ISO 9001 and performance: a method review

Implementation of a quality management system in a liver transplant programme

BACKGROUND

The management of liver transplantation has become a complex process involving different healthcare professionals. Teamwork, standardisation and definition of the best practices are essential for success, patient satisfaction and society's favourable perception of transplantation programmes.ISO 9001:2015 certification provides the necessary elements to help implement a quality management system (QMS) to ensure that patient care is performed with the highest guarantees of clinical quality and safety. The aim of this study is to describe the steps, strengths and limitations in the implementation of a QMS in a liver transplant programme (LTP).

PROJECT MANAGEMENT METHOD

This included analysing the starting point, setting up a working group, training, defining the scope of certification, preparing documentation, and conducting an internal and external audit, which culminated in the ISO 9001 quality certification award. The scope of QMS includes all the processes of LTP, from referral of candidates to long-term follow-up after transplantation.

RESULTS

The project was structured in seven phases that took place between 2008 and 2011. The implementation of QMS led to the generation of all the necessary documentation to meet the requirements of the standard, including internal and legal requirements related to the transplant activity. The establishment of indicators to measure the effectiveness of processes, risk management and the identification of incidents allows us to implement measures devoted to avoiding the deficiencies and to meet the established objectives.

CONCLUSION

ISO 9001:2015 certification has contributed to the adaptation of a new quality and safety culture focused on the patient. All activities are protocolised, everything is recorded, measured, and verified, and all steps are taken as planned. Work is carried out in terms of continuous improvement. This has led to less variability in daily clinical practice and a better understanding of work dynamics.

Fallacy of continual improvement in the longitudinal study of ISO 9001 and IATF 16949 standards

Purpose

Generic quality management system standard ISO 9001 and the automotive quality management system standard IATF 16949 both require organisations to demonstrate continual improvement in their customer satisfaction and the number of non-conformities identified during quality system audits. However, the long-term trends of these two parameters under ISO 9001 and IATF 16949 standards are not researched so far. It is expected that under continual improvement, organisations will achieve a step-function/stair-case shaped pattern. This study evaluates if this expectation is true when long-term performance of certified organisations is assessed.

Design/methodology/approach

A longitudinal exploration of three organisations certified to ISO 9001 standard and three certified to IATF 16949 standard is done. The observations are further substantiated using secondary data for the same ten years period about customer satisfaction of the major automobile manufacturers.

Findings

It is observed that none of the two indicators, i.e. the customer satisfaction and number of non-conformities, in any of the six organisations show step-wise/stair-case type improvement. All indicators followed random up and down patterns like ocean waves. It is paradoxical that certified organisations are claiming continual improvement and are remaining certified but there is actually no long-term improvement.

Originality/value

Longitudinal studies for the generic quality management standard ISO 9001 and the quality system standard for automotive sector IATF 16949 are rare. The revelation about ocean wave patterns observed in the long-term trends for customer satisfaction and the number of non-conformities in ISO 9001 and IATF 16949 certified organisations is a startling finding. It is outlandishly different from the conventional perception of a staircase-styled continual improvement pattern expected a priori in certified organisations.

A reprise of TQM practices among construction enterprises in Nigeria

Purpose

Studies on total quality management (TQM) implementation among construction enterprises in Nigeria have used few TQM constructs and variables and yielded fragmented results. This study adopts comprehensive TQM constructs and variables for comparison with the previous studies to establish the critical variables for effective TQM practices in Nigeria.

Design/methodology/approach

Data collection from a stratified sample of Nigerian construction practitioners with practical or theoretical knowledge of TQM, using web-based questionnaires consisting of twelve validated TQM implementation constructs and 65 variables. 72 home and overseas practicing professionals participated (21% response rate) using nonprobability sampling techniques. Following acceptable Cronbach's alpha reliability values equal to 0.7, the author/s rank-ordered the twelve TQM constructs and 65 TQM variables. Then, they computed the z-scores and the percentiles to identify the TQM critical variables – 75th percentiles and above, contrasted with the threshold normalized values equal to 0.5. Furthermore, Pareto analysis determined the 20% “vital many” responsible for 80% of the problem.

Findings

Customer focus, top management commitment and supplier quality management were the top-25% constructs, while employee involvement, statistical process control and design quality management were the bottom-25% constructs. Thirteen TQM critical variables emerged from the top-25% constructs.

Practical implications

Top management to involve employees to be customer-focused and driven toward suppliers' quality management system. Priority should be given to implementing the critical variables advanced in this study.

Originality/value

This study juxtaposes the results of similar studies for consistency to advance the critical success factors.

Linking ISO 9000 certification to firm performance and financial crisis: a matched sample longitudinal analysis

Purpose

This is a longitudinal study exploring the effect of ISO 9000 certification on firm's financial performance in the pre-crisis period and the 2008 financial crisis period.

Design/methodology/approach

The empirical analysis is based on a 22-year dataset with balance sheet data from 136 Greek listed firms covering the period 1992–2013. A matching technique is applied to properly estimate potential differences in the impact of ISO 9000 on firm's financial performance between the groups of certified and matched non-certified (control) firms in the entire period but, most importantly, in pre-crisis vs crisis periods, using the difference-in-differences econometric approach.

Findings

The findings indicate that certified firms exhibit significantly higher financial performance relative to the matched non-certified group in both the pre-crisis and crisis periods, which tends to persist for several years post-certification. The financial crisis has a negative and statistically significant effect on firm performance in both the certified and matched non-certified groups, which nevertheless did not differ significantly between them. Controlling for sectoral and technological differences did not harm the higher performance of certified firms relative to the matched control peers. The results remain in the same direction when the authors test the ISO 9000 effect in the sub-group of certified firms that obtained the certification at the firm-level.

Originality/value

The study is original in its sample design and hypothesis testing. The matched sample created from a sufficiently long and continuous time dataset enabled the authors to properly estimate firm performance differences of ISO 9000 between pre-crisis and crisis periods. Of additional value is the testing of sectoral/technological differences and the distinction between firm-level and plant-level certification.

ISO 9001-certified public healthcare center’s efficiency and re-certification

Purpose

The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the efficiency.

Design/methodology/approach

The sample of the research is 30 ISO 9001-certified district public healthcare centers in Jakarta. The data envelopment analysis (DEA) and the Man–Whitney U test were applied.

Findings

The research result showed that there is a variation in efficiency values of ISO 9001-certified public healthcare centers that this research studied. There are only 23 percent of the public healthcare centers that can be categorized as the technically efficient public healthcare center. Furthermore, this research also found that there are no significant efficiency value differences among the groups of public healthcare center based on the number of “re-certification” the center experienced.

Research limitations/implications

This research only involved ISO 9001-certified public healthcare center from Jakarta, Indonesia.

Practical implications

Registering ISO 9001 for the public healthcare center does not guarantee that the public healthcare center will have better efficiency. The government and the public healthcare center management should ensure that the ISO 9001 implementation method used by the public healthcare center is appropriate for improving the efficiency of the public healthcare center.

Originality/value

There is a lack of research that studied the efficiency of ISO 9001-certified public healthcare center. Furthermore, there is no research that investigates the effect of “re-certification“ on efficiency. This research fulfills the literature gaps.