Total Quality Management In Healthcare Nursing Essay

The Health Care Industry is one of the most important industries if not the most important one. The Health Care industry consists of everything from the little pharmacy across the street, drugs processing plants all the way to the hospital where we immune our kids. The Health Care industry affects nearly every living person. Most people don’t realize how important this industry is and how it affects their everyday lives, not to mention how complicated it is. That is why it is so critical that products and services of this industry are at their highest quality and are free of harm to ensure that the consumer will not face any damaging consequences. Therefore, as any other industry, quality in the health care system has become the element in the world’s market competition and Total Quality Management (TQM) plays a big role in promising that result.

Learning from mistakes is not something that is accepted in health care. Near-miss and error reporting is a vital component of safety programs across safety conscious industries. Within health care, though, many physicians are often unenthusiastic to engage in patient safety activities and be open about errors because they believe they are being asked to do so without adequate guarantee of legal protection. Having proper health care management could better prevent foreseeable human errors from reaching patients. But understanding the root causes of errors requires their acknowledgment in the first place. By having a solid management of health care some benefits includes surgical improvement and decreasing patient injury, accurate documentation, and efficient risk management.

Healthcare organizations are required to focus on total quality improvement and providing acceptable, quality health services to patients at affordable price within reasonable price, within in a reasonable time. Which means, applying zero errors to all patients services; maintaining a continuous error prevention program; training employees in medical care on such aspects as error prevention, reducing delay time and providing prompt reasonable patients needs; management system have always improvement in such systems to realize the true nature of the quality of healthcare and to be motivated towards improving this quality.

Divergently to belief, the TQM movements were not the start of concerns about quality in healthcare. The roots of quality assurance initiatives in healthcare extends at least as far back as the time of Florence Nightingale’s work during the Crimean War (1854-1856),when the introduction of nutrition, annotation and infection control initiatives in war hospitals contributed to reduction in the death rate from 42% to 2.2%. Florence Nightingale is considered the mother of modern quality assurance. It was Nightingale’s efforts to improve the quality of medical care given to British soldiers during the mid-1800s that is considered the beginning of modern quality assurance. Quality assurance activities were centered on and elaborated upon the British experience for the next hundred years (Helium, 2010).

The goal of a TQM program in a clinical healthcare setting is to reduce costs and improve customer (patient) satisfaction. This goal is achieved, in part, by seeing patients on time, charging them a fair price for services rendered, and minimizing their follow-up visits. In an administrative setting, the goal of a TQM program is to improve work processes, thereby reducing overhead not essential to the delivery of health care.

According to Mary Barrett, “Preventive systems are an essential element of a successful continuous quality improvement (CQI) or total quality management (TQM) environment (Barrett, 1993).” A serious element of a successful TQM program is changing how an organization conducts its business. TQM involve abandoning the “bad apple” approach of identifying and punishing poor performers in favor of process modification. Process modification requires organizations to identify the steps necessary to deliver services well, when the steps are refine in ways that will cost the organization less money to execute, take less time to achieve, and improve outcomes for customers. Strong inside leadership is needed to achieve these steps, along with an organizational culture not afraid of “breaking down the walls.” Healthcare financial managers must help change the way of thinking within their institutions and encourage employees to think, work, and create interdepartmentally and cross-functionally. Furthermore, employees must learn to take responsibility for customer satisfaction.

There are great opportunities for healthcare organizations to save money if they are willing to change existing processes. These savings then can be used to meet needs in other parts of the organization. We need to look for ways to do the right things, then we need to do things right.

Barrett also states, precautionary system can be specified as a technique or procedure that supports an improvement. Protective systems can be a process, an information system application, a policy, or any other technique which, when specifically applied to a method, may lead to improvement in the quality of the end result. In the healthcare industry, starting and maintaining a protective system frequently requires a change in priorities and management style (Barrett, 1993).

According to iSixSigma there are eight elements that will provide a successful Total Quality Management in an organization. These elements include:

Ethics

Integrity

Trust

Training

Teamwork

Leadership

Recognition

Communication

These eight elements make the driving force behind leadership, design, planning, and improvement initiatives according to iSixSigma. These eight elements are the key in ensuring the success of TQM in an organization and that the administrator is a huge part in developing these elements in the work place. Without these elements, the business entities cannot be successful TQM executed (ISixSigma, 2010).

The basic difference between Six Sigma and TQM is the approach. While TQM views quality as conformance to internal requirements, Six Sigma focuses on improving quality by reducing the number of defects. The end result may be the same in both the concepts (producing better quality products). ISixSigma helps organizations in reducing operational costs by focusing on defect reduction, cycle time reduction, and cost savings. It is different from conservative cost cutting measures that may reduce value and quality. It focuses on identifying and eliminating costs that provide no value to customers such as costs incurred due to waste (ISixSigma, 2010).

A key to assessing the progress of a TQM process is measurement. Acceptable quality health services to patients at affordable price within reasonable price, within in a reasonable time; Applying zero errors to all patients services; maintaining a continuous error prevention program; Training employees in medical care on such aspects as error prevention, reducing delay time and providing prompt reasonable needs to patients; management system have always improved in such systems to realize that the true nature of quality of healthcare and to be motivated towards improving this quality.

Quality must have specific measures of success. Organizations must develop measures of achievement and a major component of TQM is an ongoing, documented quality management system. In spite of billions of dollars of money spent worldwide, most of the healthcare is seen to be useless, inefficient and inadequate. Therefore there is a need to bring about a standard shift in the quality of health care delivery and to monitor and maintain it. It is obvious that those organizations, which are quality conscious and are committed to continuous quality improvement, will gain the highest consumer acceptance and would thrive at the expense of others. The ‘Quality Revolution’, as it is sometimes referred to, is nothing but putting the patient at the heart of health care and wrapping the care around it, rather than the other way around. Quality Measuring and evaluating service is important, particularly when multiple sources of discrepancy are present.

Analyzing all medical processes to remove rework and waste may build health care quality and lead to important cutback in patient cost. The use of quality-assurance programs and statistical tools can be directly applied to health-care organizations with improved quality of patient’s objectives and the results of care from the patient’s perspective. Healthcare quality does not mean that care is given by the most cultured and highly experienced professors of medicine. But that the system is developed in such a way that in any situation most ordinary yet adequately trained doctor can deliver appropriate treatment to the needy patient.

When a performance measurement system is properly in place and put into practice, managing the process and using the measurements should be a moderately easy task for the employees and managers involved. In society, information technology has provided the means of collecting large amounts of data, but in order for data to be transformed into information it must be organized and aimed at toward specific performance. As organizations continue to create and develop new ways of measuring quality improvement and process progress, research is needed on the various categories of measures. Reliable and valid measures and measurement techniques must be documented and shared with all TQM participants (Shepherd, 1995).

The best way to measure TQM’s success is to establish quantitative benchmarking data. Too often, decisions are made qualitatively, without documentation and data, making it extremely difficult to measure their effectiveness.

TQM the future

By the late 1990s some experts began to question whether TQM was a fad that would soon be superseded by yet another management technique. Despite the impressive results many companies have achieved through TQM, its future popularity is still in doubt. At the same time, however, other experts sought to apply TQM to emerging business problems, such as making computer systems compliant in the year 2000. It appears as if the underlying principles of TQM may find continued applications in business, even if they are eventually incorporated into a new movement for management innovation and organizational change.

The purpose of a TQM program is to increase the effectiveness of the organization.  According to Shiv, the first and major TQM principle is to satisfy the customer the person who pays for the product or service. Customers want to get their money’s worth from a product or service they purchase (Shiv, 2004). During an age of downsizing and restructuring, many American companies are determining that they must learn to manage more effectively. In this changing environment the economy and the industry driven by the customers, the business is open to competition worldwide.

The management is running on an older system, which adds to workers that call out more sick days and abuse the companies’ production procedure. Organizational problems decoding, means that all members of an organization participate in cultivating a vision and improving the corporate cultures. In any change program you must understand where you are before you can chart a course of where you want to be. Therefore, before executing TQM or another program it is important to add the total value of the organization in terms of its current quality or performance class and to define the level of performance or quality you wish to achieve.

One will never achieve total output for any given input, but with simple steps that can add dollars to the bottom line with an increase of production one can get close. Organization diagnose contributes information which allows a faster reacting organization to emerge, one which can deal proactively with changing emphases. Organization examination is often mentioned as the most critical element in the TQM process.

In conclusion, Healthcare organizations are required to focus on total quality improvement and providing acceptable, quality health services to patients at affordable price within reasonable price, within in a reasonable time. We have learned by past experiences as Nightingale’s efforts to improve the quality of medical care. The Health Care Industry is one of the most important industries if not the most important one. The purpose of a TQM program is to increase the effectiveness of the organization. The best way to measure TQM’s success is to establish quantitative benchmarking data. As stated “the future of TQM experts began to question whether TQM was a fad that would soon be superseded by yet another management technique.” Despite the impressive results many companies have achieved through TQM, its future popularity is still in doubt. At the same time, however, other experts sought to apply TQM to emerging business problems, such as making computer systems compliant in the year 2000. We have to continue to provide the best TQM therefore this will mean zero errors to all patients we have to remember that learning from mistakes is not something that is accepted in health care.