The relationship between quality and governance mechanisms A qualitative investigation in healthcare supply-chain networks

• Published in: Benchmarking : an international journal Vol. 27; no. 3; pp. 1085 - 1104
• Main Authors: Martins, Saturnina Alves da Silva, Machado, Marcio C., Queiroz, Maciel M., Telles, Renato
• Format: Journal Article
• Language: English
• Published: Bradford Emerald Group Publishing Limited 01-04-2020
• Subjects: Business metrics; Efficiency; Health care; Health care industry; Literature reviews; Networks; Quality management; Social factors; Suppliers; Supply chains; Total quality
• ISSN: 1463-5771; 1758-4094
• DOI: 10.1108/BIJ-03-2019-0114

PurposeRecent literature has highlighted the importance of quality and governance in supply networks. Usually, the relationships between the actors are complex, comprising both formal and informal interactions. Despite recent advances in quality and governance in supply networks, extant literature highlights the lack of quality in healthcare supply-chain networks in relation to governance mechanisms. This paper aims to investigate the role of governance mechanisms and their influence on the quality of healthcare supply networks, and assumes that governance instruments can support quality performance.Design/methodology/approachA multiple-case research approach was employed. Six organisations in the Brazilian healthcare sector were analysed (four operate only with renal replacement therapy, one is a material supplier, and one operates with renal replacement therapy and collective procurement).FindingsFindings showed that there is no formalised supply network structure in these organisations. A possible consequence of this is that the supply-network governance is dominated by informal relationships. In the quality dimension, managers' awareness is limited, but there are mechanisms in place to control the quality of the materials.Practical implicationsHealthcare managers can actively invest in the social aspects of the relationship between buyer and supplier, such as trust and commitment, thus increasing responsiveness in patient care. However, this informal procedure can lead to problems with tracking and reliability, ultimately leading to quality problems. Therefore, it is recommended that formal and informal governance instruments be used jointly to improve service quality.Originality/valueThis study suggests that the integration of formal and informal mechanisms of governance can improve the quality of supply networks. Additionally, if the administrative process is purely formal, network relationships and their efficiency will be impaired.