Different regional studies of the ISO 9001 impact, on the performance of work organizations, have shown some results with significant differences. Liao et al.(2004) has studied Australian manufacturing firms and found that certification is most likely to lead to both, actual and perceived quality improvements. Drew and Healy (2006) have shown that Irish organizations using quality management systems were performing better in assuring effective relations with customers and employees. Their research method included survey data taken from 932 companies in the private and public sector. The analysis of the results suggested that a high percentage of companies believe that their reputation, products and services increased for the better since achieving the ISO 9000 certification. Other studies, done in the US industries by Ebrahimpour et al. (1997), suggested that ISO 9001 quality management system implementation in the work organizations expect design, product, process, and supplier relationship improvements. Brown et al. (1998) reported in their research for small and medium certified enterprises in Australia that benefits and improvements are only significant in relation to internal improvement, greater quality awareness, improved product quality, and improved awareness of problems within the work organizations; while other researches have resulted with partially opposite findings when adopting ISO 9001. David and Idemerfaa (2005) have shown improvements in product development processes based on ISO 9001 standard recommendation. Simmons and White (1999) found no positive correlation between ISO certified organizations and performance. This also confirms the study done by Heras et al. (2002) who surveyed 800 Spanish companies and resulted with no positive impacts on sales and profitability. Also, a study carried out by Lai and Cheng (2005) shows that, a certification alone would not improve performance. They suggested that implementation of the quality management system in work organization, does not have a direct impact on a successful performance. They argue that benefits are only perceived internally rather than externally.
In spite of the continually updated version of the ISO 9001 standard requirements, starting from the first version in year 1987 until the latest one issued in the year 2008, and its widespread application in many different countries, there are still ambiguities whether ISO 9001 has helped organizations achieve actual performance improvements. Regardless of the type and size of businesses the organizations are running, the question “If there is an actual benefit and improvement” is still argumentative. Many work organizations could not verify the present association between ISO 9001 implementation and its performance improvements. Some work organizations have reached a level of frustration and disappointment since positive outcomes from applying the ISO quality system were not significantly noticed. The reason for that is, most probably due to the fact that most studies done on ISO 9001 QMS were not done empirically and were mostly case studies, which were descriptive, or prescriptive (Costa and Lorente, 2003). As a result of this non-ending argument, Koc (2007) has decided in his paper to investigate questions about performance improvement and how this performance is improved. This was done by surveying 106 small and medium enterprises where 79 of them were ISO 9001 certified enterprises.