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Analysing the use of mixed The use

of mixed
methods in quality methods

management literature
Patr
ıcia Moura e S
a
Faculty of Economics, Centre for Social Studies, University of Coimbra,
Coimbra, Portugal Received 9 March 2023
Revised 21 May 2023
Accepted 25 May 2023
Abstract
Purpose – Little is known about the extent to which management and engineering publications dedicated to
the study of quality management topics make use of mixed methods, what types of studies have been
conducted and how effective mixed methods have been. The aim of the current paper is to analyse how mixed
methods have been used in quality management research.
Design/methodology/approach – To address this purpose, a bibliometric analysis was conducted of papers
using mixed methods designs to investigate quality management issues and published in the SCOPUS
database. CiteSpace software was used to assist in the categorisation and mapping process.
Findings – Ninety articles were identified and analysed. The results show that mixed methods are mainly
used either to compare different perspectives drawn from quantitative and qualitative data or to develop better
measurement instruments. Sequential mixes occur more often than concurrent approaches. Moreover, there is a
link between the purpose of the study and the approaches followed to combine qualitative and quantitative
methods. Yet, the contribution of the use of mixed methods to achieving the aims of the study is not easy to
assess as the purposes of using mixed methods are often not clearly stated.
Originality/value – As one of the first papers to examine how qualitative and quantitative methods are being
combined in quality management research, this study is expected to contribute to the literature by providing
some insights into how mixed methods can be more effectively used in this field.
Keywords Research design, Quality management, Bibliometric analysis, Qualitative approaches,
Quantitative approaches
Paper type Literature review

Introduction
Although quantitative and qualitative methods have been combined in some research fields for
many decades, mixed methods designs have emerged as an important research strategy only in the
last twenty years, having been recognised as a distinct methodological tradition (Khoo-Lattimore
et al., 2019). A relevant issue is raised by Morse (2003) when he calls attention to the distinction
between “multimethod designs” and “mixed methods designs”, associating the former with the use
of two or more methods in the same project without actually combining them. In mixed methods
designs, rather than keeping different methods separate, they are combined and to some extent
integrated. As Creswell (2014) argues, in mixed methods, different forms of data are integrated into
the design analysis by merging the data, connecting the data or embedding the data.
Quantitative approaches, which tend to dominate in fields such as marketing and
operations research, have been shown to be particularly valuable in addressing optimisation
problems (e.g Eslamipoor (2023)). However, the complexity of many topics in management
research has been increasingly calling for the combination of qualitative and quantitative
methods (Papadimitriou, 2010; Graham et al., 2014). Many scholars have recommended
applying both qualitative and quantitative methods in the same project to better understand
complex problems (Currall and Towler, 2003; Azor
ın and Cameron, 2010).
The TQM Journal
The author wishes to acknowledge FCT—Fundaç~ao para a Ci^encia e a Tecnologia Project LA/P/0047/ © Emerald Publishing Limited
1754-2731
2020 for their support in carrying out this research. DOI 10.1108/TQM-03-2023-0075
TQM Similarly, the use of mixed methods design is not new to quality management researchers,
but, to the author’s best knowledge, no other papers have critically reflected upon its use.
Little is known concerning the extent to which management and engineering publications
dedicated to the study of quality management topics make use of mixed methods, what types
of studies have been conducted and how effective mixed methods have been.
To address this gap, the current study seeks to answer the following research questions.
RQ1. To what extent are mixed methods being used in quality management research?
How is the number of publications being evolved?
RQ2. How are mixed methods studies distributed in terms of regions, sectors and quality
management topics? Which are the leading journals that publish empirical quality
management research using mixed methods?
RQ3. What are the main reasons for using mixed methods in quality management
studies?
RQ4. How have different studies employed mixed methods? Which approaches dominate?
To address these questions, a bibliometric literature review was conducted. As Rejeb et al. (2023,
p. 2877) stress, “this type of review allows researchers to synthesise previous research
knowledge and inspire future research works”, making it possible to identify and classify a wide
variety of documents, while facilitating the analysis of information based on synthesised data.
The remainder of the paper is structured as follows. Following this short introduction, the
next section introduces the concept of mixed methods, draws attention to the different
purposes behind their use and describes the different approaches used to combine qualitative
and quantitative methods. In the following section, the design of the current study is
explained. It then presents the main findings, characterising the publications in terms of
journals, topics and geographic coverage, together with an analysis of the reasons presented
to apply mixed methods designs and the approaches followed. Next, a further analysis is
conducted to understand the extent to which there is a link between the purposes that justify
the use of mixed methods designs and the strategies adopted. Finally, in the conclusion, the
study contribution is highlighted and some recommendations for future research are offered.

An overview of mixed methods

Mixed methods designs combine qualitative and quantitative methods with the aim of
overcoming some of the limitations typically associated with the exclusive use of either
qualitative or quantitative approaches in addressing complex and challenging research
goals. Mixed methods designs enhance the strengths of the embedded qualitative and
quantitative approaches while eliminating the weaknesses of a single research method. In his
seminal work, Creswell (2014) identifies the following main purposes for using mixed
methods designs.
(1) Comparing different perspectives drawn from quantitative and qualitative data;
(2) Explaining quantitative results with a qualitative follow-up data collection and
analysis;
(3) Developing better measurement instruments by first collecting and analysing
qualitative data and then administrating the instruments to a sample;
(4) Understanding experimental results by incorporating the perspectives of individuals;
(5) Developing a more complete understanding of changes needed for a marginalised
group through the combination of qualitative and quantitative data;
 (6) Having a better understanding of the need for and impact of an intervention The use
programme through collecting both quantitative and qualitative data over time. of mixed
Mixed methods designs are thus expected to increase the validity of research by potentially methods
providing additional support for the study’s findings (Azor
ın and Cameron, 2010).
Nonetheless, the application of mixed methods in a project poses important challenges.
First, the cost and time needed to carry out the research typically increase (Bryman, 1988;
Azor
ın and Cameron, 2010). Moreover, since different methods call for different competencies
and skills, mixed methods research requires more experienced scholars and/or the formation
of a research team (Azor
ın and Cameron, 2010; Creswell, 2014).
Several approaches can be followed when combining qualitative and quantitative
methods. Two main factors distinguish such approaches: implementation and priority.
Implementation refers to the order in which the researcher collects quantitative and
qualitative data. Concurrent (simultaneous or parallel) designs are used when data are
gathered at the same time. In this case, the main goal is often to search for congruent findings
(Azor
ın and Cameron, 2010) which can increase the validity of the research. On the other
hand, in sequential (or two-phase) design, data are collected in stages. Quantitative methods
can either precede or succeed qualitative methods. In general, when qualitative data collection
precedes quantitative data collection, the intention is to first explore the problem under study
and then follow up on this exploration with quantitative data. This approach is mainly
adopted when the variables associated with the problem under study are unknown and there
is no pre-existing theory or model to use as a guide (Chiarini and Kumar, 2022). Alternatively,
when quantitative data precede qualitative data collection, the intention is to test the
variables with a large sample and then carry out a more in-depth exploration of a few cases
during the qualitative phase. In addition, the researcher can give identical priority to both
quantitative and qualitative methods or emphasise ones over the others. Accordingly, mixed
methods designs can be labelled as “equivalent” or “dominant”.
From the combination of these dimensions, nine alternative designs emerge. Table 1
summarises the main approaches that are followed when mixed methods are applied and
describes some of their key features.
This classification will be used to map the research designs used in the studies that have
been carried out in the quality management field.

Research design
In this section we briefly describe the procedures applied to select and analyse the papers that
used mixed methods when addressing quality management topics.
Bibliometric analysis has become very popular in recent years. The reason for this
popularity is the ubiquity and usefulness of bibliographic software and databases that obtain
and evaluate large amounts of scientific data. It requires the identification and selection of
relevant literature on a given topic. The current study has employed a systematic literature
review methodology to ensure the transparent and comprehensive coverage of the literature
(Denyer and Tranfield, 2009).
The research design involved a process consisting of the following steps: (1) establishing
the review purpose and identifying the research questions; (2) selecting the databases, search
terms and inclusion/exclusion criteria; (3) searching databases, screening the search results
against the criteria identified earlier and fine-tuning the exclusion and inclusion criteria; (4)
computing the main bibliometric indexes; and (5) analysing the results. Based on the review
goals and research questions, the research design summarised in Figure 1 was adopted.
The bibliometric analysis was based only on journal articles to ensure the reliability and
academic nature of the analysis, as suggested by Rejeb et al. (2023). For this purpose, the
TQM Concurrent mixed methods Sequential mixed methods

Equivalent QUAL þ QUAN (1) QUAN→QUAL (2) or QUAL→QUAN (3)

(1) Quantitative and qualitative data are
collected and analysed separately. Equivalent
importance is given to both methods. Results
are then compared to see if the findings
confirm or disconfirm each other.
Dominant QUAL þ quan (4) or QUAN þ qual (5)
(4) As (1) but qualitative methods dominate
over quantitative methods, which are regarded
as complementary.
(5) As (1) but quantitative methods dominate
over qualitative methods, which are regarded
as complementary
Table 1.
Main approaches
proposed in the
literature to conduct
mixed methods
research Source(s): Table by author
(2) It involves a two-phase project in which the
researcher collects quantitative data in the
first phase, analyses the results, and then uses
the results to plan (or build on to) the second,
qualitative phase. Equivalent importance is
given to both methods. The overall intent of
this design is to have the qualitative data help
explain in more detail the initial quantitative
results.
(3) Is a design in which the researcher first
begins by exploring with qualitative data and
analysis and then uses the findings in a
second quantitative phase. Equivalent
importance is given to both methods. The
qualitative data analysis can be used to
develop an instrument with good
psychometric properties. A researcher can
also analyse the qualitative data to develop
new variables, to identify the types of scales
that might exist in current instruments, or to
form categories of information that will be
explored further in a quantitative phase
quan→QUAL (6) or QUAN→qual (7) or
QUAL→quan (8) or qual→QUAN (9)
(6) As (2) but qualitative methods dominate
over quantitative methods, which are
regarded as complementary.
(7) As (2) but quantitative methods dominate
over qualitative methods, which are regarded
as complementary
(8) As (3) but qualitative methods dominate
over quantitative methods, which are
regarded as complementary
(9) As (3) but quantitative methods dominate
over qualitative methods, which are regarded
as complementary

Scopus database was chosen given its wide coverage of ranked quality journals. It is one of
the largest and most trusted databases covering a wide variety of disciplines and globally
indexing more sources than the Web of Science (Rejeb et al., 2023).
The initial search using the Scopus database was carried out in November 2022 and
returned 1,569 records. The search string used was “mixed methods” AND “quality
management” OR “TQM” OR “quality improvement” OR “excellence” in the titles, abstracts
or keywords. A filter was applied to include only articles written in English and published in
management and engineering journals (since these are the two main fields of quality
management studies). The number of articles considered was reduced to 109. Each of these
articles was carefully screened for relevance by reading the title, the abstract and, when
necessary, other sections. After removing conceptual papers or literature review papers with
no empirical data (4) and “false positives” (i.e. out of the topic records) (13) 92 articles were
 The use
of mixed
methods

Figure 1.
Study design

kept for analysis. Since we had no access to the full paper version in two cases, these two
papers had also to be excluded. Ninety articles were read in full.
Bibliometric analysis includes different techniques such as citation and co-citation
mapping. As Small (1999, p. 799), points out “a map of science is a spatial representation of
how disciplines, fields, specialties, and individual papers or authors are related to one
another”. This analysis is facilitated by the development of software, such as VOS Viewer and
Citespace. In the current paper, CiteSpace software was used to create and visualise
relationships graphically and to analyse networks based on the topic. CiteSpace provides
several different types of network construction from bibliographic data, including document
co-citation, keyword co-citation and author co-citation. In this study, we used co-citation and
keyword co-citation for knowledge mapping.

Review findings
This section starts by providing an overview based on common bibliometric indicators of
quality management literature that uses mixed methods approaches. The potential
connections among such studies are also investigated using the CiteSpace software. Then,
a more in-depth analysis is performed looking at the reasons given for the choice of mixed
methods and the particular designs that are used.

Bibliometric characterisation of publications

The 90 selected quality management papers employing mixed methods were published
between 2009 and 2022, which shows that the use of mixed methods in quality management
research is relatively recent. Moreover, as depicted in Figure 2, it is possible to identify two
periods: before 2014 (when the number of studies adopting this research design was small)
and from 2014 onwards (when, despite some yearly variations, the pace of mixed methods use
increased substantially).
TQM Many authors have contributed to the expansion of this methodology in the quality
management field. 318 authors are involved in the 90 articles analysed. The total number of
citations of articles in the analysed sample is 1,173, which corresponds to an average number
of 13,03 citations per article.
Peer-reviewed articles on quality management using mixed methods were published in 51
management and engineering journals, indicating that the papers are scattered across a
considerable number of publications. Table 2 shows the journals with at least three mixed
methods publications. The three leading journals are: the International Journal of Healthcare
Quality Assurance (12 papers), the Journal of Health Organization and Management
(7 papers) and the International Journal of Quality and Reliability Management (6 papers).
Similarly, mixed methods have been used to conduct empirical research on a diversity of
quality management topics. As shown in Figure 3, improvement, quality management
systems/quality assurance and service quality together account for more than 43% of the
research using this methodological approach. It is interesting to observe that both “hard” and
“soft” components of TQM have been looked at.
After the descriptive analysis of the selected publications, a more in-depth examination of
the content and relationships among the articles was carried out to gain further insights.
Document co-citation analysis is used to represent the overall mixed methods in quality
management bibliographic network. In co-citation analysis, the relationship between two
documents is calculated by the number of times those manuscripts are cited together (Small,
1999). As one of the most common relational techniques, article co-citation analysis assumes
an association between two publications if they are both cited in subsequent studies (Small,
1999). Using CiteSpace the following map was obtained (Figure 4). According to the software
characteristics, the highly co-cited pairs of articles are those that are close to each other. The
node represents the cited reference and the link represents how closely two publications are

Figure 2.
Number of quality
management papers
employing mixed
methods over time

Journals No. of papers

International Journal of Health Care Quality Assurance 12

Journal of Health Organization and Management 7
Table 2.
Journals with the International Journal of Quality and Reliability Management 6
highest number of TQM Journal 5
quality management Journal of Industrial Engineering and Management 3
papers employing Leadership in Health Services 3
mixed methods Source(s): Table by author
 The use
of mixed
methods

Figure 3.
Topics distribution of
the 90 quality
management papers
employing mixed
methods

Figure 4.
Co-citation map

related by using the frequency they are cited together by other publications. Additionally, a
larger node size suggests that the publication is more frequently cited. In our case, the map
(nodes 5 326; links 5 789) shows weak levels of co-citation. Many references are scattered
across the map with distant links to other papers. This does not come as a surprise, since the
selected papers share a common methodology but relate to very different topics. The
TQM references of the papers are therefore very heterogeneous. The maximum number of co-cited
references is two and no important clusters emerge. As expected, the references that are
closer to each other relate to the healthcare sector.
Using the same software, a co-occurrence analysis was carried out. Keyword
co-occurrence analysis is used to detect the knowledge base responsible for the use of
mixed methods in quality management research. The co-occurrence of keywords measures
the most common keywords used across various documents. The more co-occurrence
between two keywords, the closer their relationship is (Veloutsou and Ruiz Mafe, 2020). The
high proximity of two keywords means that they are found more frequently in the same
publications. The analysis of keyword co-occurrence network assists researchers in
identifying the fundamental topics discussed in a particular research area.
The resulting network is shown in Figure 5 (nodes 5 300; links 5 1,168). A node in the
network represents a keyword and a line between two nodes represents a co-occurrence link.
The size of a node illustrates the frequency with which a keyword occurs. Together with
words related to the methodological approach, such as “comparative study” and “qualitative
analysis”, keywords linked to the healthcare context (e.g. “hospital”, “heath personnel” and
“clinical study”) are highlighted. It is also visible the importance of terms associated with
improvement, such as “efficiency”, “continuous quality improvement”, “organization and
management” and “accreditation”.
Finally, keywords were grouped into clusters with different levels of significance. This
procedure is somewhat similar (even if less demanding) to that of concept mapping, where
knowledge is organised and presented in a schematic diagram, consisting of boxes or circles
containing concepts and arrows indicating relationships between concepts (Sieben
et al., 2021).
It must be said that, probably due to the relatively small number of papers analysed and to
their high heterogeneity in terms of topics covered, the clusters have low silhouette levels,
meaning that the results are not robust. Clusters were labelled with abstract terms using the

Figure 5.
Keywords map
MI algorithm. The eight most relevant clusters are depicted in Figure 6. The cluster with the The use
largest size is numbered as #0, with the smallest size being #7. 48 studies are included in the of mixed
“knowledge exchange” cluster (#0) and 15 in the “employee” group (#7).
methods
Reasons to use mixed methods
By analysing the research design described in each paper, it was possible to identify the
justification for the use of mixed methods and to map the approaches followed. Yet, in many
cases the rationale is not explicitly stated.
Using Creswell’s (2014) classification of the main purposes to use mixed methods, Table 3
was produced. It must be said that the rationale for using mixed methods is not always
explicitly stated in the papers. In 13 cases such purpose was not clear even after reading the
full paper. On the other hand, a few papers address more than one purpose. In such cases, one
of the purposes was considered to be dominant and the other ancillary (included in Table 3
after the “þ” character).
It becomes evident that mixed methods in quality management studies are mainly applied
in quality management studies either to compare different perspectives drawn from
quantitative and qualitative data (29 þ 8 papers) or to develop better measurement
instruments by collecting qualitative data prior to the administration of quantitative tools
(25 þ 1 papers).
Among the reasons included in the first group are:
It will thus afford a complete understanding of the research question by comparing the results of the
two studies. The convergent design helped to obtain complementary data on the same topic (. . .)
comparing the results of both qualitative and quantitative studies (Antony et al., 2022)
Whereas in the latter group we find arguments such as:
In this study, focus group (qualitative) is used as a preliminary method for refinement of
measurement scales developed from published literature. Then a survey method is used to collect
quantifiable data from a larger population (Tayyab et al., 2022).

Figure 6.
Clusters map
TQM Comparing different
perspectives drawn from
quantitative and qualitative
data
(29 þ 8 papers)
Understanding experimental
results by incorporating the
perspectives of individuals
(3 papers)
Table 3.
Main purposes for the
use of mixed methods Source(s): Table by author
Explaining quantitative results
with a qualitative follow-up data
collection and analysis
(4 papers)
Developing a more complete
understanding of changes needed
for a marginalised group through
the combination of qualitative and
quantitative data
(0 papers)
Not clear (13 papers)
Developing better measurement
instruments by first collecting and
analysing qualitative data
(25 þ 1 papers)
Having a better understanding of the
need for and impact of an
intervention program through
collecting both quantitative and
qualitative data over time
(16 þ 3 papers)

The key to the use of both methods in this research and development process was to start with
in-depth qualitative research to generate themes and content, and then use this in the creation of a
quantitative assessment tool (Taylor and Rostron, 2018).
A considerable number of studies (16 þ 3) uses mixed methods to better understand the need
for and impact of an intervention programme. This purpose seems to make sense given the
importance in the quality management field of assessing improvement initiatives over time.
This AR study was carried out during 2015–2018m(. . .)Data gathered from the qualitative research
design, i.e. several extensive interviews, were used to answer the first and the second research
questions,(. . .). Cues finding out the actual impacts (. . .) were also included in the interviews to the
reformations impact assessment evaluation. (. . .) we employed the quantitative methods (. . .) to
evaluate the outcomes more rigorously. (. . .) Comparing the results of the two phases of the study, it
can be concluded that the evaluation outcomes coming from the quantitative data are mostly in line
with the qualitative results of the interviews (Sayfouri et al., 2021).
The research design took the form of a mixed methods, longitudinal 3.5-year study aimed at
exploring transformational change in terms of content, context, process and outcomes (Coleman
et al., 2015).
Additionally, we identified four studies that used mixed methods to explain or to deepen the
findings obtained with quantitative tools.
This involved initially a quantitative approach offering the capability to measure the opinions and
views of a selected sample (. . .). The interviews were conducted and based to support the results
discovered in the questionnaire. The method aimed to expand the investigation through in-depth
discussion with industry professionals of some specific findings (Keenan and Rostami, 2021).
Finally, three papers combined qualitative and quantitative approaches to understand
experimental results by incorporating the views of individuals.
Periodic top-down QI communications were conducted over a 52-week period to promote CLB
implementation in both units. Simultaneously, it examined (a) the content and frequency of
communication related to CLB in both units, through weekly ‘‘communication logs’’ completed by
physicians, nurses, and managers, and (b) unit outcomes, that is, CLB adherence rates, through
weekly chart reviews (Rangachari et al., 2015).

Approaches used
Firstly, it is important to note that less than half of the studies do not explicitly state the
approach used when combining qualitative and quantitative approaches. Even when the
authors clearly state the approach they have used, they tend to do so in a very succinct and The use
incomplete way. of mixed
The analysis of the full texts of the selected papers shows that the majority of the studies
adopted a sequential mix (66%) and, among these, there is a slight prevalence of papers where
methods
the weight of quantitative and qualitative methods is equivalent (32 out of 59). Among the
studies that use both types of methods simultaneously, there is a tendency to devote equal
effort to quantitative and qualitative tools and techniques (see Table 4). All in all, sequential
papers where none of the methods is dominant represent 36% of the papers analysed.
Among the studies classified as “Dominant” (n 5 38), there is a balance between those in
which quantitative methods prevail (n 5 18) and those in which qualitative methods are used
more intensively (n 5 20). One of the latter examples is given by Chiarini and Kumar (2022),
who have used a sequential mixed methods design with more emphasis on the
qualitative phase.
(. . .) we used a more inductive QUAL → quant approach, which involves an initial exploration of the
research topic to generate the variables to be measured phase (. . .) (Chiarini and Kumar, 2022)
As for sequential approaches (n 5 59), only 14 began with a quantitative method (24%). The
majority uses qualitative methods first, often with the purpose of obtaining knowledge to
develop scales and design questionnaires that will be applied to larger samples, as
discussed above.
Figure 7 summarises de main approaches identified in the 90 papers analysed. Studies in
which quantitative and qualitative methods are equally important and used in parallel are the
most frequent (n 5 22), closely followed by those that begin by using qualitative methods and
give identical emphasis to both types of data (n 5 21). On the other hand, studies using
approaches classified as 2, 4 and 7 in Table 1 are residual. Five studies use what we might call
“advanced mixed methods” designs, where different forms of data (quantitative or qualitative
or both) are combined within a larger design (e.g. an experiment) or various methods are
mixed within a longitudinal study with a focus on a common objective for the multiple
projects.
In an attempt to assess the added value brought up by the use of mixed methods, the
following section takes this analysis one step further.

Further analysis
The aim of this analysis is twofold: (a) to investigate whether there is a link between the
purpose of the study and the approaches followed to combine qualitative and quantitative
methods; (b) to assess the contribution of the use of mixed methods to the achievement of the
study’s objectives.
Table 5 shows that when mixed methods are used with the purpose of comparing different
perspectives drawn from quantitative and qualitative data, researchers tend to adopt
concurrent approaches. The following quotation illustrates this alignment:

Type of mix No. % No. %

Sequential 59 66 Equivalent 32 36 Table 4.

Sequential versus
Dominant 27 30 concurrent approaches
Concurrent 31 33 Equivalent 20 22 reported in the 90
Dominant 11 12 quality management
Total 90 100 Total 90 100 papers employing
Source(s): Table by author mixed methods
TQM

Figure 7.
Pareto chart of the
research designs used
in previous studies

We used a concurrent mixed-methods design to study the effect of hospital mergers on the quality of
care. (. . .). The approach allows us to juxtapose the quantitative and qualitative findings and to
identify any discrepancies between measurable and perceived quality effects of hospital mergers
(Westra et al., 2022).
When it comes to developing better measurement instruments, sequential approaches in
which qualitative methods are applied first are the obvious choice. The following quotations
give examples of common justifications:
The study was conducted using sequential mixed methods. In-depth structured interviews were first
conducted which formed the basis for cross-sectional survey that subsequently followed (Jimoh
et al., 2019).
Building on relevant literature and 71 qualitative interviews, we identified information congruity,
competence, and empathy as key factors in online service quality. Offline service quality factors
include structural assurance and platform responsiveness. These five factors were included in a
model for user loyalty investigation, which was tested on data from 294 questionnaires from Chinese
mobile car-hailing service users. The study was conducted in two consecutive steps. First, a
qualitative investigation was initiated to understand the influencing factors of service quality under
the context of sharing economy-driven car-hailing commerce. The second step involved the use of
quantitative survey data to test the hypotheses within the research model. An exploratory sequential
design was adopted. (Cheng et al., 2018).
The relatively small number of studies with other aims makes it difficult to draw firm
conclusions. In any case, when the main purpose to combine qualitative and quantitative
methods is to understand the need for and impact of an intervention programme (in the
quality management field, often an improvement action), the scope for adopting different
methodological approaches seems to be large, as illustrated next:
 Research approach
The use
Qualitative followed by Quantitative followed by of mixed
quantitative approaches qualitative approaches methods
Concurrent approaches QUAL → QUAN (3) QUAN → QUAL (2) quan
QUAL þ QUAN (1) QUAL → quan (8) qual → QUAL (6) QUAN →
QUAL þ quan (4) → QUAN (9) QUAL → qual (7) QUAN → QUAL
Main purpose QUAN þ qual (5) QUAN → QUAL (10) → QUAN (11)

Comparing different 16 (56%) 5 (17%) 8 (27%)

perspectives drawn from
quantitative and
qualitative data
Explaining quantitative 2 (50%) – 2 (50%)
results
Developing better 1 (4%) 24 (96%) –
measurement
instruments
Understanding 3 (100%) – –
experimental results by
incorporating the
perspectives of
individuals
Having a better 8 (50%) 5 (31%) 3 (19%)
understanding of the
need for and impact of Table 5.
an intervention program Purposes vs
Source(s): Table by author approaches

The study which the paper draws upon was a mixed-method evaluation aimed to capture the
perceptions of three main stakeholder groups: national-level policymakers (15 semi-structured
interviews), senior hospital managers (a national web-based survey of 150 staff), and healthcare
practitioners (case studies within five hospitals involving 58 members of staff). Part of the study was
to use NHS Institute purchasing data to quantitatively estimate adoption rates nationally and these
findings are discussed elsewhere (. . .). This paper makes use of the ‟rich” qualitative accounts
provided by three different ‟stakeholder” groups (Morrow et al., 2012).
The three papers that have used mixed methods to understand experimental results applied
concurrent approaches.
Mixed methods (including audit, focus group interviews, and evaluation questionnaires) were used
to document changes and thus help researchers and staff reflect upon how and why practice
changed. (. . .) In particular, the focus group method was used as a vehicle for participation and
empowerment. At the same time, by analyzing data from the evaluation of the simulation-based
courses and the change process statistically as is the norm in clinical studies, we added valuable
results that could easily be interpreted by quantitatively schooled physicians (Paltved et al., 2016).
Although the real contribution of the use of mixed methods to the accomplishment of research
goals is difficult to estimate, especially because the purposes of their adoption are often not
explicitly stated, it is possible to observe that some articles give a plausible account of the
advantages of applying both quantitative and qualitative tools and techniques.
A purely quantitative or qualitative identification of the factors is, however, insufficient in
guaranteeing the success of ISO 9001 implementation. (. . .). A better understanding of the priority of
ISO 9001 implementation factors is needed so that it results in improved managerial decision-making
TQM process. The presented research addresses the quantitative-qualitative gap by combining the first,
the identification and subsequently the prioritization of implementation factors in a single
framework. (. . .) Its ability to mix qualitative and quantitative criteria in the same framework and
handle complex problems proves beneficial for a problem such as critical factor ranking and
evaluation that has predominantly intangible attributes (Almeida et al., 2018).
We began the study with a qualitative method and interviews to explore the topics, followed by a
quantitative method, the objective of which was to examine, test, and explain a model and
relationships suggested by hypotheses. (. . .) Conducting a qualitative study—interviews with
practitioners and subject matter experts—was important for developing a detailed conceptual
definition of the sustainable e-service quality, and specifying the nature of the construct and
construct dimensionality, while performing a quantitative study was important for scale evaluation,
refinement and validation (Stamenkov and Dika, 2015).
Nevertheless, only a minority of the papers analysed (19 out of 90) make such an assessment
balance.
In view of the scarce information provided in most papers, it is difficult to make a robust
assessment of the real contribution of mixed methods to addressing quality management
problems.

Conclusion
Research on quality management topics has been mainly based on quantitative studies.
Empirical studies tend to rely on the collection of a large number of observations, usually by
means of self-administered questionnaires, resulting in robust statistical power and analysis
of cross-sectional variation. On the other hand, qualitative approaches have mainly been used
to further validate scales and shed some light on contradictory (or unexpected) quantitative
findings that have arisen in previous studies. According to the literature, mixed methods
designs can be applied to increase the validity, completeness and confirmation of findings
and to minimise the inherent weaknesses of monomethod approaches.
This paper identifies and characterises the use of mixed methods in quality management
research. Ninety papers were selected and kept for full-text reading. The papers were found to
be spread across different journals, regions and sectors although in the latter case the health
care sector dominates.
The rationale for using mixed methods is often not explicit. It is important in future studies
to better justify why mixed methods are used so that the contribution of combining
qualitative and quantitative data to answering the research questions can be easily assessed.
There seems to be a link between the complexity of the research purposes and the
sophistication of the research design. In larger studies with a longer time span, different
methods are combined at different stages.
At the same time, it was possible to find papers where there is a poor identification of
mixed methods and their design. A detailed analysis of the papers revealed that a number of
scholars used a multi-method approach rather than the mixed methods they claimed to use.
This was particularly the case in papers where it did not become evident with what purpose
mixed methods were being applied. As Ivankova et al. (2006) point out, mixed methods
research “is more than a simple collection and analysis of qualitative and quantitative data; it
involves the use of the two approaches together, thus allowing a more solid analysis by
taking advantage of the strengths of each method”.
We suggest that quality management scholars should do a better job of justifying their
research methodology in order to eliminate the biases that result from choosing the
convenient methodologies. Thus, future studies should incorporate both qualitative and
quantitative aspects when formulating mixed methods research questions and emphasise the
rationale for their choices.
 The current study has some limitations. First of all, due to the keywords used in the The use
search, some papers that address quality management issues but do not have the selected of mixed
terms in the title, abstract or keywords may have been ignored. Although we are confident
that we have surveyed an extensive knowledge base, there may be articles that are potentially
methods
relevant to the scope of the study that have not been captured. Moreover, in this study, we
adopted the Scopus database. It is recommended that future research investigate other
databases (e.g. WoS, Google Scholar, etc.) to validate and extend our findings. Also, this study
focused on articles published in English in academic journals and excluded other sources (in
particular, conference papers). The sample of articles reviewed is not exhaustive since it was
restricted to specific subject areas – engineering and management- Finally, it would have
been interesting to determine whether the expected benefits of mixed methods w achieved in
each study. Yet, the lack of clarity in many papers regarding the purposes of mixed methods
use makes such an assessment more difficult and subjective. Moreover, there remains a need
for a more coherent framework that clearly identifies best practices in the selection and
coupling of appropriate methods for quality management research.
Despite these limitations, the current paper makes a small (but still relevant) contribution
to the advancement of quality management research. First, to the best of our knowledge, this
is the first study that conducts a systematic bibliometric review of the use of mixed methods
in quality management research. Most of the recent quality management literature reviews
focus on a particular topic (e.g. Chiarini, 2020; Sfreddo et al., 2021; Jasti et al., 2022; Zimon et al.,
2022) and give little (or no) attention to research designs. The current paper addresses this
gap by providing a summative starting point for researchers wishing to gain an overview of
how and what for mixed methods have been applied. Second, there are very few systematic
literature reviews of research methods across different fields and with a few exceptions (e.g.
Çakar and Aykol, 2021), those that do exist provide a bibliometric characterisation of the
papers but do not go beyond this to try to assess their effectiveness, as the present study has
done. Above all, the paper provides the researchers with a better understanding of the
purposes, strategies and methods used when combining quantitative and qualitative
strategies to investigate quality management topics. Based on some of the weaknesses
identified, the paper provides some hints on how to make the added value of using mixed
methods more explicit. Thus, the paper contributes to the current interest (and discussion) on
the use of mixed methods in management and operations research by synthesising and
extending the existing knowledge base in the field.

References
Almeida, D., Pradhan, N. and Muniz, J. (2018), “Assessment of ISO 9001:2015 implementation factors
based on AHP: case study in Brazilian automotive sector”, International Journal of Quality and
Reliability Management, Vol. 35 No. 7, pp. 1343-1359, doi: 10.1108/IJQRM-12-2016-0228.
Antony, J., Swarnakar, V., Salentijn, W., Shokri, A., Doulatabadi, M., Bhat, S., McDermott, O.,
Jayaraman, R. and Sony, M. (2022), “A global study on applicability of ISO 18404:2015
for SMEs: an exploratory qualitative study”, TQM Journal, Vol. 35 No. 7, pp. 1917-1934,
doi: 10.1108/TQM-08-2022-0276.
Azor
ın, J.M. and Cameron, R. (2010), “The application of mixed methods in organisational research:
a literature review”, Electronic Journal of Business Research Methods, Vol. 8 No. 2, pp. 95-105,
doi: 10.4236/jis.2012.33026.
Bryman, A. (1988), Quantity and Quality in Social Research, Routledge, London.
Çakar, K. and Aykol, Ş. (2021), “Case study as a research method in hospitality and tourism research:
a systematic literature review (1974-2020)”, Cornell Hospitality Quarterly, Vol. 62 No. 1,
pp. 21-31, doi: 10.1177/1938965520971281.
TQM Cheng, X., Fu, S. and de Vreede, G.J. (2018), “A mixed method investigation of sharing economy driven
car-hailing services: online and offline perspectives”, International Journal of Information
Management, Vol. 41 No. 10, pp. 57-64, doi: 10.1016/j.ijinfomgt.2018.03.005.
Chiarini, A. (2020), “Industry 4.0, quality management and TQM world. A systematic literature review
and a proposed agenda for further research”, TQM Journal, Vol. 32 No. 4, pp. 603-616, doi: 10.
1108/TQM-04-2020-0082.
Chiarini, A. and Kumar, M. (2022), “What is Quality 4.0? An exploratory sequential mixed methods
study of Italian manufacturing companies”, International Journal of Production Research,
Vol. 60 No. 16, pp. 4890-4910, doi: 10.1080/00207543.2021.1942285.
Coleman, A., Segar, J., Checkland, K., McDermott, I., Harrison, S. and Peckham, S. (2015), “Leadership
for health commissioning in the new NHS : exploring the early development of clinical
commissioning groups in England”, Journal of Health Organization and Management, Vol. 29
No. 1, pp. 75-91, doi: 10.1108/JHOM-04-2013-0075.
Creswell, J.W. (2014), Research Design: Qualitative, Quantitative, and Mixed Methods Approaches,
4th ed., SAGE Publications, Thousand Oaks, CA.
Currall, S.C. and Towler, A.J. (2003), “Research methods in management and organizational research:
toward integration of qualitative and quantitative techniques”, in Tashakkori, A. and Teddlie,
C. (Eds), Handbook of Mixed Methods in Social and Behavioral Research, Sage, Thousand Oaks,
CA, pp. 513-526.
Denyer, D. and Tranfield, D. (2009), “Producing a systematic review”, in Buchanan, D. and Bryman, A.
(Eds), The Sage Handbook of Organizational Research Methods, Sage, pp. 671-689.
Eslamipoor, R. (2023), “A two-stage stochastic planning model for locating product collection centers
in green logistics networks”, Cleaner Logistics and Supply Chain, Vol. 6 No. December 2022,
100091, doi: 10.1016/j.clscn.2022.100091.
Graham, N.K., Arthur, Y.D. and Mensah, D.P. (2014), “Managerial role in ensuring successful total
quality management programme in Ghanaian printing firms”, TQM Journal, Vol. 26 No. 5,
pp. 398-410, doi: 10.1108/TQM-01-2012-0009.
Ivankova, N.V., Creswell, J.W. and Stick, S.L. (2006), “Using mixed-methods sequential explanatory
design: from theory to practice”, Field Methods, Vol. 18 No. 1, pp. 3-20, doi: 10.1177/
1525822X05282260.
Jasti, N.V.K., Venkateswaran, V. and Kota, S. (2022), “Total Quality Management in higher education:
a literature review on barriers, customers and accreditation”, TQM Journal, Vol. 34 No. 5,
pp. 1250-1272, doi: 10.1108/TQM-11-2020-0256.
Jimoh, R., Oyewobi, L., Isa, R. and Waziri, I. (2019), “Total quality management practices and
organizational performance: the mediating roles of strategies for continuous improvement”,
International Journal of Construction Management, Vol. 19 No. 2, pp. 162-177, doi: 10.1080/
15623599.2017.1411456.
Keenan, M. and Rostami, A. (2021), “The impact of quality management systems on construction
performance in the North West of England”, International Journal of Construction Management,
Vol. 21 No. 9, pp. 871-883, doi: 10.1080/15623599.2019.1590974.
Khoo-Lattimore, C., Mura, P. and Yung, R. (2019), “The time has come: a systematic literature review
of mixed methods research in tourism”, Current Issues in Tourism, Vol. 22 No. 13,
pp. 1531-1550, doi: 10.1080/13683500.2017.1406900.
Morrow, E., Robert, G., Maben, J. and Griffiths, P. (2012), “Implementing large-scale quality improvement:
lessons from the productive ward: releasing time to CareTM”, International Journal of Health
Care Quality Assurance, Vol. 25 No. 4, pp. 237-253, doi: 10.1108/09526861211221464.
Morse, J.M. (2003), “Principles of mixed methods and multimethod research design”, in Tashakkori, A.
and Teddlie, C. (Eds), Handbook of Mixed Methods in Social and Behavioral Research, Sage,
Thousand Oaks, CA, pp. 189-208.
Paltved, C., Morcke, A.M. and Musaeus, P. (2016), “Insider action research and the microsystem of a The use
Danish surgical ward”, Action Research, Vol. 14 No. 2, pp. 184-200, doi: 10.1177/1476750315592937.
of mixed
Papadimitriou, A. (2010), “Looking for clues about quality: a multilevel mixed design on quality
management in Greek universities”, Electronic Journal of Business Research Methods, Vol. 8
methods
No. 2, pp. 85-94.
Rangachari, P., Madaio, M., Rethemeyer, R.K., Wagner, P., Hall, L., Roy, S. and Rissing, P. (2015),
“The evolution of knowledge exchanges enabling successful practice change in two intensive
care units”, Health Care Management Review, Vol. 40 No. 1, pp. 65-78, doi: 10.1097/HMR.
0000000000000001.
Rejeb, A., Appolloni, A., Rejeb, K., Treiblmaier, H., Iranmanesh, M. and Keogh, J.G. (2023), “The role
of blockchain technology in the transition toward the circular economy: findings from a
systematic literature review”, Resources, Conservation and Recycling Advances, Vol. 17
No. December 2022, doi: 10.1016/j.rcradv.2022.200126.
Sayfouri, N., Kouchekyazdi, S., Etemadian, M. and Asadi, R. (2021), “A systemic inquiry into a
hospital’s reformation actions”, Systemic Practice and Action Research, Vol. 34 No. 4,
pp. 359-376, doi: 10.1007/s11213-020-09537-6.
Sfreddo, L.S., Vieira, G.B.B., Vidor, G. and Santos, C.H.S. (2021), “ISO 9001 based quality management
systems and organisational performance: a systematic literature review”, Total Quality
Management and Business Excellence, Vol. 32 Nos 3-4, pp. 389-409, doi: 10.1080/14783363.2018.
1549939.
Sieben, J.M., Heeneman, S., Verheggen, M.M. and Driessen, E.W. (2021), “Can concept mapping
support the quality of reflections made by undergraduate medical students? A mixed method
study”, Medical Teacher, Vol. 43 No. 4, pp. 388-396, doi: 10.1080/0142159X.2020.1834081.
Small, H. (1999), “Visualizing science by citation mapping”, Journal of the American Society for
Information Science, Vol. 50 No. 9, pp. 799-813, doi: 10.1002/(SICI)1097-4571(1999)50:93.0.CO;2-G.
Stamenkov, G. and Dika, Z. (2015), “A sustainable e-service quality model”, Journal of Service Theory
and Practice, Vol. 25 No. 4, pp. 414-442, doi: 10.1108/JSTP-09-2012-0103.
Taylor, J. and Rostron, K. (2018), “The development of a safety and quality culture assessment tool
from a longitudinal, mixed method research journey”, Wordwide Hospitality and Tourism
Themes, Vol. 10 No. 3, pp. 313-329, doi: 10.1108/WHATT-02-2018-0006.
Tayyab, M., Awan, M.U., Bukhari, I. and Sabet, E. (2022), “Key determinants of quality in the
pharmaceutical supply chain”, International Journal of Quality and Reliability Management,
Vol. 39 No. 2, pp. 345-366, doi: 10.1108/IJQRM-06-2020-0213.
Veloutsou, C. and Ruiz Mafe, C. (2020), “Brands as relationship builders in the virtual world: a
bibliometric analysis”, Electronic Commerce Research and Applications, Vol. 39 No. July 2019,
doi: 10.1016/j.elerap.2019.100901.
Westra, D., Angeli, F., Kemp, R., Batterink, M. and Reitsma, J. (2022), “If you say so: a mixed-method
study of hospital mergers and quality of care”, Health Care Management Review, Vol. 47 No. 1,
pp. 37-48, doi: 10.1097/HMR.0000000000000302.
Zimon, D., Urbaniak, M., Madz
ık, P. and Prokopiuk, I. (2022), “Supply chain quality management
(scqm) literature review and model proposal in the era of industry 4.0”, International Journal for
Quality Research, Vol. 16 No. 4, pp. 1283-1296, doi: 10.24874/IJQR16.04-21.

Corresponding author
Patr
ıcia Moura e S
a can be contacted at: pmourasa@fe.uc.pt

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