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The paper sets forth and examines the assumptions underlying two global ideas – world class and best practices – and their application to (higher) education and health organizations. Our basic (ex-ante) assumption is that both sectors are influenced by organizational fields that embody these ideas. However, we also assume that these sectors differ, and thus, that one should find between sector variations in the influence of such ideas. The findings suggest that both sectors have been affected by hegemonic ideas, yet in rather different ways, and that these ideas, particularly the metrics being used, pose different challenges in the two sectors.

Purpose: The aim of the study is to consider the use of the Internet as a potential facilitator of positive health-related perceptions. Specifically, we propose that online health information seeking fosters positive perceptions of health. Using path modeling, we theorized several mechanisms through which information seeking could be conducive to positive health perceptions, which we conceptualized into the following four dimensions: (1) sense of empowerment in managing health, (2) self-reported ability to take better care of health, (3) sense of improved health-related quality of life, and (4) self-reported improvement of health.

Methodology: Our sample consisted of respondents who have used the Internet as a resource for health information (n = 710), drawn from the largest national probability-based online research panel. Our comparison subsample consisted of older respondents (age ≥ 60; n = 194). We used Internet-specific measures and employed structural equation models (SEM) to estimate the direct, indirect, and total effects of health-related use of the Internet on subjective health perceptions. Based on our review of the literature, competent health communication with healthcare providers and sense of empowerment in managing personal health were modeled as mediator variables. We assessed whether the proposed mediational relationships, if significant, differed across our indicators of positive health perceptions and whether any differential associations were observed among older adults. We run parallel models for each indicator of positive health perception.

Findings: Provider-patient communication informed by the Internet resources were perceived to impart a greater sense of empowerment to manage health among our respondents, which in turn, was associated with perceived contributions to better self-reported ability to provide self-care, increased health-related quality of life, and improvement in self-reported health. The SEM results revealed a good fit with our full sample and subsample.

Research Implications: Conceptualization of the multidimensional aspects of online health information seeking with separate multi-indicator analyses of the outcome variable is important to further our understanding of how technology may impact the pathways involved in influencing health perceptions and as a result health outcomes.

The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and hospital managers. This insight can enrich current intervention schemes used in health care to facilitate organisational change.

In this paper, the image theory of Alexander et al. on the known complex intergroup context of physicians and hospital managers is applied. The theory is operationalised in relative status, power, and goal incompatibility.

The data show the three variables are highly relevant and representative. Hospital managers see physicians as higher in professional status and power, and having different goals. Physicians see hospital managers to have higher power, lower status, and different goals. The study validates the applicability of the image theory in the Dutch hospital context. This results in a questionnaire suitable for performing a quick scan on the strength and direction of intergroup stereotyping within hospital organisations.

Data from the questionnaire give the opportunity to have insight in the way physicians and hospital managers perceive each other. This insight helps to focus attention on bottlenecks and possibilities in enhancing the co‐operation between physicians and hospital managers. Research on the relationship between physicians and hospital managers is scarce and mostly of a qualitative nature. This paper is executed in both qualitative and quantitative way, which enables us to empirically and statistically validate the data. The resulting questionnaire is applicable on an organisational intergroup level, while the focus in the extant literature is mostly on the interpersonal or intragroup level.

Accreditation and external peer review play important roles in assessing and improving healthcare quality worldwide. Evidence on the impact on the quality of care remains indecisive because of programme features and methodological research challenges. The purpose of this paper is to create a general methodological research framework to design future studies in this field.

A literature search on effects of external peer review and accreditation was conducted using PubMed/Medline, Embase and Web of Science. Three researchers independently screened the studies. Only original research papers that studied the impact on the quality of care were included. Studies were evaluated by their objectives and outcomes, study size and analysis entity (hospitals vs patients), theoretical framework, focus of the studied programme, heterogeneity of the study population and presence of a control group.

After careful selection 50 articles were included out of an initial 2,025 retrieved references. Analysis showed a wide variation in methodological characteristics. Most studies are performed cross-sectionally and results are not linked to the programme by a theoretical framework.

Based on the methodological characteristics of previous studies the authors propose a general research framework. This framework is intended to support the design of future research to evaluate the effects of accreditation and external peer review on the quality of care.

Purpose – Hospitals need to determine if an international patient department is a necessity to communicate with and manage international patients.

Design/Methodology/Approach – A benchmarking instrument was created to assess the level of professionalism in managing international patients, including reviewing and validating processes by two university hospitals, professionals, and an expert panel.

Findings – First, the differences between the hospitals depended on the will of the hospital to engage in such activities. Second, the differences depended on the embedding national context in which the hospital was situated. Further validation revealed the importance of other supportive services, such as cultural sensitivity and language. Finally, the microlevel phenomenon of international patient departments is placed within a macrolevel transnational health region development scheme.

Originality/Value – This study focused on the supply of services with respect to international patient departments, which could be related to efficiency and sustainability on a public health and health systems level.

The article's aim is to focus on the application of Six Sigma to minimise intraoperative and post-operative complications rates in a Turkish public hospital cataract surgery unit.

Implementing define-measure-analyse-improve and control (DMAIC) involves process mapping, fishbone diagrams and rigorous data-collection. Failure mode and effect analysis (FMEA), pareto diagrams, control charts and process capability analysis are applied to redress cataract surgery failure root causes.

Inefficient skills of assistant surgeons and technicians, low quality of IOLs used, wrong IOL placement, unsystematic sterilisation of surgery rooms and devices, and the unprioritising network system are found to be the critical drivers of intraoperative-operative and post-operative complications. Sigma level was increased from 2.60 to 3.75 subsequent to extensive training of assistant surgeons, ophthalmologists and technicians, better quality IOLs, systematic sterilisation and air-filtering, and the implementation of a more sophisticated network system.

This article shows that Six Sigma measurement and process improvement can become the impetus for cataract unit staff to rethink their process and reduce malpractices. Measuring, recording and reporting data regularly helps them to continuously monitor their overall process and deliver safer treatments.

This is the first Six Sigma ophthalmology study in Turkey.

The purpose of this paper is to explore the nature of research topics and methodologies employed in existing studies of quality management (QM) in research and development (R&D).

Using a systematic review methodology (SRM), this paper analyzes the literature to identify major themes, shortcomings, and key management practices.

The literature review reveals that researchers have mainly explored only how to implement quality principles and practices in the R&D environment and made little effort to explore other aspects of QM. QM practices discussed in the literature consist of top management commitment, R&D workforce involvement, training, a process‐based approach, teamwork and cross‐functional teams, fact‐based measurement and feedback mechanisms, R&D client focus, and good communication with suppliers. The dominant methodology employed in existing studies is either a case study or conceptual approach.

The paper provides researchers with valuable information about how this research area has evolved, what main themes have been discussed in the literature, and what management practices are effective in pursuing quality efforts in R&D. This study also makes a contribution to the development of quality theory in R&D by pointing out significant gaps in the current literature and suggesting important areas for future study.

The purpose of this paper is to discuss factors to support ISO 9001:2015 implementation. A framework for identification and prioritization of factors is applied in Brazilian power train suppliers (Tier 1). Brazil is the eighth largest vehicle manufacturer in the world.

The data analysis presented in this paper is grounded in an empirical study involving ISO 9001 certified Brazilian companies (47 plants) that supply auto parts to power train assembly plants. They represent almost 50 percent of the Tier 1 Brazilian power train suppliers. Data collection and analysis is performed with the participation of managers who are experts in quality management systems and ISO 9001. Analytic hierarchy process (AHP) supports the mixed methods approach. The data analysis is broken down by electrical components, machining, sub-components and small parts manufacturers.

The factors assessed are top management commitment, team commitment, training, responsibilities and authorities defined, schedule for implementation, quality culture, resource availability, integration between departments, level of bureaucracy as well as level of awareness regarding the ISO 9001 significance. A new factor was identified, which was not cited in the literature, quality staff reliability.

The research is applied to suppliers of powertrain manufacturers and could reflect other sectors. It is important observe that the automotive sector represents a microcosm of the organization in general and many production models stem from there.

Understanding the critical factors is important to ensure that managers allocate resources appropriately during implementation and maintenance of ISO 9001:2015.

Organizations around the world have, until 2018, to upgrade their quality systems to ISO 9001:2015 and the results of this paper can support strategies and decision making about that.

This paper evidences the relative importance among factors and ranks item in order of importance for ISO 9001:2015 implementation. Prior studies indicate the need to develop a mixed methods study to examine the role of the critical factors to support the ISO 9001:2015 implementation as done in this paper.

This study aims to examine the effect of human resource management (HRM) in mitigating negative effects of Lean management and Six Sigma (LM&SS) on employee well-being in health care. The authors subdivide well-being into three components: happiness, trust and health.

This is a cross-sectional, multisite survey study in internal service units of hospitals. Data analyzed using multivariate regression come from a sample of 1,886 survey respondents (42 units, N = 218 supervisors, N = 1,668 employees) in eight Dutch academic hospitals that have implemented LM&SS.

The present study findings show no or weak effects of LM&SS on the happiness and health component of employee well-being. In addition, the authors found a significant but weak direct positive effect (ß = 0.07) of the LM&SS bundle on the trusting relationships component of well-being. Therefore, moderating effects of HRM practices on the relationship between LM&SS and employee well-being seem less relevant because an existing relationship between LM&SS and employee well-being is a prerequisite for moderation (Hayes, 2009). There were unexpected side effects. Inspired by research that discusses direct effects of HRM on employee well-being, the authors tested this relationship and found that HRM has a direct positive effect on trust and happiness of employees in health care. For the health component of well-being, the present results show a weak negative effect of HRM.

This study results in a cautiously optimistic view about LM&SS in health care, provided that it is applied in a targeted manner (to improve the performance of their processes) and that HRM is strategically aligned with the goals of LM&SS to improve employees’ happiness and trusting relationships.

Unique features of the study are the focus on the consequences for employees’ well-being related to LM&SS in health care, the role of HRM in regard to this relationship and the participation of all eight Dutch academic hospitals in this research.