Obstacles to the application of total quality management in health-care organizations

Abstract

T his paper involves a signi® cant review of the obstacles that face health-care organizations that undertake total quality management (TQM ) implementation. A de® nition of the concept of quality is thoroughly explored, along with the concept of total quality. The importance of TQM in the health-care industry is discussed, and a comparison of TQ M in m anufactur ing environm ents to TQM in a health-care organization environment is made . Obstacles to the application of TQM in health-care organizations are presented and discussed and conclusions and recom mendations regarding the philosophy and practice of quality managem ent and digni® ed leadership are m ade.

Description of hospital pharmacy management practice

“…21,22 These difficulties have been reported in the literature. 28,29,30 Trust in the managers (agents of change) is a critical factor in an employee's trend to adopt the change program. A feeling of trust among the employees and managers strengthens the employees' commitment.…”

Six-Sigma implementation through Competency Based Perspective (CBP)

“…Projects that are assessed to have the most profound impact on hospital bottom-line, market share, and patient satisfaction were selected. Both physicians and hospital administration jointly shared the leadership of the implementation team -a point made by other hospital research studies (Carman et al, 1996;Weiner et al, 1997;Zabada et al, 1998). Physician involvement and direction from the beginning of Six-Sigma implementation was viewed as a key to success because the pathway was driven by the physicians order set.…”

“…These include strong top management and physician leadership and commitment; customer/patient satisfaction focus; project selection based on financial analysis; employee involvement and empowerment; a focus on continuous process improvement; education and leadership training; supplier partnerships; and the recognition of quality as a strategic management issue (Kivirnaki et al, 1997;McNabb and Sepic, 1995;Shin et al, 1998;Zabada et al, 1998). The hospital had a head start on many of these aspects while implementing TQM (Huq and Martin, 2001); this time they had a more focused approach to select the processes for improvement and leadership training.…”

The Identification of Critical Success Factors for Quality Internal IT Services in Public Sector Organisations in Hong Kong

“…TQM marks a departure from looking at quality objectively (measuring against known and measurable standards) and deals with subjective perceptions because it looks at the issue from the customer's viewpoint (Omachonu & Ross 1994). For example, it introduces concepts such as quality philosophy and culture (Kendrick 1993;Zabada, Rivers & Munchus 1998). Other authors make a distinction between measures of "hard" quality (those that are tangible like standard-based measurement and improvement) and measures of "soft" quality (those that are intangible like management attitude, leadership, values, employee ownership) (Albrecht 1990).…”