The implementation of total quality management in hospitals: How good is the fit?

Determinants of quality management systems implementation in hospitals

“…Organization culture, mentioned as the bureaucracy type, cultural type, degree of employee empowerment [1,4,9,10], and the design factors mentioned as the strategic approach [1,9,16], the size and ownership [1,10,14,15], customer focused [24], and the paradigm in solving problems [1] are reported and identified as the critical factors in QMS implementation. The degree of QMS implementation will be higher in proportion to the degree of employee empowerment, risk-free environment and innovation emphasis [4,5,25]. These may be represented as the features of a less hierarchical culture, less bureaucracy and complex structure, more risk-taking and innovative strategic approach.…”

“…A number of studies have been carried out to explain the factors influencing QMS implementation. These studies identified that the type of organization culture and technical skill as the factors determining the successful implementation of QMS [4][5][6]. However, it should be noted that limited empirical studies were conducted for healthcare setting.…”

Lessons from Sweden’s first large-scale implementation of Six Sigma in healthcare

“…Total Quality Management (TQM) has been applied in the area of healthcare for several years (Arndt and Biegelow 1995;Westphal et al 1997;Young et al 2001), as have Business Process Reengineering (BPR) (McNulty and Ferlie 2002) and Process Management (Hellström et al 2010, Hellström andEriksson 2007). More recently, Lean (Fillingham 2007;Radnor and Walley 2008) and Six Sigma (Boaden et al 2008) have grown in popularity amongst healthcare organizations.…”

Quality Management in Irish Healthcare

“…In the American context healthcare institutions take quality management seriously and many embrace wholeheartedly the teachings of Deming, Juran, Crosby and Peters, while others place it as a corporate objective and strategy. Across all institutions there is a general consensus that healthcare institutions must be quality focused [Feeney and Zairi, 1996] including lack of top management commitment, limited employee involvement [Lin and Clousing, 1995] and lack of physician involvement [Huq, 1996;Arnt and Bigelow, 1995]. Quality improvement initiatives in healthcare are likely to be limited unless they are seen as a function of the whole organisation.…”

“…Increasingly it is being viewed as a means of increasing efficiency and improving quality of care delivered. A substantial body of literature now exists on the subject in a global context [Moss and Garside, 1995;Short and Rahim, 1995;Nwabueze and Kanji, 1997;Badrick, 1996;Donabedin, 1992;Feeney and Zairi, 1996;Ovretveit, 1997;Huq, 1996;Carman et al, 1996;Arnt and Bigelow, 1995]. However, with the notable exception of O' Keefe and O'Sullivan [1997] there are deficiencies in the treatment given to quality initiatives within healthcare in Ireland.…”