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This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.

This article examines the direct effect of total quality management (TQM) practices on organizational performance (OP) and innovation (INN), as well as their indirect effect through organizational learning (OL) as a mediating variable. In addition, this survey examines company size as a contextual variable in the relationship between TQM and outcome variables.

A conceptual framework is proposed to test causal links between TQM, OP, INN and OL. To empirically test this framework, 110 questionnaires were collected from large Tunisian quality-certified industries, and 167 questionnaires were collected from small and medium-sized industries (SMIs) in order to examine the effect of company size. In this order, a multigroup analysis (MGA) is performed.

Using the structural equation modeling technique, seven hypotheses are investigated. The results reveal that TQM has a direct and significant positive effect on OP and INN. Data analysis shows that there is a significant positive effect between TQM and OL, while OL positively influences OP and INN. Furthermore, the results illustrate a mediating effect of OL between TQM and OP and INN. The results reveal that large industries and SMIs show significant differences in the relationship, including the conceptual model.

The conceptual framework can be used by practitioners for effective implementation of TQM practices to simultaneously improve operational performance, quality performance and INN. This study also focuses on the role of OL in large-scale industries.

While the relationships between TQM, INN and OP have been examined separately in previous studies, this study examines the relationship between these variables in a unique model in Tunisian industries, including OL as a mediating variable. In addition, it is one of the few studies that considers firm size as a contextual variable and provides an analysis of its effect on the relationships between these variables. This study presents new data and empirical insights into the relationship between these variables.

Effective total quality management (TQM) practices rely on the accurate classification of critical success factors (CSFs). The impact matrix cross-reference multiplication technique for classification (MICMAC) or/and fuzzy MICMAC (FMICMAC) can be used to identify key factors in the complex set. However, TQM includes both “hard” and “soft” factors, limiting application of the traditional MICMAC/FMICMAC method.

Previous literature on TQM was reviewed, CSFs were identified, and factors were sorted into soft and hard categories. The combined fuzzy integration and dual-aspect MICMAC (fuzzy dual-aspect MICMAC approach) was then applied to identify, cluster and prioritize the CSFs of TQM.

A total of 20 factors (10 soft and 10 hard) were identified and isolated to assess the manufacturing- and service-related TQM practices of the Pearl River Delta Region of China. Seven driver factors and one linkage factor emerged as the key CSFs that managers should prioritize.

A major limitation of this study is the dependency of the results on the definitions of linguistic labels. If the linguistic definitions of TQM CSFs do not closely correspond to the expert opinion data, then the analysis results may be inaccurate. Additionally, although expert opinions are utilized in the proposed method for comprehensive assessments, these opinions may influence the final results due to their inherent subjectivity.

A novel fuzzy dual-aspect MICMAC approach was developed to identify and classify CSFs for optimal TQM practices. This approach allows clustering of CSFs so that decision-makers can prioritize factors according to their dependence and driving powers. Practitioners should concentrate on the CSFs with higher driving powers for successful TQM.

This study aims to analyze how the interplay between hard and soft elements of total quality management (TQM) produces the conditions for sustaining success in the quest for quality.

A qualitative analysis (Gioia method) was carried out on an original dataset collected through both direct and indirect methods (i.e. archival sources, interviews and observations) to generate a new interpretive framework.

The interpretative framework identifies four categories of elements: trigger elements create the starting conditions for a quality virtuous cycle; benchmarking tools set the standards of performance; improvement tools enable exploration of the space of possible alternative practices and finally, catalytic forces allow the institutionalization of effective techniques discovered in this search process into new standards.

The findings the authors present in this paper are derived by a single case study, limiting the generalizability of our results in other settings.

This study has three implications: first, the design of trigger elements is critical for the success of any TQM initiative; second, the interplay of improvement and benchmarking tools at several levels should be coherent and third, to exploit the potential of TQM, efforts should be devoted to the dissemination of new effective practices by means of catalyzing elements.

The model provides a more specific understanding of the nature and purpose of the hard and soft elements of TQM and the dynamic interaction between the two classes of elements over time.

The construction business is widely recognised for its inherent complexity and dynamic nature, which stems from the nature of the job involved. The industry is often regarded as one of the most challenging industries globally in terms of implementing environmental, health and safety (EHS) practices. However, in the absence of EHS, the construction industry cannot be considered sustainable. Therefore, this study aims to identify the trends, knowledge gaps and implications of EHS research to enhance construction activities and knowledge.

The study adopted a science mapping approach involving bibliometric and scientometric analysis of 407 construction EHS publications from the Scopus database with the VOSviewer software. The study is based on journal articles from the Scopus database without restriction to any time range.

The main focus of construction EHS research identified in the study includes sustainability-related studies, risk-related, environmental issues, EHS management, integrated management systems studies, health and safety related and EHS in the construction process. Some emerging areas also identified include productivity, design, culture, social sustainability and machine learning. The most influential and productive publication sources, countries/regions and EHS publications with the highest impact were also determined.

Documents published in the Scopus database were considered for analysis because of the wider coverage of the database. Journal articles written in English language represent the inclusion criteria, whereas other documents were excluded from the analysis. The study also limited the search to articles with the engineering subject area.

The research findings will enlighten stakeholders and practitioners on the focal knowledge areas in the EHS research domain, which are vital for enhancing EHS in the industry.

To the best of the authors’ knowledge, this review-based study is the first attempt to internationally conduct a science mapping on extant literature in the EHS research domain through bibliometric and scientometric assessments.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

The study aims to deepen existing knowledge on the specific role of soft total quality management (TQM) practices in the ferry sector. Over the last decade, TQM practices have been thoroughly restructured, allowing us to develop an appropriate framework through which the relevance of each practice to this particular sector can be explained.

A narrative case study has been conducted to enhance the quality orientation and soft TQM practices adopted by a medium-sized company in the ferry sector.

The study identifies five soft TQM practices that offer valuable contributions in terms of quality orientation. These are organised into a configurational and systemic approach according to a three-level framework. At the macro level, a customer-orientated approach is paramount, as this orientation clearly points out the fundamental values of TQM. Coherently, at the micro-level, employees should be trained, involved, and empowered to truly internalise and behave according to a quality orientation. At the meso-level, dedicated leadership should support these practices and foster their effectiveness across the organisational structure.

The main limitation of this study is related to its narrative analysis. More empirically-grounded research should be used in the future to test the validity of the model.

TQM practices can leverage soft aspects, finding mutual integrations and offering reciprocal support if a bundle of practices is enforced and co-present across several layers of an organisational structure.

The model offers a configurational approach to help the ferry sector in leveraging soft TQM practices to implement TQM initiatives successfully. This is subject to external contingencies and thus requires adaptability and flexibility.

This paper aims to investigate the relationship between employee training and bank risk to verify whether and to what extent an increase in employee training, as a soft component of total quality management (TQM), affects bank risk.

The research adopts a panel regression, based on a unique dataset of a sample of Italian banks over the period 2011–2018, to test whether employee training affects bank risk, measured alternatively in terms of Z-score, a proxy of bank stability and non-performing loans (NPLs)/gross loans ratio as a proxy of credit risk.

Research findings reveal that increasing employee training leads to growing bank stability. In contrast, credit risk is not affected by employee training. However, by investigating training heterogeneity, this study found that the increase in the number of managerial training hours, as a proxy for soft skills training, negatively impacts credit risk. Therefore, an increase in soft skills leads to a reduction in bank credit risk.

This study provides empirical evidence in support of the relationship between employee training and bank risk, which seems novel in the literature. From a managerial point of view, this study highlights the need for banks to pay attention to the skills, particularly soft skills, that banks' employees must possess to effectively manage bank risk and, more specifically, the core bank risk.

Empirical evidence on the relationship between employee training, soft/hard skills and bank risk appears limited if not absent. Therefore, the findings provide insights for a more nuanced interpretation of variables that affect bank risk.

The aim of this paper is to theoretically explore the concept of leadership in a Total Quality Management (TQM) context by developing a new theoretical framework of understanding Total Quality Leadership (TQL) as well as by opening the dialogue in researching further key elements of TQL.

The approach that the paper adopts is conceptual. Based on exploration of the wider management and leadership literature of empirical and theoretical studies, this paper develops a framework of TQL.

The suggested TQL framework is composed by three main pillars, namely the proactive, adaptive and the relational. The former consists of elements like anticipation of current business environment complexities and filtering of information that enhances practice decision making. The second pillar refers to adaptation, autonomy and feedback while the last one emphasises on the importance of aspects like social interactions, engagement and empathy. The paper explains why the specific pillars with the additional elements are critical for TQM success.

Given the tremendous challenges that organisations face due to increased complexity and demanding competition of the business environments globally, the role of leadership as the major “soft” aspect of TQM approach, seems to be vital more than ever. But the type of TQL appropriate to enhance total quality success nowadays, is still (and should be) under continuous exploration. This conceptual study attempts to provide new theoretical insights of TQL as well as to open the dialogue around the main elements consisting of TQL and how the future research agenda is formulated.