Total Quality Management (TQM) is a management style that implies non-stop process of quality improvement of products, processes and

personnel work. This is a bunch of methodologies that drive company to strategic goals achievement through unceasing quality development. It is focused on production of goods and services that possess high-quality from viewpoint of customers. TQM was elaborated on basis of Edward Deming's theory. This philosophy has successfully started many years ago in Japan and USA . TQM has shown phenomenal results and now it is used in many successful enterprises all across the world. It allows obtaining faster, fundamental and more efficient business development, because it stimulates production of much better products for better prices. There are 5 "sicknesses" or mistakes that should be driven out of organization for successful implementation of TQM. If these "sicknesses" are not eliminated, they can entail failure of TQM and gradually destroy a company. Here are these "sicknesses":
Management of only basic line. Organization that takes care only about basic line of

development and manages only numeric results is doomed to failure. Management is a hard work and manager that works only with numbers lightens his/her task. Actually manager should know all process workflow and being involved into the process, understand what can be the source of problems and be an example for subordinates. Evaluating of activity with a help of quantitative rates system . Evaluating of activity with a help of quantitative rates system. Evaluating that uses system of quantitative rates, reports, annual reviews of attainments, etc. can cause forced quotes, classification and ratings that entail unhealthy competition, break of team collaboration within company. Instead of such systems managers should personally comment employees' work, advice and help to improve it. Stress on receiving of short-term benefits. If employees have experience of getting fast profits they will try to work in the same way. Management should convince workers that it is better to prefer long-term and stable growth and improvement than quick, short-term profits. Lack of strategy. If there is no any sequence of realizing goals in a company, employees will feel uncertainty about possibility of constant professional and carrier growth. Organization should have continuously realizing strategic plan where considerable part should be devoted to questions of quality improvement.
Staff turnover. If high staff turnover within organization is apparent, this indicates serious

problems. Eliminating of previous four sicknesses will help to solve this one. Management should assume the proper arrangement to make employee feel as an important part of one consolidated team. Advantages of TQM: TQM gives some short-term advantages, however majority of dvantages is long-termed, and tangible benefits from them appear only after successful realization. In big organizations this process can take few years. Long-term benefits expected from implementation of TQM - higher productivity, higher moral tonus of personnel,

decreasing of costs and increasing of consumers' trust. This will make company popular and increase its status within society. Avoidance of mistakes allows company to save money and time. Extra resources can be used for range of products and services expansion or for other improvements. TQM creates atmosphere of enthusiasm and satisfaction with performed job and welcomes awarding bonuses for creative approach to professional duties. TQM intensively uses team style of work that allows employees share their experience, use their skills effectively and apply joint efforts for solving issues. As far as team members gain experience of team problem solving they can be a part of cross-department "mega teams" that work at tasks that are beyond of local group possibilities. TQM gives to organization more flexibility in work and problem solving and improve work environment for each employee. As we can see team collaboration is an important part of TQM philosophy. In order to be efficient each team should be managed properly. For this purpose special software can be used. VIP Task Manager is intuitive, user friendly team collaboration and small project management software. It is ideal for multiple users real-time collaboration. Features include time and task planning and tracking, reporting, email and in-system notifications, file attachment, access permissions, task tree view, scheduler (calendar), charts and data import/export. VIP Task Manager is easy to use and simple to deploy. It allows team members to access the same database via LAN or Internet and see, edit, and report their tasks. VIP Task Manager includes flexible interface, customizable workflow and task attributes.

What went wrong with

TQM?
By Rebecca Anwar, Ph.D.in Physicians news digest

Published December 1996

React to this article in the Discussion Forum.

Total Quality Management - TQM. We know it well. It gripped the American workplace and crept into the health care industry in the early nineties. It was, and in some cases still is, the latest rage. From the onset, there was a lot of hype and acceptance of TQM. For many health care businesses it resulted in a commitment and an investment. They went on to retool operations, increase efficiency and improve "quality." Though some hospitals and medical practices continue to endorse and espouse the success of their TQM program, many have all but forgotten the efforts and investment made.
What went wrong? Here we are in 1996 and the enthusiasm for TQM has fizzled. Despite a sincere interest in providing quality product and service, some small to mid-sized health care organizations never got off the ground floor. For others, a considerable amount of time, energy and money was invested to develop and support a TQM program that would improve management, increase efficiency and foster team spirit. Yet, in time, programs lost momentum and the current status and success of TQM is questionable for many health care organizations. Why is it that health care has not experienced overwhelming, "long term" success with TQM? At the risk of offending TQM advocates, the following assessment is presented. TQM - A Great Idea The concept of TQM is fantastic: involve the people, examine their work flow and develop ways to improve the output, thus eliminating waste. By including staff and gathering input from everyone involved in a procedure, we are able to collectively examine the function (purpose) and flowchart the process (action taken). We can quickly identify and eliminate wasted steps and duplication. We are on the way to improving quality. So what could possibly get in the way of our success? Time Consuming and Laborious Designing a structured TQM program includes the development of "teams" and the unfortunate necessity of many meetings. And this is where the problem begins. The idea of the flowcharting and streamlining process was to eliminate steps and time. Now time is spent meeting with other team captains, documenting progress and monitoring performance. Team captains may have been assigned who may not be as committed to the TQM concept (and the investment made) as top management. In addition, the team may change. People leave the organization after we involve them and invest time in their training.

Designing a structured TQM program includes the

development of "teams" and the unfortunate necessity of many meetings. And this is where the problem begins.

Expecting Too Much Leadership Our team captains may be great on the line, and, in fact, they climbed right on the bandwagon with TQM. That doesn't mean they are natural leaders. After a year or so, it is possible that the excitement has waned. They have other things on their minds and don't want to be involved any longer as a team captain. They don't want the responsibility they have assumed. They have seen people come and go and haven't been able to generate enthusiasm. This has been discouraging and has eroded their confidence. Some of our team captains are well-intended, but are unable to succeed in a leadership role. Attrition and Change The original team received extensive training with the TQM plan. They worked with great gusto to set up a promising program. They enjoyed the fruits of early success. That was then, and this is now. There has probably been some staff turnover. It is likely that some people in the initial group have left the organization or are now working in another capacity. The people that came aboard since then really haven't bought into the concept. In addition, with the evolution of managed care, your organization has changed in order to adjust to external and internal influences. Things just aren't the same. This makes it exceedingly difficult to keep your TQM program going and to get new employees to "buy in." A Costly Investment Hiring advisors, trainers and training tools to implement your TQM program was quite an investment. On top of that, consider the lost productivity with repeatedly bringing staff together to set up the program, identify problems and determine viable solutions. And then there are all those team meetings and the mechanics of documentation and follow-up essential to monitor actions and measure results. No question about it, TQM can be a high maintenance, costly program. Can you really measure the gains achieved with your TQM program? Has the benefit exceeded the investment of time and money? Will the gains received be long-lasting, or is TQM simply the latest management rage? The WISE Approach There is a simpler way to achieve success with organizational management. The line people in an organization are critical to our success. We must respect them and appreciate them. They can help us keep a pulse on business operations. We don't need complicated manuals and written guidelines defining function and process. It is a matter of recognizing each individual's strength and appreciating their contribution. Setting up reporting mechanisms is important, but we will get automatic feedback and keep a pulse on our organization if we are wise.

Believe in your people and you will be able to inspire them to grow, produce

The principles of sound management and efficient operation lie in the individuals. Each person's contribution should be valued. Then we can examine the process and function. We must learn to watch the people in our organization and be skillful in recognizing their potential. Believe in your people and you will be able to inspire them to grow, produce and accomplish much more for your organization than you might have imagined. The value of the loyalty and dedication you receive is impossible to measure. If you support and encourage your staff, the sky is the limit. They will take

and accomplish much more for your organization than you might have imagined.

ownership not only for their performance, but also for the success of the company. Enjoy your work, enjoy your staff. They will feel it and they will help you succeed. Here it is, and it's all too simple. Rely on your human relations skills and the technical gains will follow. The concept is simple and there is little economic investment. Be a good coach, be a good cheerleader. Celebrate your success on a regular basis. Be WISE. Watch Pay attention, be observant. You can learn a lot about your people and a great deal about the organization. Too often, managers are caught up in the responsibility and the objectives they must accomplish. Stop it! Get in touch with your people. They are the link to your success. Recognize the problems they face. Have empathy and help them solve their problems. The problems aren't yours to solve. Your job is to give people the tools to solve their own problems. You can do that by watching to see what changes they face, their approach to dealing with problems and by helping them gain perspective so they can achieve the desired outcome. Start by giving them some "slam dunks" - easy wins. Deal first with problems easily solved and solutions easy to implement. Once they begin to see the results they can achieve, their confidence will grow. With the guidance of a good coach, they can excel and you will help them build incredible confidence in their own ability to solve future (more significant) problems. Inspire This is not easy for everyone. It does require you to let go and have confidence that people will grow and expand their contribution. If you set limits on people, they will fall to your lowest expectation. Expect a lot from people, give them the confidence to accomplish more, and always stand behind them. Celebrate their successes and downplay their failures. Encourage them to pick themselves up and try again, giving constructive criticism to help them grow and expand their capabilities. Support Your support will foster growth, team spirit, ownership in the organization and loyalty. You will increase productivity and quality beyond your expectations. In addition, you will encourage people to share their concerns. Communication and feedback will be open and honest. Fears will disappear. This positive response will be contagious and each person's contribution to the organization will increase. In fact, if you have a non-performing, problem employee, they will feel peer pressure that will require a response. If they attempt to "poison the well" (create negative feelings between management and co-workers), they will fail. More often than not, the problematic, non-compliant employee will change to meet the expectations of the organization or they will be compelled to leave. If this does not occur, you will need to cut the cord by replacing the individual. If you don't, you will weaken your position as a leader and experience a deterioration in staff morale. Enjoy Lighten up! This begins with valuing every employee and being enthusiastic. The common denominators that exist with managers who love

their work are basic. It is their respect for the company, their enthusiasm and confidence about what they are achieving and the pride they take in the accomplishments of the people they work with. If each of us appreciates and enjoys our staff, recognizing that their contribution is critical to our success, we will reap the rewards. If you apply these simple principles, you will be amazed at the organizational accomplishments that can be achieved. A WISE decision is a matter of applying common sense principles that respect and value the contribution of each individual. You won't need complicated, timeconsuming monitoring tools. You will have open communication and feedback that keeps a pulse on your organization. Management and staff will develop a passion for their work - it's contagious. It may be difficult to change habits and establish new work patterns. An outside expert can be the perfect catalyst to get you headed in the right direction. WISE-Watch, Inspire, Support and Enjoy - It's a personal investment in people that will bring you economic results and organizational success! Rebecca Anwar, Ph.D., is a senior consultant with The Sage Group Inc., a national consulting firm specializing in strategic planning, integrated health care development, managed care training and marketing. She is a member of the National Association of Healthcare Consultants.

An organization needs to define some standard of problem solving, so that leadership can effectively direct others in the research and resolution of issues. In problem solving, there are four basic steps.

1. Define the problem

Diagnose the situation so that your focus is on the problem, not just its symptoms. Helpful techniques at this stage include using flowcharts to identify the expected steps of a process and cause-and-effect diagrams to define and analyze root causes. The chart below identifies key steps for defining problems. These steps support the involvement of interested parties, the use of factual information, comparison of expectations to reality and a focus on root causes of a problem. Whats needed is to:

Review and document how processes currently work (who does what, with what information, using what tools, communicating with what organizations and individuals, in what time frame, using what format, etc). Evaluate the possible impact of new tools and revised policies in the development of a model of what should be.

2. Generate alternative solutions

Postpone the selection of one solution until several alternatives have been proposed. Having a standard with which to compare the characteristics of the final solution is not the same as defining the desired result. A standard allows us to evaluate the different intended results offered by alternatives. When you try to build toward desired results, its very difficult to collect good information about the process. Considering multiple alternatives can significantly enhance the value of your final solution. Once the team or individual has decided the what should be model, this target standard becomes the basis for developing a road map for investigating alternatives. Brainstorming and team problem-solving techniques are both useful tools in this stage of problem solving. Many alternative solutions should be generated before evaluating any of them. A common mistake in problem solving is that alternatives are evaluated as they are proposed, so the first acceptable solution is chosen, even if its not the best fit. If we focus on trying to get the results we want, we miss the potential for learning something new that will allow for real improvement.

3. Evaluate and select an alternative

Skilled problem solvers use a series of considerations when selecting the best alternative. They consider the extent to which:

A particular alternative will solve the problem without causing other unanticipated problems. All the individuals involved will accept the alternative. Implementation of the alternative is likely.

The alternative fits within the organizational constraints.

4. Implement and follow up on the solution

Leaders may be called upon to order the solution to be implemented by others, sell the solution to others or facilitate the implementation by involving the efforts of others. The most effective approach, by far, has been to involve others in the implementation as a way of minimizing resistance to subsequent changes. Feedback channels must be built into the implementation of the solution, to produce continuous monitoring and testing of actual events against expectations. Problem solving, and the techniques used to derive elucidation, can only be effective in an organization if the solution remains in place and is updated to respond to future changes. Excerpted from G. Dennis Beecroft, Grace L. Duffy, and John W. Moran, The Executive Guide to Improvement and Change, ASQ Quality Press, 2003, pages 17-19.