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• W193698968 abstract "The research programme focuses on Total Quality Management adoption and application.TQM which is established in a number of businesses and industries has more recently beenintroduced into healthcare. TQM definition and eclectic paradigm has been developed andtested for establishing quality performance and distinguishing radical change and continuousimprovement approach. A number of critical elements and variables concerningimplementation and application are identified which pertain to organisations which throughsize and bureaucracy operate with diverse missions, a wide range of systems and arecharacterised by degrees of rigidity from an employee mix of multiple knowledge,understanding competences skills and hence commitment.Research was conducted in healthcare provider organisations, which involved eighty-threeNHS hospitals/Trusts, wherein two pilot, twelve TQM demonstration and sixty-nine siteswere involved. The main focus concerned a case study Trust, which althoughdemonstrating keen interest in quality management had not reached the formative stages ofdeveloping TQM definition or paradigm.The research framework is based on a number of approaches in that methods selected forevaluation were appropriate both to the situation and the context of TQM strategies beingexamined. Intention was to identify successes and failures of the TQM processes applied,establish similarities and distinguishable differences and determine extent to which TOMobjectives were achieved and the impact of the processes on specific groups.The investigation was undertaken using longitudinal analysis which involved in-depthinterviews with top managers and clinicians and a mix of employees, customers, potentialcustomers and purchasers in the form of managers, consultants, hospital doctors, nurses,support services personnel, patients, members of the public and GPs. TOM Awareness andAction Seminars and Workshops involving personnel from a variety of internationalhealthcare organisations provided an additional source of data. Self-completionquestionnaires were also used.Data analysis compares and contrasts varying TQM models, processes, activities and resultsfrom degree of emphasis placed on critical elements and variables. Stage predictions andresulting outcomes are presented and quality of care improvements suggested from analysisof customer perceptions of quality and value. The findings show significant variations inapproach between the hospitals/Trusts in matters which concern organisation, managementand culture issues, resulting in a high proportion viewing TOM process as evolution fromquality assurance to radical change, hospital process re-engineering and patient focusedcare A minority only included such processes in their application of TQM.Key conclusions result from attempt at establishing some measure of success and failurefrom TQM implementation and application. Findings contribute to the extant literaturespecifically in that beyond top management and clinician commitment to high level strategicfocus is a combination of facilitator-led culture change, motivation and shared valuesdirecting attention to exceeding that of merely doing enough for reducing poor quality andcustomer complaints. Patient involvement in TOM is more problematic than literaturesuggests from both the patients and professionals perspectives of patient empowerment.Bottom-up action focused TQM paradigm working simultaneously with top down supportand commitment requires barrier breaking, culture transformation and the establishment ofinternal/external customer and supplier chains and seeking to establish opportunities forcontinuous improvement and radical change in advance of attempts at in-depthimplementation and evaluation. It is not over-statement to conclude that the majority ofmanagers and clinicians were unaware of the costs of getting things wrong.Despite TOM being acted upon as driving force for competition most had limited knowledgeof how much non-quality cost them, suggesting that they had not earlier thought itnecessary to measure the costs of none or low quality. Research results, irrespective ofapplications definition or paradigm, question the views that TQM is long-term process.Whether these may be concluded as desire to integrate TOM with other foci or vacuumsucking in panaceas was unclear. It was clear however that although quality in healthcareis sacred total quality management is not." @default.
• W193698968 created "2016-06-24" @default.
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• W193698968 date "1995-09-01" @default.
• W193698968 modified "2023-09-28" @default.
• W193698968 title "Total Quality Management : the development, application and analysis of a Total Quality Management paradigm in healthcare." @default.
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