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The objective of this project was to develop and implement an indicator system, which delivered concise, specific and relevant information for the managers of the treatment departments. The project was carried out in The Jellinek Center, a treatment service for addiction in Amsterdam, The Netherlands. During a period of ten years the indicator system called Profile Package was developed and implemented in all departments. The results of the project are: a system and an infrastructure for producing a Profile Package for each team every quarter. The departments use five critical indicators and each department has added about 40 indicators to meet their needs. On the basis of the indicators the performance of the team can be monitored. An annual reviewing cycle and goal‐finding procedure is established, which stimulates a results‐orientation. The trend of the five critical indicators over a number of years shows that the results of the departments, working with the system, are positive.

The Jellinek Center is a treatment service for prevention, care and cure of clients with addiction problems. Ten years ago the first quality improvement program was started. In 1994 the management team did the first formal self‐assessment based on the European Foundation for Quality Management (EFQM) Model and three assessors from the “Instituut Nederlandse Kwaliteit” audited the Jellinek and delivered a feedback report which was used to make an elaborate two‐year work‐plan. Five projects to improve the quality of the Jellinek Center were identified and carried out. After two years, the work‐plan was evaluated and the improvements assessed through a self‐assessment conducted by the management team and an external audit team made up of six assessors. The findings of the self‐assessment were presented to the Dutch jury for the EFQM Award and the Jellinek Center won the Dutch Quality Award. The Jellinek is not complacent, however, as it recognises that the next phase of the quality management journey is to carry out self‐assessment in all teams, redesign the treatment processes and improve performance measurements.

Different approaches to improve quality are used in organizations delivering health care. Donabedian introduced structure, process and outcome, from which other approaches like self‐assessment, accreditation, visitation, International Standards Organisation (ISO) and European Foundation for Quality Management (EFQM) can be aligned. The EFQM model is one such approach that has been adopted and adapted by the Dutch Institute for Quality Management. This article describes the background and progress relating to the use of the EFQM business excellence model within Dutch health care organizations. In addition the process for applying for the European Quality Award and the Dutch Quality Award are described in detail. Finally, the reader is enlightened regarding the work of the European ExPeRT research group who are promoting the use of quality models within health care.

The purpose of this paper is to account for a ten-year experience with the European Foundation for Quality Management (EFQM) Excellence Model implemented in the Trento Healthcare Trust.

Since 2000, the EFQM Excellence Model provided an overarching framework to streamline business process governance, to support and improve its enablers and results. From 2000 to 2009, staff performed four internal (self) and four external EFQM-based assessments that provided guidance for an integrated management system. Over the years, key controls and assurances improved service quality through business planning, learning and practice cycles.

Rising assessment ratings and improving results characterized the journey. The average self-assessment score (on a 1,000 points scale) was 290 in 2001, which increased to 610 in 2008. Since 2006, the Trust has been Recognized for Excellence (four stars). The organization improved significantly on customer satisfaction, people results and key service delivery and outcomes.

The EFQM Model can act as an effective tool to meet governance demands and promote system-level results. The approach to integrated governance discussed here may support similar change processes in comparable organizations.

The paper describes a unique experience when implementing EFQM within a large Italian healthcare system, which had a broader reach and lasted longer than any experience in Italian healthcare.

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.

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.

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.

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

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.

An assessment of the EFQM excellence model was carried out in Italy's Udine Hospital, aimed at evaluating how first and second‐level managers perceived their hospital and individual departments. The study objectives also included identifying strengths and areas requiring improvement and stimulating a quality culture.

Udine's S. Maria della Misericordia Hospital is a large specialised unit in North East Italy and similar to many regional hospitals throughout the country. The survey is a single case study of the hospital and its ten clinical departments. A 153‐item questionnaire was completed by 201 experienced respondents.

Leadership, policy and strategy, partnership and resources were rated highly, whereas people, society and customer results received lower ratings. Several improvement actions were planned, primarily with regard to the results criteria.

A two‐level self‐assessment was successfully carried out in a hospital, giving insight into the organisation's strengths and areas requiring improvement. Through the study, a systemic approach was introduced and quality awareness was heightened.

The findings are useful for other hospitals conducting EFQM self‐assessment.

The effective management of health services and the delivery of quality systems in Irish health‐care institutions have increased in significance in recent years. Consumers (patients) are expecting more of health‐care providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to health‐care management and delivery. Reviews developments in quality‐service management in the Irish health‐care sector and focuses attention on the need for the development of a model for quality implementation in health‐care institutions.

As in the world‐wide context in recent years Irish health care has undergone much change, which has led purchasers and consumers alike to call for a more efficient and effective service. Many differing approaches are being utilised in an effort to become more responsive; however, only limited results have been shown. Thus, the search for excellence is both compelling and inevitable within the sector. Here one seeks to discern the elements that offer health‐care institutions the chance to excel from an organisational perspective in their quest to become more responsive and patient‐focused. Also provides details of some forthcoming research aimed at exploring the issues and outcomes of using the EFQM excellence model to support the search for excellence in Irish health care. A follow‐up article with the findings will be published in a later issue of this journal.

To take an in‐depth look at the EFQM Excellence Model by assessing how enabler and result criteria are interrelated, and how enablers as a whole affect the complete set of results.

Provides new insight and understanding of the associations between the EFQM criteria. Canonical correlation analysis is used to measure the relationships between enablers and results, while accounting for interdependences within those sets of variables. To test the suggested causal relationship, data from a questionnaire survey conducted on 446 companies (manufacturing and service sectors) is used.

The set of enabler criteria is strongly related to the result criteria set and, with the exception of policy and strategy criteria, all the enablers and result criteria in the EFQM Excellence Model make a significant contribution to this relationship. All the enabler criteria contribute in the same way to result improvements, consequently a balanced approach in the development of enablers allows correlation between enablers and results to be maximised, thereby obtaining an optimal benefit from the EFQM Excellence Model.

The data obtained are based only on sample of Spanish firms. Studies in other countries should be conducted to ensure the reliability of the results obtained. A natural extension of this paper would be to analyse the existence of differences between industries in the EFQM Excellence Model.

A greater understanding of the linkages between the elements making‐up the EFQM model, facilitating the guiding role that award models play in the implantation of TQM systems.

A new perspective for examining the linkages between the EFQM criteria in depth. The study of the relationships between all its elements is taken into account, thereby avoiding testing isolated associations. A holistic approach to studying the relationships in the EFQM Excellence Model.

Change literature emphasizes the significance of aligning change at a systemic level for sustained effectiveness of strategic change initiatives. While this body of literature emphasizes the significance of psychological and process dimensions of managing change, research on an integrated and strategic approach to deploy, track, measure and sustain large‐scale changes has been limited and inconclusive. The purpose of this paper is to address this gap in the literature to propose a holistic conceptual framework for identifying, formulating, deploying, measuring, aligning and tracking strategic changes in organizations.

Specifically, core concepts drawn from scholarly literature and practitioner writings from distinct fields of change management and strategy deployment tools, primarily the Balanced Scorecard (BSC) as proposed by Kaplan and Norton, are reviewed, synthesized and critiqued, to inform and advance the integrated framework proposed.

The suggested approach draws significantly from the BSC framework and focuses on the use of formal steps such as developing change themes and results, setting change objectives, developing lead and lag performance measures for measuring strategic change objectives. Furthermore, the proposed framework also provides directions on how to track the progress of change initiatives with respect to the desired objectives, for evaluating the effectiveness of change deployment efforts, all through applying cause and effect linkages.

Although the focus on individual change arose to support technical deployment of change, over the years the strategic deployment process itself has not received the desired focus in the change strategy literature. The proposed framework extends the current literature on strategic change to offer academics fresh insights on the significance of a strategic approach to change deployment. An application of the framework in the context of large‐scale transformational changes in organizations can provide further evidence related to the validity of the proposed approach.

A total of 70 percent of all change efforts fail. While some fail due to incomplete diagnoses, others fail due to gaps in deployment or measurement. However, there is uncertainty about how to prevent change failure, with no one having explicitly articulated the same. A rigorous and practical approach to systematically deploy change with a continuous focus on strategic alignment has specifically been found missing in the literature. The proposed framework fills this gap to offer managers and organizational decision makers a holistic and practical tool to successfully navigate the complexities of their strategic change efforts by measuring strategic alignment in a step‐wise manner throughout the change process.

Mention of the need to use integrated and strategic performance management tools, such as the BSC proposed by Kaplan and Norton, to measure and review change and to manage the change process has been found in recent literature. However, no studies have yet provided any direction on “how” to use such integrated and strategic tools throughout the change process, to deploy measure and ensure continuous strategic alignment during transformational changes. The paper addresses this gap to propose a systematic, integrated and holistic approach for aligning change deployment.