TOTAL QUALITY MANAGEMENT PRACTICES IN HEALTH CARE ORGANIZATIONS: PERCEPTION OF HEALTH CARE PROVIDERS
DOI:
https://doi.org/10.46827/ejphs.v4i2.100Keywords:
health care providers’ attitude, health care quality measurement, TQMAbstract
Turkey has experienced a substantial development in Total Quality Management (TQM), measurement, and monitoring of hospitals. Ministry of Health has developed the Quality Standards in Healthcare (QSH) in order to adapt to international quality standards of health care to the health care services as a result of long research and experience. This study aimed to determine the effects of QSH applied in a public hospital on the quality performance of the organization. The researchers used a performance measurement model to measure the impact of the recently developed QSH on the quality performance and organizational excellence of a 320-bed public hospital in a developing country. Successful applying of TQM in hospitals requires the involvement and commitment of all health care providers. The study was carried out in an attempt to explore the attitude of health care providers applying TQM practices on hospital performance in a general public hospital. We collected data from 302 healthcare providers. We used a structured questionnaire to collect data. The study was based on total quality management theory and Kanji's Business Excellence (KBEM) model. The study used a 10-point Likert-type scale. The Structural Equation Model (SEM) was used to test whether the data obtained from the participants supported the model. The variable mean scores and path coefficients were calculated. The data were collected in five different periods between July 2017 and January 2019. The results of the study showed that the average attitudes of nurses, physicians, and administrative staff about the factors of hospital quality performance differed from the attitudes of technical staff. The study results reflected some strong areas, notably leadership, customer/patient satisfaction, quality management process, measurement, and organizational excellence. The results indicated that the hospital organization was mainly based on institutional excellence, quality improvement and patient safety, leadership and management performance, patient satisfaction and institutional learning, corporate ethical performance. The results also identified opportunities for improvement in QSH standards for human resource management and the absence of standards that address existing issues in organizations with organizational structures.
References
Appleby, A., & Jackson, C. (2000). The impact of IiP on TQM and staff motivation in general practice. International Journal of Health Care Quality Assurance, 13(2), 53-64.
Braithwaite et al. (2011). Strengthening Organizational Performance through Accreditation Research-a Framework for Twelve Interrelated Studies: the ACCREDIT Project Study Protocol, BMC Research Notes , 4:390,
Braithwaite et al. (2011). Strengthening Organizational Performance through Accreditation Research-a Framework for Twelve Interrelated Studies: the ACCREDIT Project Study Protocol, BMC Research Notes , 4:390.
Counte, M. A., & Meurer, S. (2001). Issues in the assessment of continuous Quality improvement implementation in health care organizations. International Journal for Quality in Health Care, 13, 197-207.
Çapacıoğlu, E., Çetin, O., Özçakar, N. (2018). Kamu Kurumlarında Toplam Kalite Yönetimi Uygulamalarının Deming Yönetim Metodu ile Analizi, İstanbul Management Journal, 29(85): 107–125
Danişman, Şahin & Tosuntaş, Şule & Karadağ, Engin. (2015). The effect of leadership on organizational performance. E. Karadag (ed.), Leadership and Organizational Outcomes (pp 143-168), Switzerland: Springer International Publishing
Farr, M., Cressey, P. (2015). Understanding staff perspectives of quality in practice in healthcare, BMC Health Service Research. 2015 Apr 23;15:123. doi: 10.1186/s12913 015-0788-1.
Greenfield, D., Braithwaite, J. (2008). Health sector accreditation research: a systematic review, International Journal for Quality in Health Care, Volume 20, Issue 3, Pages 172–183, https://doi.org/10.1093/intqhc/mzn005
Groene, O., Botje, D., Sunol, R. And Lopez, M.A.(2013). A systematic review of instruments that assess the implementation of hospital quality management systems, International Journal for Quality in Health Care 2013; Volume 25, Number 5: pp. 525–541.
Halis, M , Şimşir, İ . (2017). Kamu Hastanelerinde Kurumsal Performans Uygulamalari: Yönetici ve Diğer Personel Tutumlarının İncelenmesi”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6 (2), 22-32. Retrieved from http://dergipark.org.tr/gumussagbil/issue/32272/359549
Harrison, J. P. & Coppola, M. N. (2007). Is the quality of hospital care a function of leadership? The Health Care Manager, 26:3, pp. 263-272.
Hassan, D. (2006). Measuring Quality Performance in Health Care: The Effect of Joint Commission International Standards on Quality Performance, Walden University, Unpublished Doctoral
Kanji, G. K. (2002). Forces of excellence in Kanji’s Business Excellence Model, Total Quality Management, 12:2, 259-272, DOI: 10.1080/09544120120025311.
Laschinger, H. K. S., Wong, C., Mc Mahon, L., & Kaufmann, C. (1999). Leader behavior impact on staff nurse empowerment, job tension, and work effectiveness. Journal of Nursing Administration, 29(5), 28-39.
Leggat, S. G., Karimi, L., & Bartram, T. (2017). A path analysis study of factors influencing hospital staff perceptions of quality of care factors associated with patient satisfaction and patient experience. BMC health services research, 17(1), 739. doi:10.1186/s12913-017-2718-x
Listyowardojo, T. A., Nap, R. E., Johnson, A. (2012). Variations in hospital worker perceptions of safety culture, Int J Qual Health Care. 2012 Feb;24(1):9-15. doi:10.1093/intqhc/mzr069.
Meng, et al. (2018). Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals. International journal of environmental research and public health, 15(4), 769. doi:10.3390/ijerph15040769
Naghavi et al. (2012). Performance assessment at Iran’s electric power distribution company: A study based on Kanji’s business excellence measurement system (KBEMS), African Journal of Business Management Vol.6 (29), pp. 8539-8547, 25 July, 2012 Available online at http://www.academicjournals.org/AJBM DOI: 10.5897/AJBM11.1569 ISSN 1993-8233 ©2012 Academic Journals
OECD. (2017). Health at a Glance 2017 OECD Indicators, 10 Nov.2017. http://www.oecd.org/els/health-systems/Health-at-a-Glance-2017-Chartset.pdf. (20.12.2017).
Ovretveit, J. & Gustafson, D. (2002). Evaluation of quality improvement programmes. Quality and Safety in Health Care, 11(3), 270-275.
Öter, V., Südaş, H. (2017). Algılanan Hizmet Kalitesinin Hasta Bağlılığı Üzerine Etkisi: Devlet Hastanesi Üzerine Bir İnceleme, Çukurova Üniversitesi İİBF Dergisi Cilt:21. Sayı:2. Aralık 2017, ss.43-57.
Patel, U. B. (2006). Physician Chief Executive Officers and Hospital Performance a Contingency Theory Perspective, Virginia Commonwealth University, Yayınlanmamış Doktora Tezi
Polis et al. (2017). Factors Contributing to Nursing Team Work in an Acute Care Tertiary Hospital, Collegian , Volume 24 , Issue 1 , 19 – 25
Pomey, M. P. (2004). Contandriopoulos A. P., Francois P., Bertrand D.: Accreditation: a tool for organizational change in hospitals?, Int J Qual Health Care Assurance, 17:113-124.
Purbey, S., Kampan., M. Chandan. B. (2007). Performance measurement system for healthcare processes. International Journal of Productivity and Performance Management. 56. 241-251. 10.1108/17410400710731446.
Rabøl et al. (2012). Promoters and Barriers in Hospital Team Communication, Journal of Communication in Healthcare, VOL. 5 NO. 2
SKS-Hastane. (2015). (Versiyon-5; Revizyon-00), 1.Baskı, Pozitif Matbaa, Ankara.
Soysal, A , Koçoğlu, D . (2018). Sağlık İşletmelerinde Müşteri Odaklı Pazarlama Anlayışı İle Hizmet Kalite Algısı Arasındaki İlişki; Bir Hastane Örneği. Selçuk Üniversitesi Sosyal Bilimler Meslek Yüksekokulu Dergisi, 21 (1), 41-50. DOI: 10.29249/selcuksbmyd.349338
Şentürk, M., Kaya, F. (2017). Hastanelerin Performans Uygulamalarında Çalışanların Memnuniyetini Etkileyen Faktörler, AİBÜ Sosyal Bilimler Enstitüsü Dergisi, 2017, Cilt:17, Yıl:17, Sayı: 3, 17: 145-174
Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (Sixth edition). Pearson Education, United States.
Valenstein, M., Mitchinson, A., Ronis, D. L., & Alexand, J. A. (2004). Quality indicators and monitoring of mental health services: What do front-line providers think?, Journal of Psychiatry, 161, 146-154.
West et al. (2015). Leadership and Leadership Development in Health Care: The Evidence Base, The Faculty of Medical Leadership and Management, https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/leadership-leadership-development-health-care-feb-2015.pdf
Zabada, C., Rivers, P. A., & Munchus, G. (1998). Obstacles to the application of total Quality management in health care organizations. Total Quality Management, 9, 57-67.
Zink, K. J. (2008). Corporate Sustainability as a Challenge for Comprehensive Management, Springer, Berlin, Germany
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