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。
夏萍 Nancy Xia
Guangdong Province Hospital of TCM
Total Quality Management is a management approach that originated in the 1950's and has steadily become more popular since the early 1980's.
The key principles of TQM are as following :
Training 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
Measurement and recognition
Excellence teamsEmployee Empowerment
Statistical process control is the application of statistical methods to identify and control the special cause of variation in a process.》9SPC -Statistical Process Control 统计过程控制
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
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).
重复发送错误的环节，要及时停止其运作过程以防止更多缺陷的产生，直到流程被改正。There are three major mechanisms of prevention: 如何预防？
. proofing or Poka-Yoke). 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
TQM实施的一个基本步骤是对组织目前状况的评估。组织的历史、目前需求、突发事件和现有员工的素质都是TQM实施有关的先决条件。如果组织当前的状况不包括这些重要的前提条件，TQM应该推迟实施，直到组织达到这样一种状态，既在组织内实施TQM极有可能成功的状态。Implementation Principles and Processes 怎样实施？何时实施？
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.
Maslow's Hierarchy of Needs