Organisational culture and TQM implementation: investigating the mediating influences of multidimensional employee readiness for change

Despite the robust evidence for the direct relationship between organisational culture (OC) and total quality management (TQM), the mechanisms underlying this relationship are not fully explored and have received little empirical attention. This paper extends prior TQM research in a novel way by building and then empirically testing a theoretical model that includes the mediating role of employee readiness for change dimensions (ERFCs) in the OC-TQM relationship. The paper adds value through its contextual originality in being one of the first studies that are conducted in Algeria; which has special ties with the EU geographically, politically and economically. The empirical data for this study was drawn by distributing a questionnaire to 226 middle managers of Algerian firms. Our findings support the mediating roles of two dimensions of ERFC, namely: self-efficacy (ERFC1) and personal valence (ERFC4) in the OC-TQM relationship. This indicates that the improvement in TQM implementation is not a direct consequence of supportive organisational culture but rather of self-efficacy and personal valence transferring the impact of group and adhocracy culture to TQM. To this effect, these results go beyond previous research and contribute significantly in explaining the underlying psychological mechanisms in the OC-TQM relationships model

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Effects of the organizational culture andknowledge exploration and exploitation onresults in the EFQM model framework

© 2022, Emerald Publishing Limited. This document is made available under the CC-BY-NC 4.0 license http://creativecommons.org/licenses/by-nc/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Journal of Knowledge Management. To access the final edited and published work see https://doi.org/10.1108/JKM-11-2021-0868Purpose – This paper aims to adopt Cameron and Quinn’s analysis of organizational culture and March’s learning framework to analyze the type of organizational culture (OC) that promotes learning competences and whether exploration and exploitation competences (ambidexterity) improve the European Foundation of Quality Management (EFQM) results (excellent results). In addition, this research tests if these competences exercise a mediating effect in the relationship between OC and performance. Design/methodology/approach – A model is proposed whose relationships have been tested using structural equations. The sample was obtained from the SABI database. Two hundred valid questionnaires were returned via a webpage, in which four managers from each of the 200 organizations responded. Findings – The results support the proposed relationships. Adhocracy, hierarchy and market culture have a positive relationship with excellent results. A hierarchical culture develops exploitation competences, and a market culture develops learning ambidexterity. Moreover, exploration and exploitation increase results. Finally, these two cultures indirectly influence results through exploration and exploitation competences. Research limitations/implications – The proposed model can help managers who implement the EFQM model to better understand how the culture of their organization promotes learning and how these two variables improve their performance. Practical implications – Because the EFQM model requires organizations to use a knowledge management system to enhance the effect of the enabliers criteria on excellent results, the managers of these companies must know that only market and hierarchy cultures are suitable for it. Besides, this study highlights the importance of two cultural values for the implementation of the EFQM Model and, therefore, to promote excellent results: market orientation and process control. Originality/value – This study fills an existing gap in the literature by combining exploitation, exploration, OC and EFQM results in a single model and highlights the importance of market orientation and process control for excellent results and knowledge exploration and exploitation

Organizational culture for total quality management

© 2012 Taylor & Francis. This document is made available under the CC-BY-NC 4.0 license http://creativecommons.org/licenses/by-nc/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Total Quality Management & Business Excellenc. To access the final edited and published work see http://dx.doi.org/10.1080/14783363.2012.707409This study aimed to find empirical evidence about the organisational culture that fits best with a total quality management (TQM) system. Based on the classification developed by Cameron and Quinn (1999), we propose an alternative type of culture: the ‘mixed culture’ or ‘culture for quality’, which would be between adhocratic and clan cultures. It would have a double orientation – external and internal – and it would promote flexibility. The results of an empirical study of 451 companies were analysed using hierarchical linear regression methodology. The measurement of constructs used in this research was based on a review of the literature. Empirical evidence was found for the positive impact of adhocratic culture on TQM. Contrary to expectations, the clan culture has no significant effect on TQM. In addition, the mixed culture or ‘culture for quality’ is the most appropriate for a TQM system. The expected effect of control-oriented cultures was also found. In this case, both the market culture and the hierarchical culture have a negative effect on the quality management system. Finally, it was found that TQM has a significant positive effect on business performance. This effect is consistent with the literature reviewed. Consequently, managers must know the rules, values and customs that actually exist in their organisations as well as those that are more consistent with quality management. Companies with a quality orientation should promote the values and beliefs of the clan and adhocracy cultures

La gestión de calidad: importancia de la cultura organizativa para el desarrollo de variables intangibles

La gestión de calidad total frecuentemente se relaciona con una mejora en los resultados organizativos. De las diferentes dimensiones que engloban este concepto, las denominadas «variables blandas» son las que la literatura afirma que tienen una mayor incidencia en los resultados empresariales. El objetivo de nuestro estudio consiste en analizar cómo las empresas con una mayor orientación hacia la calidad promueven el desarrollo de determinadas prácticas organizativas de carácter intangible que apoyen la obtención de beneficios. Algunas de estas variables determinantes de la orientación a la calidad son la cultura organizativa, la orientación al mercado, la gestión de recursos humanos y el liderazgo. No existe un marco empírico generalmente aceptado de las relaciones entre dichas variables. Este trabajo pretende avanzar en este sentido. El modelo propuesto está formado por relaciones directas y mediadas, cuyo análisis realizamos mediante ecuaciones estructurales. Los resultados ponen de manifiesto que una cultura que promueva la flexibilidad con una orientación mixta, interna y externa, facilita la orientación hacia la gestión de calidad total y la realización de prácticas, tales como una orientación al mercado, una adecuada gestión de recursos humanos y un estilo de liderazgo que apoyen el efecto en resultados de la gestión de calidad total en las empresas.Total quality management is frequently associated with an improvement in company performance. Within the different dimensions involved in this concept, the “soft variables” have shown to be the main responsible dimensions of these improvements in organizational performance in previous studies. The objective of the present study is to analyze how companies with a quality orientation promote the development of certain organizational practices of an intangible character related with the improvement in performance. Some of these variables are organizational culture, market orientation, human resource management, and leadership. There is no generally accepted empirical framework of the relationships between these variables. The proposed model consists of direct and mediated relationships between them, using a Structural Equation Modeling to test the model. Results show that a culture that promotes flexibility with a mixed internal and external orientation, tends to lead to total quality management, and the implementation of practices such as a customer orientation, human resources management, or a style of leadership that fosters the effect of total quality management in the company performance

Effects of the UNE 166.002 standards on the incremental and radical product innovation and organizational performance

© 2023, Emerald Publishing Limited. This document is made available under the CC-BY-NC 4.0 license https://creativecommons.org/licenses/by-nc/4.0/. This document is the Accepted version of a Published Work that appeared in final form in European Journal of Innovation Management. To access the final edited and published work see https://doi.org/10.1108/EJIM-06-2023-0451Purpose – The purpose of the study has been to fill the gap detected in the literature and to analyze whether the application of management of R&D in accordance with UNE 166002:2021 allows companies to obtain higher product innovation and better performance, specifically incremental and radical product innovations. Design/methodology/approach – The population used in this study included Spanish manufacturing organizations that were active, had more than 50 employees according to the SABI. The information was collected through a structured questionnaire previously tested using a company specializing in the sector under the supervision of the authors. A total of 1,154 companies were randomly contacted in order to reach an acceptable number of 225 valid questionnaires. The data analysis has been carried out with structural equation methodology. Findings – The results obtained with a sample of 225 companies show that the application of this standard for innovation management promotes the development of new products with incremental and radical changes, and improves business performance. It has also been found that incremental and radical product innovations mediate the relationship between this standard and performance. Research limitations/implications – Firstly, the survey is only addressed to the company’s operations manager. Secondly, the sample used is cross-sectional, whereas innovation management implies a broad implementation process. Practical implications – Managers must know that radical and incremental product innovation can improve the company’s operational performance. And the most direct implication of this work is that, those companies that are committed to the development of innovations should seriously consider the application of the principles incorporated in Standard 166,002, as an instrument that improves the results of innovation in the organization. Since this SIMS promotes both types of innovations, it improves results directly and indirectly through these product innovations. Originality/value – The existing literature indicates that no empirical study has focused on the benefits of this SIMSs for innovation and BP. This paper fills this gap detected in the literature and analyzes the results of the implementation of this standard on incremental and radical product innovations and business performance

Does culture matter for the EFQM model application?

© 2022.Informa UK Limited, trading as Taylor & Francis Group. This document is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Total Quality Management & Business Excellence. To access the final edited and published work see https://doi.org/10.1080/14783363.2022.2068408The main objective of this paper is to analyse which kind of organisational culture is most suitable for the successful application of the EFQM model in the manufacturing sector. Partial Least Squares (PLS) was employed with data from a sample of 200 Spanish companies. Two managers in each organisation provided the data for analysis. The results of the empirical analysis identify the relationships between some of the variables, and contribute to the understanding of how the organisational culture can be a key factor in the company’s success by facilitating the utilisation of the EFQM enabling criteria. This research highlights the importance of an orientation towards a culture of control and stability that can support the use of the principles and results suggested by the EFQM model. The research fills the gap in the literature regarding the relationship between organisational culture and EFQM model application. The findings suggest the possibility that TQM and the EFQM model could require different organisational cultures for success