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Total quality management (TQM) of care is one of the major health concerns in the 21st century. Professionals and health care providers tried to assess different perspectives of TQM provided by different health institutions and centers around the world. Improving and enhancing the quality or value of management facilitates effective patient outcome. In terms of the total quality management, the expansion of knowledge and technology becomes common basis whereas health care system and management performs higher in acceptable levels for ensuring the safety of the patient and meeting their needs. The goals of this TQM is to provide health care professionals and patient with sufficient and most current information and care with the foundation of quality improvement fundamentals and providing improvement protocols that will stimulate further the quality management methods being used currently in the health care system.
Total quality management (TQM) in health care facilitates effective patient outcome and professional responsibility.
The major stakeholders in Total quality management id health care are providers, payers, employers and patient. Providers rend to view the quality of care in terms of technical sense such as diagnosis accuracy, health outcome results and appropriateness of therapy. Payers’ focus is on the quality care and cost-effectiveness while employers want both to keep their costs effective, and to have their employees get back to work quickly. Lastly, patients want compassion as well as competent skills with clear communication strategies (McLaughlin and Kaluzny, 2006).
For quality improvement strategies, health care professionals strive constantly in improving and developing the standards of care. They meet the challenges require health care providers to be effective leaders who foster a culture and develop partnerships that embrace innovation. They regularly attend trainings on different culture and communication style to improve communication skills, productivity, improved patient care and well-functioning teams. Getting health information about new knowledge is also a critical case or situation, they look at how to make the communication process on healthcare execute for certain situation so that the provided care is more efficient, accessible and effective. It is incorporated with competence and critical thinking. When all of these characters will be gained, surely, effective nursing care and desired outcome will be met (Rosswurm & Larrabee, 2005).
In terms of patient care, strategy involved is meeting goal and management for maintaining effective care and patient response. Preventing complications and supporting patient need is also effective. It involves a combination of many disciplines, including aspects of multidisciplinary sciences to promote the wellness and maintenance of health. This trend is addressed properly by implementation of appropriate health care interventions. In addition to the previous strategies discussed, providing the patient with appropriate instructions and activities helps prevent complications which are important in the development of pain management. New technologies can be used by these institutions as primary treatment for patient management (Melnyk, 2005)
Moreover, some health institutions use case management and performance improvement risk management as an effective way in seeking to resolve a problem relating to performance. Through the creation of these competencies, the implementation of specific tasks such as training, recording and evaluation is likely to succeed. Case management is really important in collaborating processes in planning, assessing, monitoring and evaluating care rendered for each client. Performance Improvement risk management can use approaches by utilizing a systematic methodology to investigate the root causes of problems relating to performances and then implements a plan or an intervention that necessary to that specific performance problem (McLaughlin and Kaluzny, 1999).
For health care professionals responsible for quality improvement, to be an effective manager and initiator begin with the individual appraisal of one’s self competency and enhanced education based on practices and trainings taken previously during workshops, trainings. Some of the activities that can be effective in a hospital setting are the provision of the most current information possible for the staffs using the evidence-based practice and through collaborative approach of health care professionals (Sambo et al, 2010).
Actual hospital education for professional trainings can be helpful in achieving goals and objective of total quality improvement in hospital settings. It is very essential and more effective than because of the ability to learn actual clinical practice and the orientation in quality protocols and policies in handling management problems and patients’ needs. This quality improvement programs has proved to be a highly useful and effective strategy in clinical education. This strategy allows learning to be individualized and patient centered approach, links theoretical knowledge to actual patient care and management of needs and problems. It also provides opportunity for role modeling as the health professionals maintains and develops standards of practice and competent care (McLaughlin and Kaluzny, 1999).
In my experience, there are hospitals and health care institutions that assigned every single employee to do some specified tasks, therefore a feedback from the immediate supervisor and performance appreciation is in a good status and to encourage the employee’s will to improve, and to closely adjust deficiencies in the employees performance. Everyone is starving to maintain and improve “quality” (Marceau et al, 2010). In fact, support from the management and staff is the backbone for quality maintenance, but it really has to be joined with powerful resources who will know how to efficiently spend and manage the expenses. In the light of that, a continuous development training s a must to keep the employed staff updated with all recent news concerning their performance in fields. The work environment includes the preset policies and procedures which should be written carefully in the sense of serving the organization objectives and mutually allowing the employees to feel respected, acknowledged, and protected from any misbehavior and compensated well or their good performance (Sambo et al, 2010).
In reporting systems used for performance improvement, hospitals and other health care institutions summarizes the continuous quality management monitoring that provides decisive advantage for the monitoring team. Through continuous quality management monitoring, reporting systems will identify the causes of failure in implementation and will provide guidance for success (Marceau et al, 2010).
Although quality techniques have been applied for over a decade in health care industries, there are also potential barriers to hospital management. Not all the health care institutions and hospitals produced success stories, but many did. Subsequently, many hospitals are facing potential barriers to achieve the goals in applying quality-management techniques. In the hospitals and Medical Centers that I visited the past few weeks, I recognized that some are successfully applied different TQM management techniques in a number of their departments. But some are facing dilemma on changes associated with this technique and people carrying out these task often confused on the specific actions they have to do that resulted to untimely patient care and medicine delivery. There are also miscommunications between departments such as nursing and pharmacy (Marceau et al, 2010).
Communication approach is also a potential barrier. Communicating effectively at all levels is a common barrier in the implementation of change among health care in various settings. As a member of the hospital workforce, a nurse must have the capability to communicate effectively in a non-judgmental way and stimulate other colleagues to think critically. They must also arouse enthusiasm and develop quick healing process of the patient. Moreover, they must also demonstrate resourcefulness and professionalism with infinite patience, understanding, confidence and perseverance are also challenges. Moreover, listening to patients in the hospital setting and meeting their needs is utmost important (Sambo et al, 2010).
As an organisation, factors such as competency, teamwork, organisational commitment, satisfaction and alternative opportunities are some of the problems facing the management team and must be managed accordingly. Every member is assigned to do some specified tasks, therefore a feedback from other members and performance appreciation whether verbal or written to maintain motives in a good status, to encourage the co-members to improve, and to closely adjust deficiencies in the group’s performance (Rosswurm & Larrabee, 2005). The management is in continuous flux, everyday is a new day that opens its doors to innovations, improvements, and developments. The speed motion development of every member is in all fields, and the quality consideration is of great concern especially for competitive work forces. The group is just coming together was experienced by every member of our organisation although extravert members of the group may assume leadership role (McLaughlin and Kaluzny, 1999).
One important factor for TQM continued competence. This competency is the basis for achieving goals for patient care, awareness of responsibilities for client; client advocates or the client’s designated representative; and attending to the trends in society which may result in knowledgeable competence to health care practice from different discipline within and across the health care professions. Being competent in this skill particularly improves the importance of professional awareness, accountability and competence in caring for groups and individual patient providing knowledgeable and interdisciplinary approach and a higher performance standard. Being competent in this area meet the expectations identified in ensuring patient safety and as professionals (Hunt, 2001).
Appropriate and efficient documentation process is also essential for record and management of TQM. Continuous recordings are important to determine the progression of process and ensure the most appropriate evidence-based interventions. Planning also enables health care provider to have a positive impact and assist patient in achieving the goal of care (Marceau et al, 2010).
The management team must have effective approaches (i.e. communication approach) in which the delivery of care in hospital setting will integrate the best evidence patient care data and studies. In TQM improvement strategies, implementing research studies should be carried out regularly and findings should be made accessible to all department and employees. International and other related researches are also helpful in adjusting health care tasks properly. In delivering the context of caring through supportive organizational culture, the highest quality of reforms and innovation are necessary and will result to achievement of the best outcomes (Gray, 2007).
Improving and advancing the quality of health care approach including medical devices is especially in this age of Information and Communication Technology. It is a very powerful and effective tool for expanding opportunities in either non-formal or formal health care management system (McKibbon, 2008). One of the most popular reasons for the utilization of Information and Communication Technology in hospital setting is the best way to prepare the staff for an environment or workplace where Information and Communication Technologies, particularly the Internet and computers, other related recording software technologies are useful. Technological advancement or the ability to use Information and Communication Technology for the future is seemingly more efficient and effective, is being viewed as a representation of a competitive edge in an advancing globalization of health care industry in the market (Sambo et al, 2010).
A key to successful TQM are effective organizational strategies and competent environment during the improvement to achieve the set goals and objectives. Organizations must apply TQM strategies that will determine the path of being effective and competent health care provider. Health care quality in working area need to possess leadership skills, values, critical thinking ability and case management skills. The ability to provide quality health care and ability to be competitive in practicing their duty satisfies a variety of industries (Rosswurm & Larrabee, 2005). This improves the staff’s knowledge as well as educational requirement, patient outcomes and professional practice. Therefore the organization has the need for accreditation for easy accessibility and evidence-based status to create new opportunities and fill the gaps in the industry that are experienced by healthcare workers and clients. Moreover, organizational compliance must also be embracing the social responsibility, personal ethics and service, apply new knowledge of sciences, understand the role of primary care and continue to learn and help others. At the organizational level, the learning characteristics are best practice in recognizing every situation happening in the field and making it a motivational means to improve the learning by proper preparation and continuing education (McLaughlin and Kaluzny, 2006).
In conclusion, despite the advancement level attained in health care industry which is regarded as the Total Quality Management era, there is still deliberate, urgent, purposeful and sustained effort to institutionalize TQM mechanism as an integral part of our health care system. Indeed, Total quality management (TQM) in health care facilitates effective patient outcome and professional responsibility.
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