Context: The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. Methods: The business and health care literature was systematically reviewed ...to identify contextual factors that might influence QI success; to categorize, summarize, and synthesize these factors; and to understand the current stage of development of this research field. Findings: Forty-seven articles were included in the final review. Consistent with current theories of implementation and organization change, leadership from top management, organizational culture, data infrastructure and information systems, and years involved in QI were suggested as important to QI success. Other potentially important factors identified in this review included: physician involvement in QI, microsystem motivation to change, resources for QI, and QI team leadership. Key limitations in the existing literature were the lack of a practical conceptual model, the lack of clear definitions of contextual factors, and the lack of well-specified measures. Conclusions: Several contextual factors were shown to be important to QI success, although the current body of literature lacks adequate definitions and is characterized by considerable variability in how contextual factors are measured across studies. Future research should focus on identifying and developing measures of context tied to a conceptual model that examines context across all levels of the health care system and explores the relationships among various aspects of context.
This quantitative exploratory paper evaluates the degree of adoption of a cooperative to Total Quality Management (TQM) practices as a precursor study for its readiness for ISO 9001:2015 Quality ...Management System certification. Questionnaires were developed to explore practices already implemented within the ambit of TQM. Selected participants were grouped into two: (1) Management which is the middle-level management up to the CEO and (2) Governance composed of the Board of Directors, elected and appointed officers. A total number of 37 respondents were surveyed simultaneously. Primary data gathered from survey questionnaire were tested statistically for non-parametric datasets using SPSS16 for descriptive statistics and test of normality. Test statistics using Mann-Whitney U Test examines if the adoption of Quality Management Principles (QMPs) of ISO 9001-2015 is equally perceived by the two variable groupings. The study concluded that the seven QMPs are somewhat adopted based on the result of the overall mean score. Results of descriptive statistics for each of the QMP revealed that Leadership has the highest mean. Whereas other QMPs such Customer Focus, Improvement, Process Approach, Evidence-Based Decision Making, Engagement of People, and Relationship Management are somewhat adopted. Results of Mann-Whitney U Test revealed that TQM adoption is perceived more by the Governance group than by the Management group and the two variable groupings have differing perceptions on the adoption of TQM, thus rejecting the null hypothesis of similarity among the two groups. Abstrak dalam Bahasa Indonesia. Makalah eksploratif kuantitatif ini mengevaluasi tingkat adopsi suatu koperasi terhadap praktik Total Quality Management (TQM) sebagai studi pendahuluan untuk kesiapan sertifikasi Sistem Manajemen Mutu ISO 9001:2015. Kuesioner dikembangkan untuk mengeksplorasi praktik yang telah diimplementasikan dalam lingkup TQM. Peserta yang dipilih dibagi menjadi dua kelompok: (1) Manajemen yang terdiri dari manajemen tingkat menengah hingga CEO dan (2) Tata Kelola yang terdiri dari Dewan Direksi, pejabat terpilih, dan diangkat. Sebanyak 37 responden disurvei secara bersamaan. Data primer yang dikumpulkan dari kuesioner survei diuji secara statistik untuk dataset non-parametrik menggunakan SPSS16 untuk statistik deskriptif dan uji normalitas. Uji statistik menggunakan Uji Mann-Whitney untuk memeriksa apakah adopsi Prinsip Manajemen Mutu (QMP) ISO 9001-2015 sama-sama dirasakan oleh dua kelompok variabel. Studi ini menyimpulkan bahwa ketujuh QMP sedikit diadopsi berdasarkan hasil skor rata-rata keseluruhan. Hasil statistik deskriptif untuk masing-masing QMP mengungkapkan bahwa Kepemimpinan memiliki rata-rata tertinggi. Sedangkan QMP lainnya seperti Fokus pada Pelanggan, Peningkatan, Pendekatan Proses, Pengambilan Keputusan Berbasis Bukti, Keterlibatan Masyarakat, dan Manajemen Hubungan sedikit diadopsi. Hasil Uji Mann-Whitney menunjukkan bahwa adopsi TQM lebih dirasakan oleh kelompok Tata Kelola daripada kelompok Manajemen, dan kedua kelompok variabel memiliki persepsi yang berbeda tentang adopsi TQM, sehingga menolak hipotesis nol tentang kesamaan di antara kedua kelompok.
This scoping review aimed to generate an overview of existing quality management (QM) models for inpatient healthcare published in peer-reviewed literature.
Peer-reviewed publications published until ...June 2016 were retrieved from the databases Medline, PubMed, CINAHL and Cochrane Library using search terms related to QM and models.
Publications mentioning a QM model for general application in healthcare or inpatient care in their title or abstract were included. Languages considered were: English, French, German, Italian and Spanish.
Data extraction was 3-fold. First, publication characteristics were summarized. Second, the frequency of each identified model was documented and the publications were divided into conceptual and implementation publications. Third, relevant QM models were identified and information regarding the model, including content and relationship with other models, was extracted.
Of 925 retrieved publications, 213 were included. The included publications reported on 64 different QM models that were suitable for or used in inpatient care. Seventeen models were identified as being relevant. The 17 models were then categorized into three different levels: conceptual quality improvement models, concrete application models and country specific adaptations.
This scoping review provides an overview of 17 existing QM models for inpatient care and their relationships with each other. Various types of models with differing aspects and components exist. In searching for QM models, many different concepts like QM system, accreditation or methodologies appeared. For future investigation, concepts of interest should be clarified.
Background Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to ...resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. Development, theory and application of lean thinking to health care Lean thinking evolved from a tool designed to improve operational shop-floor performance at an automotive manufacturer to a management approach with both operational and sociotechnical aspects. Sociotechnical dynamics have until recently not received much attention. At the same time a balanced approach might lead to a situation where operational and sociotechnial improvements are mutually reinforcing. Application to health care has been limited and focussed mainly on operational aspects using original lean tools. A more integrative approach would be to pay more attention to sociotechnical dynamics of lean implementation efforts. Also, the need to use the original lean tools may be limited, because health care may have different instruments and tools already in use that are in line with lean thinking principles. Discussion We believe lean thinking has the potential to improve health care delivery. At the same time, there are methodological and practical considerations that need to be taken into account. Otherwise, lean implementation will be superficial and fail, adding to existing resistance and making it more difficult to improve health care in the long term.
PurposeThe desire for firms to gain competitive advantage and improve performance has resulted in the adoption of several practices. Green supply chain practices (GSCPs), just in time (JIT) and total ...quality management (TQM) are some of the practices adopted by firms to improve operational performance (OP) and business performance (BP). This study examines the direct influence of GSCPs, JIT and TQM on operational performance and BP. The study further analyzes the synergy of GSCPs, JIT and TQM on OP and BP.Design/methodology/approachThis study employs the quantitative approach of research by using questionnaire to gather data from manufacturing managers and supply chain managers of 140 manufacturing firms in Ghana. The research uses partial least square structural equation modeling (PLS–SEM) to analyze the survey data.FindingsThe results of the analysis show that GSCPs, TQM and JIT positively influence both OP and BP. The findings reveal that GSCPs combine with JIT and TQM to improve OP and BP significantly. However, the synergy between green supply chain and TQM creates more value for both OP and BP than the synergy between GSCPs and JIT.Originality/valueThe study proposes a research model that examines both the individual and combined influence of GSCPs, TQM and JIT on both OP and BP from the developing country perspective. The study models GSCPs as an antecedent of JIT and TQM, which has not been explored.
Purpose
The purpose of this paper is twofold: first, to present a set of critical factors for total quality management (TQM) and supply chain management (SCM) practices through an extensive ...literature review; and, second, to identify the relationships among them by comparing the identified TQM and SCM practices in order to explore the concept of supply chain quality management (SCQM).
Design/methodology/approach
To meet the goals of this work, a review of published quality research papers was carried out. For this, the authors identified papers on TQM and SCM practices and observed how these practices improve the business performance of organizations. Further, on the basis of identified practices, a conceptual model of SCQM was developed.
Findings
The results presented a set of six critical factors each for TQM and SCM practices. Further, it was found that management support and commitment, customer focus, information and supplier partnership are the most common practices found in both TQM and SCM practices. The integration of TQM and SCM (SCQM) throughout the supply chain has the strongest impact on the organizational performance.
Research limitations/implications
The study used data from various research papers of reputed journals which considered the study of India’s manufacturing industry as well as other countries, which may not provide a clear picture. However, this can be overcome by applying the findings of this paper to collect data from Indian manufacturing industry in future studies.
Practical implications
Indian manufacturing industry can improve its competitive image through the synergy of TQM and SCM. The result of this paper will help in providing a greater understanding of identified TQM and SCM practices that will lead to the successful implementation of TQM and SCM strategies to enhance business performance in terms of the improved levels of customer service.
Originality/value
Much of the attention is given on TQM and SCM practices, and very few studies have been undertaken to integrate TQM and SCM practices. But as far as the authors know, there is no study undertaken to integrate TQM and SCM practices in India for the manufacturing class. Therefore, this study compares TQM and SCM practices and considers their integration and can be thus treated as filling a gap in the extant literature. Therefore, the findings of this review paper will contribute in future research.
Rationale, Aims, and Objectives
The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement ...surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS)
Methods
The DMAIC cycle has been adopted to decrease the patients' LOS. The University Hospital “Federico II” of Naples, one of the most important university hospitals in Southern Italy, participated in this study. Data on 148 patients who underwent prosthetic knee replacement between 2010 and 2013 were used. Process mapping, statistical measures, brainstorming activities, and comparative analysis were performed to identify factors influencing LOS and improvement strategies.
Results
The study allowed the identification of variables influencing the prolongation of the LOS and the implementation of corrective actions to improve the process of care. The adopted actions reduced the LOS by 42%, from a mean value of 14.2 to 8.3 days (standard deviation also decreased from 5.2 to 2.3 days).
Conclusions
The DMAIC approach has proven to be a helpful strategy ensuring a significant decreasing of the LOS. Furthermore, through its implementation, a significant reduction of the average costs of hospital stay can be achieved. Such a versatile approach could be applied to improve a wide range of health care processes.
To help improve operating room efficiency in a tertiary care facility, Six Sigma analysis was utilized. Six Sigma is a technique driven by data, methodology, and a philosophy of continuous ...improvement to help create a system in which 99.99966% of products are free from defects. This process helps to reduce variability and waste in production, while increasing quality and decreasing cost of the final product.
The steps of define, measure, analyze, improve, and control (DMAIC) methodology were used. Variables measured included close-to-cut time, patient-out to patient-in time, and room utilization. Statistical analysis was conducted, while an individual was sent to shadow various levels of operating room personnel to help recognize possible shortcomings in the system, including communication and coordination errors.
Baseline results were recorded for each surgical specialty to help determine the specific needs of each OR team. Changes in workflow, such as staggered start anesthesia times, were recommended for each level of personnel based on statistical analysis and observation. Results were followed for several years with initial data showing success of the process. However, ongoing construction and resistance to change has prevented further review.
While Six Sigma can be a valuable tool, it is essential to have a proper leadership team that includes all stake holders. The process requires horizontal and vertical leadership as well as buy-in from all individuals affected by the process. The synergy of these factors is key for success.
This study investigates how organizational culture influences the implementation of different practices incorporated in the recent Six Sigma approach as well as those associated with traditional ...total quality management (TQM). We employed the competing values framework to capture the underlying value orientations of organizational culture. Using survey data collected from 226 US manufacturing plants, the relationships between four culture types and 10 TQM/Six Sigma practices were examined via the structural equation modeling technique. The results reveal the differential effects of the culture types on the implementation of TQM/Six Sigma practices. The implications of the links between different cultures and different TQM/Six Sigma practices are discussed. While the relationship between TQM practices and culture has been the subject of prior research, this is the first look at the relationship between organizational culture and a comprehensive set of quality management practices including the new Six Sigma practices. The understanding of the advantage of each culture type should help managers achieve effective implementation of TQM/Six Sigma practices from a holistic perspective of both quality management and culture.
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