Total Quality Management: Healthcare in Queensland, Australia
Shortage of Doctors and Nurses in Queensland Healthcare Industry
Total Quality Management or TQM was coined by the U.S. Naval Air Systems Command to describe its Japanese-style management approach in terms of quality improvement (2007a). It comprises four process steps, namely, Kaizen, which is to make processes visible; Atarimae Hinshitsu, which is to focus on intangible effects on processes; Kansei, or examining the way the user applies the product; and Miryokuteki Hinshitsu, which broadens management concern beyond the immediate product (2007b). However, in more general terms, TQM is defined as a management approach for an organization, centered on quality, based on the participation of all its members and aiming at long-term success through customer satisfaction, and benefits to all members of the organization and to society (2007b).
From this, it can be understood that the aim of TQM is to improve and develop the system and approach of an organization for customer and employee satisfaction. This form of management is crucial for any organization belonging to any industry, for this determines the quality and extent of service that they can offer their customers. However, not all service sectors meet the standards required in providing quality management. Several issues can still be determined, which allows the further improvement of the service industry. Issues include the lack of funds and resources, which allow the service industry to improve and upgrade their facilities and provide the needs of employees and customers, the lack of manpower or talents, the lack of strategies in attracting and retaining customers, and the lack of strategies of sustaining and maintaining employees. In addition, providing benefits and compensation for employees and ensuring a healthy and safe working environment are also issues to be addressed. It has been reported that in today’s successful service organizations, safely and health management concerns go beyond the physical condition of the workplace to a regard for employees’ mental and emotional well-being and a commitment to protecting the surrounding community from pollution and exposure to toxic substances, which now involves the employees at all levels (2002).
Equally important, this type of service is vital in the healthcare industry, especially to hospitals and other health related establishment, where patients and health-deficient individuals rely upon their efficiency and expertise. However, due to uncontrollable circumstances, the quality of service in the healthcare industry has been declining, and this presents a myriad of quality issues and challenges in the service sector. A relevant issue that can be addressed is in terms of the service and facilities of public or government hospitals and health clinics, which have focused on the reduction of spending with their facilities and with allocation of public health care dollars (2002). An example of which are acute care hospitals, for they are complex institutions comprised of numerous medical specializations in which physicians have considerable decision-making power (2002). The reduction of allocated resources and government spending results to the lack of facilities and healthcare professionals in terms of the quality of service rendered in government hospitals, thus, lessens also the amount of healthcare services that patients receive from them. In addition, the lack of government spending and resources leads to the constraint of human resources or talent, taxpayer funding, transparency or information-sharing, lack in the establishment of effective projects and infrastructures, citizen involvement, and service delivery (2007). On the other hand, service and quality issues are also being faced by private hospitals and healthcare facilities, which consider a number of factors in order to function and render service effectively. In low and middle-income countries, factors, such as those that add to discrepancies between provider knowledge and practice are being faced. Private hospitals perceive and experience patient and community pressure in order to provide treatments, lack the capacity to enforce regulatory controls, and lack multi-faceted strategies, including the local adaptation and distribution of information (1998). In relation to this is the pressure and challenge of educating patients and communities, so that they will be able to adopt achieve treatment-seeking and treatment-taking behavior, feasible mechanisms for guaranteeing and monitoring service quality, and self-regulation by provider organizations or provider accreditation (1998). With these problems and challenges, the salvation of private hospitals in relation to the development, improvement and evaluation of strategies would depend on the involvement of their stakeholders and policy makers, and practical, inexpensive, effective, sustainable and efficient interventions, to achieve their goals (1998).
Moreover, a specific issue to be addressed in the healthcare industry is the recruitment of healthcare professionals, such as doctors and nurses, in relation to the control of quality management. Quality management is a method or process, which ensures that all activities needed to design, develop and implement a product or service are efficient and effective with regards to a particular system and its performance (2007). With this, it can be understood that this method encompasses all other strategies and techniques implemented in service organizations, which are responsible for attracting and retaining healthcare professionals in a specific healthcare institution. However, despite the existence of this type of management, several problems and issues are still faced by healthcare and service institutions, in relation to the recruitment and retention of its skillful workforce. Primarily, like any other service organizations, hospitals and other health-related establishments must be able to advertise job and position openings to attract skillful healthcare professionals. The issue that must be addressed here is the ability of the healthcare institution to utilize different available advertising channels to be able to catch the attention of healthcare professionals. Today, the use of the World Wide Web in terms of advertising could be utilized, for its use is becoming more and more indispensable (2006). This then, becomes a means for attaining quality management strategies, for an effective use of advertising channels can be a particular strategy in order to develop, design and implement a product or service (2007). Second, it has been reported that quality has been seen as a natural consequence of a sound medical education and good intentions on the part of medical practitioners, which are related to professionalism, trust and clinical autonomy (2000). With this, an issue that can be addressed is the fact that to be able to render efficient and effective service, a healthcare institution must recruit and select skillful and experienced doctors and nurses. This issue becomes relevant to the concept of quality management because the recruitment and selection of right healthcare professionals would become crucial for the effective operation of the whole institution. Considerations that can be considered include the specialization and skills of the healthcare professionals, the academic institution from where they obtained their education, the referrals from their previous work or referrals from reliable sources, and their experiences in the related field. The consideration of such factors can be used to effectively select the rightful employee for the job.
Another issue to be addressed is selecting a healthcare professional, who has the similar beliefs, mission and goals as the ones being implemented in the healthcare institution. Although the primary aim of doctors and nurses is to improve the health conditions of their patients, they must still conform to the standards of the hospital and focus on rendering the highest possible standard of service that they can afford. With this, the role of the Human Resource team would be highlighted for the members of the team will be responsible for making decisions in the selection and recruitment of employees. The issue that must be addressed here is the fact that the HRM team must be able to choose the rightful employees, who could be molded to adopt and implement the mission and vision of the healthcare institution, in line with its intention of rendering effective, efficient, and quality service to patients.
In line with the responsibility of healthcare professionals is their need and requirement for effective and efficient hospital equipments and facilities. However, the intention and responsibility of doctors and nurses will not be attained without effective and efficient hospital facilities that would cater to the needs of their patients. The issue to be addressed here is the ability of the healthcare institution to provide for the needs and requirements of doctors and nurses in terms of facilities and equipments. This aspect can be a particular consideration in the recruitment and selection of doctors and nurses, for they must be able to adapt to the facilities and equipments available to the healthcare institution. In relation to this is the fact that because of the drastic and continuous development and improvement in technology, education, and communication, the use of more sophisticated and advanced pieces of equipments are being implemented in healthcare institutions to enhance the services that hospitals can render. The issue to be addressed here is the crucial selection of skillful healthcare professionals who are willing to learn new strategies and techniques that would help the healthcare institution further improve and develop. Having effective hospital facilities is determinant in implementing quality management, as indicated in the study of (1999), who emphasized that with effective and advanced facilities, quality management in hospitals in Australia is improved and achieved, in relation to the use of its skillful healthcare professionals. From this discussion, it can be understood that Total Quality Management has a lot to do with the effective and efficient improvement and development of healthcare institutions, along with its crucial role in the recruitment and selection of skillful and rightful healthcare professionals.
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