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Total Quality Management in Healthcare

Chapter · January 2016

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Ali Mohammad Mosadeghrad Ewan Ferlie

Tehran University of Medical Sciences King's College London
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 Chapter 22- Total Quality Management in Healthcare
Ali Mohammad Mosadeghrad- Ewan Ferlie

Introduction
Healthcare organizations face a number of challenges, particularly concerning quality,
efficiency and equity. Healthcare managers using the quality management strategies can
improve healthcare systems and procedures to achieve an optimum outcome, i.e. high quality
services, patient satisfaction and better performance. Total Quality Management (TQM) aims
to improve the competitiveness of an organization through employee participation, customer
driven quality and continuous quality improvement. The term TQM was first used in 1985 by
the Naval Air Systems Command to express the Japanese management style focused on
quality control (Bemowski, 1992).
The origin of TQM is ascribed to Japan’s desperate search for quality improvements of
its products after the Second World War. In the 1950s, the Japanese Union of Scientists and
Engineers invited Edward Deming, an American management theorist, to help them improve
their economy. Deming shifted their focus from profit to quality. He encouraged them to
improve continuously the production processes based on customers’ needs and expectations.
By 1970s, the challenge of Japanese high quality and competitive price products led to
the adoption of quality management initiatives within the United States (The Economist,
1992). The quality management movement then hit Europe with the founding of the European
Foundation for Quality Management (EFQM) in 1988 to improve the position of European
industries in the world markets.
Total quality management was adopted in the health sector during the 1980s. The TQM
success in industry has encouraged many managers to examine whether it can also work in
the health sector. As a result, in the last 35 years, many healthcare managers increasingly
implemented TQM principles to improve the quality of outcomes, reduce medical errors and
increase the efficiency of health service delivery. However, many organizations are
experiencing dissatisfaction with their TQM programmes (Huq and Martin, 2000).
TQM has to be tailored to the special needs of the organization. The success of TQM
depends on various variables, which are specific to the organization’s environment, structures,
cultures, processes and procedures. There is no “one-size-fits-all” approach that can be
applied to the healthcare environment. The approach and speed of TQM implementation
should be unique to each organization. The purpose of this chapter is to introduce a TQM
model to assist healthcare managers and practitioners to improve the quality of services and
sustain competitive advantage.

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Reference:
Mosadeghrad, A.M. & Ferlie, E., (2016). Total Quality Management in Healthcare in Ortenblad, A.
Abrahamson Lofstrom, C. & Sheaff, R., Management innovations for healthcare organizations: adopt,
abandon or adapt?, Routledge.

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