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The complexity is compounded in service hospitals because of its service character, centralised control and a captive clientele with notions of perceived deficiencies. Criticism of Armed Forces Medical Services is on the rise and it is time the medical set up does a reappraisal and corrects itself rather than wait for the external forces to shape remedial action .
In health care, quality is usually understood in the context of 'clinical quality' and an implicit distinction is drawn between managerial and clinical activity. But the onus of meeting the expectations of our clientele demands a separate focus for quality improvement within hospitals, moving away from the different notions that follow traditional 'tribal' divisions within hospitals.
The emergence of quality as a major issue in health care is demanding participation in new definitions of quality that will include customer perception and satisfaction with the quality of care received . Quality and TQM The word quality has many different definitions, ranging from conventional to those that are strategic.
However, the one strategic definition that has gained international acceptance is meeting customer requirement.
W Edwards Deming, the father of concept of TQM has defined quality as a strategy aimed at the needs of the customer, present and future, whereas another quality guru, Joseph M Juran has defined quality as conformance to requirements. Five broad attributes have been identified for understanding quality .
Reliability - Ability to perform the promised service dependably and accurately. Assurance - Knowledge and courtesy of employees. Tangibles - Physical facilities, equipment and appearance of personnel. Empathy - Caring, individualised attention provided to the customers. Responsiveness - Willingness to help customers and provide prompt service. In business organisation, the process of quality improvement is now dominated by theory and application of TQM.
Armed Forces Medical College. Pune - Deming replaced the traditional view of quality control focused on defect detection and minimal acceptable levels of quality by the strategic commitment to defect prevention, continuous process improvement, and systems driven by the needs of the customer.
National Round Table on Health Care Quality, USA has concluded that problems in health care quality are serious and extensive and has advocated continuous quality improvement as a major strategy to move the health care delivery system towards improving quality .
Then again the Joint Commission on Accereditation of Health Care Organisation, USA has adopted TQM as an important standard in its review of health care institutions and has proposed total organisational commitment to continuously improve the quality of patient care. To clinicians, the theories of TQM may be interpreted as jargon, an approach to quality that originated in the industrial world and has little relevance to the health worker where customers would rather not seek their services and many physicians have indeed reacted with scepticism .
It has to be understood that our captive clientele is handicapped by a paucity of choice available to them. The people waiting for 2 hours to see a surgeon in any other queue of similar length would probably have gone else where and if people with acute myocardial infarction knew about the importance of receiving thrombolytic treatment as early as possible, they would have demanded the treatment to be given at the MI Room by the DMO rather than wait for the Cardiologist at the ICU.
With seeming dissatisfaction of our clientele with the services being provided by our hospitals and the spectre of Consumer Protection Act looming large on the horizon, it is high time an integrated effort is made for continuous quality improvement in our service hospitals for conforming to the needs of our customers. Key concepts ofTQM The key concepts of TQM, which have to be thoroughly understood before embarking on any plan for its implementation, are described in brief below .
Top management leadership - Top management commitment and leadership will have to be visibly demonstrated, drafting a comprehensive framework of mission statement, values and quality policy and facilitating the employees to see the strategic direction.
The end of the search for these answers is provided at last in clarity and conciseness. Get A Copy. Paperback , pages.
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Community Reviews. Showing Rating details. Sort order. Jan 03, Stephen rated it it was amazing. This little book is unassuming from the cover but once you open it and begin reading you are on the journey of a lifetime.
It contains what I consider some of the most important things I have ever learned about life and "the Big Picture".
I cannot recommend it enough The author is anonymous and the reason for this is explained early in the book. It is book one of a trilogy of three- each the same source and price. The content of This little book is unassuming from the cover but once you open it and begin reading you are on the journey of a lifetime. The content of the book truly is beyond price. Read it and see for yourself!
View 2 comments. Oct 10, Ron rated it did not like it. This book was given to me with absolute sincerity by an insane person at work.
He insisted that it would change my life and explain why we're all here or some such. Turns out the book was just as crazy and stupid as he was! This "book" is full of nonsensical raving BS. So I guess if that's your thing Apr 24, Barbara rated it it was amazing Shelves: Fantastic, eye-opening, what we have been waiting for in print Read this book. Jun 15, Amy rated it it was amazing. Jan 25, Allan J Ingraham rated it really liked it.
George Green is an interesting character, He has some wild stories not included in this book but that can be found on youtube. This book is channeled from Aliens that follow him around. The message is going to resonate with the type that has come into this world feeling lost and those that are losing hope in humanity.
It doesn't make the problems go away or any easier to overcome but it is nice to feel that you are not so alone and that there are people thinking about these things that are ready George Green is an interesting character, He has some wild stories not included in this book but that can be found on youtube.
It doesn't make the problems go away or any easier to overcome but it is nice to feel that you are not so alone and that there are people thinking about these things that are ready to try something new.
Sep 04, Alex rated it really liked it. Lots of great ideas and wonderful insight! Certainly worth reading again. This is a gem. Sep 04, S. Krishnan rated it it was amazing. A gem of a book with new ideas and definitely beautiful thoughts. Dec 27, George rated it really liked it.
Apr 28, Michelle marked it as to-read. Apr 17, David Mccurdy rated it it was amazing Shelves: