Advances in Research

Quality tools originally developed in manufacturing industries have become central to how pharmaceutical companies and healthcare providers manage variability, reduce error, and satisfy regulators. Lean, Six Sigma, Total Quality Management, Quality by Design, Failure Mode and Effects Analysis, and statistical process control now appear across drug manufacturing sites, hospital pharmacies, and clinical departments, yet their adoption remains uneven and frequently incomplete. This review examines how these tools are applied in pharmaceutical manufacturing and healthcare service settings, the organisational and regulatory barriers that slow or distort their implementation, and the strategies that have proved effective in sustaining continuous improvement once initial projects conclude. The review draws on peer-reviewed literature spanning operations management, pharmaceutical science, and health services research, synthesising findings on tool selection, workforce engagement, regulatory interaction, and digital transformation. Findings indicate that technical familiarity with quality tools is rarely the limiting factor; rather, implementation success depends on leadership commitment, the compatibility of improvement methods with existing regulatory documentation systems, and the presence of a quality culture that treats continuous improvement as routine practice rather than a bounded project. Regulatory frameworks, particularly those built around Good Manufacturing Practice and quality risk management guidelines, can both enable and constrain improvement activity depending on how they are interpreted locally. The review concludes that durable quality improvement in these sectors requires closer integration between quality tools, digital monitoring systems, and organisational learning structures, and it outlines directions for future research addressing this integration.