Introduction
Total Quality Management (TQM) refers to management methods used to enhance quality and productivity in business organizations. TQM is a comprehensive management approach that works horizontally across an organization, involving all departments and employees and extending backward and forward to include both suppliers and clients/customers. TQM has five major elements that are essential to successful implication, which are:
- Focus on customer satisfaction: TQM focus employees on the importance of fulfilling customers’ expectations.
- Continuous improvement: is apolicy or process that helps keep the focus on improving the way things are done through regular incremental improvements or achieving larger process improvements.
- Employee involvement: ensure that employees are involved in implementing the TQM concept.
- Strategic and systematic approach: in TQM, organizations have a strategic plan in place which integrates quality as its primary component.
- Fact based decision making:TQM requires the organization to continually collect and analyze data in order to improve decision making accuracy.
Quality management plays a crucial role in your company’s growth and performance. It is also a key resource in the competition for customer relationships, striving to deliver a superior experience. Total quality management can help the organization by maintain loyal customers, due to the continuing improvements of the products, incorporating changes, and neglecting the defects. Furthermore, quality management provides companies with the specific information they need in order to develop the goods and services that customers want. This will increase the market share and gives the organization a competitive advantage. Also, total quality management can decrease human errors, and this helps to improve the company’s validation. For example, the employees will have a list of guidelines which they have to follow it during their day to day operations.
Nowadays people demand for better healthcare systems. The importance of total quality management has risen in the health care field as it has become a part of the hospital’s competitive strategy. Using quality management in the health care system will help balance efficiency, equity, and quality which could be very challenging in order to provide a high-quality service. This strategy will improve performance and increase patient satisfaction (Mosadeghrad 2016).
In healthcare services there are three definitions distinguished; Total Quality Management from other approaches: “it is a comprehensive strategy of organizational and attitude change for enabling personnel to learn and use quality methods, in order to reduce costs and meet the requirements of patients and other customers” (Balasubramanian 2016).
Total Quality Management is also defined as “a management philosophy concerned with people and with the work processes that focuses on customer satisfaction and improves organizational performance” (A.Al-Shdaifat 2015). In other words,we use quality to reflect high value service. With this concept we can see that the importance of total quality management has increased in the health care system as it has become part of the hospitals competitive strategy.This will provide the hospital or clinic to offer potential cost saving while quality is maintained and improved. As a result of undertaking all these measures would insure the satisfaction of the patient and will reduce the risk of consequences regarding human health. Alongside using and implementing quality management this system will establishpolicies to fulfil the healthcare service providing in the market. Quality management has several principles to guide the achievement of the system. These principles were mentioned in Greame Knowles, a book on quality management, which includes the following: (Knowles 2011)
- Customer Focus
- Strategic Focus
- Leadership Focus
- Process Focus
- People Focus
- Scientific Focus
- Continual Improvement, Innovation and Learning
- System Thinking
As said above the most important focus is the customer, we must understand the customer’s needs and expectation to create the value wished. Moreover, to insure getting the most out of the system, it needs to have a committed leader who can actively drive the strategy and spread positive vibes to have better engagement with the clients. All these aspects contribute to attain a recognizable quality management system.
Research objective
The research objective of this report is to understand and to identify the use of total quality management in Celeste Medical Center.
Methodology
Our research follows a qualitative design. We conducted an interview that was based on a set of qualitative questions which were directed to the manager of Celeste Medical Center to identify what type of quality tools they use.
Literature Review
Quality management is defined as the act of managing all the actions and responsibilities required to keep a desired level of quality. This includes the aim of a quality policy, which is making and applying quality arrangement and guarantee, as well as quality control and quality development. It is also known as total quality management (TQM). Overall, quality management emphasizes on the long-term goals of the application of immediate initiatives.
At its center, quality management (TQM) is a business philosophy that holds the impression that the long-term success of a business originates from client satisfaction. TQM requires all shareholders in a firm to work together in order to advance developments, products, services and the values of the business itself.
A famous example of quality management is the Toyota’s application of the Kanban system. A Kanban is defined as a physical sign that generates a chain response, resulting in a precise act. Toyota used this knowledge to apply its just-in-time inventory method. To make its assembly line more effective, the firm decided to just keep enough inventory available to fill client’s requests as they were produced.
Thus, all pieces of Toyota’s assembly line are allocated a physical card which has a related inventory number. Before a part is fit in a car, the card is detached and moved up in the supply chain, successfully demanding one more of the same part. This permits the firm to keep its inventory lean and not overstock needless assets.(Quality Managemnet , 2018)
Quality Management in Service Industry
Overseeing the quality of products and services is essential to assure that the company excels at meeting their consumers requirements and accomplishes their organizational goals. Whether it’s an industrial company producing hardware or a software firm delivering services to customers, quality management is the very core of constant development and business advancement.
The process of handling the quality of services brought to a client according to his expectations is named Service Quality Management. It essentially measures how good a service has been delivered, to progress its quality in the future, recognize issues and fix them to increase client satisfaction. Service quality management includes the monitoring and preservation of the diverse services that are accessible to customers.
Whether it is a software company delivering services to customers or working in hospitality or travel business, service quality management is essential to handling customer’s expectations and company development.
Quality Management in the UAE and GCC Service Industry
Many contemporary organizations across the UAE, GCC and the globe are implementing total quality management (TQM)systems to please and satisfy their clients. The necessities of today’s modern world require us to deliver quality products and open services in order to increase the competitive advantage and to improve client time value. TQM involves making a client‐centered principle in the service business. Starting and implementing a TQM system in most of the service organizations is a key task. It requires a full and organized analysis of client expectations, system procedures, functions, detailing and quality restrictions. TQM has a huge effect on various service industries performance. (Talib, 2010)
Companies in the UAE are facing problems in attaining high level of client satisfaction and constant progress. Lately, quality divisions such as center of quality have been added to many firms in the United Arab Emirates whether to the government, private, or semi-government firms. This is because good quality management is anessential field that should be combined in such firms.
There is a requirement to study Total Quality Management and barriers of application of TQM in UAE firms. TQM arena is a new management style that came in 1980s in US and therefore, UAE firms have been influenced by the novel management style; though, no information or evidence is given in journals or documents concerning the affects or achievement aspects in UAE. The culture in UAE still requests experimental evidence and actual case successes to simplify the new style built on results.
Total Quality Management is a novel philosophy of management that was recognized in United Arab Emirates and the Gulf region quite recently. Total Quality Management in UAE nevertheless, received slight care and studies from researchers and experts concerning the critical success aspects and constant development. (AbdulAziz & Al Ali, 2012).
Research Methodology
Our research is qualitative research. Qualitative research is a scientific, exploratory method used to gather non-numerical data. We used this method to enquire and gain more understanding regarding quality management. As a team, we prepared a questionnaire and conducted an interview with the Manager of a small medical centre in Al Ain.
Questionnaire development
We first drafted 8 questions which covered areas including; quality management, quality control, performance standards and customer satisfaction. Then we continued to edit the questions until we came up with the final 10 questions.
Data collection
A member of our team Miss ReemKheir had contacted an aesthetic clinic known as Celeste Medical Center to schedule an appointment with the top manager.
On the day of the meeting, which was on 7th October 2018, all the team members were prepared for the interview with their set of questions. After arriving at the clinic, we were taken to the manager’s office, and with permission we started to record the interview. The interview session lasted for 30 min to answer all our questions.
The interview was conducted in English. It was a two-way conversation where we were supported even by their monthly quality checklist towards the end of the session. After leaving the clinic, the team members discussed their experience of the session. It was not surprising when we all agreed that the there wasn’t any formality involved in getting to choose a flexible time for an interview with the manger, which is unlikely for many other companies. Since our objective of this research is Quality Management, it was imperative that we also analysed the clinic’s conditions and equipment’s. We were given a friendly tour to look around the clinic to better understand their services conditions and hygiene standards. Finally, we took away a lot of information from the interview, which will be further discussed in the analysis of this research paper.
Analysis
Strategies in measuring customer satisfaction
The clinic has high quality services because of the type of machines uses. The origins of machines are from the best countries in the market to satisfy their customers. This results eventually in a very good service given to their customers. As a part of measuring their satisfaction, they have not implemented any such strategy to measure service after its completion or after visiting the clinic. Leaders establish a comprehensive plan for their business to manage the daily operations. Failing to contribute towards strategic customer management plan could risk the business its survival. The clinic could initiate by creating a plan for managing the customer satisfaction that outline the initiatives, and milestones. They should figure what they want to achieve and how do they want to record its feedback technically. To measure the satisfaction dimensions that they want to measure, the clinic must have its objectives set and their standards which should be in compliance with the HAAD standards.Finally, an approach to collect the data, analyse the customer response, and address major issues for continual progress. (Duggan, 2018)
Measuring customer feedback
The clinic has feedback forms always placed in the reception. There are also suggestion boxes, and the employees of the clinic accept complaints in person. However, the manager at the clinic is the one who reviews these feedbacks forms and evaluates them in his own perspective. There is no software, or anytactics implemented for measuring customer satisfaction. The Manager could consider liable approaches best suitable for measuring customer satisfaction from techniques such asmeasuring customer growth orthrough the referral rate.(Olsen, 2011)
Future planning to develop the approach of receiving customer feedback & incorporating or using technology
The clinic does not receive many complaints. Therefore, we understand that our customers are satisfied. However, when these complaints are made, they are only recorded through the feedback form or left in the suggestion box. Management is later approached to resolve those issues face-to face with responsible persons.
Motivating team to achieve quality performance standards
The management team of the clinic believes that it is a must for their employees to match the standards of service that is expected of them in the line of service where demand is very high, and it is believed that this is very sensitive because the customers are directly impacted through it. The technicians and doctors are informed from the phase of their selection and orientation about what is expected from them in this regard. The management team provides its employees with greater monetary rewards than what is given in their local industry market. This is one of their motivational approaches. For their overtime after the completed shift for the employees, the manager applies the minimum wages as per labour laws and multiplies it by 2 times its amount, as a motivational technique for working extra hours in the clinic.
Enforcing Quality
Celeste Medical Centre has a contract with another quality company who regularly check their machines. However, it seems that they are not reliable enough as the manager informed us that he must be there in person when an inspection takes place. This is because he has seen some sort of neglecting of ethics from their behalf in the form of putting tags on machines which haven’t been checked.
Overall satisfaction with the outcome of quality at the clinic
The current manager is satisfied with the quality of the existing machines but mentioned that when he was first hired as a manager, he was not satisfied with all the operations running in the clinic. The previous manager didn’t have any contracts with health insurance companies and wasn’t following the health authority standards. He acknowledged that as a manager, it was the first crucial thing he had to do. To ensure that quality controls were enforced.
Although the manager didn’t mention using any tools to measure patient’s satisfaction regarding quality, one could suggest that using patient satisfaction surveys could be beneficial. Studies have shown that patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. In the western world, specifically in Germany, measuring satisfaction has been required since 2005 as an element of quality management reports. Furthermore, since 2002, the Department of Health (DOH) has launched a national survey program in which all NHS trusts in England have to survey patient satisfaction on an annual basis and report the results to their regulators. Therefore, measurement of patient satisfaction is a legitimate indicator for improving the services and strategic goals for all healthcare organizations ( Al-Abri& Al-Balushi, 2014).
HAAD standards
The company started following HAAD standards in August 2017 with the help of an insurance coordinator because they had more knowledge about them.
HAAD is responsible for licensing, quality control, and regulating all of the health care facilities and health professionals in the Emirate of Abu Dhabi.HAAD standards are consistent with JCI standards but focus on the fundamentals of patient and facility safety. All health care facilities in Abu Dhabi must achieve the authorized or compulsory standards during an inspection to be licensed in the Emirate. Each new version of the standards, which is conducted approximately every three years, reflects the dynamic changes occurring around the globe in health care. As a general principle, licensed providers are expected to meet the following professional obligations:
- Ensure the clinical and other professional qualifications of all staff according to HAAD licensing policies; in turn licensed clinical staff is expected to act in a manner that is consistent with international good practice in the management of patients to maintain safety and provide such benefit as they are able.
- Ensure their facilities and equipment are enough to deliver safe, high-quality care in accordance with international good practice.
- Ensure there are healthy clinical and management processes for the tracking of patient safety and the effectiveness of treatment, including the keeping of accurate, fit-for purpose clinical records.
- Report any occurring incidences that result in a risk to patient safety or compromises the
- delivery of high-quality care. ( Health Policy & Regulation, Health Authority Abu Dhabi, 2008)
- The importance of HAAD standards are very clear. It was also very noticeable that the quality of service in the centre improved after adopting the HAAD standards.
Software that measure quality management
The company doesn’t have any special software directly related to quality, but they have an employee system that shows the duties of each doctor, and a patient schedule to manage bookings.
It would be extremely beneficial and in fact necessary that the company invests in a QMS. One could be ENCOR, which is an award-winning software platform, that provides comprehensive quality reporting solutions for hospitals and clinicians.
Standards at a clinic that differ from the department of health standards in UAE
The company do also have their own set of slightly different standards that they apply. They have a check list in every room which is collected at the end of the day to measure and observe how many patients have visited the clinic, and how many patients have cancelled the appointment.
One of the checklists they could use in the future is a Patient Safety and Quality Improvement (PCQ) scoring requirement, which is one of the measurements of HAAD Standards. PCQ will be very valuable to the centre because quality and safety will be rooted in the daily work of the health care professionals and other staff. Doctors and nurses will assess patient needs and provide care. PCQ can help them understand how to make real improvements to help their patients and reduce risks (Health Policy & Regulation, Health Authority Abu Dhabi, 2008).
Conclusion
From our research, we come to conclude that Celeste Medical Center uses some techniques in order to enhance its quality. However, we observed that it’s mostly manual based and they haven’t installed any special software, nor do they have any strategies to enforce quality management. TQM is an important aspect of any business because it will help the organization in eliminating human errors, increasing customer’s satisfaction, and improving the company’s performance.
References
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AbdulAziz, E., & Al Ali, A. S. (2012). Total Quality Management Implementation. A Study to Critical Success Factors and Continuous Improvement to UAE organizations, 122.
Al-Abri, R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman medical journal, 29(1), 3-7. https://www.haad.ae/HAAD/LinkClick.aspx?fileticket=dI0JyhF3pDc%3D
Balasubramanian, M. 2016. “Total Quality Management [TQM] in the Healthcare Industry.” Science Journal of Public Health 4. doi:10.11648/j.sjph.20160404.11.
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