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Drawing on the results from a questionnaire survey conducted in Taiwan, this paper discusses the experiences of small and medium‐sized enterprises (SMEs) in ISO 9000 certification. The empirical results indicate that the pursuit of ISO helps Taiwanese SMEs gain benefits in internationalization, quality improvement, sales enhancement, and cost reduction. The effects of motivation and implementing the process on benefits from ISO are statistically significant. Implementing ISO with either passive or active motivations leads to more internationalization. Active motivation and documentation through auditing lead to quality improvement with the passage of time. Consulting private consultants in implementing ISO decreases quality improvement. Employees’ active participation in implementing ISO leads to sales increases and cost reduction. A consensus regarding how to implement ISO leads to cost reduction. These empirical results show that implementing ISO with the TQM spirit of continuous improvement and company‐wide employee participation could result in significant benefits for small and medium‐sized enterprises.

Total quality management (TQM) has been a widely applied process for improving competitiveness around the world. The implementation of TQM usually consists of both TQM philosophy from Deming’s “14 points”, Juran’s “ten steps”, and Crosby’s “14 steps” and techniques such as SPC, QCC, benchmark, QFD, etc. The integration of philosophy and methods are usually used in implementing practices of TQM. Some researches indicated only TQM philosophy enhances quality performances; the others indicated both philosophy and methods help. This research conducts a questionnaire survey in Taiwan to test the following propositions: TQM philosophy enhances quality performance; TQM methods enhance quality performance; and the integration of TQM philosophy and TQM tools enhances quality performance. The results showed TQM philosophy, and TQM tools have a positive relationship with business performance. The integration of TQM philosophy and tools positively influenced both cost reduction and business performance.

Overwork and overcrowding in some periods was an important issue for the out‐patient department of a local hospital in Chia‐Yi in Taiwan. The hospital administrators wanted to manage the patient flow effectively. Describes a study which focused on the utilization of doctors and staff in the out‐patient department, the time spent in the hospital by an out‐patient, and the length of the out‐patient queue. Explains how a computer simulation model was developed to study how changes in the appointment system, staffing policies and service units would affect the observed bottleneck. The results show that the waiting time was greatly reduced and the workload of the doctor was also reduced to a reasonable rate in the overwork and overcrowding periods.

This paper presents the results of an empirical study on the contribution of ISO 9000 standards towards total quality management (TQM). The paper is a continuation of the authors’ research on the ISO 9000 standards effectiveness and capability as an entry key to TQM. The literature review of the above issue revealed the need for a formal empirical study to resolve the existing debate about the standards’ long‐term contribution and true value to ISO 9000‐certified companies. For the purposes of this study, a TQM measurement instrument was developed and tested for its reliability and validity to measure TQM performance improvement in certified companies in Greek industry. This performance improvement was then used to test the basic research hypothesis: “Can ISO 9000 standards provide a good first step towards TQM?”. The results of the study are presented in eight basic TQM categories, showing the certified companies’ performance improvement in the basic elements of each category, and revealing their strengths and weaknesses on their way to TQM.