Advantages of TQM (Total quality management) in the hospital and healthcare industry.

Total Quality management in the hospital and healthcare industry is a comprehensive approach involving contractors, customers and involving all operations, process management, performance measurement, team work and employee involvement to improve customers quality of service and care. Through ISO (International Organisation for Standardization) and JCI (Joint Commission) accreditation hospitals and the healthcare industry can aim to achieve total quality management in their management and operations. The advantages of TQM in the hospital and healthcare industry are as follows: 1. Improved Customer Satisfaction Mitra (2012) says that the need of every patient visiting the hospital is quick, effective health care provided in an atmosphere of comfort. The JCI in its 4th Edition of accreditation standards for hospitals state that A health care organization should consider the care it provides as part of an integrated system of services, health care practitioners and professionals, and levels of care, which make up a continuum of care. TQM is a customer-approach. It is based on customer expectations and on meeting customer needs and requirements. TQM increases customer satisfaction by enhancing quality. According to Nayab (2011) TQM aims at improving quality, and identifies the best measure of quality as matching customer expectations in terms of service, products, and experience. Through the ISO, there are a number of guidelines that allow improved customer service, for example assessing patient satisfaction at every level, enhancing courteous relationships between hospital staff and patients, better time management which reduce patient waiting time, interdepartmental integration and cooperation which enhances customer satisfaction and services. Also, JCI accreditation provides meaningful
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indicators to improve the quality and patient safety in hospitals, for example, International Patient Safety Goals, Access to Care and Continuity of Care, Patient and Family Rights, Assessment and care of Patients, Anesthesia and Surgical Care, Medication Management and Use, Patient and Family Education. Through TQM there will be less customer complaints. A satisfied customer will build the image of the hospital and create goodwill. The hospital can thus earn customer loyalty. There is also a good impact on society. 2. Empowerment TQM allows for empowerment in the healthcare industry by identifying the sources of leadership as well as conveying the importance of leadership in making each hospital an effective, efficient resource for the community and its patients. TQM embodies the principles of excellent patient care through effective leadership. The JCI provides standards to enable hospitals to identify the responsibilities of those who govern, manage and have authority in the organisation, and further to this they provide standards on the direction of departments and services to provide integrated quality management for better outcomes. The JCI in its 4th Edition of accreditation standards for hospitals also detail standards that highlight the continuous need for planning, designing, measuring, analyzing, and improving clinical and managerial processes under clear leadership. The JCI states that the TQM approach takes into account that most clinical and managerial quality issues are interrelated. Thus, efforts to improve those processes must be guided by an overall framework for quality management and improvement activities in the organization, overseen by a quality improvement and patient safety oversight group or committee. This is beneficial for the healthcare industry because leaders will work together well to coordinate and to fit

together all the organizations activities, including those designed to improve patient care and clinical services. 3. Improved efficiency in operations A huge portion of the increased annual healthcare expenditure is because of waste and inefficiency in hospitals. The healthcare industry can benefit from TQM both in cost and care. The fundamental changes that are taking place in healthcare industry and hospitals are based on the implementation of TQM. Implementing TQM in the healthcare industry brings in process re-engineering, increased staff competence leading to efficient work methods which will bring about reduced wastage and actual expenditure. Continuous Improvement

TQM become the basis for long-term continuous improvement. Since healthcare is a service industry, quality management become a tough process. Through ISO there will be inspection and testing which will continuously monitor the accuracy and timeliness of patient care and all the supporting functions that affect that care including quality checks, assessments at all process stages. Process Management

One of the main objectives of Total Quality Management is to achieve productivity and process efficiency by identifying and eliminating problems in work processes and systems. Nayab (2012) says that TQM addresses key problem areas such as mistakes in work processes, redundant processes, unnecessary tasks, and duplicate efforts. TQM principles if followed also help to predict such mistakes and unproductive activities. ISO is a process-oriented approach. ISO requires the hospitals to look at the bigger picture rather than individual departments and individual processes. So the best results can be achieved

when activities and resources are managed together. Improving process efficiency also brings about benefits for the healthcare industry in terms of time and cost savings. Involvement in quality improvement

With TQM staff lower and middle management become more involved in the decision making process. Staff should also gather data, analyse them and make recommendations for improvement. The ISO quality system lists performance indicators (Pis) which allow for the hospitals and healthcare industry to continuously seek improvement in quality. The hospital will decide which Pis are relevant for monitoring its processes and output. Further to this, a minimum standard which is acceptable and reasonable can be set for each Pi. Monitoring the Pi through checking if the results meet the given standards allows the hospital to take the necessary corrective action for improvements and progress in quality of services. TQM also benefits the healthcare industry by enabling quality measurement. Through conformity of ISO standards, processes within the healthcare industry are transparent; this allows changes to be made in a controlled manner. Processes will be audited by both internal and external auditors and there will be a strict document and control process which is also a part of the ISO quality system. These measurements can overall lead to improvements of the quality system, improvement of the design and performance of the health care processes and improvement of the quality of health care. Training and education Health care organisations need a variety of skilled and qualified people to satisfy its mission and to meet patients needs. TQM involves principles involve recruiting, evaluating, and appointing staff who are best suited for their roles through a coordinated, efficient, and uniform process.
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ISO standard on quality management stress the importance for continuous improvement and training process to assure improved understanding of roles & responsibilities among employees; and enhanced communication and coordination between departments. TQM through JCI accreditation boosts staff recruitment and development. The Joint Commission (2011) says accreditation can attract qualified personnel who prefer to serve in an accredited organization. Accredited organizations also provide additional opportunities for staff to develop their skills and knowledge. The JCI also provide education to improve business processes and professional advice and counsel to enhance staff education. This is beneficial to the healthcare industry because it reduces and controls hazards and risks, prevents accidents and injuries, maintains safe conditions and enable staff to monitor and report situations that pose risks for the hospitals. TQM also benefits the hospitals because it involves emergency management, for example response to paramedics, disasters, fire safety, dealing with hazardous materials, etc.

4. Competitive Advantage

Today there is a highly competitive healthcare environment, through complying with ISO and JCI standards the hospital and healthcare industry can maintain superior performance. Total Quality Management allows all-round benefits and makes hospitals and the healthcare industry more competitive. TQM implementation can lead to higher business performance of the healthcare industry and to a higher employee, customer, and personnel satisfaction.

References
Nayab N. 2011. Looking at the Benefits of TQM. Brighthub PM. Retrieved from: http://www.brighthubpm.com/monitoring-projects/70318-looking-at-the-benefits-oftqm/. Dr Puay Cheng Lim, Dr Nelson K H Tang. 2012. Tot al Qual i t y Man a gem ent i n P ract i ce: A S i ngapo re He al t hcar e S t ud y. International Journal of Applied Health Studies (ISSN: 1742-5263) Volume 1 Issue 2. Retrieved from: http://www.managementjournals.com/journals/health/article17-p3.htm. Sujata Mitra. 2012. Benefits of Total Quality Management in Tata Main Hospital Retrieved from: http://medind.nic.in/haa/t01/i1/haat01i1p83o.pdf. H. P. A. Geraedts1, R. Montenarie1 and M. J. Hendriks. 1999. Medica Mundi. The Benefits of ISO Certification and Total Quality Management in a Radiology Department. Volume 43 Issue 4. Retrieved from: http://www.healthcare.philips.com/pwc_hc/main/about/assets/Docs/medicamundi/mm _vol43_no4/mm_vol43_no4_article_the_benefits_of_iso.pdf. (N.A) 2013. Joint Commission International. Accreditation for Hospitals. Retrieved from: http://www.jointcommissioninternational.org/Programs-Hospitals/ (N.A) 2011. Joint Commission. Benefits of Joint Commission Accreditation. Retrieved from: http://www.jointcommission.org/assets/1/18/Benefits_of_Accreditation.pdf