Total Quality Management TQM Total Quality Management

Quality improvement can result in: How can Total Quality Management Help to Meet the Demands of the Healthcare Industry? Quality improvement can result in: Increased revenue -Customer focus and Quality Care attract the best customers. * Improving inter and intra departmental work flow. -Providing care in a more timely manner. -Eliminating rework, mistakes, waste. -Improved employee satisfaction. *Each of these issues reduces cost and improves customer satisfaction.

Total Quality Management as a Model for Competitive Advantage Essential Elements of TQM 1. Continuous improvement of quality in every process. -perfection is the goal, but it is unobtainable. 2. Obsession with customer focus. 3. Long-term objectives take precedence over short-term. 4. Paradigm change is essential. -holistic approach, not cut-and-paste. 5. Commitment by all: management to the and front-line workers. 6. Competitive advantage starts with the staff technologist. 7. Teamwork.

Quality Control vs Quality Assurance vs Total Quality Management. QC- Equipment Provide quantitative data on instrument used in nuclear medicine To assure it equipment meets manufacturer and government standards. QA- synonymous with inspection Standardization. Measurements used to document minimum achievement. Assigning blame. TQM- synonymous with continuos quality improvement Benchmarking. Measurements used to provide feedback for process improvement. Blameless system.

The Case for Empowerment Where’s it Flow? Front-line workers are the key to satisfying customers, improving processes, reducing waste, and product/process innovation. -W.E. Demming As quality of life replaces money as motivation, workers do not want to feel managed, they want to participate in the business decisions affecting them. -W.J Ransom

Ownership Commitment Empowerment Responsibility Creating the Stewardship Environment Ownership Empowerment Commitment Responsibility

Empowerment to achieving a competitive advantage by organizing the work force Allows employees to utilize their skills, creativity, knowledge to improve product/service/process quality and reduce cost. Focus on Level 4 and 5 of Maslow. Errors are generally the result of systems failures not individual failures. “The Challenger Launch Decision” --Dr. Diane Vaughan. To err is human. Prepare for it by minimizing opportunities to make mistakes.

Reality Most organizations are only capable of limited degree of empowerment. Organizations that gain competitive advantage from an empowered work force are truly unique.

How do we turn the organization over to the employees? Management sophistication. Executive leadership. Transformational leadership. Levels of empowerment. Stewardship environment.

Implementing the principles of TQM in the Nuclear Medicine Department. Vision Mission Values Direction from Administrative Level: Train/inform/develop commitment Identify success factors Develop a strategic plan with team members (start small) Identify indicators --initial assessment Implement plan/action --outcome assessment Respond to outcome assessment Recognize achievements

Barriers to implementation of TQM Heavy reliance on QA paradigm. The search for the perfect plan. Lip service. Lack of vision. Lack of understanding of the principles of TQM by leadership. Resistance to change (that’s not the way we do it). Short-term focus? Advantages: Most healthcare workers do care. Teamwork is relatively good (believe it or not). Driven by sense of purpose. Long term focus?

Lack of support/culture. Lack of cooperation from other departments. TQM philosophy - effectively implemented Requires executive level support? Barriers: Lack of vision. Lack of support/culture. Lack of cooperation from other departments. Employee motivation. Advantages: Autonomy. Physician support.

Another Comment on MGT Styles Remember the following slides? CEO Staff Staff CEO Which one is prevalent in your institution?

CQI Leadership Customer-focused Obsession with Quality Teamwork Looking for Faults in the System Continual Education and Training

Where’s the focus? Who’s the owner? Customer Driven Owner Supplier Input Action Output Customer Outcome Where’s the focus? Who’s the owner?