Knowledge management as perceived by quality practitioners

Knowledge management as perceived by quality practitioners

The Authors
Dianne Waddell, Bowater School of Management and Marketing, Deakin University, Melbourne, Australia
Deb Stewart, School of Management, Victoria University, Melbourne, Australia

Abstract

Purpose – This paper seeks to explore the relationship between knowledge management and quality management with a particular focus on the role of quality culture. The paper also aims to address the assumption that as knowledge management reaches its maturity, in terms of acceptance as an important part of doing business in the modern world, quality will again become the mantra of successful companies.

Design/methodology/approach – A total of 1,000 quality managers from Australian organisations were surveyed for their perspectives on current and future knowledge management and quality management approaches. The questionnaire utilised both quantitative and qualitative data collection methods. The questionnaire was broken into three sections: respondent profile, current knowledge management and quality management practices, and future predictions for both knowledge management and quality management.

Findings – The key finding of the paper was that organisations would have to embrace a quality culture as a fundamental component of implementing knowledge management in order to compete successfully in such a dynamic business environment. The responses from this survey assist in identifying the relationship between knowledge and quality management, and the importance and future of both knowledge and quality management.

Originality/value – This paper is based upon the assumption that quality is in fact, resurging. It has identified quality culture as the significant link between knowledge management and quality management that leads to successful competitive advantage. Organisations are urged to recognise knowledge management as a vehicle for success not a stand-alone process. It is the first time that such a survey has been designed, and the first time a paper has produced an explanation to the current situation.

Article Type: Research paper
Keyword(s): Knowledge management; Quality; Perception; Australia.

Journal: The TQM Journal
Volume: 20 Number: 1 Year: 2008 pp: 31-44
Copyright ©Emerald Group Publishing Limited
ISSN: 1754-2731

Introduction

This paper explores the relationship between knowledge management and quality management; paying particular attention to how knowledge management and quality management can be managed to assist the development of a quality culture. This paper begins by outlining the research concept, presenting the relevant literature, which builds up to the formation of the methodology employed by the authors, and concludes with final assertions and research implications. The key finding of this paper is that there does appear to be a link between knowledge management and quality, utilising the quality culture as a medium, and knowledge management is playing a significant role in the resurrection of the quality movement.

There are three suppositions the authors' of this paper have made, which are key to understanding how this paper has been constructed and how the relevant literature was selected. The first supposition is that knowledge management can lead to a sustainable competitive advantage. This is founded on the premise or view that knowledge is intangible and unique thus making it an important component for an organisation's competitive advantage. This paper explores the link between knowledge management and a sustainable competitive advantage, and how the quality manager can facilitate such a relationship. As the theory indicates, the relationship between knowledge management and its use as a competitive advantage is the domain of the quality manager. Current opinions on this relationship are explored in the data collection section of this paper. The second assumption is that quality is making a resurgence in current business practice. The authors propose that quality management is slowly but steadily gaining prominence in organisations, after a period of significant decline in recent times. This assumption positions the paper amongst the growing literature around knowledge management, and the already well-established literature regarding quality management. The third supposition is that organisations can incorporate knowledge management via processes and/or systems using a quality culture. This position is explored in the paper by addressing how quality management concepts can assist with the growing development of knowledge management within current businesses.

There are particular areas of this paper – namely a discussion on knowledge management and its components, the exploration of the role of quality in today's world, and the discussion on the link between knowledge and quality management. The paper draws together these three areas of research foci first, through an exploration of the relevant literature, and second, through the methodology section, where 1,000 quality managers from Australian organisations were surveyed.

Knowledge as a source of competitive advantage

Much of the literature acknowledges that we are undergoing a global shift towards a knowledge-focused economy. For example, Walczak (2005, p. 330) states that the “worldwide economy has shifted from an industrial manufacturing/product orientated economy to one based on knowledge and services, where the principle commodity is information or knowledge.” Due to this new borderless society that we operate in today, the importance of knowledge management is being realised and identified as the critical success factor for today's businesses (Lim et al., 1999).

Organisations realise that knowledge management can contribute to their bottom line, but most importantly they see knowledge management as a way of providing competitive advantage (Gloet and Berrell, 2003; Lee and Yang, 2000; Prasad, 2001). In a study completed in the USA of the top 40 management consultancies, over 60 per cent of them identified knowledge management as a key success factor of their businesses (Ofek and Saravay, 2001).

It is apparent from the literature that today's organisations “know that in order to succeed they have to view knowledge as an asset and manage it effectively” (Lim et al., 1999, p. S616). The question then becomes how effective is knowledge as a source of competitive advantage. The answer revolves primarily around the notion that knowledge is intangible which then makes it more difficult to imitate (Lim et al., 1999). This is further illustrated by Colin (2002), cited by Lin and Tseng (2005, p. 208) who argues the “creation of business value mainly comes from intangible assets, such as knowledge.” The reason for its intangibility is that there are barriers around knowledge, thus making it difficult to transfer or replicate; hence its uniqueness. Hlupic et al. (2002, p. 94) concur in a statement from their paper that “Knowledge Management is seen as the vehicle for organisational effectiveness and competitiveness.” The underlying principle though, is that organisations must firstly fully understand the potential knowledge management can offer to their organisation and business processes if managed effectively, which is based on the notion that “knowledge has become the main competitive tool for many businesses” (Rowley, 1999, p. 416).

There remains considerable confusion though between practitioners and academics as to a meaningful definition of knowledge management and the components of the knowledge management process, such as data, information and knowledge (Gloet and Berrell, 2003). Lim et al. (1999) attempt to address this confusion by citing Lynn (1998, p. S615) who asserts that “knowledge stems from data” with data being the essential component that when combined yields information, which when transferred and acted on creates knowledge. Mauro (1999, p. 16) defines knowledge as being “acquainted with facts, principles and truths acquired through sight, experience or report … also implies being in a state of knowing, with a clear perception of facts and truths.” Lee and Yang (2000) concur and define knowledge as being more than information.

The connection between knowledge and knowledge management is discussed by Walczak (2005, p. 331), who argues that knowledge is “any data, skill, context or information that enables high quality decision making and problem solving to occur” and that therefore, knowledge management is “any process that facilitates the capture, distribution, creation and application of knowledge for decision making.” Lee and Yang (2000, p. 784) also assist in defining between knowledge and knowledge management as they provide a common knowledge management definition in their paper:

[…] the collection of processes that govern the creation, dissemination and leveraging of knowledge to fulfil organisational objectives.

The key similarity between all of these definitions is that knowledge is not fixed or stable, but quite the opposite (Walczak, 2005; Lee and Yang, 2000; Rowley, 1999; Styhre, 2003), in that it is fluid and emergent and that knowledge is generally produced through a “series of operations turning data into information and further into knowledge” (Styhre, 2003, p. 33).

In an attempt to sort through the many different definitions of knowledge found in the literature, two main types of knowledge emerge which can be categorised as either explicit or tacit knowledge.

Explicit knowledge is referred to as tangible knowledge that is precise and can be formally articulated (Lin and Tseng, 2005; Srdoc et al., 2005) and is generally knowledge, which has been “encoded into some media external to a person” (Walczak, 2005, p. 332) such as documents, electronic files, procedure booklets, and so on. Lim et al. (1999, p. S616) concur by stating “explicit knowledge is the knowledge that can be easily captured artificially.” Examples of explicit knowledge within the workplace include, job descriptions, vision and mission statements, business strategies and the like.

Tacit knowledge on the other hand is not as tangible and is more difficult to formalise or articulate as it generally is knowledge that is stored within an individual and as such is personal and context specific (Lin and Tseng, 2005; Srdoc et al., 2005). This type of knowledge includes “cognitive learning, mental models and technical skills” (Walczak, 2005, p. 332). Tacit knowledge is generally referred in the literature as the know-how that individuals possess within themselves and as such cannot be easily shared or documented like explicit knowledge.

In association with the two types of knowledge, there are also two paradigms of knowledge management, which have been drawn from the principles of explicit and tacit knowledge: the information view and the humanist view of knowledge management.

The information view of knowledge management complies with the explicit type of knowledge and focuses on the ability of information and communication technology (ICT) to be able to capture, store, index (codify) and retrieve data (Gloet and Berrell, 2003). The underlying assumption is that through the efficient capture of data, information, and knowledge, that it will be able to repeatedly leverage to provide an organisation with competitive advantage.

On the other hand, the humanist view of knowledge management provides for a focus on the people aspect of knowledge management and as such relates more closely to the notion of tacit type knowledge (Gloet and Berrell, 2003). The focus here is not so much on the storing of data, but rather on the way information and knowledge is shared and transmitted within an organisation. Those who subscribe to the humanist view of knowledge management propose that the focus should be on the nature of learning, the ways in which the organisation can harness knowledge and the way it levers knowledge management to gain competitive advantage through the capture of information and its retention and dissemination throughout the organisation (Gloet and Berrell, 2003). This view is closely aligned to the ideal of organisational learning.

Given that knowledge management is now seen as an economic and political imperative by managers (Gloet and Berrell, 2003) it will impact on the strategy formulation processes of senior management. Thus, depending on whether the organisation deals with knowledge management from a humanist perspective or from an IT perspective will help determine how resources are distributed within the firm to support this knowledge management perspective.

Quality today

We know quality when we see, or touch, or taste, or feel it. But often it is very difficult to define in any sort of adequate manner. Lee et al. (2001, p. 692) state “the most common definition of quality can be regarded as excellence, value, conformance to specification, and meeting or exceeding customers' expectations.” Feigenbaum (1997), cited by Cobb (2000) argues the concept of quality as expressed by buyers is no longer based primarily on the dimensions of a product or attribute of a service, but rather the approach to quality is changing to one based on the fundamental buying discipline with expectations for complete customer satisfaction. Nevertheless, quality may be regarded as a construct of our own knowledge, thinking, and experience. Our understanding of quality also has the ability to be shifted as our experience grows or changes.

In a similar vain to the two primary components of knowledge, there are two main approached to quality: quality assurance (QA) and total quality management (TQM). The first of the two main approaches to quality, QA, is systematic in nature (Sinclair and Collins, 1994) and its major purpose is “the conformance of products, services and processes with given requirements and standards” (Jabnoun, 2002 citing Moreno-Lonzo and Peris, 1998, p. 183). QA utilises systems and documented processes as a means to achieve quality planning and defect prevention, and as such requires the involvement of senior management to ensure that the proper systems are in place to achieve conformance (Jabnoun, 2002). The most widely used example of QA is the ISO 9000 series, which are founded on eight quality management principles: customer focus, leadership, involvement of people, process management, system approach to management, continuous improvement, factual approach to decision making, and mutually beneficial supplier relationships (Lin and Wu, 2005, p. 969). Jabnoun (2002) proposes a QA control process based on the above definition of quality assurance. The process involves: setting standards, providing the input that will enable workers to conform with standards, measuring performance, analysing the measured performance data, and taking corrective action.

The second approach to quality is TQM, which by comparison with QA is less systematic. TQM was adopted in the 1980s by many organisations, however it was not until the 1990s that TQM became a favoured competitive strategy by many organisations seeking a point of differentiation (Terziovski et al., 2000). TQM is focused on the “proactive pursuit of continuous improvement; understanding the internal customers concept; quality is each employee's responsibility; and organisation wide training and development” (Terziovski et al., 2000, p. 24). There is little agreement in the literature as to what components make up TQM, however the most cited include continuous improvement, customers satisfaction, team working and top management responsibility (Knights and McCabe, 2002 citing Dean and Bowen, 1994).

The primary difference between QA and TQM lies in their foundations: QA is founded on conformance and control, while TQM is founded on customer satisfaction and continuous improvement which is integrated into a quality culture. QA is adopted by an organisation through a systemised process, which proposes a static approach to quality management. TQM on the other hand, is continuous in nature and therefore a more dynamic approach to quality management, where top management develops a integrative and cohesive culture, which infuses, reinforces and supports the value of TQM (Jabnoun, 2002). As such, it is the cultural values which “play the main role in ensuring customer satisfaction and continuous improvement in the total Quality Management process” (Jabnoun, 2002, p. 188).

Knowledge management and its links with quality

It appears that both quality management and knowledge management are complementary, if not compatible, as the strategies of both are long term for the intention of gaining competitive advantage and overall improved performance. The success of both may be measured by the degree of participation of employees at all levels; the encouragement and full utilisation of skills and abilities; and the support and strength of knowledge management practices within the organisation.

Lee et al. (2001) considered two aspects of knowledge management: knowledge acquisition (KA) and knowledge dissemination (KD). In their research they investigated the link between knowledge management and product quality by considering knowledge acquisition as the beginning process of knowledge management whereas knowledge dissemination as the final process of knowledge management. In particular they investigated the effect of the level of knowledge acquisition from customers – managers realise that customer wants and desires are changing, that customers' expectations must be clearly understood, and that their company must conform to customer expectations. This customer focus requires companies to build up close relationships with their customers and constantly acquire knowledge/information about their product so as to improve their products' quality according to customers' feedback (Lee et al., 2001, p. 691).

Lee et al. (2001, p. 691) also examined the effect of the participation of employees in knowledge dissemination:

The encouragement of face-to-face interaction between product development team members enables creative improvisation and real-time knowledge sharing, leading to effective knowledge dissemination … The important process of Knowledge Management in organisational settings is the transfer of knowledge to locations where it is needed and can be used.

Knowledge management then may be viewed as the means to an end, that is, quality, not the end in itself.

For the purposes of this paper, the authors support the more holistic approach to quality and knowledge management, that is a focus on TQM. It is the author's assertion that knowledge acquisition (as supported by quality processes/certification processes) plus the development of a quality culture through active knowledge dissemination leads to a TQM within an organisation.

Research methodology and results

In order to explore if there is in practice a relationship between knowledge and quality management, 1,000 quality managers from Australian organisations were surveyed, of which there was a 23 per cent response rate.

The questionnaire comprised three sections: Section A consisted of eight questions intended to develop a profile of the respondent; Section B asked specific questions pertaining to knowledge management, quality management and quality performance; and Section C involved four open-ended questions which addressed current opinions on knowledge management and quality management.

A clear definition of knowledge management – a means by which people systematically gather information and share it with others in the organisation to achieve better performance – was given at the beginning of the questionnaire so as to provide context for the ensuing questions. The sections of questions were devised based upon the suppositions of the researcher, and the logical division of the areas of interest: respondent profile, quality performance, knowledge management, and quality management. Each question within the sections was devised through indications from the literature and from areas of interest. To ensure that a meaningful conclusion could be drawn from the research, both quantitative and qualitative data collection methods were employed in the survey.

Sections A and B employed a quantitative data collection approach. A seven-point Likert scale where participants responses were measured between Strongly agree (represented by 1) and Strongly disagree (represented by 7) with the option of Do not know/Not applicable (represented by 0) was designed for all questions in Section A and B. All results from Sections A and B were analysed using SPSS.

Section C followed a more qualitative methodology where the questions provoked more open-ended responses. Common trends in the responses were therefore isolated and analysed. It was deemed unnecessary to use a qualitative package such as Nu*dist due to the response rate and variability in responses. It must be noted that it was very rewarding to see the respondents take the open-ended questions seriously with the writing of detailed answers. Such insights have led to a wealth of information about the perspectives of practitioners on knowledge management, quality management and the relationship between the two.

Section A: respondent profile

The purpose of this section in the questionnaire is to identify the profile of the respondents. Of the 250 respondents, 78 per cent were male, with 62 per cent of the total respondents aged between 36 and 55 years of age. The majority of the respondents had post-secondary education (36 per cent with a Bachelor degree and 17 per cent TAFE qualifications) with 18 per cent having a Masters Degree or higher.

The majority of the respondents, close to half (45 per cent) held the title of quality manager, while the rest of the respondents titles varied greatly, e.g. managing director (7 per cent), technical manager (6 per cent), director (6 per cent) and general manager (5 per cent).

Industry representation was surveyed, with most respondents coming from the manufacturing sector (31 per cent) followed by business services sector (23 per cent), and the balance of the respondents coming from a diverse range of industry sectors (e.g. the next representation was construction with 7.7 per cent). Tenure at the organisation was of interest. Close to 11 per cent has been with the organisation for less than a year, over 51 per cent of the respondents had been with the organisation for between five and 20 years, and 11 per cent exceeded 20 years with their organisation.

Finally, membership of professional associations was surveyed and diverse responses were gathered. Of the 56 organisations listed, the majority (14 per cent) were members of the Institute of Engineers. A small range of respondents were members of other organisations such as the Australian Institute of Management (AIM), and ironically only 2 per cent were members of a quality association (AOQ).

Section B: knowledge and quality management in practice

Table I represents questions focused on the level of knowledge acquisition that organisations receive from their customers. Most respondents (54 per cent) actively encourage comments from customers on their products or services, with 20 per cent of the organisations providing strong incentives for this feedback. Working closely with customers is seen as of paramount importance to the majority of respondents (69 per cent) as they regularly collect data and analyse the information to better improve their service (53 per cent). A total of 30 per cent of respondents acquired more information from their customers rather than screening their competitors, with another 31 per cent sourcing information about both their customers and their competitors.

Question two aimed at determining the level of participation of employees in knowledge dissemination. As presented in Table II, 77 per cent of respondents commented that employees regularly communicated with each other both formally and informally about customer needs with brainstorming being the most popular method (47 per cent). Only 15 per cent of respondents had incentive schemes for employees even though best practices were measured, reported and followed in their organisation (56 per cent).

The third question as presented in Table III, was aimed at identifying Quality processes within organisations. As expected of this cohort of respondents, 86 per cent had standardised process instructions for employees, with 44 per cent having a large proportion of their equipment or processes under statistical quality control. What is surprising is that only 25 per cent made extensive use of statistical techniques to reduce variance in quality processes, and only 31 per cent had employees self-inspect in order to identify and eliminate non-value-adding activities.

Question four regarded the quality culture present within the organisation. A total of 58 per cent, as presented in Table IV, identified that there was a feeling of teamwork within their organisation; with much the same number reporting that a common mission/purpose is communicated by top management. Further, 62 per cent reported that employees would put in extra effort to meet customer needs and 48 per cent felt that employees had the freedom to use their own judgement.

Table V presents the final question, which explored quality performance. Of the respondents, 70 per cent identified that their organisation had sound financial performance indicators (such as return on investment (ROI), market share, etc.) in place; and a similar number (72 per cent) were of the opinion that their organisation was always responsive to customer demands such as delivering in full and on time. A total of 47 per cent suggested that their employees were highly satisfied with their employment at the organisation, and 67 per cent of the respondents reported that they receive highly favourable responses from their customers on the product/service being delivered.

Section C: relationship between quality and knowledge management

Knowledge management supporting the organisation

The first question began by asking the respondents how knowledge management was supporting their organisation. There was overwhelming consensus that the respondents thought knowledge management supported their organisations. Comments to the effect that “Knowledge Management provides the technical and commercial basis for all quality procedures” whilst it “enables [the company] to tap into tacit knowledge stored in experienced employees when tackling unique problems etc.” were prolific.

There were common themes amongst the responses as to how knowledge management supported their organisations, such as information sharing, empowering employees, improved customer service, and ultimately assisting in achieving the organisations goals. The most common theme was that knowledge management facilitated information sharing. This was exemplified by comments such as:

[knowledge management] fosters information sharing and to learn from others' experiences.

Personnel from project management, engineering, quality, finance, construction, etc. are encouraged to post knowledge objects frequently on the global interface of the company.

Information sharing has lead to rapid growth and innovative approach to business.

The theme of empowering employees can be seen in comments such as:

Assists employees with ownership of process …

Assist in involving employees when developing work instructions.

Comments such as “Facilitates customer feedback and quarterly management reviews” and “Knowledge management underpins the organisation core customer service” demonstrate the theme of improvement customer service. There was little negative feedback, but any pessimistic comments appeared to centre around “owners dominating what ideas get implemented” or that “Knowledge management works better in larger companies.”

Impact of knowledge management on quality subsystems

The second question pertained to the perception as to what impact the respondent felt knowledge management had on their quality subsystems. Of the four questions asked, this question created the most feedback. Respondents were very articulate when conveying their thoughts with comments such as “it is an essential part of our operation.” In particular its application can be seen in comments like:

Quality of procedures and processes have been improved by transferring tacit knowledge to process flow charts.

Short phrases like “Knowledge is power” and “Huge impact” were numerous with very little negative feedback.

There were two common responses as to how knowledge management impacted on organisational quality subsystems: improvement as a result of information sharing, and assisting the running of the whole quality management system. The first common response, improvement as a result of information sharing, is exemplified by comments such as:

Subsystems have improved due to better information sharing.

Reduces the time taken to get a project up and running due to accessibility of past project records with ease.

The second common response, assisting in the running of the whole quality management system, can be drawn from comments like:

Is an inherent part of the QA [Quality Assurance] system.

Better information has lead to optimising Quality Management.

Supports, refines and improves the situation.

There were few negative comments.
Future of quality management

The question regarding their opinions on the future of quality management was of considerable value. There were mixed views in responses, with some predicting a favourable future for quality management, and a small group with negative projections. There was a very interesting general theme that quality was on its “way back” and that it will be “integrated into normal business procedures using knowledge management.” The majority of responses inferred that it will “move away from traditional process driven quality to a more result driven/customer satisfaction point of view.”

There were certain commonalities between the responses, namely that the future of quality management was seen as focused on continuous improvement and best practice, that quality assurance is pivotal for continued success, and that quality should be integrated into business management systems. Responses indicating that the future of quality management would include continuous improvement and best practice are exemplified by responses such as:

A 100 per cent commitment to continuous improvement.

Assist in continuous improvement to process control.

Vital. All organisations should adopt a quality management system which provides accountability, consistency, understanding and improvement of both internal and external deliverables.

The following responses are demonstrative of those responses that felt that the future of quality management would involve quality being integrated into business management systems:

To be part of the whole of company operations rather than act as a part.

Having fully integrated management systems which will have significant benefits to quality management.

As stated above, the favourable predictions for the future of quality management were in abundance, however there was a small minority projecting a less positive future, stating comments like “It is a dying thing,” “A necessary evil,” “Not a major player” and “Would like to see it disappear.” While the prophets of doom were constrained to a minority, it is important to note that there are still some respondents who did not see the future of quality management as “bright.”
Knowledge management's impact on the future of quality

The final question was focused on whether knowledge management would have any impact on the future of quality; the answers to which were quite revealing. In contrast to the previous question, the numbers of responses was comparatively low and short. Where respondents were confident about the future of quality, they did not appear to be so confident when it came to the involvement of knowledge management in that development. It appeared that presently knowledge management supports and has significant impact on an organisation's quality systems but the role of knowledge management in supporting the quality agenda is somewhat vague. There were several similar responses indicating that “Knowledge Management and Quality Management will work hand in hand” and “There would be a heavy reliance on Knowledge Management to drive Quality Management systems,” however there was an equal amount of one-worded responses like “Absolutely,” “Yes” and “Definitely” with little elaboration. Interestingly, of the 230 responses only one reply called it “Just the newest academic buzz word for simply good business practice.”
Conclusion

Through the analysis of responses to the survey, and through the examination of the relevant literature, it can be stated that knowledge management and the quality management movement are intrinsically linked in developing a competitive advantage. Such an advantage can be achieved through the application of quality processes which help the organisation move closer to the customer thus allowing them to better understand customer motives, needs, and wants.

This paper clearly conveys knowledge management to be more than just data. Knowledge management is the process by which data are turned into meaningful and useful information. The level and type of knowledge shared within the organisation determines the ability of an organisation to succeed amongst its competitors. Knowledge management provides benefits for all types of organisations, however managers within these organisations must be able to determine what information is relevant given a specific situation and what approach to apply in order to adapt knowledge successfully into their organisation.

Quality management on the other hand, can be said to be the beneficiary of successful knowledge management. This paper demonstrates that both knowledge management and quality management impact greatly on an organisation's competitive advantage with a proactive quality culture being the link. Understanding this link between knowledge and quality systems is vital. The key benefit of understanding the link between the two is that the organisation is able to deliver superior product and/or service to their customers.
Implications for management

What can be established from this study's findings so far is that the involvement of knowledge management in the resurgence of quality management is not a passing fad, but holds great significance in the future management of quality systems. The results and discussion presented above portray valuable lessons for practitioners and researchers in the quality and knowledge management fields.

The success of knowledge management processes is greatly enhanced when its importance in the delivery of quality is understood and realised. By adopting well designed quality systems within the organisation to monitor and structure the way in which knowledge is created and captured, a tacit understanding of organisational knowledge be developed and worked towards by all individuals within the organisation.

This paper proposes that through the development of knowledge management as a discipline in the post industrial world, quality will once again become the mantra for organisations as they move forward into the future.

ImageLevel of knowledge acquisition from customers (in percentages)
Table ILevel of knowledge acquisition from customers (in percentages)

ImageParticipation of employees in knowledge dissemination (in percentages)
Table IIParticipation of employees in knowledge dissemination (in percentages)

ImageQuality processes (in percentages)
Table IIIQuality processes (in percentages)

ImageQuality culture (in percentages)
Table IVQuality culture (in percentages)

ImageQuality performance (in percentages)
Table VQuality performance (in percentages)
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Corresponding author

Deb Stewart can be contacted at: deb.stewart@vu.edu.au