Purpose – The purpose of this paper is to examine the extent of total quality management (TQM) practices implemented in Palestinian hospitals and their relationship to organizational performance using the Malcolm Baldrige National Quality Award criteria. Design/methodology/approach – A survey of 51 hospitals operating in the West Bank of Palestine was conducted in order to test the validity and reliability of TQM constructs and their relationship to organizational performance. Findings – The results showed that TQM constructs used in this study are positively related to hospital performance and for the most part the relationship was significant; they were capable of explaining a significant portion of variance in performance. Three elements were found to be strongly significant predictors of performance- people management, process management, and information and analysis. Research limitations/implications – Although hospitals operating in the Gaza Strip were excluded from the study, this research promotes critical management practices that help channeling organization resources into areas aimed at improving quality and performance. Practical implications – The study showed that there are certain areas where administrators or managers need to focus on should they aspire for better performance. The constructs used in this study can be used to assess the implementation of quality practices and highlight areas for movement. Originality/value – This paper provided practitioners, administrators, and academics with a fresh perspective on quality management practices and their impact on organizational performance. It also served as a foundation for future initiatives and programs aimed at improving quality in hospitals.

Purpose The purpose of this paper is to assess the level of total quality management (TQM) implementation in Palestinian governmental and non-governmental hospitals using the Malcolm Baldrige National Quality Award (MBNQA) framework. Design/methodology/approach The study is based on collecting data using a survey questionnaire that was designed according to the MBNQA criteria. In total, 363 questionnaires from governmental and non-governmental hospitals operating in Gaza Strip were analyzed to assess the level of TQM implementation level in all hospitals (governmental and non-governmental). Findings The main results of this study indicate that Palestinian hospitals operating in Gaza Strip perform at a relatively acceptable level. Comparing results shows that the performance of non-governmental hospitals is better with higher degree of TQM implementation than the governmental hospitals. Detailed analysis identifies improvement opportunities-related specific aspects of the human resources focus and the performance results. Research limitations/implications Although this study has collected data from one Palestinian Territory, the Gaza Strip, it still identifies the critical factors and practices for TQM implementation within the Palestinian healthcare organizations to improve performance. Practical implications This paper suggests that business excellence models such as the MBNQA criteria can be used to assess the level of implementation of quality practices and identify the strengths and weaknesses to improve the quality of service delivery, processes, and performance of hospitals. Originality/value Despite the widespread use of TQM in the developed countries, little attention has been placed to implement and assess the quality initiatives by organizations in the developing countries and even fewer in low-income Arab countries (Aamer et al., 2017; Øvretveit and Al Serouri, 2006). In addition, a very few number of studies in reference to the assessment of TQM implementation in the Palestinian context, in general, and in healthcare organizations, in particular, highlight the need for this study. To move the field in that direction, the goal of this research was to assess the level of TQM implementation in the healthcare organizations (mainly hospitals) in Gaza Strip (one of the least fortunate areas of the Palestinian-occupied territories) where no prior similar research studies could be found. Therefore, this study contributes to filling this gap in the literature by providing empirical assessment of TQM level of implementation in Gaza Strip hospitals.

Purpose – This paper aims to provide an assessment of the quality of management practices and implementation in hospitals operating in the West Bank of Palestine using the Malcolm Baldrige National Quality Award (MBNQA) Criteria. Design/methodology/approach – Based on the MBNQA Criteria, a survey of 51 hospitals was conducted using questionnaires, interviews and focus groups to gather data. Data were analyzed and compared across all administrative types of hospitals using the MBNQA points system. Findings – The results show that the performance of non-governmental organizations and private hospitals was superior with respect to all other administrative types. A closer look at the results show that all hospitals exhibit areas of concern such as human resource focus, information and analysis, as well as performance results. Research limitations/implications – Despite the exclusion of hospitals operating in the Gaza Strip, this research promotes critical management practices aimed at improving quality of management practices and their subsequent implementation in the surveyed hospitals. Practical implications – The MBNQA Criteria, as well as other quality assessment tools, can be used to measure the various activities of hospitals and identify competencies and weaknesses in a tangible manner to improve hospital performance. Originality/value – This paper presents a fresh perspective on the quality management issues in Palestinian hospitals to practitioners, administrators and academics using the MBNQA Criteria. Also, it serves as a foundation for future initiatives and programs aimed at improving quality in hospitals.

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PurposeThis study aims to analyze the nature of challenges facing five low-tech Palestinian small and medium-sized enterprise (SME) clusters and to understand their dynamics. The study proposes a number of key policies necessary to foster start-ups and the growth of the current clusters.Design/methodology/approachFive low-tech Palestinian clusters were selected for investigation. Using multiple sources of evidence, the research questions are answered using a case study approach. Twelve semi-structured in-depth interviews were conducted with representatives from the government, private sector and universities. Content analysis was used to analyze the data obtained from the interviews.FindingsThese five low-tech clusters in Palestine are located in a complex environment that imposes a mix of challenges which adversely affect their performance. The challenges facing Palestinian clusters are different in terms of their degree of complexity. The common challenges facing the Palestinian low-tech SME clusters are the fundamental lack of innovative stimulation policies or of incentives in the Palestinian ecosystem, lack of trust, unfair competition, limited access to finance, lack of access to promising markets and the limited collaboration between different parties. More focused policies are suggested to the Palestinian authorities.Practical implicationsClusters represent a new and complementary way of understanding an economy, organizing economic development, enhancing competitiveness and innovation through sectoral specialization and cooperation and implementing public policies. In the overwhelming majority of Palestinian entities categorized as SMEs, clustering adds value to the firms from the point of view of productivity and by battling unemployment, which is rampant among Palestinian youth.Originality/valueEven though the issue of clusters in SMEs has been well researched in developed countries, empirical studies are still lacking in this developing region. The attention given to policies in this article allows using the insights gained for cluster development in Palestine.