Total quality management in developing countries: A case of pharmaceutical wholesale distribution in Pakistan

Evaluation of Soft and Hard Total Quality Management at Shahroud University of Medical Sciences

BACKGROUND AND OBJECTIVES

This research aims to examine the current level of soft and hard Total Quality Management (TQM) at Shahroud University of Medical Sciences and explore the factors contributing to its success.

METHODS

The present cross-sectional study included 462 university managers and employees selected by stratified random sampling method in 2022. The participants were asked to answer TQM, soft TQM, and hard TQM questionnaires. The data were analyzed using ANOVA and chi-square tests, Pearson's correlation coefficient, and structural equation modeling.

RESULTS

Managers made up 73 of the participants (15.8%). The average score for TQM was 143.02 ± 11.56, soft TQM 52.47 ± 9.35, and hard TQM 36.49 ± 9.54. There was no statistically significant variation in the mean score of hard TQM, soft TQM, and TQM based on gender or course completion. There was a strong and positive link between the scores of soft TQM, hard TQM, and TQM. Leadership commitment, employee suggestion systems, problem-solving groups, information quality, and preventive maintenance were strongly associated with quality management in the structural equation model.

CONCLUSION

Given the university's average level of TQM implementation, it appears that steps should be taken to improve the evaluation process and provide feedback to employees. Steps should also be taken toward improving the commitment of senior management to implementing and enhancing the system of employee suggestions, establishing problem-solving groups, and training job duties. TQM can assist employees and increase the quality of the information to improve the university's rank in quality management.

Impact of big data analytics on sales performance in pharmaceutical organizations: The role of customer relationship management capabilities

In this era of technology development, every business wants to equip its salesforce with a sustainable salesforce automation system to improve sales performance and customer relationship management (CRM) capabilities. This study investigates the impact of big data analytics (BDA) on CRM capabilities and the sales performance of pharmaceutical organizations. A research model was tested based on 416 valid responses collected from pharmaceutical companies through a structured questionnaire. Structural equation modeling (SEM) was employed using Smart-PLS3 to confirm the contribution of BDA to improving CRM capabilities and sales performance. The study finds that individual characteristics such as self-efficacy, playfulness, and social norms, along with organizational characteristics such as voluntariness, user involvement, user participation, and management support, are positive predictors of salesforce perception of BDA. This positive perception of BDA increased the person-technology fit in the salesforce, which ultimately increased the CRM capabilities and sales performance.

Effect of service quality on doctor’s satisfaction and prescribing behavior in pharmaceutical supply chain – a study with reference to a major Indian pharmaceutical company

Purpose

The purpose of this paper is to develop a scale for the measurement of service quality at the manufacturer–doctor interface of the pharmaceutical supply chain and to study the impact of service quality on doctor’s satisfaction and doctor’s prescribing behavior. Doctors from two major states of South India were selected for the study. A doctor perceived service quality scale with three dimensions having eight items was developed through confirmatory factor analysis (CFA) in the pharmaceutical context. Structural equation modeling (SEM) technique was used to show the relationship between service quality, satisfaction and prescribing behavior. The critical factors of service quality were identified, and a model was developed showing the relationship between service quality, doctor’s satisfaction and doctor’s prescribing behavior which has not been explored in any research. This model will be helpful in further development of new concepts and for analyzing the reasons for the failure of doctors in providing quality service. 

Design/methodology/approach

A total of 200 doctors from three major cities of South India were selected. A doctor perceived service quality scale with three dimensions having eight items was developed through CFA using Parasuraman Service quality scale (Parasuraman, 1985, 1986, 1988) as the basis in the pharmaceutical context after focus group discussions with company experts, retailers, doctors and academicians. SEM technique was used to examine the impact of service quality on doctor’s satisfaction and prescribing behavior.

Findings

There is no universal set of dimensions and items that determine service quality in manufacturing industries, especially at the manufacturer–doctor interface of the pharmaceutical supply chain though service quality plays a very important role in affecting the performance of manufacturing industries. The critical factors affecting the quality of service for a pharmaceutical company at the manufacturer–doctor interface of the supply chain were identified, and its impact on doctor’s satisfaction and their prescribing behavior were studied.

Research limitations/implications

This research contributes to the development of service quality scale for measuring service quality in pharmaceutical manufacturing company, especially with reference to manufacturer–doctor interface of the supply chain which was not thoroughly explored earlier. A model was developed showing the positive relationship between service quality and doctor’s satisfaction and doctor’s prescribing behavior in pharmaceutical supply chain which is a new concept not proved experimentally.

Practical implications

The study is very useful for the pharmaceutical manufacturing companies to identify the service quality factors affecting doctor’s satisfaction and their prescribing behavior thereby leading to development of new measures for improving the performance of the pharmaceutical supply chain. This study can lead to identification of problems involved in pharmaceutical supply chain and also leads to generation of new ideas and development of new concepts for influencing doctor’s satisfaction and doctor’s prescribing behavior which in turn can help in providing better health.

Social implications

This study actually has a direct impact on the society. If factors affecting doctor’s satisfaction and prescribing behavior are identified automatically, the end consumer, i.e. patient, can be satisfied in a better way, and better medical care can be provided. If doctor’s problems are identified, then better solutions can be provided to patients; this in turn has a lot of positive impact on the pharmaceutical company and society in general.

Originality/value

This research will act as a base for generating ideas relating to how quality service provided by a company will have an impact on doctor’s satisfaction and his prescribing behavior in pharmaceutical supply chain .To the best of the authors’ knowledge, this study is the first of its kind of the conceptual aspects of service quality, satisfaction and loyalty explained in terms of pharmaceutical supply chain as service quality, doctor’s satisfaction and doctor’s prescribing behavior and proved experimentally.

Pharmacists' viewpoint towards their professional role in healthcare system: a survey of hospital settings of Pakistan

BACKGROUND

Pharmacy service is an essential part of a healthcare system. The profession of pharmacy is well recognized and is practiced to its full potential in developed countries however, it is underutilized in developing countries such as Pakistan. The recognition of pharmacist's role as healthcare professional is limited. This study aimed to document pharmacists' attitude towards their role in Pakistan's healthcare system, their experience with doctors and their perceptions towards involvement in medicines management.

METHODS

A 4-month cross-sectional survey (Jan - Apr 18) was conducted targeting pharmacists practising in 26 tertiary care hospitals across Pakistan using a developed and validated questionnaire in both Urdu/English languages. Chi square (χ²) test was used to report any associations between independent variables, i.e., education, type of hospital and work experience and, dependent variables, i.e., pharmacists' attitudes, experience, and perception. A p-value of ≤0.01 with value of Cramer's V ≥ 0.3 was considered cut-off for establishing statistical significance. The study was approved by ethical committee and local hospital committees.

RESULTS

Three hundred ninety-six questionnaires were returned out of 500, i.e., response rate = 87.9%. Most participants (92.2%) interacted with doctors at least once daily. Most interactions were related to drug availability inquiry (72.5%). Most pharmacists (91.4%) mentioned that pharmacy duties are mostly clinical in nature. 93.4% of the respondents indicated that pharmacists are reliable source of information regarding general medicines. Furthermore, 87.4% reasoned inadequate training for not being able to discuss issues of clinical nature with doctors.

CONCLUSION

Pharmacists were willing to perform their duties and provide healthcare benefits to patients however, they seemed sceptical of advanced clinical pharmacy roles such as intervening in prescriptions and medication therapy, consultations and prescribing. There is a need to increase awareness regarding pharmacist's role. Therefore, it would be helpful if trainings and seminars are conducted on the importance of clinical pharmacy to improve the pharmacy services in Pakistan's healthcare system.

Classification and positioning of TQM practices for implementation in steel industries

Purpose

The purpose of this paper is to classify the total quality management (TQM) practices and position them based on their importance in the implementation of TQM in steel industries for obtaining improved business performance and customer satisfaction.

Design/methodology/approach

The study undergoes a deep literature review to recognise the TQM practices necessary for the implementation of TQM in the steel industry. The identified 17 practices were grouped under three activities such as “breakthrough activities”, “improvement activities” and “routine operational and maintenance activities” with experts’ suggestion. The positioning of 17 TQM practices and 3 activities of TQM was done using an analytical hierarchy process (AHP) technique as per their relevance in TQM implementation.

Findings

The findings of the research show that though all the 17 practices and 3 activities of TQM play a vital role in the successful implementation of TQM in steel industries, breakthrough activities have gained more weightage as compared to the other two activities. Top management commitment, quality system and continuous improvement are relatively more important than the other practices.

Research limitations/implications

The research has limitation analogous to the AHP technique. The technique considers all the sub-sets of each nod to be independent from each other, whereas in real world this does not stand true.

Practical implications

The study positions the TQM practices and activities on the basis of their relevance in TQM implementation in the steel industry, thus helping the managers in understanding which practice has to give how much importance for TQM implementation in steel industries. By following the practices according to the weights, the managers can achieve the results desired from TQM implementation.

Originality/value

The study gives the implementation priorities of TQM practices in the steel industry. To the best knowledge of researcher, it is the first study in the steel sector for TQM implementation. The lacuna was reported by the literature, and the researcher has made an attempt to fill that gap.

Total quality management: a critical literature review using Pareto analysis

Purpose

Due to its impact on business performance total quality management (TQM) has gained a lot of importance by businessmen, managers, practitioners, and research scholars over the last 20 years. Therefore, the purpose of this paper is to critically assess the literature on TQM and find out the areas where future research is required.

Design/methodology/approach

To achieve this purpose the articles published in the last 20 years were studied in a systematic way and a snapshot of the same was prepared in the tabular format with points such as year and journal of publication, application and country, statistical method used, and findings of the study such as practices and impact of TQM. After identifying the practices and impact of TQM a quality tool “Pareto Analysis” was applied on them for development of the model.

Findings

The findings provide the practices of TQM and its impact on the performance of a business. The gaps from the literature have been identified and areas for future research have been suggested. On the basis of the findings a generalized framework of TQM has been suggested which can be applicable irrespective of the sector.

Practical implications

The research will help academicians and future researchers to have a clear understanding of TQM in different rosters.

Originality/value

Ample literature is available on TQM but in the best knowledge of authors no study has taken place to integrate the reviews and findings of 102 research papers of the last two decades.

TQM and organizational performance using the balanced scorecard approach

Purpose

The purpose of this paper is to examine the relationship between the implementation of total quality management (TQM) and organizational performance, using the balanced scorecard (BSC) approach.

Design/methodology/approach

In order to investigate the relationship between TQM and BSC, a questionnaire was developed and distributed to 30 largest pharmaceutical distribution companies in Iran. Structural equation modeling was used to evaluate the measurement model and to test the research hypotheses using the data from 933 completed questionnaires.

Findings

The results supported the research model and revealed that TQM implementation can positively and significantly influence the BSC and its four perspectives.

Practical implications

Considering the strong association between TQM and all four perspectives of organizational performance (BSC), managers should strongly leverage the implementation of TQM practices in order to reach their strategic objectives.

Originality/value

This study is the first empirical study conducted on the association of TQM and BSC in the pharmaceutical industry. The findings of this study provide strong evidence supporting the implementation of TQM in the pharmaceutical context.

TOPSIS approach to prioritize critical success factors of TQM

Purpose

– The pharmaceutical industry has a critical impact on health promotion. It is essential to identify and prioritize the critical success factors (CSFs) within this industry to ensure successful implementation of total quality management (TQM). Therefore, the purpose of this paper is to identify and prioritize CSFs that affect TQM successful implementation in the pharmaceutical industry.

Design/methodology/approach

– Based on a thorough review of the literature and building on the earlier studies, a valid questionnaire was developed and sent to 320 managers in pharmaceutical sector. In total, 210 completed questionnaires were returned. The technique for order of preference by similarity to ideal solution (TOPSIS) was used to rank and prioritize CSFs.

Findings

– Results of the data analyses showed that information and analysis, management commitment, relationship with suppliers, and customer focus are the top four CSFs for the successful implementation of TQM in the pharmaceutical sector.

Originality/value

– Using TOPSIS approach, this is the first study that determines CSFs that have impact on successful implementation of TQM in the pharmaceutical sector. There have been limited studies investigating the CSFs in developing countries. The findings will be useful in helping manager to successfully implement TQM in emerging markets. The approach will help future studies to examine the impact of successful implementation of TQM on firm performance in other industries and in emerging markets.

The state of the journal: four years of publication

Purpose

The purpose of this paper is to reflect on the development and progression of the International Journal of Pharmaceutical and Healthcare Marketing and include comments on its future direction.

Design/methodology/approach

The paper takes the approach of an essay format.

Findings

The journal has published key papers in pharmaceutical and healthcare research and continues to develop an interdisciplinary character with contributions from scholarly and practice‐oriented sources.

Originality/value

The paper provides a contemporary appraisal of the status and positioning of the journal.