Although quality techniques have been applied for over a decade in manufacturing industries, Total Quality Management (TQM) is a relative new system to the American healthcare industry. The American healthcare industry could possibly benefit more from the implementation of a Total Quality Management (TQM) system than any other industry in the United States. Total Quality Management (TQM) is the challenge of meeting and exceeding customer expectations. As quality has become such an essential part in customer satisfaction we must come to realize that Total Quality Management (TQM) is in one way or another here to stay.
Total Quality Management (TQM) is a common sense approach that could be implemented in any business, and stresses process improvement at all levels of an organization and the importance of understanding how to achieve goals efficiently. The goal of a Total Quality Management (TQM) program in the healthcare setting is to reduce costs and improve customer or patient satisfaction. This goal is achieved, in part, by seeing patients in a timely manner, charging these patients a reasonable price for the services they are receiving, and reducing patient follow-up visits.
In the health care administrative setting, the goal of any Total Quality Management (TQM) program is to improve work procedures; therefore reducing overhead that is nonessential to the delivery of health care. There are great opportunities for healthcare organizations to save money if they are willing to change existing processes. These savings then can be used to meet needs in other parts of the healthcare organization. Perhaps no other industry could benefit more from implementation of Total Quality Management (TQM) techniques than the healthcare industry.
Experts maintain that a huge portion of the nation’s annual healthcare expenditures can be attributed to waste and inefficiency. Spending on health care nationwide has hit record highs, as much as 14 percent of the nation’s total economic output, according to the Commerce Department. Health plans purchased by businesses account for about one-third of total health expenditures. “The waste is astronomical,” says A. Blanton Godfrey, chairman and CEO of the Juran Institute, a consulting firm based in Wilton, Conn. “At least 20 percent of the lab tests are unnecessary.
Every infection is waste. Every complication after open-heart surgery is waste and triples the bill. ” “By reducing the number of infections, which means improved quality for patients, a hospital also saves a bundle of money,” says Godfrey. “There are wonderful synergies. In many cases, high-quality care actually costs less. ” Much of the Congressional debate has been focused on overhauling the healthcare delivery system and establishing healthcare reform, making sure all Americans have access to affordable healthcare.
Total Quality Management (TQM) would complement that effort by focusing on improving the processes involved in delivering quality service, often with the benefit of cutting costs. Establishing Total Quality Management (TQM) programs in healthcare organizations will become more essential as healthcare reform takes place. In the future, healthcare organizations will be asked to do much more for their patients and customers, but will have fewer resources with which to do so, and healthcare financial managers will need to play a leadership role in ensuring organizational success.
A significant part of a successful Total Quality Management (TQM) program is changing the way an organization conducts its business. Total Quality Management (TQM) takes on an approach that favors the process revisions as opposed to singling out and punishing poor performers. Process revision requires organizations to identify the steps necessary to deliver services well, and then improve those steps in ways that will cost the organization less money to perform, take less time to carry out, and improve the end result for patients and customers.
The George Washington University (GWU) Medical Center, for example, has successfully applied a Total Quality Management (TQM) system throughout a number of departments within their hospital. Before the implementation of Total Quality Management (TQM), patients often didn’t get their medication delivered in a timely manner and it appeared that prescriptions were getting lost. As a result, “there was a major war between nursing and pharmacy,” says Roger Chaufournier, assistant vice president for quality. “It rivaled Desert Storm. When an interdisciplinary Total Quality Management (TQM) team of George Washington University (GWU) medical center staff members studied the problem, the team came to the conclusion and found that no one was at fault. The Total Quality Management (TQM) team concluded that the system just didn’t work. Physicians wrote prescription orders on patients’ charts, but since so many others needed the patients charts, the prescription orders or instructions often reached the pharmacy many hours later or never even arrived in the pharmacy at all.
The pharmacy was then blamed for losing the doctors’ orders even though many times the orders were never received. Once the Total Quality Management (TQM) team discovered the real problem, it was fairly easy to develop a system to speed up the process of getting prescription orders directly to the pharmacy. Strong internal leadership is needed to accomplish these steps, along with an organizational culture not afraid of “tearing down the walls. ” Healthcare financial managers must help change the attitudes within their institutions and encourage employees to think, work, and create interdepartmentally and cross-functionally.
Furthermore, employees must learn to take responsibility for customer satisfaction. There were also problems within the George Washington University (GWU) medical centers oncology unit, where patients would arrive at noon to begin elective chemotherapy. Sometimes they had to wait until midnight or even later before they were allowed to begin chemotherapy treatment. The Total Quality Management (TQM) team dissected the process of admitting a chemotherapy patient to the hospital, and it turned out to be much more complicated than the hospital had imagined.
The Total Quality Management (TQM) team worked together to find efficient ways to improve the process. Today, the patient’s doctor faxes the chemotherapy prescription to the hospital at least 24 hours before the patient arrives. All the admissions paperwork is done before the patient ever arrives, rooms are prepared in advance of patient check-in, and attending physicians try to discharge patients early in the day. It appears that the Total Quality Management’s team advanced planning approach for elective admissions has made a huge difference.
Now the average time between admission and start of chemotherapy has decreased from 11 hours to less than two hours. This change alone often cuts a full day from the patient’s hospital stay, reducing the bill by more than $1,000. Total Quality Management (TQM) is the challenge of meeting and exceeding customer expectations. Total Quality Management (TQM) has been applied to the manufacturing industry for quite some time but is a relatively new concept in the healthcare setting.
The benefits that are seen from Total Quality Management (TQM) implementation makes one realize that Total Quality Management (TQM) may be the answer to many of the quality issues that have been seen in the healthcare industry over the years. With quality so closely related to the degree of which a patient or customers considers themselves to have had satisfactory care, we must realize that Total Quality Management (TQM) as part of the healthcare industry is essential and here to stay. The general goal of a Total Quality Management (TQM) program in the healthcare industry is to reduce the cost while also improving the patient satisfaction.
In order to achieve these goals there has had to be changes to the procedure and processes that allows an organization to be successful while allowing the needs of the organization and it customers to be met satisfactorily. This is a great opportunities for healthcare organizations to save money, time, and effort if they are willing to change existing processes. We can see the success that Total Quality Management (TQM) can provide but it is up to healthcare leaders to take that success and grow their organizations in quality care for their customers and their businesses.