Assessment of TQM implementation level in Palestinian healthcare organizations

Association between war-related traumatic events and blood pressure trajectory: a population-based study among the mid-aged and older Palestinian adults living in Gaza

Background

Little is known regarding health status in an environment characterized by instability and ongoing war risks. This study investigated hypertension disease burden and associations of war-related traumatic events with blood pressure (BP) trajectory over time amongst mid-aged and older Palestinian adults in Gaza Strip.

Methods

From nine primary healthcare centers, medical records between 2013 and 2019 were collected for 1,000 mid-aged and older Palestinian adults living in Gaza. Multinomial logistic regression analysis examined associations between war-related traumatic events and BP trajectories derived using latent class trajectory analysis (LCTA).

Results

The prevalence of self-reported injury (of participants or their family members), death of a family member, and violence due to house bombing was 51.4%, 54.1%, and 66.5%, respectively. In total, 22.4% and 21.4% of participants had constant-very-high (CVH) systolic BP (SBP) (>160 mmHg) and diastolic BP (DBP) (>95 mmHg), and normal-stable SBP and DBP was found only 54.9% and 52.6%, respectively. Injury (participants or family members), death of a family member, and violence due to house bombing during wars were associated with CVH SBP with odds ratios [95 CI, OR = 1.79 (1.28-2.48), 1.90 (1.36-2.65), and 1.44 (1.01-2.05)], respectively. The corresponding figures were [95 CI, OR = 1.92 (1.36-2.71), 1.90 (1.35-2.68), and 1.62 (1.13-2.38)] for CVH DBP. Living in debt was positively associated with CVH SBP, [95 CI, OR = 2.49 (1.73-3.60)] and CVH DBP, [95 CI, OR = 2.37 (1.63-3.45)].

Conclusion

The disease burden related to war-related traumatic events is high and positively related to adverse BP trajectory among the mid-aged and older Palestinians living in Gaza. Intervention programs are needed to manage and prevent chronic diseases in this vulnerable population.

The importance of service design and information and analysis in enhancing organizational performance through a mechanism of organizational excellence in public sector organizations

Purpose

The study aims to examine the joint effect of service design (SD), information and analysis (IA) and organizational performance through the mechanism of organizational excellence.

Design/methodology/approach

To achieve the goal of this study through the hypothesized model, a survey questionnaire research design was employed. The data were collected from Dubai Police organization. Out of 550 questionnaires, 320 questionnaires were returned. The partial least square structural equation modeling (PLS-SEM) approach was used to analyze the data for measurement and structural models.

Findings

The statistical results confirmed the positive and significant effects of IA on organizational excellence and excellence on organizational performance. The mediation role of organizational excellence between IA and organizational performance was also confirmed.

Research limitations/implications

Throughout this study, further details and valuable implications have been discussed. Findings provide several practical implications. Findings also help practitioners and managers make proper decisions when implementing SD, IA and excellence practices in their organizations. With the joint effect of SD, IA and organizational excellence, organizations can achieve maximum strong performance and remain in a competitive market.

Originality/value

This study is a unique empirical research study that examines the joint effect of SD, IA and excellence on performance relationships within the public sector in general and police organization in particular, which is limited especially in research of Middle East countries.

Exploring the impact of total quality management initiatives on construction industry projects in Pakistan

The impact of total quality management on organizational performance has been studied extensively, however, the impact of total quality management initiatives on project performance is an area of ongoing research. The key objective of this research is to explore the impact of total quality management initiatives on project performance in the construction industry of Pakistan. Data was collected from 326 personnel working at different management levels across some of the leading construction firms operating in Pakistan. Analysis revealed that operational focus, management commitment, and employee involvement were deemed as dominant total quality management factors affecting project performance in the construction industry. Mediation analysis revealed a significant relationship between employee involvement and project performance mediated by management commitment. Research limitations and directions for future research have also been identified.

An investigation of mediating factors for export–import business performance excellence: a systems perspective framework for Thailand

Purpose

The Baldrige criteria for assessing business performance excellence (BCPE) suggests a relationship among seven self-assessment categories. The purpose of this paper is to take an in-depth look at the BCPE by testing the causal relationship among categories grouped into four basic dimensions – driver triad, work core, outcomes, and brain centre. Identifying meaningful interrelationships for leaders helps them transform their organisations to achieve performance excellence.

Design/methodology/approach

A systems perspective supports system mapping for understanding meaningful interrelationships among dimensions and mediating factors affecting business performance excellence. A 35-item questionnaire designed to measure seven categories of the BCPE (version 2022–2023) was administered to export and import (EXIM) businesses across Thailand. Valid responses (n = 290) were analysed through SPSS and AMOS via structural equation modelling (SEM) to test the hypotheses and explore the influencing factors.

Findings

A strong systems perspective focus is essential for high organisational performance. The result reveals that all seven BCPE categories are significantly linked. In addition, mediation analysis (taking selected mediators) proved hypothesised cause-and-effect relationship as significant. The results demonstrate that the brain centre plays a crucial role in driving business success promulgating its influence within the model.

Research limitations/implications

This study provides the necessary backgrounding in systems perspectives confirming that the BCPE premises on a set of four basic dimensions: driver triad (leadership, strategy, and customers category), work core (workforce and operations category), brain centre (measurement, analysis, and knowledge management category), and outcomes (results category). These four dimensions define the essentials of an integrated management system. Further, the study shows that measurement, analysis, and knowledge management directly influenced customer focus, the highest coefficient path among the criterion in the Baldrige framework. This is the critical driver in predicting performance outcomes via meaningful feedback.

Practical implications

From a managerial point of view, the structured system management framework proposed provides a specific guide for the alignment in quality management, which can change its practice in business management and award assessment. The results evidence a significant relationship among driver triad, work core, brain centre, and outcomes to propose a form of system management. The findings help award examiners or business practitioners provide system mapping for evaluation – i.e. how well organisations meet their goals and how best to prepare feedback reports to applicants that paint meaningful pictures.

Originality/value

This study promotes a systems perspective when approaching business performance excellence, whereas other studies provide evidence to individual relationships. Moreover, the examined interrelationship among dimensions – driver triad, work core, outcomes, and brain centre – provide novel system mapping to guide managers, practitioners, or award examiners in evaluating quality management practice.

The impact of organisational communication satisfaction on health care professionals' work engagement

AIM

To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs).

BACKGROUND

Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations.

METHODS

A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data.

RESULTS

The HCPs reported a moderate level of OCS (M = 4.96, SD = 0.94) and work engagement (M = 5.56, SD = 0.96). The impact of OCS on work engagement was found to be positive and statistically significant (β = .524, p < .05). No significant difference was revealed in level of OCS or work engagement among the HCPs according to their job categories. Only years of experience significantly influenced their OCS.

CONCLUSION

Improving HCPs' satisfaction with organisational communication is vital in enhancing their work engagement and, ultimately, sustaining health care manpower.

IMPLICATIONS FOR NURSING MANAGEMENT

Strategies for improving the quantity and quality of organisational communication must be prioritized to strengthen work engagement among HCPs. These strategies include management's role in and ways of communicating essential information about their organisations to HCPs.

Barriers to Total Quality Management for sustainability in Indian organizations

Purpose

The paper aims to identify key human and operational focused barriers to the implementation of Total Quality Management (TQM). It develops a comprehensive structural relationship between various barriers to successfully implement TQM for sustainability in Indian organizations.

Design/methodology/approach

With the help of expert opinions and extant literature review, we identified the case of TQM failure companies and barriers to implement TQM effectively. Interpretive Structural Modeling (ISM) and fuzzy MICMAC techniques are employed to develop a structural model and the identified barriers are categorized based on their dependence and driving power in the various categories.

Findings

From the intensive case analysis, we identify fourteen barriers that constrain the successful implementation of TQM. The findings also provide a hierarchy of barriers in which the absence of top management involvement and ineffective leadership are the human barriers having the highest dependence.

Research limitations/implications

The critical inputs show the implementation of TQM in the firms being more proactive and well prepared in the selected five companies. The study's emphasis on barriers will help organizations in implementing TQM for better sustainability in an organizational context.

Originality/value

In the successful implementation of TQM, barriers need to be identified because failure has often eliminated the organizations from the market. Thus, TQM is the source of strength to achieve higher productivity, profitability, and sustainable business performance. The barriers must be identified to improve organizational performance to contribute to sustainable development.

Measuring the impact of soft and hard total quality management factors on customer behavior based on the role of innovation and continuous improvement

Purpose

Total quality management (TQM) is a part of the total quality assurance perspective. This system, which is considered as a type of managerial philosophy, employs all organizational levels to constantly ameliorate the quality of goods and service. The purpose of this paper is to measure the effect of hard and soft TQM factors on the behavior of customers based on the role of innovation and continuous improvement.

Design/methodology/approach

The research model was extracted from TQM variables in hard and soft parts, customer behavior, innovation and continuous improvement by reviewing the literature and research background. Based on this, a questionnaire was prepared and then, distributed among the statistical population including 374 project managers, quality assurance managers as well as quality control managers by using simple random sampling. All sub-criteria of questionnaire were determined using Delphi technique, to test the research model. Having gathered the questionnaire, the hypotheses were analyzed by using structural equation modeling and AMOS software.

Findings

According to the statistical analyses, TQM has a significant effect on customer behavior through continuous improvement of the quality and innovation. Also, regarding the obtained results, the highest effect was related to the effect of hard TQM factors on customer behavior through innovation as 0.62. Furtheremore, TQM soft factors such as human resource management have significant effect on customer behavior through quality improvement and innovation. Moreover, TQM hard factors are effective on customer behavior through quality improvement and innovation.

Research limitations/implications

The questionnaire was designed and distributed in order to evaluate the hypotheses in this study. One of the primary rationales behind utilizing this method instead of other methods such as interview was high geographical distribution of organizations. Using other moderator variables such as knowledge management, customer knowledge management and customer emotions can be conducted in the future in this area.

Practical implications

Changing the organizational relationships from task orientation to the process orientation, and controlling the organizational performance by measuring process innovations and improvements, while paying attention to the customer satisfaction system are suggested in this paper. These implications should be implemented in construction projects by department of project management office. Furtheremore, providing different communication for receiving the opinions of the customer and imposing them in the product and service, paying attention to the response system and customer complaint, implementation of this process in the organization, and having a process approach for presenting and developing services are the main subjects in this regard.

Originality/value

Unlike previous studies on this subject, a structural equation model is used for assessing unobservable latent constructs and their related interrelationship in measuring the impact of TQM factors. Focusing on customer behavior which is a broader domain than customer satisfation through continuous improvement of the quality and innovation is another value of this research.

An empirical study to investigate the effects of critical factors on TQM implementation in the garment industry in Bangladesh

Purpose

The purpose of this paper is to investigate the factors that enable total quality management (TQM) implementation in the readymade garment (RMG) sector of Bangladesh. More specifically, the present study is a supplement of the previous call from research to investigate the TQM-enabling factors from a broader aspect of organizational change.

Design/methodology/approach

This study was conducted through an online survey, followed by phone calls. Data were collected using a questionnaire survey with 256 respondents of the Bangladeshi RMG sector. The TQM-enabling factors were divided into five distinct groups, based on strategic or overall changes required within an organization for TQM implementation. A theoretical research model was created to investigate the contingency of various TQM-enabling factors. Structural equation modeling (SEM) was applied to confirm the factor that enabled TQM implementation in the RMG sector of Bangladesh.

Findings

The main finding of this study shows that structural, strategic, contextual and human resource-enabling factors are significant to TQM implementation in the Bangladeshi RMG sector.

Research limitations/implications

This study has been completed in single time frame. Therefore, consideration of the time factor is completely ignored in this research. Furthermore, understanding of TQM-enabling factors in this research relied on quantitative findings only. Also, this study was limited to one industry and one geographic region. However, this study could determine whether data triangulation will provide a good perception on enabling factors and the methodology can be extended to other industries and regions.

Practical implications

This study provides a research methodology for other manufacturing industries that are planning to implement TQM in their organization. This research will contribute to the existing literature by examining the contingency of various TQM-enabling factors in the context of the Bangladeshi RMG sector, and it, therefore, provides direction to increase the success rate of TQM implementation. Furthermore, the research methodology can be used in other studies for variation of contextual variables such as size of the industry, developed or underdeveloped country and manufacturing or service industry.

Originality/value

The methodology used in this study can lead the way for other industries in the RMG sector that implements TQM in their organization. Also, this research further contributes to the existing literature by investigating the contingency of various TQM enabling factors in the context of the Bangladeshi RMG sector and developing associated strategies to raise success rate of TQM implementation.

Ranking model of total quality management enablers in healthcare establishments using the best-worst method

Purpose

Recent years have witnessed a significant rise in Indian healthcare establishments (HCEs) which indicate that there is a constant need to improve the healthcare quality services through the adoption and implementation of TQM enablers. The purpose of this paper is to identify such enablers and then propose a ranking model for TQM implementation in Indian HCEs for improved performance.

Design/methodology/approach

The study identifies 20 TQM enablers through comprehensive literature survey and expert’s opinion, and classifies them into five main categories. The prominence of these enablers is established using a recently developed novel multi-criteria decision making (MCDM) method, i.e. best-worst method (BWM). The importance of the various main category and sub-category enablers is decided on the basis of their weights which are determined by the BWM. In comparison to other MCDM methods, such as analytical hierarchy process, BWM requires relatively lesser comparison data and also provides consistent comparisons which results in both optimal and reliable weights of the enablers considered in this paper. Further, a sensitivity analysis is also carried out to ensure that the ranking (based on the optimal weights) of the various enablers is reliable and robust.

Findings

The results of this study reveal that out of five main category enablers, the “leadership-based enablers (E1)” and the “continuous improvement based enablers (E5)” are the most and the least important enablers, respectively. Similarly, among the 20 sub-category enablers, “quality leadership and role of physicians (E14)” and “performing regular survey of customer satisfaction and quality audit (E52)” are the most and the least dominating sub-category enablers, respectively.

Research limitations/implications

This study does not explore the interrelationship between the various TQM enablers and also does not evaluate performance of the various HCEs based on the weights of the enablers.

Practical implications

The priority of the TQM enablers determined in this paper enables decision makers to understand their influence on successful implementation of the TQM principles and policies in HCEs leading to an overall improvement in the system’s performance.

Originality/value

This study identifies the various TQM enablers in HCEs and categorizes them into five main categories and ranks them using the BWM. The findings of this research are quite useful for management of the HCEs to properly understand the relative importance of these enablers so that managers can formulate an effective and efficient strategy for their easy and smooth implementation which is necessary for continuous improvement.

Can Leadership Enhance Patient Satisfaction? Assessing the Role of Administrative and Medical Quality

This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria.

Quality management principles and school quality

Purpose

The purpose of this paper is to test the relationship of process approach (PA), customer focus approach (CFA) and school quality with the moderation of professional certification of school principal to fill the gap of quality management practices in private schools.

Design/methodology/approach

Study applied quantitative design with the sample of 401 principals of private schools. Questionnaires were adapted from different studies, and pilot study was carried out. Confirmatory factor analysis was done along with structural equation modeling.

Findings

Results indicate that the process approach has a significant effect on functional quality and academic quality of schools. Customer focus approach medicates the relationship of process approach and functional quality. The study found no evidence of the relationship of moderation of professional certification of school principal with process approach, functional quality and academic quality.

Practical implications

Study contributed through the generation of new dimensions of school quality, putting professional degree of school principal as a moderator and by providing basis to understand the implementation of quality management system in schools. The outcomes of study will guide school managers to implement the process management approach to improve the school quality.

Originality/value

Originality of the study is defined in three ways; first, it is first study that examines the relationship of process approach, customer focus approach and school quality with the moderation of professional certification of principal. Second, it chooses “single” schools that have not been subject of any quantitative research exclusively. Third, it is a first attempt to examine the working of private schools in Pakistan with respect to quality management principles.

Prioritizing the barriers of TQM implementation from the perspective of garment sector in developing countries

Purpose

The purpose of this paper is to investigate the relative importance of different total quality management (TQM) implementation barriers in the context of Readymade Garment (RMG) industries in Bangladesh. Present study has developed a hierarchical framework of several TQM barriers to assess their importance. Expert opinions from RMG industries have been taken to evaluate the importance of one barrier over another.

Design/methodology/approach

Methodology adopted in this study to find out the rank of different TQM barriers is fuzzy analytic hierarchy process.

Findings

The study shows that, according to order, inappropriate planning of TQM implementation program, lack of financial support, lack of employee training, lack of empowerment of employees, lack of sufficient physical resources, etc. are critical barriers and hampering the successful implementation of TQM program in this sector.

Research limitations/implications

This study has both theoretical and practical implications. It has found out strong and weak contribution of different barriers during TQM implementation. Therefore, this finding will strengthen the knowledge of successful implementation of TQM and will further enrich the existing literature in the context of manufacturing industries in developing countries. Moreover, this finding will also help the decision makers in preparing an effective plan for successful implementation of TQM by utilizing limited resources.

Practical implications

Moreover, our results will aid the managers of RMG sector to find the weight of importance of different barriers. Accordingly, they will make a plan to overcome the major TQM barriers which will increase the success rate of TQM implementation. Every Successful program will bring business excellence. These findings could be a guideline for TQM implementation program in developing countries.

Originality/value

Present study possesses some significant values. First, so far our knowledge go, no other study has developed a hierarchical structure of TQM barrier on the basis of overall change needed within the organization for TQM implementation. Second, this study could be a good guideline for TQM implementation program in RMG sector in developing countries.