This paper is based on material from a research project on the state of quality management in The Netherlands in 1995/96. A questionnaire was developed, starting from the Dutch adaptation of the European Foundation for Quality Management (EFQM) framework. The main part consisted of 20 so-called enabler variables, each reflecting six levels of quality management in an organization.The EFQM framework is an heuristic complex of notions and ideas about a general relationship between leadership and business results. However, a stricter nomological structure of the enablers, based on a large sample, might be helpful in evaluating assessment results in individual cases.A rather broad hypothesis about the empirical structure of the enablers was confirmed. There exist positive, moderate associations between the enabler variables. The information in the questionnaire on the use of quality management tools was used as an external criterion for the validity of this internal enablers structure. In contrast with our expectations, however, the representation of quality management tools (QMT) by means of a specific unidimensional scaling model appeared not to be a useful instrument of validation. This raises new questions for further research.

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Q-mode research designs, Agreement and association, Consensus,

In the current decade, client requirements appear to play an increasingly important role in designing not‐for‐profit organisations, in particular in the domains of services and healthcare. Quality function deployment (QFD) is a well‐known design method. This method has a vested reputation in industrial production as a means of systematically incorporating customer requirements in product design. However, in the domain of the services, and especially the professional services, there is little experience in applying QFD. Application in this domain probably causes problems, for instance with respect to the customer concept, which is more ambiguous in this domain, and with respect to the interrelated nature of the product (service) and the process. In this paper we present some limitations of conventional QFD outside physical industrial production and we present a refinement and an extension of QFD for healthcare applications, based on research methods in the social sciences. Illustrations are given from two cases in Dutch healthcare organisations.

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