1. TQM Total Quality Management

2. 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. -Eliminating rework, mistakes, waste. -Providing care in a more timely manner. * Improving inter and intra departmental work flow. -Improved employee satisfaction. *Each of these issues reduces cost and improves customer satisfaction.

3. 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. Requires an all-hands-on-deck effort from both management and front-line workers. 6. Front-line workers are the key to competitive advantage. 7. Teamwork.

4. The difference between Quality Assurance and Total Quality Management. 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.

5. 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

6. Ownership Commitment Responsibility Empowerment Creating the Stewardship Environment

7. Empowerment as a means of achieving a competitive advantage through 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.

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

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

10. Implementing the principles of TQM in the Nuclear Medicine Department. 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 Vision Mission Values Direction from Administrative Level:

11. Barriers to implementation of TQM Barriers: 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?

12. Can the TQM philosophy be effectively implemented in the absence of executive level support? Barriers: Lack of vision. Lack of support/culture. Lack of cooperation from other departments. Employee motivation. Advantages: Autonomy. Physician support. Employee motivation.

13. Another Comment on MGT Styles Staff CEO Staff Which one is prevalent in your institution?

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

15. Customer Driven Supplier InputActionOutput Customer Outcome Owner Where’s the focus? Who’s the owner?

16. The Key to CQI Customers Workers MGT Board

17. So where do we go from here?  Do you see TQM working in the healthcare arena?  What will stop this from happening?  What might force it to occur?  Where would you like to work when you graduate – X – Y – X?  What motivates you to work?  In the end its up to the individual to make change happen.

18. End of Lecture Return to the Table of Content