Framework is proposed using the outline of: Co-Define, Co-Design and Co-Refine. Those who take part in co-creation processes are recommended to be called co-creators, with less focus on “empowerment” and more about facilitating people to harness the power they already have. Utilising online and hybrid delivery methods can be more inclusive, especially in response to the COVID-19 pandemic. The use of co-creation needs to be evaluated more moving forwards, as well as the output co-created.

In early 2014, recent Stanford University graduate Tyler Shultz was in a quandary. He had been working at Theranos, a blood-diagnostic company founded by Elizabeth Holmes, a Stanford-dropout wunderkind, for almost a year. Shultz had learned enough about the company to realize that its practices and the efficacy of its much-touted finger-prick blood-testing technology were questionable and that the company was going to great lengths to hide this fact from the public and from regulators.

Theranos and Holmes were Silicon Valley darlings, enjoying positive press and lavish attention from potential investors and technology titans alike. Just as companies like PayPal had revolutionized the stagnant payments industry and Uber had upended the for-hire transportation sector, Theranos had been positioned as the latest technology firm to substantially disrupt yet another mature sector: the medical laboratory business. By the start of 2014, the company had raised more than $400 million in funding, and had an estimated market valuation of $9 billion.

Shultz's situation was exacerbated by the fact that his grandfather, the highly respected former US Secretary of State George Shultz, was on the Theranos board and was one of Elizabeth Holmes's biggest supporters.

But Tyler Shultz worried about the customers he was convinced were receiving highly unreliable and often inaccurate blood-test results. With so much at stake, Shultz wondered how he should proceed. Should he raise his concerns with the firm's investors? Blow the whistle externally? Report to industry regulators? Go away quietly?

This case and its subsequent four brief follow-up cases are based largely on interviews with Tyler Shultz, and outline the dilemma he faced and the various steps he would take both to extricate himself from his unsavory position and let the public know the full extent of the deception at Theranos.

Five optional handouts are available to instructors to further discussion after the case has been debriefed. The handouts serve as additional decision points for the students if your class time permits.