Total Quality Management in Healthcare Environment

Total Quality Management in Healthcare Environment EVALUATING HEALTH IMPROVEMENT (UNIT FIVE) BY AKINADE TOYESE In this paper we will discuss how to cultivate total quality management and develop a culture of on-going improvement with focus on a public health organization. We will also identify ways to incentivize employee performance and evaluate incentives in terms of motivational effectiveness. BRIEF SUMMARY OF A PUBLIC HEALTH ORGANIZATION IN NIGERIA AND THE POPULATION IT SERVES The University College Hospital Ibadan is a public health organization which was established in November 1952 by parliament act to respond to the training need of medical personnel and other health care professionals in Nigeria and other West African Sub-Region (UCH, 2015). Her vision is to be the â€Å"flagship† tertiary healthcare institution in the West Africa sub-region, which offers world-class research, training and services, and first choice for seeking specialist health care (UCH, 2015). Although the hospital is primarily a tertiary institution, it has appendages of community-based outreach activities in six cities where it provides primary and secondary healthcare services. It has fifty-six service and clinical departments and runs ninety-six consultative out- patient clinics a week in fifty specialty and sub-specialty disciplines. There are also special treatment clinic for the treatment of sexually transmitted diseases and the people living with HIV/AIDS (UCH, 2015). However, because of the breakdown and poor state of primary health care facilities in the region (UCH, 2015) â€Å"the hospital still caters for lots of primary and secondary healthcare burden. The number of patients in the accident and emergency of the hospital averages six hundred thousand annually, and about one hundred and fifty thousand new patients attend the various out-patient clinics annually. The institution enjoys a full patronage of both national and international clientele due to its manpower, facilities, and track records†. STEPS TO TAKE TO CULTIVATE TOTAL QUALITY MANAGEMENT AND DEVELOP A CULTURE OF ONGOING IMPROVEMENT. Health Care Systems throughout the world are undergoing significant changes. These changes are due to acknowledgment of either medical errors or system errors (Ruiz and Simon 2004). Other factors responsible for these changes include: Legal obligation for quality management (Moeller et al. 2000), the sophistication of medical care and increasing costs of health care (Ramanathan, 2005). Total quality management seeks to create a culture whereby all employees are continually examining and improving the organization of their work with a view to satisfying customer requirements (Goodwin et al., 2006). This is especially critical for health institution in that better health is the â€Å"raison d’à ªtre† of a health system, and unquestionably its primary or defining goal (WHO, 2000). Joiner and Scholtes (1985) discussed total quality management under three key components: the client as the defining factor in determining quality, the teamwork as a means to unifying goals and a scientific approach to decision-making based on data collection and analysis. Furthermore, quality chain idea can be used to cultivate total quality management. According to Morgan (1994) quality chain is described as chain of suppliers and customers. Goodwin et al. (2006) examined the health of the quality chain in four discrete stages: Inspection: Usually an after-the-fact screening process to assess the quality and conformity of services or products produced. Quality control: Monitoring the process of service delivery at each stage in the chain in order to eliminate the causes of unsatisfactory performance. Quality Assurance: Assessment of the systems quality and the steps taken to improve quality. Total quality management: The application of quality management principles at every level of the organization. This medium will necessitate a change in behavior amongst staff to commit to the quality management agenda. Finally, it is recognized that several elements need to be in place to help such organizations move in the direction of improving the quality of care on a systematic basis. These include the availability of training for the staffs, the development of teamwork among the staff, the development of a structure to support quality improvement, and a set of standard measurable targets through which to assess change (Goodwin et al., 2006). WAYS TO INCENTIVIZE EMPLOYEE PERFORMANCE AND EVALUATE MOTIVATIONAL EFFECTIVENESS OF INCENTIVES Incentives for the employee are to motivate the employee to perform better and have long lasting effect on their performance. If â€Å"you get what you pay for,† then it presumably follows that one should pay for what one ultimately wants (Cutler 2005). If a health program’s primary objective is good patient or population health outcomes, it would seem natural for performance incentives to reward good health or health improvement directly rather than the use of health services or other health inputs. Rewarding health outcomes rather than health input use not only creates strong incentives for providers to exert effort, but it can also create incentives for providers to innovate in developing new, context-appropriate delivery strategies (Grant and Kimberly, 2013: 4). Incentive can be monetary or non-monetary (Asaad Assaf, 2011). The monetary incentive can be performance-related pay such as the increment in salary, bonuses, and other financial benefits such as housing allowance or health care compensation. Non-monetary incentives include: words of appreciation, thank you letter, nomination of department employee of the month, sending an employee to a conference, flexible work hour (Asaad Assaf, 2011). Meanwhile, the extent to which staffs can participate in decision-making and how much support they receive from their managers also motivate the employee to perform better (Goodwin et al., 2006). Nevertheless, there is a need for a public health organization to adopt a method for motivating and rewarding its staffs. Performance-related pay is one approach to using pay to provide an incentive to individuals to work more effectively to meet organizational goals, both in terms of quality and efficiency (Goodwin et al., 2006). Performance-related pay can be seen as one approach to using pay to provide an incentive to individuals to work more effectively to meet organizational goals, both in terms of quality and efficiency (Goodwin et al., 2006). It won’t be encouraging if two persons receive the same pay when one is performing much better than the other. When there is a performance-related pay incentive for a hardworking staff or a job well-done, it will motivate the staff to do more for the improvement of the organization and also encourage the other staff to be effective and hard working in other to meet the organization goals. In conclusion, Goodwin et al. (2006) had explained that â€Å"the experience with PRP is mixed and its transfer to the health sector has been associated with a range of problems: Tension is often created in providing performance-related incentives to individuals, since this can preclude their ability to work towards wider organizational objectives. In health care, team contribution prevails over the contribution of individual members of staff. The power of professional organizations enables them to resist management initiatives. The agency relationship between health care professionals and patients can exclude and disadvantage employers. Employers try to retain insiders rather than recruit outsiders, even if they have to pay more. However, if PPR is applied to the right organization or system-wide needs, it may enable individuals to work more for the benefit of the organization. References: Armstrong, M. H. Murlis, (1994) Reward Management: A Handbook of Remuneration Strategy and Practice, London: Kogan Page Asaad, A., F.A. Assaf, (2011) ‘Incentive for Better performance in Health Care’, Sultan Qaboos, University Medical Journal, 11 (2) pp: 201-206, Available at: http://:www.ncbi.nlm.nih.gov/pmc/articles/PMC3121024/, (accessed: 04/04/2015) Cutler, D., (2005) Your Money or Your Life: Strong Medicine for America’s Health Care System,  USA: Oxford University Press. Goodwin, N., G. Reinhold, V. Iles, (2006) Managing Health Services, Understanding Public Health Series, Maidenhead: Open University Press pp. 143-152 Grant M., S. B. Kimberly, (2013) Pay-for-performance incentive in low and middle income country health programs, national bureau of economic research, NBER Working Paper Series, Cambridge, p. 4 Johnson, O. A., (2011) ‘Total Quality Management (TQM) Factors: An Empirical Study of Kwara State Government Hospitals’, Ethno Med, 5(1) pp. 17-23 Joiner, B., P. Scholtes, (1985) Total Quality Leadership vs. Management by Control, Joiner and Associates Moeller, B., J. O’Reilly, J. Elser, (2000) ‘Quality management in German health care the EFQM excellence model’, International Journal of Health Care Quality Assurance, 13 pp. 254-258. Morgan, P., (1994) Total quality management, in E. Monica (ed.) Management in Health Care, A Theoretical and Experiential Approach, Basingstoke: Palgrave MacMillan. Ramanathan R., (2005) Operational assessment in hospitals in Sultanate of Oman. International Journal of Operations Production Management, l25 pp. 39-54. Ruiz U., J. Simon, (2004) ‘Quality management in healthcare: A 20-year journey’, International Journal of Health Care Quality Assurance, 17 pp. 23-33. UCH, (2015) ‘UCH vision and mission’, Available at: http://uch-ibadan.org.ng/content/vission-and-mission, (Accessed 06/04/2015) â€Å"University College Hospital, Ibadan†, (2015) Wikipedia, Available at: http://en.wikipedia.org/wiki/University_College_Hospital,_Ibadan, (Accessed 06/04/2015)

The Case of the Lightning Strike

In forwarded e-mails across the country are many stories of frivolous lawsuits with huge payouts.   First, there is the story of Kathleen Roberson who won $780,000 after breaking her ankle tripping over her own son in a furniture store.   Carl Truman of Los Angeles won $74,000 when a neighbor reversed over his hand with a Honda Accord.   The court knew that he had sustained this injury in his attempt to steal the hubcaps, yet ruled in his favor anyway.   The case that I am about to present to you is almost as silly as the first two, but the tone of the article is perfectly serious one in a national publication (Reader’s Digest). Van Maussner and three of his friends went golfing at a country club in Atlantic City.   The skies were dark with rain clouds, but the sports enthusiasts would not allow it to put a damper on their time.   After they reached the 12th hole, Maussner was struck by lightning and nearly died of his injuries.   Later, he sued the course for negligence, as they did not have the â€Å"proper safety procedures in place to protect patrons from lighting†(Gerber, 152). He lost at the lower court, but won at the Superior Court who ruled, â€Å"injuries through acts of God don’t exempt courses from liability†(Gerber, 153).   Is it any wonder why frivolous lawsuits flourish when companies are liable for events beyond their control?   Whatever happened to checking the weather report before going out and a little thing called personal responsibility? This paper will examine the case of the plaintiff and isolate the flaws in his argument. First, the article mentions that the men â€Å"prided themselves on hitting the links throughout the year, regardless of the weather†(p. 151).  Ã‚  Ã‚   This point is relevant because it would imply that it did not matter what the weather channel or club personnel warned—they would have gone about their business regardless.   In fact, the club checked the reports before allowing them on the course in the first place since there was no mention of lightning in the forecast. In a similar case (Ned P. Harris v. United States of America) the plaintiff was going rock climbing when he was struck by lightning.   When it came to court, the judge dismissed the case because, â€Å"He saw no power in the plaintiff’s argument that the National Park Service was to blame for his current situation†(Percelay, 68). The second argument the plaintiff made was that there was no system in place to protect players from inclement weather.   In fact, the club had an evacuation process for more than 40 years: at the first sign of bad weather, employees would cart around the golf course and warn players off.   In fact, two caddies tried to get the group to seek shelter, â€Å"but the men decided against it†(Gerber, 152). Third, it was further argued that â€Å"the country club did not have signs posted about its evacuation plan, nor did it begin telling players to seek shelter at neighboring houses until after his accident.   If the club had proper precautions in place, he would not have suffered the injuries†(Gerber, 153).   Under U.S. Law, if a corporation has an evacuation procedure in place but does not utilize it correctly, it may be held liable. Under scrutiny was â€Å"whether the club [promoted safety] in the way it posted evacuation notices and monitored dangerous conditions, and if it should have built shelters and provided and audible signal†(Gerber, 153).   Would such a system truly prevent lighting strikes in the future?   History has shown a large number of people knowingly venture out in spite of unfavorable weather conditions, i.e. storm trackers, scientists, the curious, and the careless.   Anyone that exposes themselves willingly to extreme weather takes his own life in his hands. In sum, the article tried to achieve balance by including both sides of the story.   However, in creating sympathy for Maussner by implying the negligence of the country club, Gerber tacitly encourages the abdication of personal responsibility for universal liability if it includes the possibility of safety for everyone.   Also, frivolous lawsuits give rise to more frivolous lawsuits. Five years ago, (9 years after Maussner’s case was settled) obese teenagers sued McDonald’s for making them fat. â€Å"McDonald's is responsible for their obesity because it did not provide the necessary information about the health risks associated with its meals†(Santora).   This was the first case of its kind heard in court.   In order for society to get back on track, people need to assume responsibility for their own choices and accept the consequences, whatever they may be. Works Cited Gerber, Robin. â€Å"You Be the Judge: When lightning strikes a golfer, is the country club at fault?† Reader’s Digest. August 2007, pp. 151-153 Percelay, James. Whiplash!: America’s Most Frivolous Lawsuits. Riverside, NJ: Andrews McMeel Publishing Santora, Marc. â€Å"Teenagers’ Suit Says McDonald’s Made Them Obese.† The New York Times. 21 Nov. 2002 Accessed 20 Aug. 2007 at http://query.nytimes.com/gst/fullpage.html?sec=health;res=9A0DE7DC1439F932A15752C1A9649C8B63 ;

Lakeland Wonders Case Study Essay

1. How will the new CEO’s vision transform the Lakeland Wonders organisation? †¢ Change of brand image- no longer ‘Handcrafted with pride in the USA’. †¢ Change of organisational culture with the proposed expansion. †¢ Create new revenue streams with expansion into new markets. †¢ Departure from the traditional style of the company. 2. What are the main concerns of the stakeholders who do not agree with her vision? †¢ Loss of Lakeland Wonders image and ‘94 year tradition’. †¢ Expanding too quickly could damage the company, concern over speed of change. †¢ Potential logistics issues with outsourcing. †¢ Concern over quality control and possible damage to brand image. †¢ Local, long term partners would be lost. †¢ New CEO’s lack of clear brand strategy for proposed new products. †¢ Union issues- threatened by outsourcing, not consulted earlier on, etc. †¢ New CEO’s plan to bring in new people (Cecil, Pat) will make long term employees feel threatened and insecure. 3. Does your group think the proposed strategy is a good strategic move for Lakeland Wonders? If yes, why? If not, why not? We think that the proposed strategy is a good move for the following reasons: †¢ Increased growth potential, increased profits- enabling the company to grow in line with targets set by board. †¢ Expansion into growing market-mid non-electric market only segment predicted for double digit growth. †¢ Ensures the company remains competitive over the long term. †¢ Cost effective.  Ã¢â‚¬ ¢ New staff, new ideas and fresh growth- overall improvement for the company. However there are also some negatives: †¢ The overall planning is needs to be effective and complete otherwise it could be damaging to the company. †¢ CEO’s push to force through the changes is causing divisions within the company. †¢ Potential loss of the core quality of the company (traditional, made in USA, etc.) †¢ Risk alienating current customers.

Essay about Genetically Modified Foods vs. Organic Foods

A new kind of foods called the genetically modified foods has been creating a quiet revolution in the American market for the past several years. Scientists are able to produce these new foods by transferring genes from one organism into another across species boundaries. This new technique has been developed to improve the shelf life, nutritional content, flavor, color, and texture of foods. Since 1994, about 45 genetically modified foods such as tomato, corn, soybeans, canola, and potatoes have been marketed in the United States. About two-thirds of foods that are processed in U.S. contain genetically modified ingredients. So, we the people are consuming these foods without realizing the fact that they are not produced naturally.†¦show more content†¦No antibacterial compounds are available resistant to this disease but genetic engineering has developed the first trees to resist this devastating disease and increased the consumption level. Specific foods have been develope d to correct malnutrition problems. To this end, plants have been modified to provide increased and more stable quantities of essential amino acids, vitamins, or desirable fatty acids. For example, golden rice has been genetically modified to increase beta-carotene content which may help to overcome the severe vitamin A deficiencies that cause blindness and iron. Plants can also be genetically modified to grow well in areas of low production potential. For example, two researchers in Mexico inserted a gene from a bacterium into papaya and tobacco to produce acid-tolerant crops. The crops thus secrete citric acid from their roots by combining with toxic metals which in turn making the soils accessible to protect the tropical forests which contain most of the world’s species of plants and animals. Genetic engineering also helps to decrease or eliminate the allergenic proteins that occur naturally. For example, it has been already used to reduce the levels of major allergen in r ice and peanuts. Genetic engineering brings closer the prospect of commercial production in plants of edible vaccines and therapeutics for preventing and treating human diseases like cancer and diabetes. The genetically derived vaccines are potentiallyShow MoreRelatedBenefits Of Genetically Modified Foods905 Words   |  4 Pagesto be coming nightmare? It has been three decades since the discovery of genetically modified foods (foods formed by organisms that have gone through altering DNA using the procedures of genetic engineering.) In the year 1983, the original genetically modified herb was manufactured with antibiotic-resistant tobacco. A near decade after, the FDA (food and drug administration) had finally approved to put a genetically modified tomato on the market. 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