Empirical evidence on applying the European Foundation for Quality Management Excellence Model, a literature review

Towards a further step in understanding business excellence models: a comparative approach

Purpose

A comparative analysis of the validity of business excellence models (BEMs) has rarely been empirically pursued. In addition to their similarities, BEMs exhibit differences in terms of their criteria, relations and emphasis, and some researchers have claimed that it is because these models tend to represent underlying cultural, economic, or social dynamics, as well as global best practices. Based on three such BEMs (the Malcolm Baldrige National Quality Award (MBNQA) model, the European Foundation for Quality Management (EFQM) model and the King Abdul Aziz Quality Award (KAQA) model), this paper introduces a four-phase study to analyse these models comparatively.

Design/methodology/approach

This paper: (1) conceptually delineates the distinctive natures of and differences between the three models; (2) develops a comprehensive measurement model based on the content of these models; (3) reviews the relevant literature on BEMs; (4) discusses the motivation behind this comparative approach and (5) introduces a four-phase study to comparatively analyse these models.

Findings

A comprehensive measurement model and three structural models are developed, but empirical tests have not been performed. This developed approach is introduced here as a first step in the advancement of our understanding of BEMs and their underlying theory.

Originality/value

The range of variability and complexity of BEMs—i.e. a holistic and comparative empirical view of BEMs—have not so far been fully considered, and findings in this domain tend to be inclusive, while some of the underlying relations of these models have not been investigated. This paper contributes to filling these research gaps.

Proposal of a theoretical model to identify organizational decline

This study aimed to propose a conceptual model of Identification of Organizational Decline, based on two indicators: Organizational Satisfaction Indicator and Financial Indicator. For the study, we used two bibliometric reviews, which, ultimately, associated the variables of the foundations of excellence in quality with organizational decline. As a result, we observed that the topic of organizational decline in companies has factors of managerial, physical, financial, and behavioral nature, and that their performances worsen by their lack of initiative in using the three planning processes (strategic planning, budget, and control) in a structured way. Regarding companies that seek excellence in quality, these concerns become increasing demands for their managers, who must develop responsible practices and tools to achieve a good performance, bearing in mind the constant search for satisfaction and retention of customers not only for the final product, but throughout the chain process. Thus, the literature on this topic is vast, and this study is justified because it notes a strong relationship between the lack of factors of excellence in management and organizational decline.

Use of the EFQM excellence model to improve hospital pharmacy performance

BACKGROUND

Quality management systems are widely used to improve the quality and efficiency of healthcare services. However, evidence regarding the value of the European Foundation for Quality Management (EFQM) model in improving the performance of hospital departments is lacking.

OBJECTIVE

To describe the value of the EFQM model as a quality framework for improving the performance of a hospital pharmacy department (PD).

METHODS

DESIGN

A case study describing the development of the Enablers' criteria of the model and the results achieved.

SETTING

PD in a tertiary-care teaching hospital of the Madrid Public Health Service (Spain).

INTERVENTIONS

Four self-assessments were conducted using the questionnaire "Perfil" during the period 2008-2017. A quality improvement plan was developed on the basis of the results of each self-assessment. A balanced scorecard was used to track progress. Improvement in quality management was externally evaluated by the Spanish Management Excellence Club in 2010, 2013, and 2017.

MAIN OUTCOME MEASURES

Change in the scores obtained in the external assessments, the quality improvement initiatives implemented for each Enabler's criteria, and the results of key performance indicators.

RESULTS

The EFQM was a useful framework for self-assessment and a good system for identifying improvement initiatives. The model progressively improved the services provided for patients, the safety and efficiency of pharmacotherapy, productivity of the PD, and customer and staff satisfaction. The external assessment scores exceeded 300 points in 2010, 400 points in 2013, and 500 points in 2017. Scores for all of the criteria progressively improved, particularly in 'people'.

CONCLUSIONS

The EFQM was a practical tool for improvement of PD performance, especially in areas such as strategic planning, people management, and innovation. The main difficulties were the lack of decision-making capacity in relevant areas and benchmarking with other PDs.

Drivers and internalisation of the EFQM excellence model

Purpose

Although the European Foundation for Quality Management (EFQM) Excellence Model has been widely adopted throughout Europe, a thorough examination of the factors that contribute to the internalisation of the model (i.e. a substantive adoption) has been neglected in the literature. The purpose of this paper is to present a model that analyses the drivers of the real internalisation of the EFQM excellence model, with a focus on the role of motives for adoption, and appraisal and compensation systems.

Design/methodology/approach

An empirical study was carried out based on a sample of Spanish organisations that had been awarded EFQM recognition. Structural equation models, cluster analysis and ANOVA were used to examine the research questions.

Findings

Internal motives concerning the creation of a participative style are the main driver of internalisation. Moreover, having an appraisal system-oriented towards the development of employees helps the substantive adoption of the EFQM model. These findings reinforce the importance of the soft elements of the EFQM model.

Originality/value

This study enhances evidence about the motives for adoption and their influence on the internalisation of the EFQM model. It analyses internalisation in a novel context, EFQM recognised organisations, and contributes to the debate about the efficacy of the EFQM model to performance improvement, by unveiling the factors that could foster the internalisation of the model within the organisational routines.

An exploratory study of the results of the implementation of EFQM in private Spanish firms

Purpose

The implementation of business excellence models is becoming a key competitive priority for companies, but the type of results they obtain by implementing such models and the importance of such results remain open issues. The purpose of this paper is to clarify the results obtained by companies that implement the European Foundation for Quality Management (EFQM) excellence model, with a focus on their importance and nature.

Design/methodology/approach

An empirical study was conducted in 68 Spanish firms that were immersed in the process of implementing EFQM. The methodology consists of a descriptive analysis and factor analysis in order to determine which groups of results are the most important. Finally, clusters of firms are analyzed to establish their profile in relation to these groups, using cluster analysis.

Findings

This study shows that the main results of the implementation of EFQM are an improvement in the external image of the company and an increased efficiency of internal processes. In addition, the results can be grouped into internal results, human resources results and economic results, with the first group being the most important. Finally, the results show that there are three groups of firms, categorized according to their results orientation: highly results-oriented, moderately results-oriented and minimally results-oriented.

Practical implications

Companies are in a better position to anticipate and solve the problems that may arise during the implementation process if they understand the results of the implementation of EFQM, along with the motivations for and barriers to the implementation. Also, this research shows that the bodies promoting and motivating quality should make a special effort to emphasize the importance of non-financial results in companies that implement EFQM.

Originality/value

This paper extends the knowledge in the field of business excellence models by developing an instrument to measure implementation results from the perspective of quality managers who were specifically appointed to lead the implementation of the EFQM excellence model in companies.

Sustainable Enterprise Excellence: Attribute-Based Assessment Protocol

This paper is intended to design and provide a reliable and valid measurement instrument to aid organizations that wish to self-assess their performance and positioning relative to sustainable enterprise excellence. Recent research trends in performance excellence, quality management, and organizational sustainability have been directed towards integrated management systems (IMS). Sustainable Enterprise Excellence (SEE) is among these integrated management systems. SEE is undergoing ongoing development and its measurement scale is rudimentary, hence it lacks the more sophisticated sorts of measurement scales often used for organizational self-assessment purposes. A scientific approach is used herein to devise a more comprehensive SEE-oriented organizational assessment against six proposed performance results-oriented domains or constructs: governance and strategy, process implementation, sustainability performance, financial performance, innovation performance, and human capital performance. Each organizational performance construct is to be measured by ten attributes-based items. Maturity scale ratings that range from 0 to 10 reflect organizational performance relative to the associated item and the sum of item ratings across a construct reflects performance within the specific domain, the summation of the six construct scores then yields a measure of the overall organizational performance with respect to SEE. The assessment areas against which organization performance compares poorly suggest opportunities for improvement of associated business processes, the achievement of which will contribute to a sustainable future.

Conceptualizing and assessing improvement capability: a review

Purpose

The literature is reviewed to examine how ‘improvement capability’ is conceptualized and assessed and to identify future areas for research.

Data sources

An iterative and systematic search of the literature was carried out across all sectors including healthcare. The search was limited to literature written in English.

Data extraction

The study identifies and analyses 70 instruments and frameworks for assessing or measuring improvement capability. Information about the source of the instruments, the sectors in which they were developed or used, the measurement constructs or domains they employ, and how they were tested was extracted.

Results of data synthesis

The instruments and framework constructs are very heterogeneous, demonstrating the ambiguity of improvement capability as a concept, and the difficulties involved in its operationalisation. Two-thirds of the instruments and frameworks have been subject to tests of reliability and half to tests of validity. Many instruments have little apparent theoretical basis and do not seem to have been used widely.

Conclusion

The assessment and development of improvement capability needs clearer and more consistent conceptual and terminological definition, used consistently across disciplines and sectors. There is scope to learn from existing instruments and frameworks, and this study proposes a synthetic framework of eight dimensions of improvement capability. Future instruments need robust testing for reliability and validity. This study contributes to practice and research by presenting the first review of the literature on improvement capability across all sectors including healthcare.

The EFQM Model as a framework for total quality management in healthcare

Purpose

– To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as a framework for TQM in healthcare.

Design/methodology/approach

– Data on a national representative survey about quality management (QM) in the hospital population in the Netherlands were used to conduct this study. The survey had five measurement points between 1995 and 2011.

Findings

– The results of the study show that applying the EFQM Model in hospitals is related to improvement in organizational performance over time, a feedback loop in which hospitals use their results to further improve their organizational processes is established, and improvement is stronger when all the model’s elements are considered simultaneously.

Practical implications

– The results of the study can be applied by quality managers of healthcare institutions to achieve higher quality of care.

Originality/value

– Previous research on the relationship between the EFQM excellence model and TQM neglects two essential characteristics of the TQM philosophy, namely, the holistic perspective on QM and the presumed feedback loop of organizational performance that feeds a cycle of continuous quality improvement. The study provides new insights into the long-term benefits of applying the EFQM Model as a framework for TQM in healthcare.