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As a way of alleviating nursing workforce shortages, health care managers are employing two types of workforce flexibility: supplemental staffing and floating among units. In this paper, the authors investigate the moderating effects of two critical situational variables – namely, job-level workload and severity of illness (SOI) in a given unit – on the relationship between workforce flexibility and quality of care as assessed by the nurses at the unit-level.

The authors empirically test the relationship between a unit's floating of nurses and the use of supplemental workforce on the quality of patient care and the moderating role of patient SOI and job-level workload on this relationship using 357 hospital-unit observations.

The authors find that situational variables play a critical role in flexible staffing strategies and they should be accounted for carefully to obtain the best quality of care outcomes. The authors find that the well-known negative effect of supplemental staffing on quality of care is not universal and appears to be moderated by the situational factors studied in this paper.

For best outcomes, staffing manager who oversee multiple units should use supplemental staff on units that have lower job-level workload and on units that have high severity of illness. The authors also find that managers of units with patients who are less-severely ill should encourage nurses to float out and return to their home unit. This strategy will improve quality of patient care in the home unit.

While some research analyzes the direct link between flexibility and quality performance, how this relationship is affected by varying situational factors within a unit has not been studied so far.

This research aims to explore the fine-grained relationships between nurse staffing and hospital operational performance with respect to care quality and operating costs. The authors also investigate the moderation effect of competition in local hospital markets on these relationships.

A six-year panel data is assembled from five separate sources to obtain information of 2,524 USA hospitals. Fixed-effect (FE) models are used to test the proposed hypotheses.

First, nurse staffing is initially associated with improved care quality until nurse staffing reaches a turning point, beyond which nurse staffing is associated with worse care quality. Second, a similar pattern applies to the relationship between nurse staffing and operating costs, although the turning point is at a much lower nurse staffing level. Third, market competition moderates the relationship between nurse staffing and care quality so that the turning point of nurse staffing will be higher when the degree of competition is higher. This shift of turning point is also observed in the relationship between nurse staffing and operating costs.

The study identifies three ranges of nurse staffing in which hospitals will likely experience simultaneous improvements, a tradeoff or simultaneous decline of care quality and operating costs when investing in more nursing capacity. Hospitals should adjust nurse staffing levels to the right directions to achieve better care or reduce operating costs.

Nurses constitute the largest provider group in hospitals and profoundly impact care quality and operating costs among all health care professionals. Optimizing the level of nurse staffing, therefore, can significantly impact the care quality and operating costs of hospitals.

The purpose of the study is to report on an in‐depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used.

The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and applied scales for the measurement of perceived service quality.

A focused and rigorous examination of customers' views of the importance of the service elements is provided. The study confirmed previous research that the application of SERVQUAL in the public sector can produce different service quality dimensions from those found in private sector services. It was also found that the service quality gaps, and the relative importance of the five dimensions of service quality, were the same for students and staff, albeit with some specific differences. Reliability was the most important dimension for all customers and the greatest improvement in service quality would be achieved through improved service reliability.

The implications of these findings for the department are discussed, together with the value of SERVQUAL to the public sector, in general, and Higher Education, in particular, in assisting with improvement of services. Further research at the HEI which would benefit the department is identified as well as a broader project to survey service provision and approaches to quality measurement across HEIs.

In an increasingly consumerist environment, a serious approach to service quality can only enhance the reputation of HEIs which address the area in a coherent and consistent manner. This study details a useful approach.

Quality initiatives demand that management and staff share a mutual interest in improving the quality of customer service through continuous improvement. These demands are currently being pursued against a background of organizational restructuring, redundancy and pressures on staff to increase productivity that are inconsistent with promoting a shared interest in improving service quality. Argues that management needs to reflect on the consistency of its actions in relation to the underlying rational of quality initiatives.

Previously, a questionnaire survey was conducted and it was found that some management practices were more influential to service quality than others. The purpose of this paper is to identify in more detail the reasons behind the survey findings.

Eighteen in‐depth interviews into a range of management practices which support service quality were conducted.

It was found that there were difficulties in implementing some of the management practices due to the type of staff employed and to the nature of tasks undertaken.

As the purpose of this research is to facilitate interpretation of the quantitative data, the investigation did not go in detail beyond mass and technological services. Hence, individual organisational characteristics, individual circumstances, or details of the service offered to customers are not considered beyond the category of either mass or technological services.

The paper identifies that the actual contribution from different management practices to service quality varied, and explains the reasons behind the diverse contributions in each type of service business.

This paper summarizes our research into the impact that current Air Force quality assurance staffing practices have on key unit performance metrics.

Interviews and Delphi surveys culminated in the development of a quality assurance staffing effectiveness matrix. The matrix was used to calculate historical quality assurance staffing effectiveness at 16 Air Force combat aircraft units. Effectiveness scores were then regressed with unit historical data for 25 metrics.

Nine metrics were deemed statistically significant, including break rates, cannibalization rates, flying schedule effectiveness rates, key task list pass rates, maintenance scheduling effectiveness rates, quality verification inspection pass rates, repeat rates, dropped objects counts and safety/technical violations counts. An example benefit‐cost analysis for changes in quality assurance staffing effectiveness presents compelling evidence for maintenance managers to carefully weigh decisions to leave quality assurance personnel slots empty, or to assign personnel possessing other than authorized credentials.

Maintenance managers can use this method to help determine personnel assignment strategies for improving quality assurance unit performance with respect to similar metrics, and other managers could adopt this general approach to more effectively link personnel resources to their organization's key performance indicators.

Explores the relationships between quality assessment and staff development in higher education and their role in changing the culture of higher education. Addresses the processes of quality assessment and the nature of staff development. Demonstrates how staff development has contributed to quality assessment and how quality assessment has contributed to staff development, and offers some suggestions for future directions.

Describes an action research project to improve quality in three hospital departments including operating theatres, X‐ray, and medical records. The approach combined quality assurance (QA) or audit methods with those of continuous quality improvement (CQI) or TQM. The intention was to bring about improved organizational performance through an emphasis on bottom‐up rather than top‐down methodology, and to assess the relative effectiveness of different quality strategies being used within the hospital. Baseline studies of organizational climate and of patient perceptions enabled evaluation of effectiveness. Provides a description of the background to various health‐care quality strategies, and argues that several perspectives are required if all stakeholders (e.g. policy makers, professionals, patients, and managers) are to be satisfied. Describes the responses of staff, superiors and professionals and recommendations offered for more effective quality strategy implementation.

In every manufacturing company, irrespective of size, product and other variables, management are constantly involved in quality‐related decisions which have a direct effect on product quality. An analytical method is described for assessing an organisation's approach to quality management. On application, managers are provided with information on the reality of their quality assurance activities. An overview of some of the issues involved in decision making is provided, followed by an outline of the research methodology, and, finally, the “method” is presented with some results arising from its application.

Many organizations are investing much time and effort in the management of quality. A few enlightened ones even have a vision to be the best. G. Howland Blackiston, the president of the Juran Institute, noted recently that, “All around the world companies are waking up to ‘quality’. Everyone is touting quality. Many are attempting it. Some organizations have gotten enviable results by using the concepts of ‘managing for quality’ dramatically to lower their costs, increase their profits and become more competitive in an increasingly competitive market. For these winners, quality has become an integral part of their business strategy”.