Tm Helthcre

TQM in Healthcare

The increase in public, professional and political interest in TQM is especially obvious in the United States of America. Reasons suggested for this interest in the USA (Graham, 1990) are probably true, if to a lesser extent, in Singapore. These are interrelated and include rapid advances in medical science, paradoxically demonstrated poor healthcare, rising costs of medical care, increased consumer education, expectations and power, the proliferation of service institutions and also increased Government involvement in healthcare provision and regulation.

As in many other countries, TQM in healthcare came from industrial experience in the development of TQM concepts, theories and practices. However, to implement the same concept into the healthcare industry would be a disaster. Although anecdotal evidence suggests that the healthcare industry is not uniquely different from any other organisation or industry; closer examination suggests that the healthcare industry is, in fact, uniquely different on five major counts:

i. its closer linkage to politics

ii. its complex organisational structure

iii. its inherent characteristics: intangibility, heterogeneity, inseparability, perishability, labour intensive, a credence product

iv. its objective is continually shifting, its environment is under siege from concurrent government changes

v. differences in the perceptions, values and work ethic of the healthcare

providers

Recognising these differences is imperative to the successful implementation and development of a TQM system in healthcare. Whatever the differences and problems, TQM should not be directly transferred into the healthcare industry. It is up to the quality professionals in healthcare to define principles, philosophies and techniques that will determine the quality standards appropriate for their own industry. The authors in this paper establishes the principles of TQM in a hospital setting, as TQM is very complex when implemented...