TOTAL QUALITY MANAGEMENT IN

HEALTHCARE ORGANIZATIONS
AN OVERVIEW

POONAM CHAUDHARY
Senior Medical Technologist
GMCH-32
CHANDIGARH
 QUALITY OF HEALTH CARE

 Quality: „A strategy aimed at the needs of customer for

present & future‟ (Edwards Deming).
 „Conformance to requirements‟ (Philip B Crosby).
 „Totality of features & characteristics of hospital
services that bear on its ability to satisfy stated & implied
needs of its patients‟.
 AIM To provide quality, efficient & economic management
of health care delivery system.
QUALITY HEALTHCARE-HISTORY
 WHY QUALITY?
 Rapid advancement in  Multicentric and
healthcare due to rapid multifaceted functions
diagnosis and day care  To accomplish the
surgeries. organisational
 ↑awareness in patients objective i.e., the
 ↑ market competition quality healthcare at
 Healthcare team of skilled
the minimum cost.
and unskilled  Medical tourism
DIMENSIONS OF QUALITY
 QUALITY MANAGEMENT SYSTEM
 Quality does not happen
by chance.
 It needs to be developed.
 In any HCO, it is
established in a planned
way keeping in mind the
objectives of the
HCO, staff involvement
and considering the
patient needs.
 It is the result of sincere
efforts, intelligent thinking
and skillful execution.
DEVELOPMENT OF TQM IN HCO
QC-QA-TQM
 QUALITY CONTROL
A TOOL FOR QUALITY ASSURANCE

 Quality control means that all the products/services rendered to the

patient care are carried out as per the product design criteria /SOP so
that there is not any chance of defects/errors.
 It comprises of measuring the process, analysis of data under effective
supervision.
 SOP‟s-are based upon certain guidelines keeping the quality
parameters in mind.
 For example, emergency room physicians have SOPs for patients
who are brought in an unconscious state; nurses in an operating
theater have SOPs for the forceps and swabs that they hand over to
the operating surgeons; and laboratory personnel have SOPs for
handling, testing, and subsequently discarding body fluids obtained
from patients.
 The absence of QC will lead to the medication error or the patient care
negligence.
QUALITY CONTROL ELEMENTS
 QUALITY ASSURANCE
 It is the planned or systematic actions necessary to provide adequate
confidence that a patient services or safety will satisfy given
requirement for quality.
 QA may act as an audit function since it includes the assessment or
evaluation of the quality of care; identification of problems or
shortcomings in the delivery of care; designing activities to overcome
these deficiencies; and follow-up monitoring to ensure effectiveness
of corrective steps.
 It can also be understood as the system of defect prevention.

PRIMARY OBJECTIVE:
ENHANCEMENT OF PATIENT CARE
QUALITY ASSURANCE SYSTEM
QUALITY ASSURANCE SYSTEM
QUALITY MANAGEMENT SYSTEM
A MODEL
 TOTAL QUALITY MANAGEMENT
 TQM means that the organization culture is defined
by and supports the constant attainment of
customer i.e., the patient satisfaction through an
integrated system of tools, techniques and training.
 It involves the continuous improvement of
organization processes, resulting in high quality
products and services.
 Hence, TQM is “a continuous, customer-
centered, employee driven improvement.”
 TQM PRINCIPALS
4 common principles:
 Do it right the first
time to eliminate
costly rework.
 Listen to and learn
from customers and
employees.
 Make continuous
improvement on every
day matter.
 Build
teamwork, trust, and
THE CORE CONCEPT OF TQM
CONTINUOUS QUALITY IMPROVEMENT
THE QUALITY CIRCLE
TQM-ESSENTIAL COMPONENTS
ESSENTIALS OF TQM
A TQM MODEL
 Seven Basic Quality Tools

Check Sheet Run Chart

Fishbone Diagram

Histogram

Pareto Chart Scatter Diagram

Flow Chart

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ROOT CAUSE ANALYSIS
ISHIKAWA FISH BONE
DIAGRAM
USE OF FLOW CHARTS
USE OF HISTOGRAMS
USE OF PARETO CHARTS
USE OF RUN CHARTS
USE OF CONTROL CHARTS
USE OF SCATTER DIAGRAM
LEAN MANAGEMENT AND 6
SIGMA
 6 DMAIC Process

 Define
 Measure
Control Define
 Analyze
 Improve
Act Plan
 Control

Check Do
Improve Measure

Analyze
8-31
TQM AND ACCREDITATION
TQM- A NEED OF THE HOUR
BENEFITS-TQM
BENEFITS-TQM
THANK YOU