Concepts of Total Quality Management and Six Sigma - Term Paper Example

Concepts of Total Quality Management and Six Sigma Introduction: It is seen that while Six Sigma (SS) and Total Quality Management (TQM) are major aspects in health care industry, they have distinct personalities and individual traits, but could be combined into one major cohesive force underpinning the health care industry. Before we enter into the discussion regarding traits displayed by TQM and SS, it is important to define these terms, especially with regard to this industry and this understanding “is key to the future of healthcare quality.” (Komashie, Mousavi & Gore, 2007, para.5). Six Sigma is a “rigorous set of processes and techniques to measure, improve and control the Quality of care and service based on what is important to the customer (Woodard, 2005, p.229).” (Majdi, 2009, para.1). The main aspects regarding SS is to provide nil level tolerance of errors in the health care sector, thus offering maximum safety and degree of care in heath care provision. The main areas in which SS could possibly offer its services are medication, supply chain management strategies in tandem with suppliers and vendors, medical reporting, settlement of claims and the outcome of the condition of patients in different levels of care giving. One of the most significant aspects of SS is that it is amenable to quantitative measurements and analyses by the implementation of DMAIC, that is, define, measure, assess, identify and control. Total Quality Management (TQM), on the other hand, is more subjective in its approach, and fundamentally, “The goal of a TQM program in a clinical healthcare setting is to reduce costs and improve customer (patient) satisfaction.” (Weinheimer, 1993, para.2). Thus, the main objectives of TQM in hospital settings are to find ways and means to improve the quality of service - lesser waiting time, attending complaints promptly and efficiently, providing computer generated prescriptions, reducing medical errors and malpractices to minimal levels, and in short, rendering maximum health care service possible in the minimum timeframe. All these are qualitative aspects, but given the scope for improvement, a blending of SS and TQM (both quantitative and qualitative) could deliver maximum benefits and advantages to customer, clients and patients in a well rounded and innovative way. Perhaps, the best comparison between SS and TQM could be in the delineation of common goals and objectives of these two systems- total patient care and commitment using measuring tools and industry benchmarks. While their respective methods may be slightly different in approach and technique, the ultimate objective of maximum patient care and redefining the horizons of service is similar in both cases. With changing times, the demand and profile of patient care in hospital settings are being constantly redefined and remodeled. With data and information just a mouse click away, the need for paramount patient care has reached a new high level, and is constantly increasing with each passing day. Under such circumstance, the main aspects of SS combined with TQM would be in terms of delighting customers with enhanced quality of service at curtailed time and efforts. Thus, there is need for continually reprogramming human, technical and operating skills like never before, perhaps updating skill sets and their usage for patient care and comfort rendering. Thus, an aspect termed as the quality of processes rendered is fast assuming center stage as never before. This process entails both qualitative and quantitative, as depicted through both TQM and SS. TQM is a set of management principles that are practiced in an organization to ensure continuous development of an organization by consistently meeting the customer requirements. The customer requirements are met by delivering high quality products through various control measures. The concept of TQM is used as process measurement tool for continuous improvement in an organization. “Total Quality Management (TQM) is a comprehensive and structured approach to organizational management that seeks to improve the quality of products and services through ongoing refinements in response to continuous feedback.” (Total quality management, 2009, para.1). This concept is used by all organizations as they are engaged in producing and delivering quality goods and services. TQM deals with all the aspects that are directly or indirectly involved in the production process. This concept is not only oriented towards quality in the production process but also aims at improving the quality of an organization as a whole. “TQM processes are divided into four sequential categories: plan, do, check, and act (the PDCA cycle)”. (Total quality management, 2009, para.2). In the first stage, the relevant problems are identified and are addressed to the respective authorities, the data with respect to the problems are gathered and the root causes for the problems are identified. In the second stage, various solutions are developed and those solutions are implemented. After implementing, their effectiveness is measured by using various measurement tools. In the third stage, results of effectiveness are generated after comparing the data from the previous stage. And finally the fourth stage involves documentation of the results that are gathered and dissemination of the information to others about the changes in the process and finally making appropriate recommendations for the problems that will be well thought-out in the next PDCA cycle. Total Quality Management in Health Care Sector: Maintaining and improving quality has emerged as an important factor that must be taken into consideration for all the health care sectors. This concept is considered as an important tool in developing and improving the quality of the products and services that are distributed from a health care sector. The two important components of TQM in a health care sector are leadership skill of the top management and the customers. For the successful implementation of TQM, awareness or training should be provided to the customers as well as the workforce within the sector. It is not meant for short term but it is a long term strategic commitment which is practiced by most of the health care sectors. Concept of Six Sigma: “Six Sigma is often criticized as ‘an old wine in a new bottle.” (Antony, J., Antony, F. & Taner, n.d., p.3). SS is a process which is used by most of the organizations to identify the deviations in the products and the work process. The concept of SS was developed by Motorola in the year 1980. This concept is used by the organizations to reduce rate of deviations. SS helps the companies to produce qualitative and excellent products and services. In a six sigma training there are four belts which show the expertise of the person in that particular field. These belts in the respective order are “yellow belt, green belt, black belt and master belt.” (Jane82, 2008, para.4). The yellow belt indicates that the person possesses basic knowledge about the six sigma process. The green belt indicates that the person is capable to handle challenging projects. The black belt indicates that the person is capable to lead a team and has the ability to provide training to the members in the earlier mentioned two belt groups. Finally comes the master belt; the person in this belt is responsible for framing the strategy of the company and is also responsible for training the members in the black belts. Six Sigma in Health Care Sector: This concept was mainly developed for manufacturing industries to improve the quality of the products, but as the time passed, its importance has extended to the service sector also. This concept is very new in health care sector. In the manufacturing sector it was used as a tool to identify the root cause for the problem, but in the service sector it is used for clearing the transactional mistakes which are happening in the organization. In the health care sector, Mount Carmel Health which is situated in Columbus was the first to implement the six sigma concept. It has been proven that the six sigma methodologies are performing at their best in improving the quality and efficiency of services rendered in the health care sector and also helps in eliminating the human errors that are often considered as critical. Comparative Analysis between TQM and Six Sigma in the Health Care Sector: Generally speaking, both the concepts mean the same - improving quality. But there exists a significant difference between these two. Comparative analyses between these two topics are discussed below: TQS is an older concept which was implemented in most of the health care sectors and was found that there was no decline in the rate of medication errors. When the new concept called ‘Six Sigma’ was implemented, it helped the health care sectors to reduce the rate of medication errors. TQS identifies the problems, and based on those problems quality measurement tools and methods are identified, whereas the Six Sigma identifies the root cause of the real problem and take necessary action to avoid the mistake for the next time. The concept of TQM involves effective data collection and analysis. It is not implemented as an effective tool for reducing medical errors, whereas the Six Sigma being a new concept it has proven its potential in tumbling the medical errors in the health care sector. The effort of six sigma is not different from the total quality management, but the goals that are set in the six sigma are more aggressive all the methods are defined clearly. TQM involves in improving the quality of health care services and when it reaches a stage it is not possible to make improvements in the quality. It is different in six sigma because it mostly concentrates on the quality improvement of the processes in the subsequent level. As per TQM, the term quality means confirmation to the requirements that are internal to the organization, whereas in SS quality of services is improved by reducing the number of medical errors. TQM is considered as a broad concept because it mainly focuses on improving the individual operations that are not related to the businesses process, where as the six sigma is considered as narrow concept where it concentrate on improving the entire operations of the organization that are within a single business process. TQM can be performed by any managers who have the basic knowledge regarding the quality, whereas SS requires skilled professionals who are certified as black belts in the health care sector. Conclusion: In the present context of health care industry, the main aspects that need to be considered would be in reducing patient waiting time (for outpatients) and maximum degree of care and consideration for inpatients. There are several aspects that providers need to provide cognizance for. It could be in terms of expectations of patients, the various processes involved, how quality aspects enunciated by SS and TQM could be enforced and monitored. Besides this, the quality team needs to identify the sub divisions of critical items for in patients - food, comfort zones, proper caring and use of mechanical and non-mechanical aids, toilet help and so on and so forth, good communication systems, all of which are critically important for patients. For outpatients, this could be reduced waiting time, quicker disposal of cases and better medication service management. Time and efforts are critical measures and need to be fully endorsed in the DVAIC plans, and TQM studies planning and execution. Quality Managers and SS specialists need to work in tandem to identify, initiate, execute and provide feedback assessment for administering SS and TQM. Initially, this regular reporting mechanism could be slightly tedious. Once it is totally imbued into the system, it becomes a part of the ongoing structure and ceases to be cumbersome. Moreover, the benefits and advantages of these systems far outweigh their disadvantages and constraints. The main aspect that needs to be considered is that TQM and SS need to be tailor made and fitted into the health care system, based on the shortcomings and deficiency in the present system. They do not seek to supplant existing systems but only aid to reduce inefficiencies, wastages and duplication of work processes, promote efficiencies and better caring and, in effect, introduce qualitative and quantitative economies and better performances. Thus, TQM and SS could be seen as strategic execution of plans, programs and practices that could add impetus and momentum to the management’s desires of total quality management, and help employees to clearly know their respective roles and functions along the performance lines. It could also be seen in terms of how employees could contribute better to the present scheme of things – better patient-provider relationship, lower costs, improved levels of health care and evolving of continuous improvement schemes rendered by greater and more extensive usage of SS and TQM, among others. The main idea is to provide total care for patients at reasonable costs and minimum efforts. Reference List Antony, J., Antony, F., & Taner, T. (n.d.). Six sigma in healthcare industry: Some common barriers, challenges and critical success factors: Six sigma versus total quality management (TQM). Google Docs. Retrieved November 22, 2009, from http://docs.google.com/viewer?a=v&q=cache:SHxlthbOkOwJ:www.sixsigmascotland.co.uk/Six%2520Sigma%2520in%2520Healthcare%2520Sector%2520-%2520Public%2520Service%2520Review%2520Jou..pdf+TQM+and+Six+Sigma+practices+in+a+health+care+sector&hl=en&gl=in&sig=AHIEtbRHJWEz6HQx9-wLCSKFxNCLVAIF1w Jane82. (2008). Six sigma concepts: About six sigma belts. Saching.com. Retrieved November 22, 2009, from http://www.saching.com/Article/Six-Sigma-Concepts/904 Komashie, A., Mousavi, A., & Gore, J. (2007). “Quality management in healthcare and industry: A comparative review and emerging themes: Originality/value.” Journal of Management History, 13 (4), 359-370. Emerald Group Publishing Limited. Doi: 10.1108/17511340710819598 Majdi, C. (2009). Six sigma and total quality management in healthcare. Transition Consultants: The Practice Sales and Financing Company. Retrieved November 22, 2009, from http://www.transitionconsultants.com/articles/20-six-sigma-and-total-quality-management-in-healthcare Total quality management. (2009). Search CIO.com: Technology Management Strategies for the Enterprise CIO. Retrieved November 22, 2009, from http://searchcio.techtarget.com/sDefinition/0,,sid182_gci799434,00.html Weinheimer, C F. (1993). Total quality management is here to stay - total quality management in healthcare industry –vantage point-column. BNet: The Go-To Place for Management. Retrieved November 22, 2009, from http://findarticles.com/p/articles/mi_m3257/is_n9_v47/ai_14509867/?tag=rbxcra.2.a.22 Read More