Quality Management at Roundal Wright Retirement Home - Essay Example

Quality Management at Roundal Wright Retirement Home It appears the residents have a perception of poor quality of service at the Roundal Wright Retirement Home A. Starting from theoretical approaches to "quality", explain how quality might be defined at Roundal Wright Retirement Home One of the major theoretical approaches to "quality" is that of Walter Shewhart, who formulated the Shewhart Cycle for Learning and Improvement. This is a quality management concept and tool that is generally regarded as the PDSA Cycle. This cycle is divided into four quadrants, and there is constant process of moving from one section to another. (ominlingua, 2006) There is thus a never ending cycle of quality improvement: the individual or business never gets to the stage where they say, "now I/we have reached perfection". Thus the business has a method of "process improvement decisions to be based on data, not opinion and speculation" (Shewhart, 1980). This concept of continual quality improvement can be as useful in defining quality for a service business (such as the Roundal Wright Retirement Home). Quality is thus at least partially defined by the constant need to improve operations, as Winder (1996) suggests, "quality is the ongoing process of building and sustaining relationships by assessing, anticipating, and fulfilling stated and implied needs . . . it is fundamentally relational" (my emphasis). In the case of the retirement home, "quality" can thus be defined as the quality of life being provided to and being perceived by the residents of the home. Perception is the important matter here. While in theory a service may be perfectly adequate, the actual test of it is whether the customer sees it is as adequate. There is something personal and emotional to the idea of quality that, while apparently counter to the "data" driven model of Shewhart's vision, is in fact an integral part of it. The "emotional" factor is part of the data. Thus within the concept of quality, "you cannot separate the process and the human factor . . . when Quality is built into a product, it generates emotions and feelings within those who have taken part . . . you'll know it, they'll know it, and each of you will prosper from it" (quality digest, 2006). Thus within the home both the old people and the employees will be happy with the service being provided. In particular, if genuine quality was being provided by the cook he would know it, rather than making excuses and giving explanations for the old people's complaints. B) Which quality assessment tools would you use to analyse the situation at the home and why The tow main tools that will be used are qualitative and quantitative in approach. The first tool will be a survey of all residents to discover the overall satisfaction (or lack thereof) that exists with regards to the quality of their lives within the home. The survey will be a mixture of close and open ended questions. Thus a series of multiple-choice, "The home is clean, quite clean, quite dirty, very dirty" etc. questions will be mixed with ones that ask for input from the residents: "how good are the meals", "what suggestions would you make for meal improvement and management of meal-times." There are several reasons for such a survey approach. First, it moves away from the ad hoc, essentially anecdotal evidence that has thus far been collected. Thus, Sandy has conducted research into what the residents think, but it is likely that only those who have something to complain about talked to her. People do not go out of their way to praise a business in the same way that they will to complain about it. The proportions between positive, neutral and negative comments can thus be determined. Second, the survey approach will involve the residents in improving quality. Thus, if they see that some of their ideas have been implemented, they will feel that they have an empowered role within their own living situation. This is an aspect of the "relational" nature of quality. The old people must feel that there is a relationship between their complaints/needs and changes that will occur. The quantitative assessment tool will consider such matters as the average amount of money that is being spent on each resident. These statistics might be compared with the expenditure at other homes. Questions such as whether it is the bottom-line amount of money being spent that matters, or how it is being spent should be considered. Thus is the 3 pounds per head that is currently being spent really adequate Or is that 3 pounds not being utilized in as efficient a manner as possible How are other homes organized vis--vis the mealtime organization As can be seen, the quantitative measurements and analysis lead back to qualitative considerations. Thus the residents of the home are probably unconcerned with the comparison between the amount spent on them compared to other facilities: they are concerned with the quality of service that they are receiving for that investment. 2) What quality improvement models would you recommend, and how would you apply them to improve service quality specifications Consider the resource implications of your recommendations for service improvements in both financial and other areas The main quality improvement model that is recommended will be one of continuous improvement. Thus the ideas of the Shewhart Cycle should not only be a theoretical background, but also a practical influence on what actually happens within the facility. For example, is having just one cook really an effective use of resources Of course the idea of constant quality improvement does not imply an ever increasing amount of monetary and other resource investment. There is only a finite amount of resources to meet what may be seen as an infinite possibility for improvement. For example, if there was enough money to expand the kitchens and to spend 30 pounds/head on the meals that it is clear that the number of complaints about the food would clearly fall precipitously. But this is not a practical/pragmatic possibility. A model that concentrates too much upon the relational aspects of quality will perhaps come up short because it is impossible to please all of the people all of the time. Here Taguchi's Loss Function is useful. Taguchi establishes a measure of a user's dissatisfaction with a product's performance as it deviates from a target value. The loss function suggests that be selecting product designs/manufacturing processes (or in this case services rendered) that are "insensitive to uncontrolled sources of variation - noise factors - quality is improved" (Roy, 2001). These ideas will be of importance within the old people's home because of the "turnover among guests" and that "perhaps the menu agreed with an earlier group is no longer to this group's taste." The same can be said of the rest of the services offered by the home. The task will be to find menus, kitchen practices, meal management and even landscape gardening that will please as large a proportion of the residents as possible, even with the changing demographics that are implied by a high turnover. The task will be to produce systems that have as few noise factors as possible. The best manner to apply this model to the various activities within the home will be to initially divide them into major categories. Thus the following may be drawn up: Physical plant operations. Food services Entertainment provisions Medical services Staff management Within each of these main categories a series of sub-categories is devised: PHYSICAL PLANT Individual unit maintenance. Overall building maintenance. Ground maintenance. Landscaping design. FOOD SERVICES Cook choice and supervision. Food choice. Pricing. Mealtime organization The same kind of divisions can occur within each of the other sections. Once the whole operation of Roundal Wright has thus been defined and delimited then individual attention can be paid to each of the activities. Of course many of them occur in concert with one another, and exit in a dynamic equilibrium in which each effects the other. Thus the management should consider whether the amount of time that the residents spend in line dictates their judgment of the food. A happy eater is likely to appreciate the food more than an unhappy eater. Thus are the complaints really about the food Dividing the home's operations into discrete units will enable such comparisons to take place. Rather than concentrating upon the overall operations from the point of view of the staff and management of the home, it would be useful to reverse the perspective. Thus a consideration of the living experience of various residents of different types: from the basically healthy 55 year old to the impaired 85 year old may well identify areas where improvement can occur. As it stands, one of the major gaps within the home is a clear and successful management structure. It appears that at the moment the operations merely stroll from one moment to another without any real planning. Without clear management, that follows some of the tested functions of management, any attempt at quality improvement will be doomed to failure. According to Certo and Certo1 (p.8) there are four basic functions for management. These are planning, organizing, influencing and controlling. These four activities have been defined by Carter (2005) in the following manner. Planning is concerned with the future impact of today's decisions. Organizing is the focus on division, co-ordination and control of tasks within the organization as well as the flow of information within it. Influencing is directing people's behavior through motivation, communication, group dynamics, leadership and discipline. Controlling is a four step process of establishing performance standards based on the operation's objectives. It involves measuring and reporting actual performance. The manager does not merely need to analyze in an inward sense, but also needs to be able to communicate his/her findings to subordinates and superiors. This leads to the influencing function of management. This aspect of management relies upon what are popularly known as "people skills". These are perhaps inherently difficult to learn, based as they are on intuition, instinct and knowledge of human nature. However, certain aspects of group dynamics and motivation can be learned, at least in a theoretical sense. How to apply this theory to individual situations is of course another matter. One of the most important facets of influencing is managing the delicate balance between giving employees specific, clearly defined tasks and enabling them to use their own imaginations. MIT (Massachusetts Institute of Technology) report that they were much more likely to become enthusiastic about their work if they felt they were part of an organization that actively sought out learning opportunities. (Carter, 5) Such an organization is always ready to change when the opportunity arises: it is not stuck in a paradigm paralysis in which change is virtually impossible. These ideas may be specifically applied to the cook at Roundal Wright. The attitude of the cook seems to be that he is a one-man kingdom and that his views should hold sway. There is tendency for those within his profession to think of themselves that way. The manager of the whole home needs to decide how far the cook is to be allowed to use his initiative and how far his task need to be defined and limited. In one basic sense the cook's job is very easy to define: he is to provide food for the residents of the home. But in others, it is more amorphous and imprecise:- how far should he be allowed to organize the overall management of the meal services. Should he be able to introduce a waitress service (with the concomitant added costs) on his own initiative As can be seen, these models of management perhaps raise more questions than they give answers. This is a strength rather than a weakness however. At the moment it seems as though too few questions are being asked at Roundal Wright. Questions may lead eventually to answers, and hence to the influencing of quality. Such influence will involve several different elements. First, expectations must be set and results must be fairly measured. Feedback must also be linked to consequences, whether good or bad, and commitment and imagination must also be encouraged. (Miller, 12) Influence is thus a complex process in which employees must know what is expected of them while also trusting that they will be fairly evaluated and provided with timely feedback. If an employee does not feel that he/she is part of such a process then commitment to the company is likely to suffer, along with actual performance. Motivation on an individual level, such as annual reviews etc. must be combined with group dynamics and general morale-boosting management tactics. The manager must balance concern for individual needs and performance with his overall function as a leader of a group. At times communicating with one employee may hinder group dynamics, especially if that employee's ideas are in conflict with the group's. The manager must take care not be seen to be favoring one individual over another, or over the group, while taking into account the unique and individual needs of every employee. Once again, these skills are often innate rather than learned, although managers can be pointed into the right directions through "Best Practices" seminars and workshops. Influencing leads into controlling as managers must decide what performance standards to devise and how to enforce them. Once again, a degree of employee autonomy is the growing trend within corporations. This may be linked to the increasing amount of streamlining of corporations that has led to multi-tasking and the need for employee independence. Employees no longer have one goal or set of standards to meet, but often a myriad of different activities that make it difficult to evaluate their performance by the simple criteria that were use in the past. As Carter puts it, managers "must be prepared to explain to your employees why their goals exist." (Carter, 54). Once the management at Roundal Wright has formulated clear goals and expectations, devised a system for explaining and enforcing them - service quality within the institution should improve. Constant stress should be made that the employees are providing a service to the old people how live there. This is a simple but profound realization that may at times become lost within the complexity of models or the chaos of day-to-day business operations. Works Cited Carter, Louis et al. Best Practices in Leadership Development and Organization Change: How the Best Companies Ensure Meaningful Change and Sustainable Leadership. Wiley, San Francisco: 2005. Miller, Brian. Keeping Employees Accountable for Results. Amacom Books, New York: 2005. Roy, Ranjit. Design of Experiments Using the Taguchi Approach: 16 Steps to Product and Process Improvement. Wiley, London: 2001. Shewhart, Walter. Economic Control of Quality of Manufactured Product. American Society for Quality, New York: 1980. Winder, Richard. Judd, Daniel. Organizational Orienteering. Quality Management Conference, New York: 1996. www.omnilingua.com www.qualitydigest.com Read More