Total Quality Management in Irish Healthcare - Case Study Example

 Total Quality Management in Irish Healthcare Introduction Total Quality Management (TQM) is now recognized as a most significant factor of successful businesses world over. It ensures proper quality for an output or service, managing efficiently the cost effective use of the inputs. Unlike the past trends, Quality and Reliability have become the overriding factors which customers look at for their choice. Apart from the manufacturing sector, service sectors such as healthcare institutions, hospitals etc., are also adopting the TQM approach to increase their efficiency and cost effectiveness. However, there are several barriers to overcome for successful implementation of TQM. This study focuses on such three main barriers which were highlighted in the findings from a research study in the Irish Health Care sector, emphasizing on the factors related to quality implementation. These show the barriers which act as resistance to change to TQM and they are (i) Organizational culture (ii) Interdepartmental barriers (iii) Quality not given its significance. The paper finally concludes giving the recommendations to overcome these issues. Organizational Culture resistance to change The organizational culture prevailing in the Irish hospitals are the ones guided under conventional management styles. Hence the culture within lacks the modern concepts like the multidisciplinary team approach which is highly essential to deliver in such service sectors which also leads to breakdown in communications. As per the research study, 47 percent of hospitals agreed to the organizational culture resistance as a barrier. These Irish hospitals which were organized and exercised on a hierarchical basis, monitored by bureaucratic cultures, are resistant to employee empowerment thus blocking the TQM approach. Changing such a prominent culture is not an easy task as the organizational culture is often overlooked and cannot change with mere announcements or mission statements but may gradually develop through alteration of policies and daily practices. There should be a change in the personal perceptions of employees shifting their priority to the patient’s side. Interdepartmental barriers Hospitals generally are hierarchical establishments with strong interdepartmental barriers. This means the professionals engaged in the healthcare sector have worked with their autonomy acquired through traditional management style and kept themselves maximum separated from the management. This nature of gap between departments acts as a barrier as for TQM initiative it is necessary that no one person or department is superior to another. This barrier was reported around 30 percent as per the survey conducted. Interdepartmental barriers are much more complex than obstacles in the usual business and have a more diffuse authority structure. In the hospital sector the nature of the work is more complex and the higher the qualifications of the medical professionals even make the hierarchy tough. The assignments of responsibilities seem to be unclear and also responsibilities are diffused through numerous organizational units that tend to think in only their own department structures. Quality is not given its significance The research study of the Irish healthcare revealed that 17 percent counted that the quality factor is not looked upon with its significance. This valuation was a concern as in spite of growing awareness quality was seen as a separate and secondary issue for 17 percent employees in the healthcare sector. The reasons for this is due to the fact that activities are not directed to producing improvement to clinical care or to making changes which staff and managers see as critical to their work. They also think that if there is much adherence to quality principles as per the quality code, it will restrain their value addition and fears of their stagnant position. Recommendations The factors discussed above shows three barriers from among the obstacles distinguished from TQM implementation as per the Irish healthcare research study. The ways and means to overcome these three barriers are dealt next. As for the (i) Organizational culture resistance, employees have to be considered part of strategy implementation in general. For a TQM initiative, employees should be made involved so that they get a better insight and could thus avoid their resistance. Implementing such strategic changes requires the confidence, cooperation, and competencies of the organization's technical and managerial people, and thus by involving their culture, their resistance and discontent could be avoided. To change a corporate culture making them value its employees and their views requires fundamental change that often requires individuals to change their beliefs, which makes the continual development of a company's vital asset-human resources. The organizational culture is what the people within experiences and this culture finally determines whether the sustained change is successfully accomplished. Thus, for Irish hospitals to achieve the transition to TQM there must be a change in attitudes, communication, and employee involvement etc., rather an entire organizational change. For overcoming the (ii) Interdepartmental barriers and to avoid power struggles between departments and within hierarchies, a plan with clear assignments of responsibilities regarding detailed implementation activities should be created. Through this approach, responsibilities become evident, and potential problems could be avoided before they arise. Successful quality improvement programs require a structure that minimizes the layers of management, empowers employees, bridges the communication barriers and fosters the workplace creativity. While many hospitals are being restructured, many elements of the old functional hierarchical structure still persist and this has to be eliminated fully to achieve the TQM success. (iii) Quality not given ultimate significance: To overcome this barrier, managers within healthcare institutions need to strengthen accountability; however at the same time they also need to pay attention to the ways in which they can lead and direct quality actions such as empowering staff and devolving authority to making changes to improve quality. In other words, responsibility for leading the quality effort must be shared equally between professionals and management. An essential question for managers is how to assess performance during and after the implementation. This assessment or control function is a key aspect of the implementation processes and will help to keep a sense of significance that quality should hold in a health care institution. Conclusion An efficient TQM implementation has an enormous impact on a company's success. Basically, a well-formulated strategy towards implementation can only initiate a sustainable added value for the healthcare institution. Research study evidences emerging from this study reveals that the culture within Irish hospitals is not changing fast enough to embrace the quality management philosophy. Any change effort must recognize the diversity of the organizational culture that exist within hospitals and therefore transform themselves from traditional bureaucratic institutions to more participative enabling organizations. Employees must hence be convinced of the need for change in their work practices and must be involved at all stages of the process, which can foster strong leadership and initiate widespread communication. Despite the many difficulties encountered from quality management implementation, a significant number of hospitals (67 per cent) have reported that their efforts had been reasonably successful and in addition an awareness of quality and patient satisfaction had improved. Thus it could be seen that if proper measures are taken to strategically implement the TQM principles with maximum employee participation the Irish healthcare industry can overcome all the currently existing barriers and flourish in its service maintaining Total Quality Control. Read More