King Faisal Specialist Hospital and Research Center’s Global Standards

Introduction

The main role of the global medical industry is to provide quality, reliable, and affordable medical care services; in the above light, world Health Organization (WHO), European Union, United Nation bodies, and different regional and national bodies have continued to support programs that improve medical care provision. Jointly, the above bodies require medical facilities to offer high-quality medical facilities. To attain the noble objective of quality medical care services, system within medical facilities must be operating effectively and seen to jointly contribute to the vision and mission of the industry (Möller 2006).

As any other business entity, an effective operation calls for the collaboration of different players, sectors, departments and human resources to develop a unit that contributes to the noble goal. Majority of global medical care services have embraced the use of technology in one area or another. There is a fast move from the traditional doctor/clinical officer, patient consultation to better services that involve the use of technology products to solve and diagnose patients. Machines like X-rays machines, thermometers, and other similar hospital equipment’s are products of the past; however, there are other new components that have come to assist the industry offer quality services. They include the use of e-records, e-procurement, and e-medical reports. These new segments have been facilitated by the development of technology (Pickton & Broderick 2005).

Borrowing from the retail industry, medical services industry has continued to adopt electronic medical components particularly medicine; with growth in electronic commerce, there has been the emergence of stock computerized management systems that endeavour to improve service delivery. The methods are used to keep track of medicine in an organization and facilitate the provision of quality medical services (Donaldson 1995). One such system in use today is the Global Standard 1 (GS1).

GS1 is an open global standard for product identification and bar-coding; GSI Health participates the industry following industry initiatives and workgroups to drive health IT policies, standards, architecture, and interoperability strategies; the enables greater visibility and collaboration in the healthcare supply chain. GSI has the main mandate of facilitating improvements of quality standards adoption builds trust among stakeholders; the stakeholders include human capital and the sector in general. At the time of improvement of the efficiencies, they automatically lead to better patient care and improved financial performance. It aims at improving efficiencies in medical facilities by promoting current/modern management systems that are reliable and effective (Kontopoulos 2009).

King Faisal Specialist Hospital and Research Centre

King Faisal Specialist Hospital and Research Centre is a national health facility located in Riyadh, Saudi Arabia; the facility aims at providing reliable and effective medical care services to the entire Saudi Arabian republic. Its positioning has seen the company able to attend to first patient cases, referral cases, and emergencies. The facility has medial and support staffs of approximately 8500 to manager its bed capacity of 850 beds with the capacity, the company requires an effective supply chain management system that will see every corner of the facility integrated into a single platform. King Faisal Specialist Hospital and Research Centre’s the supply and logistics department has a vital role to play; it ensures the facility has continued supply of medicine and other medical apparatus.

For the last 29 year, the facility has handled referral cases in oncology, organ transplantations, cardiac surgery, and genetic diseases; it is among medical facilities in Saudi Arabia respected for its quality and effective human resources management team. It the medical crew comes from different nationality and has placed diversity at its core with over 60 different nationalities and ethnic backgrounds. Other than what happens indoors, the company has been able to make some medical journals productions which among them include a bi-monthly general medical journal, the Annals of Saudi Medicine. The facility also has a college that offers medical care training to students using the equipment of the facility. With this, the facility aims at developing or attaining some development and continuity in the medical care system. Due to its quality, the facility offers medical facilities to the Saudi Royal Family and other VIP’s visiting the country. With such an appealing portfolio, King Faisal Specialist Hospital and Research Centre’s management has opted to adopt Global Standard 1 (Kouvelis, Chambers, & Wang 2006).

The facility aims at bringing onboard suppliers, group purchasing organizations, manufacturers, wholesalers/ distributors, hospitals, and physicians to record and track product information. The facility using the system has been able to understand why there are differences that open the flood gates for medical errors that severely impact patient safety and the quality of care. With the current state of the art, this research is a report that evaluates the impact that GSI has had at King Faisal Specialist Hospital and Research Centre (Kaushik & Cooper 2000).

GS1 has been implemented to deal with the growing challenge that has prevailed in the health industry which among others includes increased costs and deteriorating quality. The technological development included reforms that the hospitality industry aimed at adopting. It offered the platform through which value analysis processes were conducted, implementation of changes in reimbursement based on patients’ outcomes and the general performance of patients care continuum. Through the system, the hospital has been able to use Global Data Synchronization Network (GDSN) to update hospital systems with standard information like those of product attributes that are important to patient safety; with the shared information, medical officers are able to recommend and prescribe the right medication to a patient. The system has assisted medical officers to diagnose different diseases; for instance, using the system, a medical officer will know the kind and number of say allergies that exist and using the system is able to do a quick scan on the medications available for such kind of an ailment.

GS1 has called for medical equipment and medicines suppliers to have bar codes on their primary package (inner package) and also on the secondary package (outer packages); with the existence of information fed via the code, medical officers are minimizing the number of errors they are having in their prescriptions. On the other hand, patients are receiving services that can be characterized by fewer medication errors (Ketchen & Hult 2006).

Supply chain integration can be viewed as a competitive advantage which has great strategic value for the organization. GS1 is a strategy to address integration issues in organizations. Companies used to adopt information systems in the way business was conducted whereas nowadays, with GS1 the strategy is overturned, in other words, the business processes need to be adjusted to fit the GS1 system. Organizations will gain the most advantages from GS1 by incorporating the system in a strategic and organizational context. GS1 can also have a great impact on the company’s culture. Moreover, through providing universal, real-time access to operating and financial data, the systems allow the company to simplify the management structures, producing a flexible and democratic atmosphere. However, different views about ERP systems exist. They think GS1 systems break down hierarchical structures, make people more innovative and free because ERP systems standardize the main business operations. The ways in which the business is running will be changed substantially when the ERP system is installed.

Whether or not organizations will gain a competitive advantage and therefore a good return on investment will depend on whether it can attain a better fit between the business processes and the GS1 systems. The GS1 system can streamline business processes by utilizing a central database. It claims to be able to reduce costs and improve productivity. But organizations need to consider the following arguments before they can decide if GS1 systems are for their businesses:

  • What level of customization will be made? An organization needs to adjust its operations to meet the GS1 systems’ requirements instead of customizing the software. The adapting process will need strong leadership, effective management and time and money to counter resistance.
  • What level of integration is needed? Legacy systems need to be integrated to avoid duplicate work and keep data integrity.
  • One needs to work out the data security requirements and make data security a main part of the software selection process.

The dramatic shift to knowledge economies has generated a flurry of interest in workplace creativity and innovation; today’s medical care industry environment requires organizations to develop strong capabilities to innovate for long-term success and survival. This requires businesses to develop creative work environment and develop innovative products and services. Haag, Cummings, McCubbrey, Pinsonneault & Donovan 2006 assert that creativity and innovation can be viewed as closely related constructs as they exhibit significant overlap in characteristics. To facilitate the discussion presented in the latter part of this section, it is imperative to have a clear understanding of the two constructs (Haag, Cummings, McCubbrey, Pinsonneault & Donovan 2006).

As pointed out by Haag, Cummings, McCubbrey, Pinsonneault & Donovan 2006, creativity refers to the ability to generate novel and useful ideas, mainly at the individual level while innovation refers to the process of developing and implementing these new ideas. Thus, the innovation of GS1 at King Faisal Specialist Hospital and Research Center can be defined as the process of capturing, filtering, developing, accepting and implementing new ideas, processes, products, or services. Haag, Cummings, McCubbrey, Pinsonneault & Donovan 2006 asserts that creativity fuels innovation and therefore, it is imperative for organizations to generate creative ideas and effectively utilize their innovation process to realize the value of those ideas (Hines 2004).

Review of literature reveals a large number of scholars and practitioners have acknowledged the importance of innovation to facilitate organizational success and survival. Literature reveals that the concept of innovation has been defined in a number of ways. According to Amabile (1988), innovation can be defined as the process of successfully implementing the various creative ideas generate within an organization (Ozsomer, Calantone &DiBonetto 1997).

Additionally, West and Farr (1990) highlight that innovation can be referred to as the planned and deliberate attempt to introduce and apply various new ideas, processes or products within a particular group or organization in an attempt to generate significant benefits such as higher productivity, better service/product quality and improved working conditions (Leach 2005). Montalvo (2006) points out the presence of two types of innovation in an organization – ‘internal’, which deals with the collaboration and communication between various individuals and departments; and ‘external’ innovation, which deals with an organization’s willingness to enhance its organizational boundaries. It is possible for senior management to impact and lead innovation within the organization by influencing organizational enablers of innovation (Oppenheim 1997).

Research conducted by Fernie & Leigh, 2009 establishes six key enablers of innovation in an organization. They are integrative organizational structures, emphasis on diversity, multiple structural linkages inside and outside the organization, intersecting territories, collective pride and faith in people’s talents, and emphasis on collaboration and teamwork. Further, Fernie & Leigh 2009 also identified a series of enablers of innovation such as ‘processes, systems and structures; culture and competencies; and networks’. Moreover, according to Fernie & Leigh 2009, innovation is usually a forced decision and is rarely ‘spontaneous’. Therefore, there is a need for leaders to develop a structured approach to innovation and creativity (Fernie & Leigh 2009). Further, Rosenfeld and Servo (1990) also assert that creativity is the “starting point for any innovation”. This discussion reiterates the need to develop a creative work environment to facilitate and lead innovation in an organization.

To drive innovation within the organization, there is a need to blend creativity with business processes by developing and supporting a creative environment that recognizes and nurtures innovation. In this regard, Amabile et al. (1996) study of creativity within organizations is of utmost importance. Fernie & Leigh 2009 pointed out the six key characteristics that help in differentiating between high-creativity workplaces and low creativity workplaces. These include organizational encouragement to innovate and contributions, supervisory encouragement to support workgroups and show confidence, workgroup supports, freedom to be creative and innovative at work, sufficient resources, and (a challenging workplace environment. It is important for organizations to provide their employees with the freedom to experiment and be creative (Nunnally 1978). Also, Fred, 2000 are of the view that to build a creative workplace environment it is important for the management to develop goals that encourage creativity and innovation and to communicate these goals to the employees in an effective manner. Fred, 2000 emphasizes that individuals within the organization are more likely to engage in a creative behaviour if an organization is able to clearly communicate the importance of creativity and innovation as valued business goals (Fred 2000).

Research Purpose

Main research question

What is the impact of the adoption of GSI at King Faisal Specialist Hospital and Research Centre?

Second question

Has conflicts that existed between the procurement department, stocks segment, and the sales department eased because of the system?

Third question

What are the areas that have come up that need continued development?

GSI was implemented at the organizations stock management department, supply chain management, the transport department and the docking segment (Stanton 2008); Faisal Specialist Hospital and Research Center supply chain management manager has the mandate of ensuring the objectives of the costly engagement has been attained (Roberts 1994). The management has the mandate of evaluating every scene and every outcome of the process to advise the management if there is any improvement required (Lewis 2004).

When dealing with health care organizations to GS1 has developed as a special form of bar-coding that combines stakeholders in the sector with the aim of ensuring there is effective sharing of medical information; some of the stakeholders in the industry include pharmaceuticals, medical equipment’s, and products suppliers and manufacturers, hospitals, and other medical facilities (Crother-Laurin 2006). GS1 was developed through the collaboration of HLS (GS1 EPCglobal Healthcare and Life Sciences Industry Action Group), players in the medical services provision, and GS1 HUG (GS1 global Healthcare User Group); the main objective of the new development was to improve patient safety, supply chain security & efficiency, traceability and accurate data synchronization (United Nations Standard Products & Services Code 2010).

Industrial background

The global medical care services are faced with different challenges and advancements. It is responsible for ensuring and maintaining a healthy community through its services supported by research and development; the industry constitutes institutions like various hospitals, physicians, nursing homes, diagnostic laboratories, chemicals, medical equipment, pharmacies and ably supported by drugs, pharmaceuticals manufacturers and suppliers (Nellis & Parker 1997). According to world health organization (WHO) basic wants, health comes in as number five. Being healthy is a component of personal initiatives that include choosing the foods that someone eats, living in a clean environment and following basic hygiene parameters. Despite efforts at the personal level, there are times that humankind cannot deviate from being sick. When sick, they need quality and reliable medical care services to make them productive once again. The health care industry has the mandate of coming up with a new method of facing different diseases that face humankind. The industry is expected to offer high-quality medical care services that the world can remain productive (sick community can hardly make a positive contribution to an economy, they actually demand more from the economy through their regular medications) (Anctil 2008).

With the noble goal and expectation that the globe has over the industry, the industry uses different tools and approaches to meet customer demands, some of the services deployed by the industry are those of medical professionals, IT professionals, sales/marketing professionals, this industry also utilizes the expert services of public policy workers, medical writers, clinical research lab workers, and health insurance providers. One of the main reason why players in the industry have to be passionate of what they do is that the industry involves dealing with people’s life thus can’t afford to joke or take any risk with them. In the wave of advancement in technology, the industry can be commended for the fast adoption of the new development with the aim of improving service delivery (Davide 2010).

As far as Supply chain management or Logistics management is concerned, the industry has noted the need to have an effective system that brings all players on one platform for efficiency, transparency and sharing of information. Having an effective supply chain system is thus taken as a strategic management tool, which involves the ultimate provision of products and services. When dealing with supplies of different types necessary for the industry setting requirements, there are three main categories that they can be classified; they are producers, purchasers, and providers. Producers in the industry include medical-surgical products companies, pharmaceutical companies, manufacturers of capital equipment and information systems device manufacturers. For efficiency, all these producers must develop high standard goods, tools and services to the consumers (in this case the providers).

The medical industry supplies include among others the following players grouped purchasing organizations (GPOs), product representatives from manufacturer pharmaceutical wholesalers, medical-surgical distributors, and independent contracted distributors; with this wide range of players, the industry has a need to have an effective and reliable system through which it can get the right supplies when required. Other than the players above, there are other different categories of players who rely on the supply chain system to conduct their businesses; they include hospitals, systems of hospitals, integrated delivery networks (IDNs), and alternate site facilities. The above players should coordinate and ensure each work on its area to boost the general performance of the industry; their common goals, objectives or agendas are quality provisions, value additions, and physical distribution of material stocks, trading products, work in progress inventories, and manufactured goods.

Although the medical industry has been on the forefront looking for the right systems to support its trade, the industry has been having challenges of outdated IT systems and infrastructure, ad-hoc procurement systems, lack of executive involvement, poor inventory and distribution management, and no process improvement culture. This has been possible because of its much concentration which rests on research and development of medications and technologies directly relating to the provision of health care services like surgery; they seem to have forgotten the genesis of the entire process which is the supply chain system.

Research methods

To develop the research, the researcher adopted varying data collection method as well as data interpretation. All the method chosen were aimed at answering the research questions of the paper. The methods included are both primary and secondary methods; using the two methods, the researcher aims at attaining high-quality report and recommendations. The most important question that the research seeks to answer is whether adoption of GSI Health care system is likely to improve provision of quality, affordable, and reliable medical care services; the report will aim at reviewing what success the implementation has brought at King Faisal Specialist Hospital and Research Center. With the understanding of the needs of having an effective supply chain system, the research will look into both the gains and challenges that the system has brought to the health facility.

Hypothesis

The assumption that the research will be conducted under is that implementation of the GSI System will improve the provision of quality medical care services; the parameters that have high correlation is quality medical information and service quality.

Alternative hypothesis

There is a correlation between quality medical services products (the information provided by GSI System) and the provision of quality medical care services

Null Hypothesis

There is no correlation between quality medical services products (the information provided by GSI System) and the provision of quality medical care services. To get an in-depth analysis of the situation on the ground and evaluate the effect that GS1 has had on King Faisal Specialist Hospital and Research Center, the researcher adopted a deductive reasoning research methodology approach. The methodology is unique, appropriate and reliable because it’s a systematic method of obtaining knowledge where one proceeds from a general point of view to a specific analysis; in this case, the general view was that technology and integrated supply chain system leads to better business/better management of the supply chain operations. The methodology moves from the known to explain the unknown; other than the known stated above, the researcher moved from belief or information that there increased demand professionalism and effective logistics and supply chain management in hospital facilities and medical centre.

The choice of the method was triggered by scholarly works from different documentary resources that recommended such a method to be the most favourable method in qualitative research (research that an in-depth solution from the research is needed. To come up with a reliable solution, it was considered meaningful to presents the data and other sources of documentary evidence much aligned to the overall research objective; this called for massive data research and primary data analysis. With the understanding, the paper looked at both primary and secondary data and information to offer the right solution to challenges affecting the medical care industry with the focus being on supply chain management at King Faisal Specialist Hospital and Research Center. The sensitivity of the matter makes it important to make use of all the sources of documents with due consideration so that the results obtained are meaningful; although the different methods were used, the case study approach was given many preferences and was supported by other data collection methods integrated into it; the research does not claim any particular data collection method or data analysis and therefore any method for data collection such as testing, interviewing, surveying can be used in the case study method.

Research Methods

Based on the objective which is to explore the effect that GS1 has had on the medical facility, there was a need to have much time. With a deductive stance, the researcher considers the results of the statistical surveys. This approach is a well-established method for examining existing theory and explaining existing phenomenon as well as predicting how it is likely to develop which allows for the possibility of changing or advancing it in the future indicates that quantitative measurement is suitable for the clearly defined research issue, leading to a simple data interpretation. A questionnaire, moreover, is the distinct form of quantitative analysis, collected in a large number of samples. Therefore, in this research, a quantitative approach is used and the data is collected through the utilization of questionnaires. A case study is a suitable research method carried out in this study because it provides the fundamentals of better understanding by focusing on specific issues. A case study is a strategy for performing the research that accords with an observed investigation of a specific contemporary event within its real-life circumstance by using diverse sources of evidence (James & MichaeL 1995)

According to Yin (1993), a case study is an appropriate research method when researchers are trying to attribute causal relationships and not just wanting to explore or describe a situation. This method can also be used as various aims such as offering a rich explanation or testing to generate theories. In order to collect a large number of opinions of those who are involved in GS1 system implementation or utilization, a quantitative method is needed. A survey is appropriate for this study; statistical analyses on collected data will be conducted. Leedy and Ormrod (2005) pointed out a survey design is the most suitable approach when we seek the agreement of large numbers of viewers regarding a certain topic.

The survey goal is related to questions like “How..?”, “What..?”, therefore a questionnaire which will be presented to the ERP experts or users are the most convenient way to gather the opinions (George 2003). As the participants of the survey will be ERP system experts or users, we need to focus on sending survey emails to the ERP system providers and companies which have adopted the systems. To collect effective data, selections of questions are designed covering different themes which will differ depending on the participants. For the GS1 experts, themes will be related to ERP implementation and successful factors whereas for the ERP system users, themes will be associated with the usability, improved productivity and reduced labour. Leedy and Ormrod (2005) suggest that a standard set of questions be designed, followed by extra questions which are more customized to the individuals, seeking further clarification to investigate the participant’s opinions.

Secondary sources/achieved data

The first method of collecting data and laying a strong foundation in the research analysis was the use of secondary sources; secondary sources were used to give the researcher a wide range of information about the world’s supply chain trends. It started by focusing on the larger supply chain elements and trickled down to the facility in the case and the new system on board. Wide literature review created the foundation through which other issues where analyzed; it focused on those issues that influence reliable supply chain management at King Faisal Specialist Hospital and Research Center, it focused on areas like patient’s satisfaction and quality services and the influence of government and company’s social corporate agenda.

Interviews

Although the main method that was adopted for collecting data for the research was a case study method, the researcher integrated it will numerous methods to get a wider review of the data? One such method that was the central stage was the use of interviews. Interviews were conducted on employees with much preference given to those employees who worked directly in the supply chain system. This meant that they could give an informed judgment on the new state at the facility and probably assist in looking for a solution in the future. An analysis of the logistics involved will be done; the interviews assisted in comparing the performance of the former state of King Faisal Specialist Hospital and Research Center when using the old procuring system and its current state with GS1 system. Though interviews were informal and formal and focused on all employees, much of the focus was on procurement departments (Hanssens, Rust, & Srivastava 2009).

Case study and survey

The nature of the business question for this research is special in that it looks at a single business process at King Faisal Specialist Hospital and Research Center that can influence the entire facility decisions in different areas. The research question of this research proposal looks into a business process that has just been implemented and much feedback and reviews from concerned parties have not been attained yet. King Faisal Specialist Hospital and Research Center is among the initial health facilities to have the system while others are still in the initialization/implementation stage; the nature of the research question will call for the need to undertake a case study and survey on existing medical services stakeholders (Borodzicz 2005).

When undertaking the approach, care is noted that supply chain management has numerous players; for a comprehensive result, there is need to consider not only the facility under review but also all those players that come into the picture; in the survey, the choice will be focused on distributors, suppliers, manufacturers, users, and medical facilities that have adopted the system. To get a wider picture, the researcher evaluated the differences on quality service provision with those organizations that have failed to implement the system; care was taken to focus on areas that gave rise to appropriate answers to the challenges of the question. When undertaking the research survey, the researcher was keen to keep the original objectives of the research and not deviate whatsoever (Duening, Hisrich & Lechter 2009).

The chosen method of collecting data arrived at using different approaches and the rationale evaluated; the methods of collecting data chosen combine both secondary and primary sources of data. The combination will offer in-depth information on supply chain management using the GS1 system and how its implementation has affected the state of King Faisal Specialist Hospital and Research Center. Preferences of physicians and medical practitioners were captured for better analysis and get to realize what motivates them to buy certain goods; as the researcher interacted with employees of King Faisal Specialist Hospital and Research Center, he was realizing every step and move to offer some other areas that require future research and development. Much of data collection was done at King Faisal Specialist Hospital and Research Center, however as has been stipulated above, there was a need to look into the larger picture and involve other players in the medical care supply chain systems (Esquerre 2005).

  • Medical facilities; they will be the main focus of study and will be well represented by King Faisal Specialist Hospital and Research Center; the category that the case facility will represent are hospitals, clinics, both private and public, that have/have not adopted the system; the comparison of their differences will be the main focus.
  • For an effective supply chain management, the role played by suppliers, distributors, manufactures, middlemen, controllers, policymakers, and sellers of medical care products like medicines is paramount, the research looked into all these parties as they affected the process of the implementation
  • Manufacturers of medical care products; they have much effect on how the supply chain system will fair, with the understanding, the researcher was keen to interpolate their effect and the role they played in the entire GS1 system implementation
  • Patients and beneficiaries of medical care services they include those people with incurable diseases; they were considered to reflect how the new structure of the facility is affecting their conditions as well as their implementation; the rate of the condition management will be evaluated.

The above method of collecting data called for effective sampling; to determine the sample population to be adopted in the research, the researcher will use stratified sampling. The method is superior in that it focuses on specific sub-group to investigate the research question; in the question, the area of focus was the supply chain department and those people or employees at King Faisal Specialist Hospital and Research Center that get direct linkage with the department. The case of King Faisal Specialist Hospital and Research Centre was not much special in that case focus was on medical care facilities, suppliers of medical care products, distributors and manufactures of medical care services. Using the stratified sampling methods, determination of the population from the larger one leads crucial stage is to determine the specific organizations to be investigated by the study (this has been previously been determined as King Faisal Specialist Hospital and Research Center). The research was limited to only one medical care facility to ensure there is maximum concentration and an easy trail of events note that this is happening when the facility has already adopted the GSI Health care system; when evaluating a single organization, the research will consider the entire supply chain.

This section has depicted a survey has been carried out with the help of emails and concentrate on the teachers, graduate staffs and King Faisal Specialist Hospital and Research Centre. One of the main objectives of the method was to involve employees from various fields of employment which would help in the fulfilment of the actual aim of the study. The sample size for the research has been stated as 20; for the purpose of the research questionnaire by emails were sent to 20 employees from the fields depicted above. The responses of the survey came into the hands of the researcher and it was found most of the employees from the various fields have completed the survey. The questions were designed to help in the generation of the data for the survey and for this purpose, most of the questions were close-ended. The responses from the respondents of the survey will be analyzed in the next section of the paper.

It has to be stated, the responses from the respondents have been able to develop data which will be useful in the fulfilment of the research aims and objectives. The time period for the collection of the survey was given 15 days within which the researcher took into account the completed surveys. This will be analyzed in the subsequent sections and will help in the development of the proper renditions to the study. It has been stated earlier in the paper, there were 10 questions in the survey which have been prepared to keep in mind the aims and objectives of the research paper. The responses to the questions will be analyzed one by one to find out the connection between the engagement of the employees and the performance of the organization. The responses of the survey are also expected to find out the ways by which the employees can be made a part of the organization. This can be made possible by analyzing the data gathered in the survey one by one. The main aim was to evaluate the response that employees have had on the new system to the company logistics.

The questions were aimed to find out the ability of the employees to clarify the kind of products they need to have for effective delivery of quality services. Most of the employees in the survey stated who they were always sure of the expectations from the system and an evaluation of how well their expectations had been met that far. It has to be stated the development of the organization is in many ways dependent on the activities of the employees in the organization. Every organization in the modern business world has clear cut aims and objectives to underline what they want to achieve in the market. However, the management of the organization has to make the employees understand the pros and cons of the aims and objectives. They have to make it clear to the employees in the organization what is expected of them. This influences the activities of the organization.

The literature review has depicted a study by Wellins, Bernthal, and Phelps (2005) which underlines the employees are to understand what is expected of them. This is often the first step of employee engagement in the organization. The strategies of the company are to be aligned with the activities of the employees. This will make the employees understand their value in the organization. And thus they will be more willing to give more efforts to the activities of the organization. In the case of the question in the survey, it has been found out most of the employees are aware of their responsibilities in the organization. This underlines most of the employees in the surveyed organizations are taken to be an important part in their respective organizations. They are given details of their jobs and the activities which are expected of them. This helps them deliver more efforts to their job which can go a long way in the development of the activities of the organization.

It has also been found in the case of the question a small number of respondents seldom understand what is expected of them in the job. Another one was found to be aware of the job responsibility sometimes. These responses underline the fact there are organizations which have not given too much importance to clarify the responsibilities of the employees. This can have an influence on the activities and the performances of the organization in the long run. The responses of the employees state they are not involved with the activities of the organization. They do not take themselves to be a part of the organization. The discussions made in the literature review of the paper states tell this situation can be difficult to handle by the management of the company.

The management of the company will not be able to make the employees work according to the overall aims and objectives of the company which can be really difficult in the long run. Therefore, from the responses of the question, it can be underlined the clarity of the activities and the responsibilities of the employees in the organization are important for the fulfilment of the aims and objectives of the companies in the long run. The question was aimed to find out the ability of the organizations to delegate the job to the employees according to their expertise. It has been found out in the earlier sections of the paper if the employees are given the opportunity to do what they did best then the satisfaction of the employees at work will increase. This can do a lot to increase employee involvement in the activities of the company.

The responses of the questions from the survey have found out only a handful of employees are seldom given this opportunity. This means the employee will not be doing the job he does best in the course of the job every day. This can influence job satisfaction and the moral of the employee. Thus, the employee will not be connected to the job and will not think of himself as a part of the organization. This can be disastrous for the long term activities of the company. However, the survey has also found out some employees are given the opportunity to do the job which they do best sometimes and some employees are always given this opportunity. Naturally, job satisfaction and the involvement of the employees with the company in this regard will be much more in comparison to the previous employee. This underlines the fact the employees are given the opportunity to specialize themselves in a particular job. This can help in making them real expert in the field.

The literature review has underlined the fact the employees who are given the opportunity to specialize themselves and move forward in the company ladder are more likely to be a part of the company. They will think of themselves as a part of the objectives and goals of the company and this will increase the involvement with the company. Thus it can be said the employees who are provided with the opportunity to do what they do best every day will go a long way in increasing the employee involvement with the company. A strategic sampling method is to be used in this study, whereby only those respondents who are related to the topic will be the subjects of the survey. GS1 managers and consultations from famous GS1 providers are intended to be interviewed. GS1 system users from the companies which adopted GS1 systems are also our target respondents. The research method was selected due to cost and time-saving. Administering the questionnaires can be time-consuming and using respondents who are irrelevant to the study also waste time and resources in terms of preparing and collecting data. Therefore, the research will only involve GS1 experts and users as they have the relevant experience and information regarding the GS1 systems selection, implementation, and usage.

Validation of Data

Qualitative studies are plagued by validity issues especially since most of them have a lack of triangulation. To avoid this issue, this study is to utilize multiple perspectives as an approach to validate the findings of the study. The qualitative method is chosen as the literature recommends multiple perspectives for validation of explanatory qualitative studies. The participants’ opinions will be sought regarding the findings of the study. The findings will be taken back to the participants and their perspectives of the findings will be obtained based on their personal experiences.

Ethical Issues

Salkind (2006) believes that the main ethical issue that is related to the research is maintaining the privacy of the participants; when dealing with ethical issues, two main aspects that are considered for application are confidentiality and Anonymity. To ensure confidentiality, the research assures that any information will not be disclosed to any third parties. To ensure that no information leaks and create confidence, the participants will remain anonymous to the researchers during the study to ensure anonymity; the facility and the participants’ consent are sought before the survey is conducted. The participation is completely voluntary and they can refuse to answer any questions through the importance and aim of the study is also explained. The identities of the participants will remain anonymous and all data will be treated confidentially. The questionnaires will be designed excluding questions which may sound personal, therefore profession and years of using ERP systems will be adequate when analyzing the data.

Results

With the implementation of GS1 at King Faisal Specialist Hospital and Research Center, the management had the vision of addressing four main areas such as product management, sourcing and services, purchasing systems and technology, and inventory and distribution management. The automation of the supply chain systems at the facility meant that the company will have an adequate supply of medical and logistical materials. King Faisal Specialist Hospital and Research Center operation/procurements managers were mandated with the role of ensuring that their hospital has quality and quantity supply of materials at any one instance. GS1 at the system was meant to add value to the entire facility to placed much focus on inwards logistics, outwards logistics and reverse logistics. When coming up with the GS1 system, the company has numerous choices that it had to scrutinize, some of the technologies included Global Data Synchronization Network (GDSN), Radio Frequency Identification (RFID). Geographical Information System (GIS), and various Data Mining (DM) technologies, we are now cashless, paperless, wireless and seamless in the day-to-day operational activities, Electronic Point of Sales (EPOS), Electronic Point of Sales systems (Epos), Electronic Data Interchange (EDI) and the GS1 system. The choice of the GS1 system was triggered by its effect to handle the following objectives that the facility had with its system:

  • The quality objectives; the system has shown the ability to assure an adequate supply of materials in a facility when they are needed; other than the supply, the system has shown the potential of ensuring global quality through its central management.
  • Quantity objectives; the system has shown the ability to supply quality materials for various purposes in the facility
  • Supply of materials at a competitive price (price objective)
  • The system aims at ensuring that forward logistics, reverse logistics, inward logistics and outwards logistics are well operated and they collaborate with each other; this will be the way that a smooth running of the business will be affected

To better understand how the system has affected the operations of the system, this paper will look at the three areas independently:

Product management

Firstly, the healthcare industry is a hub of activities and a cottage industry; clinicians are independent contractors with specific preferences and clouts for supplies. Despite the preferences, some adjustments in the system as far as supplies and processes are occasionally accommodated. At King Faisal Specialist Hospital and Research Center, it can be estimated that Physician Preference Items (PPIs) account for 40% of total medical supply spending. Despite the allowance that the hospital has given to physicians, the management was stomaching the burden of the varying supplies meant to satisfy every clinician’s needs or preferences. The supplies initially constituted too many expenses and failure to have an added value to the system.

Despite the expected and observed resistance that was faced at the facility, eventually, the targeted physicians relaxed and adopted the changes in products delivery. GS1 was used to give information to the medical practitioners on the available products in the markets and how they have been used or can be used in the line with their duty. With the enlightenment, the players started getting relaxed on other products or equipment’s other than the ones they had initially preferred. GS1 was a successful project that promoted the spirit of buy-in from physicians; for example, the system promoted the spirit of universal adoption of cost-effective items for use within the hospital; the net effect of this was low costs of medical care provision at the facility (Livingston 2008). The success of the project is convincing the physicians to adopt new methods were successful to a rate of over 90% which was largely achieved in part through their use of a process the management called “Sourcing and Standards teams”; the teams consisted clinical experts and sourcing personnel, evaluate and determine the best and most cost-effective products to implement.

With the teams, the hospital was able to develop a matrix of decision making when making purchases with the sole aim of ensuring that the right equipment’s and hospital facilities are available throughout the year in the facility. Other than developing the pathways and system through which a purchase could happen, the teams in their meetings involved prioritizing the features that physicians prefer and utilize most of them when making their decision-making matrix; in the move to toss some professionalism, the procurement managers are given a chance to educate physicians on the financial impact of various supplier options. The team were also keen to use consensus in minimizing post-sourcing disagreement instead of majority rule; this resulted in the high compliance rate and buy-ins from all physicians (Polaniecki 2008).

Another element of product development that can be observed as a result of the GS1 adoption at King Faisal Specialist Hospital and Research Center is fully testing of surgical equipment. The team ensures that before a commitment has been made to purchase a certain item, then the management has initiated the need to test the machine using various mock processes like the once the machine is aimed at attaining (McCartney 2004). For instance, when committing for a surgery machine, the management with the assistance of the team undertakes a mock surgery to test the reliability of the machine. Other than at the hospital level, players in the global GS1 unit have come up with methods of ensuring that products they get to medical care providers are of high quality. They have established their own testing kits and systems to see that before they recommend for a product, then it’s of the wanted quality. The larger GS1 team focuses on a consensus approach to selecting products and agreement to the centralized testing rather than individual hospital product selection testing; this has allowed having reputation growth and discouraging counterfeits products (Porter & Van 1995).

As far as costs of products are concerned, GS1 takes the global view of ‘total cost’ rather than just ‘unit product cost’. Using this method, the central body is determining the types of products to purchase and yet have effective cost management. This evaluation process is nicknamed ‘from cradle to grave’ within GS1 facilities; this way the system is seen to protect medical care providers from exploitation by manufacturers (Porter 1985). When determining or recommending the price at which a certain supply should be sold, the body considers among other the initial input costs of the product from the types of raw materials used how this will impact the disposal cost associated with the product; with the approach, there is a fair costing adopted. For instance, certain surgical machinery may have a lower unit cost initially, but if the tool utilizes reagents that contain heavy metals, then the disposal costs or expense incurred will be substantial thus there is need to consider that when determining its cost. With the approach adopted by GS1 global management system, King Faisal Specialist Hospital and Research Centre has been able to know the products in the market and have their prices set at their best cost after determining different elements that influence current and future costs (Porter 1980).

Sourcing and Services

Using the GS1 system, Group purchasing organizations (GPO) have benefited from economies of scale through either supplying to a number of providers at once or linking to suppliers who have quality and quantity products from the system; with this, it has provided significant cost-saving opportunities. The cost-effectiveness has been attained through the adoption of GPOs and contracted Broadlane, a GPO, to conduct all of the negotiations with its supplier vendors. The advantage of this is that there has been a global network of suppliers; gives GS1 the leverage to access more suppliers. When products are provided at relatively low costs or the suppliers are having the benefits of economies of scale, the benefit is transmitted to individual facilities like King Faisal Specialist Hospital and Research Centre who depend on the system.

The manner in which benefits accrue to individual hospitals like King Faisal Specialist Hospital and Research Centre as far as their efficiency in production is concerned can be traced from the benefits that accrue from general GSI streamlining; on its part, GS1 has managed to streamline purchases and sales processed and provide cost savings, it expects most of their supply chain savings to come from better contract terms (Ebbena & Johnson 2006). The cost management is effected through effective systems of through savings from price improvements, rebates, administrative fees and overhead cost; with the random and fast change in the system, King Faisal Specialist Hospital and Research has been able to enhance its property development and reduced its costs of supplies (Michael 2006). Management can now rest assured that supplies ranging from medication are of the highest possible quality and are freely available.

With the system of GS1 in place, King Faisal Specialist Hospital and Research head of procurement department have managed to trickle down the operations of the supply chain functions into two major departments, the procurement section and traffic/freight. Both the departments work hand in hand to ensure that the hospital benefits from the framework of the supply chain that it has implemented (Rappold, 2003); the integrated supply chain as supported by GS1 can be looked at two main levels; from the manufacturer to the company’s stores (inward logistics), and from the stores to the customer (outwards logistics). The system is targeted at ensuring that the company maintains a wining relationship with suppliers, manufacturers and the internal structures (Duening 2009).

When using the system it gives King Faisal Specialist Hospital and Research Centre chance to visualize the global environment and compare the business risks and opportunities that can be available; the available chains of supplies are brought on the same platform and analyzed accordingly. GS1 has proved to be a strong decision-making tool in the centre, the management has been able to tap its design to designed for visualizing real-world data of countries, states, cities; the deviation point of the system is that the globe has suppliers who manufacture who make different products that the company stocks (Lynch 2003). With the number of suppliers, GSI assists the management to find the shortest route to get a supply to minimize the costs and time; the mode and method of supplies deliveries play a crucial part in the general performance of the centre. The lower the accessibility and the faster the delivery system, the lower the cost of getting products, the system also seeks the alternative path if something goes wrong to allow the flexibility of operation activities, one of the five performance objectives in operations management (Dhillon 2007). The system operates from the understanding that King Faisal Specialist Hospital and Research Centre has a number of suppliers of different commodities so the company accepts requests of supply and those responds to future supplies according to the demands of a certain commodity; the system has information on previous performance of a supplier that can be of great help making the current decision (Robinson & Fornell 2006).

The system GS1 simplify the complex operating tasks by not only mapping the locations but more importantly, drawing relationships spatially as well as identifying value in each relationship; it also stocks the company with details on the way to handle a future purchase. According to Gates, Lana, “GS1 analyzes and represents information visually, allowing for greater understanding of the operating environment around the corporate. Route analysis helps managers to generate the most efficient route (best route / shortest route) that the vehicle should take between the company and its supply chain link” (Gates 2009), the above statement illustrates the role that the system plays in contemporary supply chain system (Montgomery 1978).

Another area that the system has come to address is the effect of the developing trend in the healthcare industry of outsourcing of supply data management to professional supply data service providers, the system by its own has been able to have such important information and is using them to facilitate trade and improve the supply chain system in the company (Rios & Riquelme 2008).

The base of GSI strategy is value innovation which pursues differentiation and low cost simultaneously; its systematic approach is provided to avoid the inefficiencies and make the competition irrelevant by rebuilding barriers to create a leap in value for both the King Faisal Specialist Hospital and Research Centre’s stakeholders and patients. With relation to innovation, Ketchen & Hult 2006 assert that innovation is a strategic decision that is critical to many organisations as it provides one important way to adapt to changes in markets, technology, and competition. Likewise, innovation has an impact on a firm’s strategic initiatives, processes, and organisational structure. A firm can obtain an advantage by innovation in market positioning, which is not merely innovation in the technical arena but in the strategic sense. Ketchen & Hult 2006 argues that a firm can win without the fight by carefully positioning itself to critical positions, which furnish competitive advantages that are mostly incontestable. Besides, innovation can be pursued by the repeatable processes of blue ocean strategy. In turn, if a company’s offering is nothing more than an imitation or increasing improvement over its competition, it will only be treading water in a red ocean.

In the current environment, value creation of most products and services has moved towards innovation, since it regards continuous change as a motivating force that drives economic development). According to Backhaus and Ketchen & Hult 2006, creating value means increasing the total value that can be divided among the transaction partners. Additionally, innovation opportunities are often based on improvements in functional features and benefits in a market-based approach. By contrast, it is more difficult to create value in red oceans. Blue oceans will become red after 10 or 20 years as the industry moves into maturity and structures are inflexible. Direct competition among players in mature markets hinders any remarkable creation of value and limits value creation in the long term.

From the abovementioned points, the innovative practices of value innovators lead to advantages. However, one innovation is soon exceeded by another innovation. Thus the only way a first-mover can retain its growth is to launch new products and stay one step ahead of the competition. This requires a high rate of technological innovation and new product development. King Faisal Specialist Hospital and Research Centre, for example, has dominated its blue ocean for more than a decade. But this company is now involved in a highly competitive red ocean with descending performance. The reason is its failure to reach out for another value innovation in face of constant competitors’ imitation (Ketchen & Hult 2006).

With the adoption of GS1, King Faisal Specialist Hospital and Research Centre has been assisted to take advantage of opportunities as they come along; this means that it ensures its goods are delivered when they are needed; its aims at ensuring that there are no goods lying in the warehouse; goods are either on shelves displayed for sale or in transit (Andraski and Novack, 1996). Operating effective inventory management, information on market dynamics, supplier’s power and the costs of goods should be undertaken, there is also need to have all procurement departments integrated into the system for proper communication among them (Kouvelis, Chambers & Wang 2006).

The system of GS1 has a similar approach with just in time logistics: the system allows a company to maintain the limited number of warehouses; this ensures that between loading and unloading of goods, there is minimal storage (Kinsella 2003). This system will ensure that King Faisal Specialist Hospital and Research Centre suppliers get their goods timely in their best state; it will also facilitate the delivery of supplies to customers; collaboration among different supply chain management players is the main strength that the King Faisal Specialist Hospital and Research Centre has managed to attain with GS1 (Haag, Cummings, McCubbrey, Pinsonneault & Donovan 2006).

King Faisal Specialist Hospital and Research Centre had no option other than maintaining a good business relationship with its suppliers further; this will assist in making sure that there is reliability in the supply of materials. GS1 offered the platform through the system that aimed at enhancing the relationship that prevails. The relationship meant that suppliers were getting more concerned on the demand they get from medical facilities like King Faisal Specialist Hospital and Research Centre and aimed at fulfilling the demand in quality and quantity; suppliers have crucial information that they can give to the company and assist in making strategic decisions to take advantage of market opportunities (Mentzer 2001).

King Faisal Specialist Hospital and Research Centre needed to look into its database for suppliers; some suppliers have supplied satisfying equipment’s leading to better medical care services provision. To using GS1, the company has been able to maintain a pool of data detailing these times for future decision-making; it is from the system that the management has been able to build building blocks that enhance the relationship between the facility and suppliers (Simchi-Levi, Kaminsky & Simchi-levi 2007). GS1 creates documentation of past transactions for future audits and decision making; other than the documentation, the system is made in such a way there is always a just in time supply. GS1 just in time supply approach sees the company have adequate supplies at any one point in time. (Mentzer 2001).

King Faisal Specialist Hospital and Research Centre’s procurement department is mandated with this task, it considers factors like:

  • Reliability: through the use of GS1 system, the management has been able to answer some of the burning questions facing the company which include, the supplier able to deliver when called upon whether in short notices or otherwise how much can the supplier be relied upon; is the supplier able to deliver when called upon whether in short notices or otherwise?
  • Capability: future recorded transitions have been able to give an insight about the capability that different suppliers have; this assists in procuring from those suppliers who can meet the demands of the company at any one time (Hines 2004).
  • Price: as illustrated, above, GS1 system ensures that the prices sold for a commodity are the right or the fairest price; it answers the question of: does the supplier offer well at an appropriate rate? When prices go down do the suppler adjust them accordingly? What technical advice as far as prices are concerned do the supplier offer to its customers?
  • Experiences: GS1 is a platform of information and experiences sharing; using the system, King Faisal Specialist Hospital and Research Centre has been able to know was the experience that the company had in the last business with the supplier, which include did the supplier disappoint facility or the industry in general? (this information should be gotten from the supplier management system)
  • Quality assurance and effectiveness: when vetting for quality, GS1 had been able to answer the query to note the general response of customers (medical care providers) and the responses that customer has had when using some products. Others include, an analysis of strong a particular supplier’s brand name is (Larson & Halldorsson 2004).

The above questions have been challenging to the King Faisal Specialist Hospital and Research Centre’s supply chain system but GS1 has given a satisfactory answer (Larson & Halldorsson 2004).

Purchasing Systems and Technology

The medical hospital/facilities have been facing a challenge in the kind of technology they have been having. They have for a long time depended on an outdated computer system that can hardly support the changing industries and associated changes. With the coming of GS1, King Faisal Specialist Hospital and Research Centre has been able to have effective business structures that facilitate purchasing and managing stocks. The system has taken centre-stage in promoting technological development among the facilities instead of the traditional notion that the facilities need not have effective ways (Ries & Trout 1986). With GS1, King Faisal Specialist Hospital and Research Centre has realized it’s not only necessary to have the structures but it’s even more important to have working systems.

GS1 has further improved the facility area of purchasing systems and technology; the system has facilitated the team to use the new technology/development called virtual item files, which have already been deployed in other industries, under the system, the organization can be able to use data of different sources to make the right decision (Peltier 2002). The system integrates different complex supply chain systems into one framework that facilitates third party data management providers can help GS1 integrate their existing data repository with the purchasing/requisition systems; this has facilitated growth in database management. The system has facilitated faster, more valuable and easier access to necessary supply information when ordering; this means that the organization can concentrate on its core business of improving medical care services (Wheelen & Hunger 1999)

GS1 has been able to facilitate on-time or immediate supplies management/stock management system; using the system when an order (an order, in this case, means for example when some medicines have been dispensed from the pharmacy) they processing through GSI system, then the buyer after placing the order will have the details keyed at the selling point. The completion of the transaction which is via a click of a bottom will mean that information has been passed to the store department that a sale has been made and thus stocks have reduced. This assists in managing the reorder level and keeping the company rich with the products necessary for production (Hitt, Hoskisson & Ireland 2003)

King Faisal Specialist Hospital and Research Centre’s store managers can get real-time information from one point; this boosts confidence and improves customer service. The system has seen the collaboration among different departments as information is passed through the system for convenience; it ensures that there is effective supplier integration, queuing strategy and capacity planning is enhanced (Ranchhod & Gurau 2007).

Globalization and improved international relations have improved markets that organizations can sell their products. When selling in the international markets, an organization’s sales and marketing team should be robust to effectively advise their organization on the best business and corporate strategy to adopt in the global market. One of the most obvious advantages is the integration of different departments into one system; GS1 has seen all system integration into a system possible. When King Faisal Specialist Hospital and Research Centre operates as a single unit, then the corporation and business integration are enhanced; better corporation means that the centre will offer high-quality services; there is no one department that feels is more superior to the other. King Faisal Specialist Hospital and Research Centre’s leaders are able to monitor transactions and business deals at a single point thus facilitating the establishment of areas of deficit for strategic actions; this has been assisted by GS1 implementation (Blackhurst 2003).

Inventory and Distribution Management

The system has been of great help to the facility as far as managing of their inventory is concerned. There are different costs associated with managing inventories and stocks. The costs include storage costs, handling costs, as well as costs of managing the stores (Parker 2009). With the effective change, the system has come to limit any effects or costs that result from supply chain system with the most talked one as the Bullwhip effect (O’Brien 2003). The Bullwhip effect is a supply chain phenomenon which arises with increasing demand variability; it’s a trend of larger and larger swings in inventory in response to changes in demand; the net effect is likely to be uncontrolled stocks leading to business losses (Bakker 2002).

The effect occurs when:

  • There is over batching; this ensures that the facility has the right supplies required for the optimal operation of the facility
  • Poor supply chain management that has limited coordination; this has been eliminated by the use of the system(Paliadelis 2005)
  • Poor communication among departments more so supply chain, procurement, stores, and sales department, it also includes delayed times for information and material flow
  • Overreaction to backlogs, free return policy, shortage gaming and demand forecast inaccuracies (Ward & Glass 2008).

To avoid the occurrence of the Bullwhip effect, hospital facilities have adopted strategic supply chain management system; King Faisal Specialist Hospital and Research Centre has seen the benefit of the appropriate GS1 system. The GSI system has ensured there is good communitarian among departments more so the sales, procurement, and supply chain system. Information technology should also be used in supply chain systems (Roddick 2001). It’s worth noting that some of the challenges that faces firms is how to maintain their stocks at levels that will ensure there are adequate supplies at all times and maintain the firm afloat. This calls for the combination of different tactics that include ensuring that all departments are operating effectively. The sources of materials and medical equipment are another area that always a need to be focused on; managers or the firm have ensured there is continuity in business through the provision of structures that facilitate growth (Fred 2008).

Discussion, Implications and recommendations

GS1 system results at King Faisal Specialist Hospital and Research Centre have resulted in a number of benefits to the centre’s operations as well as how it’s relating with other players in the medical field. The system has seen the facility able to effectively transact business and handle patients in the right manner considering the operational costs involved. The general gain that organizations get from having effective supply chain management has been discussed and results of it have been evident at King Faisal Specialist Hospital and Research Centre; the facility using the system is able to provide high-quality products at minimal costs. Business enterprises have been the main pioneers of using customized business applications to handle different elements of their lives; they have used them as their source of inspiration in cost management and flow of business (Barney 2007).

When the system (GS1) was implemented, it aligned with the mission and vision of King Faisal Specialist Hospital and Research Centre which revolve around the provision of high-quality medication; the facility has brought positive changes in the health care sector. The new global system aims at improving the general provision of quality and reliable medical care services to the world through reinforcing collaboration and effective costing among different players in the industry. The system principles are reinforced on data synchronization to address patients’ safety matters through improved supply chain management and efficiency in different segments of players of the industry. So far, the system has gained numerous successes in places it has been implemented; they include the adoption of the system in 2008 by leader companies in the sector of health care. Some of the companies involved in the adoption included GSK, Johnson & Johnson, Comparatio, CVS, McKesson and Premier Medtronic, and Merck (the above are manufacturers) and Group Purchasing Organizations; and now it has proved to be an effective method of improving medical care provision at King Faisal Specialist Hospital and Research Centre (Haberbeg & Rieple 2001).

The system embraces the spirit of logistics management, stock movement management, supplier’s data management, as strategic management tools, with their ultimate goal as that of the provision of products and services required by players in the medical facilities. At King Faisal Specialist Hospital and Research Centre the system has been used to create growing efficiency in operational functions were focus is on quality provisions, value additions, and work in progress inventories, physical distribution of material stocks, trading products, and manufactured goods (Hambrick and Finkelstein & Mooney 2005). at King Faisal Specialist Hospital and Research Centre, the system has been used to link different players in the logistics/supply chain management; the linkage offers a platform through which they can share many and complex pieces of data to facilitate efficiency, effective costing, information sharing, innovation and invention growth, transparency and improves business and health care provision (Wolf, Bradle & Nelson 2005).

When using the system, the benefits are in two-folds; for instance, the technology used in making a certain machine or medicine can be communicated by manufacturers and distributors. When this happens, then the entire industry is moving in the right direction as far as improving and response to changes in demand is concerned; the efforts ensure users of the products understand what they are dealing with. When using GS1, King Faisal Specialist Hospital and Research Centre has been able to contribute to the growing medical care industry through essential sharing and the importance of the data to all players in the sector (Couturier & Davide 2010).

Summary and conclusion

King Faisal Specialist Hospital and Research Centre main reason for the adoption of the GS1 system is to look for avenues through which supply chain can be managed effectively and still maintain operations costs at minimal costs. GS1 is an internationally accepted language and central control that targets to reinforce supplies quality management and enhancing relationships that different in the medical care industry have; using the method King Faisal Specialist Hospital and Research Centre aimed at developing reliable structures for effective business (Pielstick 2005). GS1 has the role of ensuring health facilities have material supplies of the right quality; King Faisal Specialist Hospital and Research Centre before the method had been having the challenge of harmonizing and maintaining a single reliable and efficient quality level.

GS1 system goes a step further to ensure that medical components and products have been given an appropriate price that resembles their quality, reliability and to some extent their quantity; when effectively managed, patients get reliable and quantity products. To fulfil its objectives, GS1 manages/integrated the supply chain management operations in three main levels that are interlinked for an effective process; ensuring quality, ensuring cooperation, and facilitating good pricing of commodities; the system has called upon King Faisal Specialist Hospital and Research Centre management to join efforts with other medical service provisions and their stakeholders (David 2008). The collaboration and common effort pulling are necessary for maintaining the quality of their services and the sharing of information (Fred 2008). The following are the main areas that GSI Health care has been able to attain at King Faisal Specialist Hospital and Research Centre:

  • The system has reduced medication errors. It’s through the system that the right information is passed to the medical facility; information and experience from other sections and areas in the globe plays a crucial point in improving service knowledge and quality improvement. Medical professionals at King Faisal Specialist Hospital and Research Centre have been boosted to know what kind of medicine they are giving their patients and probably the effect it has had in the past to those patients who used it (Rahman, & Bhattacharyya 2003)
  • Patients are now confident that they will get medicated at the right time through the right route and in the right dose. This has come true through the operations of the system that facilitates documentation and sharing of burden among different players; dosage and the timing of the same is important for quality medical care; this will be facilitated by the adoption of the system (Parker 2009)
  • Efficient traceability and accountability promotion; GS1 has ensured that companies have high levels of dependencies and each can be accountable of its actions and did; manufacturers and suppliers are easily traced by the system thus in the case of further consultation, it is easy.
  • Efficient product authentication with product authentication, then players can get the right medicine and be guaranteed that its quality; in case of elapse of quality, then manufacturers can be traced back
  • Less time spent on manual documentation, leaving more time to consult directly with patients; this is likely to improve the efficiency and effectiveness of medical care provision (Huang 2000)
  • With the adoption of GS1, the facility has been able to undertake cost reduction strategies effectively; this has been attained through increased supply chain efficiency. The cost of medication when the cost of medication has been managed, the effects are wide and reaching, it assists in general improvement of the health care system (Kraemer 2003).
  • GS1 has assisted King Faisal Specialist Hospital and Research Centre to have an improved order and invoice process. This has transmitted to Optimized receiving and planning of supplies when this happens, then the organization benefits (Tan 2010).
  • In the medium term, King Faisal Specialist Hospital and Research Centre has reduced inventory and increased productivity (Bruce & Fottler 2005).
  • Improved product recall and improved shelf management, and improved service levels/fill rate
  • The system has assisted King Faisal Specialist Hospital and Research Centre in having an improved benchmarking and management of supply cost. This has resulted in an elimination of the need for relabeling and proprietary codes (Paliadelis 2005)

Quality enhancement level, at King Faisal Specialist Hospital and Research Centre, has been able to use the GS1 Health-care system to purchase and make production decisions depending with the demand that the in the facility; the system tries to merge demand and supply to ensure steady and reliable supplies (King 2002). It’s through the system that the company can get quality medications and medical equipment’s through its ability to effective contracting, scheduling, and process planning (Ross 2006). Quality enhancement offers an organization’s management room to develop the frameworks that the supply chain and logistics management will work on.

The method aims at operating through to ensuring quality and quantity delivery of materials, medications, and medical information. Other than looking at the interests King Faisal Specialist Hospital and Research Centre, the system considers the need of suppliers, patients, and other players in the system in the efforts of benchmarking operations against those of competitors and enacting best practice policies. GS1 system involves reliable and consistent supplies of the right commodities/medication. This assists King Faisal Specialist Hospital and Research Centre to have effective structures to compete or jointly facilitate medical care improvement with other players in the market; with this in mind logistics managers ensure they have aligned processes in the best interest of the company (Leach 2005).

King Faisal Specialist Hospital and Research Center adoption of the computerized internal control system (GSI Health care system) has seen the follow of consumable and fixed assets improve. When using the system, the company has been able to develop an integrated supply chain management and facilitate effective sharing of medical information; this has played a significant role in maintaining and improving efficiency in the facility. Through the system of GSI Health care system, the medical facility has been able to offer physical verification of materials delivered to input them in the computer database. When this is taking place, then the quality and quantity elements of the materials are highly considered. Every time the production department is making an order, GS1 is put to task to ensure that there are effectiveness and quality in medications, medical equipment’s, and tools used by physicians (Kraemer 2003)

A critical review of research methods

The main method adopted for data collection is the survey method. Under the method, the research was keen to observe the trend and the effect that adoption of GS1 had at King Faisal Specialist Hospital and Research Centre; much of the focus of the method was to interpolate what the hospital has gained in terms of efficiency, quality improvement, and how staff members have adopted to the new system of managing supply chain management (Shane 2003). The survey involved human capital in the facility with the intention of getting their input on what the facility has been able to attain that far and how well they predict the trend will continue (Rotella, Abbott & Gold 2000).

It’s through the method that recommendations for future improvements were gotten. The research paper methods were adopted with the responsibility to finding out the connection between the GS1 technology in at King Faisal Specialist Hospital and Research Centre, its performance in the long run, and the net effect of the computerization. The research has also looked to find out the ways by which King Faisal Specialist Hospital and Research Centre can increase the engagement of the employees, medics, and professionals of different cadre in ensuring supply chain operations in an effective and reliable manner. For the development of the research paper, a literature review has been finished on the basis of the past literary works finished in the field (Thomas & Donna 2010).

It has been found out the success of the system dependent on various aspects with staffs’ engagement being one of the main parameters that determined its success or failure. The employees are to be made to be felt like a part of the organization and their inputs are highly valued and considered by the management. It is highly unlikely they will themselves feel like a part of the organization. Thus it is the job of the management to make them feel so; when employees feel part and parcel of the firm, they will give good inputs in decisions of the supply chain (Saunders, Lewis & Thornhill 2003). They have to be paid well, they have to be given all the opportunities to improve, they have to understand the value for their work, they have to understand the importance of their activities in the overall functions of the company, teamwork has to be developed. The engagement of the employees has a positive influence on the activities of the company and can help in the development of the customer satisfaction of the companies. This in turn can help the company to be successful in the long run. The research finished in the paper has been able to find out the same points and it has been able to point out the fact the employee engagement and the performance of the companies is directly related (Simchi-Levi, Kaminsky & Simchi-levi 2007)

The research paper deals with an interesting subject in the course of the connection of employee engagement and the degree at which GS1 will be effective. The research finished in the paper has been developed as a survey which included a questionnaire and was supplied to the employees of 3 different organizations (Margerison 2002). The responses of the survey have underlined the fact the management played a crucial role in the development of the employee engagement of the company. It has to be stated here “people like to be moved, rather than to move” and thus it is the responsibility of the management to make the activities of the employee engagement to be successful. The survey has found out the management has to develop the motivational factors for the employees to be a part of the organization. They are to be rewarded for their works, they are to be provided feedbacks, they have to be developed as a team, they have to be constantly motivated, they have to make understand the importance of their position in the company etc. The main aspect of the findings has been the employees are to be motivated at regular intervals (Schmalensee 1982). They are to be rewarded or the management has to take the responsibility to improve the workplace environment of the company. This will help in the development of employee engagement in the company and will help the company to fulfil the overall aims and objectives (Mentzer 2001).

Using the survey method, the level of interaction of the system (GS1) and employees in an organization gave an account of what needed to be improved in the system to make it better and facilitate it in addressing staffs and management needs. Much focus is placed on how the management has been able to change the organization and held to its new development of an integrated supply chain management system. The other major focus that the method was able to capture is the mood of employees and the rate at which the system addressed patients’ needs and surpassed their expectations. Using the survey method, the reliability of GS1 has been able to be noted and attained. The management and their interaction with the system have been evaluated and its documentation will be used for future improvement of the system (Larson & Halldorsson 2004).

Technology assists an organization to improve its efficiency and effectiveness. Resources are more focused on the agenda of the company to facilitate better services. For instance when records within hospital facilities are kept in a systematic manner, then when offering services, the providers will get quick access to the records that in turn facilitates fast and quality medical services provision. Systems maintain more durable and reliable records than the case would be for the manual system of data capture and data-keeping (Beynon-Davies 2009). With the system, history of patients will be maintained and revisited occasionally if need be to facilitate in service provision.

There are some instances where medical data of a patient may be required by another facility where he is seeking medical care. When using an integrated system, such data and information sharing will be fast and accurate. It’s important to comment here that the provision of quality medical services has a large connection with the historical analysis of a patient and also with the current state of the patient. With an integrated system, medics will be able to share what they hold on request (the request should have proper authorization either from the patient, his proxy or any other body mandated with the task), this, in turn, facilitates the provision of quality medical services (McFarland, Bloodgood, & Payan 2008).

Research and development in the medical field can be facilitated when information, diagnoses and patients’ responses to particular medications have been well documented and shared with relevant bodies. GS1 system will be paramount in ensuring that the information has been shared across the medical scenes to facilitate innovation, invention, and development in the medical field. GS1 is likely to integrate and seek information from more than one country, the wide-spread of information sources is likely to benefit the users of the information as it will offer different opinions, views, and outcomes; this is crucial in the development of new systems and ways of operating in the medical scenes( Näslund 2002).

With the development of GS1, the facility has been able to integrate different departments and maintains a uniform set of operations. Thing and activities can flow effectively and all contribute to the growth of medical care offered by the facility. When issues of quality befall the facility, the management is able to undertake a follow up as they had initially gotten the products from a supplier who can be held liable of any misfortunate resulting from substandard goods (Murphy 2005). Another main area that GS1 has looked into is the development of reliable suppliers-hospital facility such that credit terms have improved. When doing business, it’s almost impossible to work without borrowed capital. Borrowed capital can come from suppliers through their commodities; with GS1, it has enabled the growth of company-company relationship leading to improved interaction and better credit terms. This is an area that the facility has capitalized especially when getting capital and expensive goods like X-ray machines, Surgery y, and information technology equipment’s (Andraski & Novack 1996).

The globe is undergoing numerous changes; different parts of the globe are having different experiences and innovations (Avery 2004). With GS1, the choice of products that the facility is getting has greatly increased. New players in then board come with the technologies and new inventions to the benefit of the company. Global integration has meant that players with new products are gotten on board for the good of the medical facility. The system has enabled innovators or developers to market their products across the globe and still adhere to some set regulations of standard (Brodsky & Newell 2010). Taking the case from a broader angle, with GS1, scientists, innovators, and developers in the medical care industry have been encouraged to improve service delivery.

This has been facilitated by the platform of marketing that the system creates and also much sharing of information (Nedungadi 1990). Other than a platform, the system acts as a virtue team platform were players of the medical care industry can use in solving medical care challenges (Hambrick & Finkelstein & Mooney 2005). The players can sell and contribute to various medical decisions in their move to increase care or seek a solution to matters facing the industry. Different players who come from different parts of the world can express their feelings on issues of discussion as triggered by the system. When the general environment of the industry increases, supplies are the main beneficiaries. Hospitals, like King Faisal Specialist Hospital and Research Centre, get products and services that can further increase their production and service quality delivery (Kurtz, MacKenzie & Kim 2009).

Recommendations

GS1 benefits have been noted and are highly appreciated at King Faisal Specialist Hospital and Research Centre this is a positive move in improving service delivery in the facility, however much need to be done to further improve the quality (Cooper, Lambert & Pagh 1997). The following are the areas the facility should look into:

Further integration

The facility should embark on further integration among departments. GS1 on its own has much focused on the supplies and procurement departments however irrespective of how well the department work, it cannot work in isolation. Physicians say and inputs should be considered when making the procuring decision. Although the facility aimed at harmonizing the demand of physicians to products that are likely to be cheaper but of high quality, the initial demand of physicians should be considered. Another area that the facility should note is that GS1 does not offer a feedback channel. The facility should get feedback from physicians and patients to determine whether the products they are getting are of the right quality and its production is okay (Kerin & Peterson 2009).

Focus on the whole facility, not on different segments

Although the facility is focused on having effective structures, the management should be wise to understand that the system will only be effective in the medium and long term if all segments of the facility are interlinked with the role of seeing success (Crother-Laurin 2006). The current medical environment is characterized by rapid and ongoing change; innovation and innovativeness have been highlighted by the information revolution. New product development is one of the recommended strategies to effectively attract development and quality improvement as well as maintaining the existing users. Additionally, value-added and premium products are advantageous and profitable compared with those generic products (Bate, Robert & Bevan 2004).

As a result, the facility can achieve product innovativeness and sustain its leading position in the naturally-oriented medical care market by means of continuous investment in research and development in the long run. Moreover, in order to link the brand values with the patients’ loyalty, King Faisal Specialist Hospital and Research Centre should develop the association by getting involved in community actions, local events and charities. In brief, whether King Faisal Specialist Hospital and Research Centre determines to take any action in the future, it is imperative to follow the principle to focus and renew its strategic methods and leave behind the scattered marketing attempts years ago (Beerney 2007).

When it comes to the trends of the medical services system, there will be more and more medical facilities showing concerns about environmental protection and contributing to social benefits (Howell & Shamir 2006

). Hart et al. asserted in 2000 that all businesses and markets will be constrained by and dependent on ecosystems and nature. It appears that competitive advantages are gained by firms that are better capable of incorporating concerns for the environment into their strategic planning process. In order to keep a competitive advantage, such capability must be valuable and irreplaceable. Consequently, the domestic cosmetics companies are strongly recommended to lay stress on environmental issues and devote the efforts to producing naturally sourced products (Keramally 2003).

Future research and development

According to the research limitations, this research is based on a small number of respondents; thus, further research should attempt to investigate on a more nationwide scale and include a greater sample in order to obtain better information. In addition, data collection in future research can adopt both qualitative and quantitative survey methods for adequate information, as well as the in-depth understanding of people’s attitudes towards the brand image in a more far-flung investigation. Moreover, the analysis methods employed in this research are the main factor and regression tests from the SPSS program. It is suggested that future researchers endeavour to conduct further research by using different methods, such as correlation analysis, to obtain a far-reaching outcome (Avenell 2005).

In respect of the research subject, this study revolves around the blue ocean strategy and brand image in the cosmetics field; the future research should try studying the subject from a broader perspective or relative businesses. For the influential factors of brand loyalty, future studies can put emphasis on the external market environment, organizational structure, consumer behaviour, and product development etc. while this study focuses on perceived qualities, brand awareness and brand association. Furthermore, the Internet plays a critical role in today’s business environment, and the percentage of consumers’ on-line purchase preference for cosmetics is on the rise. Future studies can thus extend their research range and consider the supplementary variables such as on-line shoppers’ behaviour, supply chain management or distribution strategies to have a better eye for marketing strategies and brand image (Shane 2003).

References

Andraski, J & Novack, R, 1996, ‘Marketing Logistics Value: Managing the 5 P’s,’ Journal of Business Logistics, Vol. 17 no. 1, pp. 23-39.

Anctil, E, 2008,’ Marketing and Advertising the Intangible’ ASHE Higher Education Report, vol. 34 no 2, pp. 31-47.

Avenell, K 2005, ’Sustainable leadership’, The Australian educational leader, vol. 27, no.3, pp. 29-48.

Avery, G, 2004, Understanding leadership: Paradigms and cases, SAGE Publications, London.

Bakker, P, 2002, ‘Free Daily Newspapers-Business Models and Strategies’, The International Journal on Media Management, vol. 4 no. 3, pp. 180-187.

Barney, J. B, 2007, Gaining and sustaining competitive advantage, Upper Saddle River, Pearson Prentice Hall.

Bate, P, Robert, G & Bevan, H 2004, ‘The next phase of healthcare improvement: what can we learn from social movements?,’ Quality and Safety in Healthcare, Vol. 13 no. 1, pp. 62-67.

Beerney, J. B, 2007, sustaining competitive advantage, Upper Saddle River, Pearson Prentice Hall.

Beynon-Davies, P, 2009, Business Information Systems, Basingstoke, Palgrave.

Borodzicz, E, 2005, Risk, Crisis and Security Management, Wiley, New York.

Blackhurst, R 2003, ‘The freeloading generation, ‘British Journalism Review, vol. 163 no. 9, pp. 53-59.

Brodsky, R & Newell, E 2010, ‘Procurement Pressures’, Government Executive, vol. 42 no.7, P. 38.

Bruce, F & Fottler, M 2005, Human Resources in Health Care, Managing for Success, Health Administration Press, Michigan.

Cooper, C, Lambert, D & Pagh, J 1997, ‘Supply Chain Management: More Than a New Name for Logistics’, The International Journal of Logistics Management, vol. 8 no. 1, pp. 1–14.

Couturier, S & Davide, S 2010, ‘International market entry decisions: the role of local market factors’, Journal of General Management, vol. 35 no. 4, pp. 45-63.

Crother-Laurin, C 2006, ‘Effective Teams: A Symptom of Healthy Leadership’, The Journal for Quality and Participation, vol. 29,no. 3, p. 4-6.

David, F 2008, Strategic Management: Concepts and Cases. Pearson Education, New Jersey.

Davide, S 2010, ‘International market entry decisions: the role of local market factors’, Journal of General Management, vol. 35 no. 4, pp. 45-63.

Dhillon, G 2007, Principles of Information Systems Security: text and cases. John Wiley & Sons, New York.

Donaldson, G 1995. ‘A New Tool for Boards, ‘The Strategic Audit, Harvard Business Review, vol. 35 no. 4, pp. 45-63.

Duening, N, Hisrich, D & Lechter, A 2009, Technology Entrepreneurship, Academic Press, New York.

Duening, N 2009, Technology Entrepreneurship, Academic Press, New York.

Ebbena, J & Johnson, A 2006. Bootstrapping in small firms: An empirical analysis of change over time, Journal of Business Venturing, vol. 21 no 6, pp. 851-865.

Esquerre, B 2005. Have You Done Your S.W.O.T.? Today? Fitness Business Pro, vol. 21 no12,p. 24.

Fernie, J & Leigh, S 2009, Logistics and Retail Management: Emerging Issues and New Challenges in the Retail Supply Chain. Kogan Page, London.

Fred, D 2000, Strategic Management: Concepts and Cases, Pearson Education, New Jersey.

Fred, D 2008, Strategic Management: Concepts and Cases, Pearson Education, New Jersey.

George, R 2003, The ethics of information technology and business, Wiley-Blackwell, New York.

Haag, S, Cummings, M, McCubbrey, D, Pinsonneault, A & Donovan, R 2006, Management Information Systems For the Information Age, McGraw Hill, Canada.

Haberbeg, A & Rieple, A 2001,The Strategic Management of Organisations, Prentice Hall, London.

Hambrick, D & Finkelstein, S & Mooney, A 2005, ‘Executive job demands : New insights for explaining strategic decisions and leader behaviors’, Academy of Management Review, vol. 30 no. 3, pp. 472-490.

Hanssens, D, Rust, R & Srivastava 2009, Marketing Strategy and Wall Street: Nailing Down Marketing’s Impact. Journal of Marketing, vol. 73 no. 6,pp. 115-118.

Hines, T 2004, Supply chain strategies: Customer driven and customer focused, Elsevier, Oxford.

Hitt, M, Hoskisson, R & Ireland, K 2003, Strategic Management: Competitiveness and Globalization, Thomson Learning, South Western.

Howell, M & Shamir, B 2005,’ The role of followers in the charismatic leadership process : Relationships and their consequences’, Academy of Management Review, vol. 30, no. 1, pp. 96-112.

Howell, M. & Shamir, B. 2006.’ The role of followers in the charismatic leadership process : Relationships and their consequences’ Academy of Management Review, vol. 30, no. 1, pp. 96-112.

Huang, L 2000, ‘Choice of Market Entry Mode in Emerging Markets: Influences on Entry Strategy in China’, Journal of Global Marketing, vol. 14 no. 2, p. 83.

Kaushik, K & Cooper, M 2000, ‘Industrial Marketing Management’. Management, vol. 29 no.1,PP. 65–83.

James, A & Michael, F 1995, The Success Paradigm: Creating Organizational Effectiveness Through Quality and Strategy, Quorum Books, New York.

Keramally, S 2003, Gurus on Marketing, Thorogood, London.

Kerin, R. A & Peterson, R. A 2009, Strategic Marketing Problems: Cases and Comments, Pearson Education, London.

Ketchen, J & Hult, T 2006, ‘Bridging organization theory and supply chain management: The case of best value supply chains.’ Journal of Operations Management, vol. 25 no. 2, Pp.573-580.

King, R 2002, Leadership in the NHS: Leading at all levels. Nursing Management, vol.8 no.9, pp. 26–27.

Kontopoulos, G 2009, Online Inventory Management Systems Advantages. Wiley, New York.

Kouvelis, P, Chambers, C & Wang, H 2006, ‘Supply Chain Management Research and Production and Operations Management: Review, Trends, and Opportunities.’ Production and Operations Management, vol. 15 no. 3, pp. 449–469.

Kraemer, H 2003,’Keeping it Simple’, Health Forum Journal, vol. 46 no. 3, pp. 16-20.

Kurtz, L MacKenzie, F & Kim, S 2009, Contemporary Marketing, Cengage Learning, New York.

Larson, P.D & Halldorsson, A 2004, ‘Logistics versus supply chain management: an international survey.’ International Journal of Logistics: Research & Application, vol. 7 no. 1,pp. 17-31.

Leach, L 2005,’Nurse Executive Transformational Leadership and Organizational Commitment’, Journal of Nursing Administration, vol. 35, no. 5, pp. 228-237.

Lewis, P, 2004, Team-Based Project Management, Beard Books, Washington.

Livingston, J 2008, Founders at work: stories of startups’ early days, Apress, New York.

Margerison, C, 2002, Team leadership, Cengage Learning, Gale.

McCartney, J 2004, Accounting: A Framework for Decision Making (Book). Pacific Accounting Review (Pacific Accounting Review Trust), Vol. 16 no. 1,PP. 77-80.

McFarland, R, Bloodgood, J & Payan, J 2008, ‘Supply Chain Contagion’, Journal of Marketing, vol. 72 no. 2, pp. 63-79.

Mentzer, J 2001, ‘Defining supply chain management’. Journal of Business Logistics, vol. 22 no. 2,pp. 1–26.

Michael, P 2006. Advanced Accounting: Concepts & Practice. Issues in Accounting Education, vol. 72 no. 2, pp. 63-79.

Möller, K 2006, ‘Marketing Mix Discussion – Is the Mix Misleading Us or are We Misreading the Mix?’ Journal of Marketing Management, vol. 22 no. 3, pp. 439-450.

Murphy, L, 2005,’ Transformational leadership: a cascading chain reaction’, Journal of Nursing Management, vol. 13 pp. 128-136.

Montgomery, R 1978, Accounting–Its Principles and Problems (Book). Accounting Review, vol. 32 no. 5, pp.321-338.

Näslund, D 2002, ‘Logistics needs qualitative research – especially action research.’ International Journal of Physical Distribution & Logistics Management, vol. 32 no. 5, pp.321-338.

Nedungadi, P 1990, ‘Recall and consumer consideration sets: influencing choice without altering brand evaluations’. Journal of Consumer Research, Vol. 17 No.3, pp.263-76.

Nellis, J & Parker, D 1997, The Essence Of Business Economics, Prentice Hall of India Pvt. Ltd, New Delhi.

Nunnally, J 1978, Psychometric theory, McGraw-Hill, New York.

O’Brien, J A. 2003, Introduction to information systems: essentials for the e-business enterprise. McGraw-Hill, Boston, MA.

Oppenheim, A 1997. Questionnaire design, Interviewing and Attitude Measurement, Continuum, London.

Ozsomer, A, Calantone, R &DiBonetto, A 1997, ‘What makes firms more innovative? A look at organizational and environmental factors.’ The Journal of Business & Industrial Marketing, Vol. 12 No. 6, pp. 400-11.

Paliadelis, P 2005,’Rural nursing unit managers: education and support for the role’, Rural and Remote Health, vol. 5 no. 1,pp. 1-7.

Parker, G, 2009,Team Leadership: 20 Proven Tools for Success, Human Resource Development Press, New Jersey.

Peltier, R 2002, Information Security Policies, Procedures, and Standards: guidelines for effective information security management, Auerbach publications, Boca Raton.

Pickton, D & Broderick, A 2005, Integrated Marketing Communications, Pearson Education, London.

Polaniecki, R 2008, ‘In Focus,’ Credit Union Management, Vol. 31 No. 1, pp. 56-58.

Porter, M 1980, Competitive strategy, Free Press, New York.

Porter, M 1985, Competitive advantage, Free Press, New York.

Porter, M & Van, C 1995, ‘Green and competitive,’ Harvard Business Review, Vol. 73 no. 5, 120-134.

Rahman, Z & Bhattacharyya, S 2003, ‘First mover advantages in emerging economies: a discussion,’ Management Decision, Vol. 41 No. 2, pp. 141-147.

Ranchhod, A & Gurau, C 2007, Marketing Strategies: A Contemporary Approach, Financial Times Prentice Hall New York.

Ries, A & Trout, J 1986, Positioning: the Battle for your Mind, McGraw-Hill, New York.

Rios, R.E & Riquelme, H.E 2008, ‘Brand equity for online companies.’ Marketing Intelligence & Planning, Vol. 26 No. 7, pp. 719-742.

Roberts, L 1994, Process Reengineering: The Key To Achieving Breakthrough Success.Milwaukee, New York.

Robinson, W & Fornell, C 2006, ‘Sources of market pioneer advantage in consumer goods industries,’ Journal of Marketing Research, Vol. 22 No. 3, pp. 305-17.

Roddick and the Body Shop’, Publishers Weekly, Vol. 247 No. 43, pp. 63.

Roddick, A 2001, Body and Soul: Profits with Principles – The Amazing Story of Anita Roddick and the Body Shop, Crown Publishers, New York.

Ross, S 2006, ‘A conceptual framework for understanding spectator-based brand equity,’ Journal of Sport Management, Vol. 20 No. 1, pp. 22-38.

Rotella, M, Abbott, C & Gold, S.F 2000, Business as unusual: the triumph of Anita, Wiley, New York.

Saunders, M, Lewis, P & Thornhill, A 2003, Research Methods for Business Students, Pearson Education, Essex.

Schmalensee, R 1982, ‘Product differentiation advantages of pioneering brands,’ American Economic Review, vol. 72 no. 1, pp. 349-366.

Scott, A. 1982, The Value of Formal Planning for Strategic Decisions. Strategic Management Journal, vol. 72 no. 1, pp. 349-366.

Shane, S 2003. A General Theory of Entrepreneurship: the Individual-Opportunity, Edward Elgar, Nexus.

Simchi-Levi, D,Kaminsky, P & Simchi-levi, E 2007, Designing and Managing the Supply Chain, Mcgraw Hill, New York.

Tan, J 2010, Adaptive Health Management,’ Information Systems, vol. 124 no. 125, p. 189.

Thomas, E & Donna, L 2010, Export/Import Procedures and Documentation, AMACOM Div American Mgmt Assn, New York.

Ward, J & Glass, L 2008, ‘INVENTORY MANAGEMENT SYSTEMS,’ National News, vol. 100 no. 1, P.24.

Wheelen, L & Hunger, J 1999, Strategic Management and Business Policy: Entering 21st Century Global Society, Addison Wesley, Massachusetts.