TQM in Healthcare

Quality Management in Irish Healthcare

“…In the competitive environment of the 1990s hospitals must operate under multiple constraints. The cutting edge of competition increasingly centres on quality: quality as defined by a myriad of regulators and professional accrediting bodies, quality as defined by the physician and the employer, quality as defined by the patient, the family and the employee [Feeney and Zairi, 1996].…”

“…In the American context healthcare institutions take quality management seriously and many embrace wholeheartedly the teachings of Deming, Juran, Crosby and Peters, while others place it as a corporate objective and strategy. Across all institutions there is a general consensus that healthcare institutions must be quality focused [Feeney and Zairi, 1996] including lack of top management commitment, limited employee involvement [Lin and Clousing, 1995] and lack of physician involvement [Huq, 1996;Arnt and Bigelow, 1995]. Quality improvement initiatives in healthcare are likely to be limited unless they are seen as a function of the whole organisation.…”

“…Its foundation lies in the philosophy and methods pioneered by quality management gurus, Deming, Juran, Crosby and Oakland. Many managers within healthcare would reject the usefulness to themselves of TQM concepts and would strongly argue that the modern philosophy of TQM is more applicable to manufacturing than to the healthcare service sector [Feeney and Zairi, 1996]. The purpose of quality management in healthcare according to LXLI [1997] is to establish a system that measures and manages patient care in a way that provides the optimal medical service for all patients.…”

“…The purpose of quality management in healthcare according to LXLI [1997] is to establish a system that measures and manages patient care in a way that provides the optimal medical service for all patients. Another common debate among healthcare workers is the concept of 'customer' which is seen as unsuitable to healthcare provision since the customers, 'patients', do not necessarily enjoy going to hospital and their requirements and treatments are not by choice [Feeney and Zairi, 1996]. On the other hand, Berwick, Enthoven and Bunker [1992] proposed that TQM can be used effectively within the healthcare systems as a powerful force for improvement.…”

“…Increasingly it is being viewed as a means of increasing efficiency and improving quality of care delivered. A substantial body of literature now exists on the subject in a global context [Moss and Garside, 1995;Short and Rahim, 1995;Nwabueze and Kanji, 1997;Badrick, 1996;Donabedin, 1992;Feeney and Zairi, 1996;Ovretveit, 1997;Huq, 1996;Carman et al, 1996;Arnt and Bigelow, 1995]. However, with the notable exception of O' Keefe and O'Sullivan [1997] there are deficiencies in the treatment given to quality initiatives within healthcare in Ireland.…”