Developing a theory of total quality management - using the delphi technique

Quality has become an important determinant of competitiveness, to the point that it is now widely considered to be the foundation upon which other factors that contribute to competitive advantage, such as cost, speed of delivery, reliability of delivery and flexibility, must be built. Total Quality Management (TQM) has emerged as a prominent tool for organisations in pursuit of lasting improvements in quality, business performance and, for introducing change. A large and increasing number of organisations are starting to adopt TQM in recognition of its strategic importance. The importance of quality is also recognised by governments and industrialists throughout the developed world. The increasing number of awards expounding the value of TQM is a manifestation of the importance placed on the concept. All the signs indicate that the adoption of TQM is unlikely to diminish. Despite the interest, and the attention of many researchers and writers, TQM remains an imprecise subject. Examination of the large volume ofTQM related publications revealed that the literature is dominated by prescription and anecdote and highlights a lack of empirical work. A number of broad areas can be identified where it would appear that the literature has remained irreconcilable or under-developed. Moreover, it appears that the domination of TQM's development by practitioners has resulted in the absence of a theoretical grounding for TQM. These findings pointed to the need for substantive research to extend the current knowledge and understanding of TQM and to support its future development. The aim of this study was to address these broad areas and to fill an important gap in the existing knowledge and understanding ofTQM. More specifically, the aim was to develop an inductive theory o/TQM based on the expert opinion o/practitioners in the leading organisations. For the purpose of this study "theory" is defined as comprising three components: concepts, relationships and underlying logic. The study achieves this aim through the explication of the views of a sample of best practice TQM organisations representing a wide range of industry sectors. The design of the research was motivated by the distinctive shortfalls in the domain and strategy of previous TQM research. After evaluating the methodological options available, the Delphi method was identified as the most relevant and practical research technique. A modified Delphi survey comprising four planned rounds of postal questionnaires was used to collect the study's primary data. Conversion of this primary data into the proposed theory involved a profound process of interpretation and refinement which centred around explaining the logic underlying the salient TQM variables that were identified. Exploratory factor analysis was used to aid the interpretive processes. The salient variables were heuristically organised into a set ofTQM concepts and the interrelationship digraph technique was used to facilitate the extraction of the salient relationships between the concepts from the core body of underlying logic. The study identifies nine key concepts of the TQM approach and puts forward seven key propositions that explain the important relationships between them. The three core concepts are Customer Focus, Internal Collaboration and DynamiclEnergetic Leadership. The study corroborates the belief evident in the more recent TQM literature that TQM is a management philosophy. The idea that TQM is a "management fad" is refuted. The study provides strong evidence that TQM is universally applicable to 'for profit' organisations. It is also shown that the impact of TQM goes beyond management practice. TQM is undeniably concerned with the attitude, the values and the behaviour of all of the members of an organisation. The primary data in this study came from a sample that comprised 'for profit' organisations only. The proposed theory has therefore been derived in this context. This represents the main boundary to which generalisation can be taken. An objective of the study was to test the proposed concepts in order to refine the proposed theory. This objective was only partially met due to unexpected diversity in some of the qualitative primary data. This study has expanded understanding by contributing an inductively developed theory of TQM to the present knowledge. This interpretation of TQM, which identifies the logic underlying the relevance of the important TQM variables, transcends a description of TQM which is specified purely in terms of the relevant variables. The study also contributes an understanding ofTQM that explicitly distinguishes its purpose from its mechanics. The core practical contribution of the study is that it can act as a conduit to improve practitioner understanding. Practitioners seeking to improve the performance of their organisation to a position of sustainable competitive advantage through the introduction of a TQM approach can have an understanding of TQM that is based on proven practice. The study also contributes a set ofTQM concepts and an interrelationship digraph that can act as a base-line from which existing TQM approaches may be critically examined. Furthermore, the study contributes a theory of TQM to the development of a sound theoretical framework that can systematically and appropriately guide future research

Embedding interprofessional education in an Australian university: an exploration of key leadership practices

Little has been published on successful leadership practices in interprofessional education despite these practices being the focus of contemporary leadership theories. This thesis aims to advance our understanding of leadership in the higher education context. The research explores the impact of several leadership practices in facilitating the embedding of interprofessional education into health sciences curricula in an Australian university. A model of leadership in interprofessional education has been developed from the findings

Application of knowledge management principles to support maintenance strategies in healthcare organisations

Healthcare is a vital service that touches people's lives on a daily basis by providing treatment and resolving patients' health problems through the staff. Human lives are ultimately dependent on the skilled hands of the staff and those who manage the infrastructure that supports the daily operations of the service, making it a compelling reason for a dedicated research study. However, the UK healthcare sector is undergoing rapid changes, driven by rising costs, technological advancements, changing patient expectations, and increasing pressure to deliver sustainable healthcare. With the global rise in healthcare challenges, the need for sustainable healthcare delivery has become imperative. Sustainable healthcare delivery requires the integration of various practices that enhance the efficiency and effectiveness of healthcare infrastructural assets. One critical area that requires attention is the management of healthcare facilities. Healthcare facilitiesis considered one of the core elements in the delivery of effective healthcare services, as shortcomings in the provision of facilities management (FM) services in hospitals may have much more drastic negative effects than in any other general forms of buildings. An essential element in healthcare FM is linked to the relationship between action and knowledge. With a full sense of understanding of infrastructural assets, it is possible to improve, manage and make buildings suitable to the needs of users and to ensure the functionality of the structure and processes. The premise of FM is that an organisation's effectiveness and efficiency are linked to the physical environment in which it operates and that improving the environment can result in direct benefits in operational performance. The goal of healthcare FM is to support the achievement of organisational mission and goals by designing and managing space and infrastructural assets in the best combination of suitability, efficiency, and cost. In operational terms, performance refers to how well a building contributes to fulfilling its intended functions. Therefore, comprehensive deployment of efficient FM approaches is essential for ensuring quality healthcare provision while positively impacting overall patient experiences. In this regard, incorporating knowledge management (KM) principles into hospitals' FM processes contributes significantly to ensuring sustainable healthcare provision and enhancement of patient experiences. Organisations implementing KM principles are better positioned to navigate the constantly evolving business ecosystem easily. Furthermore, KM is vital in processes and service improvement, strategic decision-making, and organisational adaptation and renewal. In this regard, KM principles can be applied to improve hospital FM, thereby ensuring sustainable healthcare delivery. Knowledge management assumes that organisations that manage their organisational and individual knowledge more effectively will be able to cope more successfully with the challenges of the new business ecosystem. There is also the argument that KM plays a crucial role in improving processes and services, strategic decision-making, and adapting and renewing an organisation. The goal of KM is to aid action – providing "a knowledge pull" rather than the information overload most people experience in healthcare FM. Other motivations for seeking better KM in healthcare FM include patient safety, evidence-based care, and cost efficiency as the dominant drivers. The most evidence exists for the success of such approaches at knowledge bottlenecks, such as infection prevention and control, working safely, compliances, automated systems and reminders, and recall based on best practices. The ability to cultivate, nurture and maximise knowledge at multiple levels and in multiple contexts is one of the most significant challenges for those responsible for KM. However, despite the potential benefits, applying KM principles in hospital facilities is still limited. There is a lack of understanding of how KM can be effectively applied in this context, and few studies have explored the potential challenges and opportunities associated with implementing KM principles in hospitals facilities for sustainable healthcare delivery. This study explores applying KM principles to support maintenance strategies in healthcare organisations. The study also explores the challenges and opportunities, for healthcare organisations and FM practitioners, in operationalising a framework which draws the interconnectedness between healthcare. The study begins by defining healthcare FM and its importance in the healthcare industry. It then discusses the concept of KM and the different types of knowledge that are relevant in the healthcare FM sector. The study also examines the challenges that healthcare FM face in managing knowledge and how the application of KM principles can help to overcome these challenges. The study then explores the different KM strategies that can be applied in healthcare FM. The KM benefits include improved patient outcomes, reduced costs, increased efficiency, and enhanced collaboration among healthcare professionals. Additionally, issues like creating a culture of innovation, technology, and benchmarking are considered. In addition, a framework that integrates the essential concepts of KM in healthcare FM will be presented and discussed. The field of KM is introduced as a complex adaptive system with numerous possibilities and challenges. In this context, and in consideration of healthcare FM, five objectives have been formulated to achieve the research aim. As part of the research, a number of objectives will be evaluated, including appraising the concept of KM and how knowledge is created, stored, transferred, and utilised in healthcare FM, evaluating the impact of organisational structure on job satisfaction as well as exploring how cultural differences impact knowledge sharing and performance in healthcare FM organisations. This study uses a combination of qualitative methods, such as meetings, observations, document analysis (internal and external), and semi-structured interviews, to discover the subjective experiences of healthcare FM employees and to understand the phenomenon within a real-world context and attitudes of healthcare FM as the data collection method, using open questions to allow probing where appropriate and facilitating KM development in the delivery and practice of healthcare FM. The study describes the research methodology using the theoretical concept of the "research onion". The qualitative research was conducted in the NHS acute and non-acute hospitals in Northwest England. Findings from the research study revealed that while the concept of KM has grown significantly in recent years, KM in healthcare FM has received little or no attention. The target population was fifty (five FM directors, five academics, five industry experts, ten managers, ten supervisors, five team leaders and ten operatives). These seven groups were purposively selected as the target population because they play a crucial role in KM enhancement in healthcare FM. Face-to-face interviews were conducted with all participants based on their pre-determined availability. Out of the 50-target population, only 25 were successfully interviewed to the point of saturation. Data collected from the interview were coded and analysed using NVivo to identify themes and patterns related to KM in healthcare FM. The study is divided into eight major sections. First, it discusses literature findings regarding healthcare FM and KM, including underlying trends in FM, KM in general, and KM in healthcare FM. Second, the research establishes the study's methodology, introducing the five research objectives, questions and hypothesis. The chapter introduces the literature on methodology elements, including philosophical views and inquiry strategies. The interview and data analysis look at the feedback from the interviews. Lastly, a conclusion and recommendation summarise the research objectives and suggest further research. Overall, this study highlights the importance of KM in healthcare FM and provides insights for healthcare FM directors, managers, supervisors, academia, researchers and operatives on effectively leveraging knowledge to improve patient care and organisational effectiveness

EUROPE - The Strategic Choices

It is a great pleasure to introduce the second volume of the RECiFER Eurofutures Publication Series. Like the first volume the second volume is dedicated to the European Parliament as a challenging inquiry into the Future of Europe. The rich and differented content of the volume — “Europe — the strategic choices” — was created by innovative and competent effort of forty Authors representing eminent international organizations and academic institutions

CCCC Kick the Habit: A UN Guide to Climate Neutrality

This book describes the importance of climate neutrality in order to reduce the impact of global warming. Climate neutrality requires reduction in emissions of greenhouse gases, such as carbon dioxide, methane, nitrous oxide, and others

Rethinking the law school

Law, by its very nature, tends to think locally, not globally. This book has a broader scope in terms of the range of nations and offers a succinct journey through law schools on different continents and subject matters. It covers education, research, impact and societal outreach, and governance. It illustrates that law schools throughout the world have much in common in terms of values, duties, challenges, ambitions and hopes. It provides insights into these aspirations, whilst presenting a thought provoking discussion for a more global agenda on the future of law schools. Written from the perspective of a former dean, the book offers a unique understanding of the challenges facing legal education and research