TOTAL QUALITY MANAGEMENT

Developed by Dr.
W. Edward Deming
 Based on the premise that the
INDIVIDUAL is the focal element on
which production and service depend (i.e., it must
be a customer-responsive environment) and that
QUALITY is an
the quest for

ONGOING PROCESS
 ALWAYS room
for improvement
 A FEEDBACK LOOP
between administrators,
workers, and
consumers
 A system of management based on
EVERY staff member
the principle that

must be COMMITTED to maintaining

high standards of work in EVERY aspect of a

company's operations
 Marketing
Finance
Design
Engineering
Production
Customer Service
etc.
 EMPOWERMENT OF
EMPLOYEES by providing positive
feedback and reinforcing attitudes
and behaviors that support quality and
productivity
 KNOWLEDGABLE,
ACCOUNTABLE, and
RESPONSIBLE
 Describes a management
approach to LONG-TERM
SUCCESS through
CUSTOMER SATISFACTION
TOTAL QUALITY MANAGEMENT PRINCIPLES
By Deming (1986)
1. Create a constancy of purpose for the
improvement of products and service
2. Adopt a philosophy of continual
improvement
3. Focus on improving processes, not on
inspection of product
4. End the practice of awarding business on
price alone; instead, minimize total cost
by working with a single supplier
5. Constantly improve every process for
planning, production, and service
6. Institute job training and retraining
7. Develop the leadership in the
organization
8. Drive out fear by encouraging
employees to participate actively in the
process.
9. Foster interdepartmental cooperation,
and break down barriers between
departments.
10. Eliminate slogans, exhortations, and
targets for the workforce.
11. Focus on quality and not just quantity;
eliminate quota systems if they are in place.
12. Promote teamwork rather than
individual accomplishments. Eliminate the
annual rating or merit system.
13. Educate/train employees to maximize
personal development.
14. Charge all employees with carrying out
the total quality management package.
 ADVANTAGES OF TQM
• Strengthened competitive position
• Adaptability to changing or emerging market
conditions and to environmental and other
government regulations
• Higher productivity
• Enhanced market image
• Elimination of defects
and waste
• Reduced costs and better
cost management
• Higher profitability
• Improved customer focus and satisfaction
• Increased customer loyalty and retention
• Increased job security
• Improved employee morale
• Enhanced shareholder and stakeholder
value
• Improved and innovative processes
 DISADVANTAGE OF TQM
• Can be difficult to implement
 Toyota Production System
a production system built on the COMPLETE
ELIMINATION of waste and focused on
the pursuit of the most efficient
PRODUCTION METHOD possible

(Toyota Motor Company, 2010)

ROOT CAUSE OF THE
PROBLEM
 ONE AT TIME
WHERE AND WHEN
WITH WHOM THEY OCCUR
 NOT EASY
 change in organizational culture, values,
and roles
eliminating problems at their root VS
solving an immediate problem at hand
 requires a substantial commitment of
leadership time and resources
 requires a tremendous amount of staff
preparation and involvement
 Medication errors
• Errors made did not occur from individual
recklessness
• Errors occurred because of flaws in the way
that the health delivery system is organized
and delivered
 Strategies in reducing Medication
Error
• Create an environment that include better
reporting of the errors occurring
• Leapfrog initiatives
• Reform of the medical liability system
• Other point-of-care strategies such as bar
coding, smart IV pumps and medication
reconciliation
 Six Sigma Approach
• An approach to
create a culture of
safety and
management at
the institutional
level
• Sigma – statistical
measurement that
reflects how well a
product or process
is performing (the
higher the value,
the better
performance)
 Integrating leadership roles and
management functions with quality
control
• All managers are responsible for monitoring the
quality of product that their units produce
(Product = Patient care)
• Evaluate organizational performance form a
systematic, scientific, and objective viewpoint
• Determine the standards to measure quality care
in their units
• Develop and implement quality control programs
(that measure result against those standards)
 Integrating leadership roles and
management functions with quality
control
The Nurse Leader-Manager must:
1. Be inspiring subordinate
2. Be role-model for high standards
3. Have vision
4. Be risk-taker and accountable
5. Be self-aware
6. Be change agents