The relationship between quality and governance mechanisms A qualitative investigation in healthcare supply-chain networks Saturnina Alves da Silva Martins Department of Production Engineering, Paulista University – UNIP, S~ao Paulo, Brazil, and Marcio C. Machado, Maciel M. Queiroz and Renato Telles Post Graduate Program in Business Management, Paulista University – UNIP, S~ao Paulo, Brazil Abstract Purpose – Recent literature has highlighted the importance of quality and governance in supply networks. Usually, the relationships between the actors are complex, comprising both formal and informal interactions. Despite recent advances in quality and governance in supply networks, extant literature highlights the lack of quality in healthcare supply-chain networks in relation to governance mechanisms. This paper aims to investigate the role of governance mechanisms and their influence on the quality of healthcare supply networks, and assumes that governance instruments can support quality performance. Design/methodology/approach – A multiple-case research approach was employed. Six organisations in the Brazilian healthcare sector were analysed (four operate only with renal replacement therapy, one is a material supplier, and one operates with renal replacement therapy and collective procurement). Findings – Findings showed that there is no formalised supply network structure in these organisations. A possible consequence of this is that the supply-network governance is dominated by informal relationships. In the quality dimension, managers’ awareness is limited, but there are mechanisms in place to control the quality of the materials. Practical implications – Healthcare managers can actively invest in the social aspects of the relationship between buyer and supplier, such as trust and commitment, thus increasing responsiveness in patient care. However, this informal procedure can lead to problems with tracking and reliability, ultimately leading to quality problems. Therefore, it is recommended that formal and informal governance instruments be used jointly to improve service quality. Originality/value – This study suggests that the integration of formal and informal mechanisms of governance can improve the quality of supply networks. Additionally, if the administrative process is purely formal, network relationships and their efficiency will be impaired. Keywords Quality management, Healthcare, Supply network, Governance Paper type Research paper 1. Introduction For decades, enterprises in emerging economies, including healthcare organisations, have had cope with a decrease in productivity, mainly because of logistics problems and poor infrastructure associated with geographical disparities and distances between locations (Getele et al., 2019). In recent literature, several research works have been published concerning the healthcare supply chain and healthcare quality management. Kwon et al. (2016) investigated strategic areas in which the healthcare supply chain can increase efficiency while improving the quality of care. Abdallah and Alkhaldi (2019) researched lean management in healthcare to identify possible research gaps, discussing the current state of implementation of lean-management practices in healthcare. The impact of supply-chain Quality and governance in supply network 1085 We are thankful to CAPES - Brazilian Research Foundation for supporting and funding this research. We also thank the anonymous reviewers for their helpful comments. The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/1463-5771.htm Received 11 March 2019 Revised 25 October 2019 Accepted 28 December 2019 Benchmarking: An International Journal Vol. 27 No. 3, 2020 pp. 1085-1104 © Emerald Publishing Limited 1463-5771 DOI 10.1108/BIJ-03-2019-0114