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Total Quality Management & Hospital management 全面质量管理与医院管理 PowerPoint PPT Presentation

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Total Quality Management & Hospital management 全面质量管理与医院管理. 夏萍 Nancy Xia Guangdong Province Hospital of TCM. 案例 1. 某医院妇产科值班助产士带领护校的实习生值小夜班。 22 时 30 分,两人一起处理完两个产妇后,助产士去取夜餐。回来后,实习护士准备给婴儿配奶,并问助产士怎样配方,奶粉和水的比例怎样掌握?答:“一般配就行了”。给婴儿喂奶完后,即给上午出生的 3 名婴儿配葡萄糖水。

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Total Quality Management & Hospital management 全面质量管理与医院管理

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Total Quality Management & Hospital management

Nancy Xia

Guangdong Province Hospital of TCM


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Total Quality Management is a management approach that originated in the 1950's and has steadily become more popular since the early 1980's.

  • Total Quality Management, TQM, is a method by which management and employees can become involved in the continuous improvement of the production of goods and services. It is a combination of quality and management tools aimed at increasing business and reducing losses due to wasteful practices.

  • The TQM philosophy of management is customer-oriented. All members of a total quality management (control) organization strive to systematically manage the improvement of the organization through the ongoing participation of all employees in problem solving efforts across functional and hierarchical boundaries.

  • Some of the companies who have implemented TQM include Ford Motor Company, Phillips Semiconductor, SGL Carbon, Motorola and Toyota Motor Company.

Definition of TQM

  • TQM is a management philosophy that seeks to integrate all organizational functions (marketing, finance, design, engineering, and production, customer service, etc.) to focus on meeting customer needs and organizational objectives.

  • TQM views an organization as a collection of processes. It maintains that organizations must strive to continuously improve these processes by incorporating the knowledge and experiences of workers.

  • The simple objective of TQM is "Do the right things, right the first time, every time".

  • TQM is infinitely variable and adaptable. Although originally applied to manufacturing operations, and for a number of years only used in that area, TQM is now becoming recognized as a generic management tool, just as applicable in service and public sector organizations. TQM must be practiced in all activities, by all personnel, in Manufacturing, Marketing, Engineering, R&D, Sales, Purchasing, HR, etc

Principles of TQM

The key principles of TQM are as following :

Management Commitment

  • Plan (drive, direct)

  • Do (deploy, support, participate)

  • Check (review)

  • Act (recognize, communicate, revise)


Suggestion scheme

Measurement and recognition

Excellence teams

Employee Empowerment

Fact Based Decision Making

  • SPC (statistical process control) 12

  • DOE13, FMEA 14

  • The 7 statistical tools

  • TOPS (FORD 8D - Team Oriented Problem Solving)

Continuous Improvement

  • Systematic measurement and focus on CONQ

  • Excellence teams

  • Cross-functional process management

  • Attain, maintain, improve standards

Customer Focus

  • Supplier partnership

  • Service relationship with internal customers

  • Never compromise quality

  • Customer driven standards

Statistical process control is the application of statistical methods to identify and control the special cause of variation in a process.9

SPC -Statistical Process Control

DOE- Design of Experiments

  • A Design of Experiment (DOE) is a structured, organized method for determining the relationship between factors (Xs) affecting a process and the output of that process (Y).

  • Other Definitions:1 - Conducting and analyzing controlled tests to evaluate the factors that control the value of a parameter or group of parameters.

  • 2- "Design of Experiments" (DoE) refers to experimental methods used to quantify indeterminate measurements of factors and interactions between factors statistically through observance of forced changes made methodically as directed by mathematically systematic tables.

FMEA-Failure Modes and Effects Analysis

A procedure and tools that help to identify every possible failure mode of a process or product, to determine its effect on other sub-items and on the required function of the product or process. The FMEA is also used to rank & prioritize the possible causes of failures as well as develop and implement preventative actions, with responsible persons assigned to carry out these actions.Failure modes and effects analysis (FMEA) is a disciplined approach used to identify possible failures of a product or service and then determine the frequency and impact of the failure.9

The Concept of Continuous Improvement by TQM

  • TQM is mainly concerned with continuous improvement in all work, from high level strategic planning and decision-making, to detailed execution of work elements on the shop floor. It stems from the belief that mistakes can be avoided and defects can be prevented. It leads to continuously improving results, in all aspects of work, as a result of continuously improving capabilities, people, processes, technology and machine capabilities.

  • Continuous improvement must deal not only with improving results, but more importantly with improving capabilities to produce better results in the future.

  • The five major areas of focus for capability improvement are demand generation, supply generation, technology, operations and people capability.

  • A central principle of TQM is that mistakes may be made by people, but most of them are caused, or at least permitted, by faulty systems and processes. This means that the root cause of such mistakes can be identified and eliminated, and repetition can be prevented by changing the process.

  • TQM

Preventing mistakes (defects) from occurring (Mistake - proofing or Poka-Yoke).

Where mistakes can't be absolutely prevented, detecting them early to prevent them being passed down the value added chain (Inspection at source or by the next operation).

Where mistakes recur, stopping production until the process can be corrected, to prevent the production of more defects. (Stop in time).

There are three major mechanisms of prevention:

. A preliminary step in TQM implementation is to assess the organization's current reality. Relevant preconditions have to do with the organization's history, its current needs, precipitating events leading to TQM, and the existing employee quality of working life. If the current reality does not include important preconditions, TQM implementation should be delayed until the organization is in a state in which TQM is likely to succeed


Implementation Principles and Processes

  • If an organization has a track record of effective responsiveness to the environment, and if it has been able to successfully change the way it operates when needed, TQM will be easier to implement. If an organization has been historically reactive and has no skill at improving its operating systems, there will be both employee skepticism and a lack of skilled change agents. If this condition prevails, a comprehensive program of management and leadership development may be instituted. A management audit is a good assessment tool to identify current levels of organizational functioning and areas in need of change.

An organization should be basically healthy before beginning TQM. If it has significant problems such as a very unstable funding base, weak administrative systems, lack of managerial skill, or poor employee morale, TQM would not be appropriate.

CQI in the health care industry


Method and Processes



Principle of total quality management in hospital

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Maslow's Hierarchy of Needs

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