Purpose External knowledge is generally believed to be of prime importance to SMEs. However, a review of the literature shows that no empirical research has looked at knowledge management issues at the interorganizational level in SMEs. This paper reports on an empirical investigation with UK SMEs in the service sector to identify their needs and practices regarding inter-organizational knowledge transfer, and thus provide empirical evidence to support the above belief.Design/methodology/approach A two-tier methodology (i.e. using both questionnaire survey and interview approaches) is deployed to address the main research objectives. A questionnaire survey of SMEs is carried out to investigate their current inter-organizational knowledge transfer situation and managers" perception on various relevant issues. Then twelve face-to-face interviews with SME managers are conducted to further validate key findings drawn from the questionnaire survey.Findings The empirical evidence collected from the survey and interviews confirms the general belief that external knowledge is of prime importance for SMEs, and demonstrates that SMEs have very strong needs for external knowledge and inter-organizational knowledge transfer. Research limitations/implicationsThe findings provide very strong underpinning for further theoretical research on inter-organizational knowledge transfer in SMEs. However, this study has certain limitations: its results may not be applicable to other industrial sectors or the same sector in other countries; or to micro or large companies; nor does it involve cross-cultural issues. Originality/valueBy adopting a two-tier research methodology, this study provides more reliable understanding and knowledge on SMEs" inter-organizational knowledge transfer needs and practices, and fills the gap that exists in the empirical investigations on the subject.

While total quality management (TQM) has been widely applied in the management of change, and is likely to remain a priority into the next century, failure rates at times above 75 per cent give cause for concern. The study on which this paper is based has reviewed TQM as an approach to change management. Four interrelated classifications of organisational change are presented: change as structure (or “functional change”), process, values, or power distribution. Of these, it is contended, TQM adequately addresses only process change, with incidences of failure closely correlated to the application of process‐based TQM techniques in change contexts characterised by structure, values or power. This study suggests that, for TQM to be applied successfully, either an approach is required which adequately addresses all types of change context (a so‐called “systemic” approach), or its application needs to be restricted to those contexts where process dominates.

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This paper is an account of a case intervention, undertaken at a National Health Service hospital outpatients department. The intervention utilised a soft systems approach, to address gaps between the customers' and providers' expectations, and simulation was used within this framework. A procedure to reduce unexpected non-attendance of patients has been implemented. Patient bookings are now scheduled according to simple rules, with the result that in-clinic waiting times have been reduced. A model of the intervention process has been accepted by the key stakeholders as a sensible framework for continuing investigations. More widely, the participants increased their knowledge of their own systems. The results from the case suggest that the time spent following this approach may be worthwhile in some interventions, but there are concerns relating to the time needed, and the cost of such an approach. The paper provides a critique of the framework and the intervention, and concludes that this approach is probably viable in unpaid, collaborative, investigations where there is little or no cost. However, time and cost may prove prohibitive in the case of paid consultancy.