SERVICE QUALITY

EXCELLENCE IN HEALTHCARE
ASSIGNMENT 2
VIGNESH.D
2022HB28505

DEMING’S 14 POINTS
1. Create constancy of purpose for improving products and
services.
2. Adopt the new philosophy.
3. Cease dependence on inspection to achieve quality.
4. End the practice of awarding business on price alone; instead,
minimize total cost by working with a single supplier.
5. Improve constantly and forever every process for planning,
production and service.
6. Institute training on the job.
7. Adopt and institute leadership.
8. Drive out fear.
9. Break down barriers between staff areas.Eliminate slogans,
exhortations and targets for the workforce.
10. Eliminate numerical quotas for the workforce and numerical
goals for management.
11. Remove barriers that rob people of pride of workmanship,
and eliminate the annual rating or merit system.
12. Institute a vigorous program of education and self-
improvement for everyone.
13. Put everybody in the company to work accomplishing the
transformation.
1. Create a Constant Purpose Toward Improvement
 Plan for quality in the long term.
 Resist reacting with short-term solutions.
  Don't just do the same things better – find better things to do.
 Predict and prepare for future challenges, and always have the
goal of getting better.
2. Adopt the New Philosophy
 Embrace quality throughout the organization.
 Put your customers' needs first, rather than react to
competitive pressure – and design products and services to
meet those needs.
 Be prepared for a major change in the way business is done.
It's about leading, not simply managing.
 Create your quality vision, and implement it.
3. Use a Single Supplier for Any One Item
 Quality relies on consistency – the less variation you have in
the input, the less variation you'll have in the output.
 Look at suppliers as your partners in quality. Encourage them
to spend time improving their own quality – they shouldn't
compete for your business based on price alone.
 Analyze the total cost to you, not just the initial cost of the
product.
 Use quality statistics to ensure that suppliers meet your quality
standards

TOTAL QUALITY MANAGEMENT AND LEAN

MANAGEMENT
What is Total Quality Management (TQM)?
Total Quality Management (TQM) is a management framework based on
the belief that an organization can build long-term success by having all
its members -- from low-level workers to its highest-ranking executives --
focus on improving quality and, thus, delivering customer satisfaction.

This management approach is used to simplify supply

chain management, as well as to detect, reduce or remove errors. TQM
requires organizations to focus on continuous improvement, or Kaizen.
TQM focuses on continual internal and process improvements over the
long term, thereby enhancing the quality of produced products or
services.
All departments that contribute to the creation of a product or service --
including design, engineering and marketing teams -- participate in TQM.
Management acts as a facilitator by providing quality staffing and training
and setting goals.

TQM has no single agreed-upon approach but does follow eight guiding
principles that focus on improving quality.

Importance of TQM
TQM can have a beneficial effect on employee and organizational
development. By having all employees focus on quality management
and continuous improvement, companies can establish and uphold
cultural values that create long-term success for both customers and the
organization. TQM's focus on quality helps organizations identify skill
deficiencies in employees, along with the necessary training, education
or mentoring required to address those needs.

With a focus on teamwork, TQM leads to the creation of cross-functional

teams and knowledge sharing. The increased communication and
coordination across disparate groups deepens institutional knowledge
and gives companies more flexibility in deploying personnel.

Principles of TQM
TQM prescribes a series of ways for organizations to accomplish this,
with the pathway to successful continuous improvement centered on the
use of strategy, data and effective communication to instill a discipline of
quality into the organization's culture and processes.

More specifically, TQM highlights the processes that organizations use

to produce their products, and it calls for organizations to define those
processes, continuously monitor and measure their performance, and
use that performance data to drive improvements. In addition, it requires
all employees and organizational departments to be part of this process.
The eight guiding principles that TQM uses to improve quality include the
following:

1. Customer focus. The customer determines the quality level of

the products and services. Customer input is valued, as it
provides a better understanding of what the customer needs.

2. Employee involvement. All employees must participate in the

processes and system. They must be properly trained and
given the needed resources to complete their tasks on time.

3. Focus on process. Processes must be continually analyzed to

identify weaknesses. Every employee who takes part in the
process should be properly educated in their contributions,
ensuring the right steps are taken at the right time.

4. Integrated business systems. All TQM processes should be

integrated into a business process. Integrated systems convey
potentially useful data across departments, enabling everyone
to be on the same page.

5. Strategic and systematic approach. Planning and

management are required using a strategic plan with quality as
a base component.

6. Continual improvement. A focus on continually improving

quality helps an organization adapt to changing markets and
achieve competitive advantages.

7. Focus on data. Data should be collected, documented and

analyzed to improve decision-making accuracy and to predict
trends based on previous history.

8. Communication. Communication between teams with

information such as strategies, methodologies or timeliness is
essential to improving operations. Good communication can
also motivate employees and improve morale.
Implementation principles and processes
The general process of implementing TQM follows these steps:

1. The organization assesses its current culture and quality

management systems and identifies core values.

2. Management decides to commit to TQM and develops a TQM

master plan.

3. The organization identifies and prioritizes customer demands.

4. Management maps the processes needed to meet customer

needs.

5. Management creates a team to oversee efforts to improve

processes.
6. Management starts contributing to the process by providing
additional planning and training.

7. Management creates a process to standardize daily process

management.

8. Management continually asks employees for feedback.

Implementing TQM is a long-term commitment, and the length of time

needed for planning, development and implementation varies by
organization.

Benefits of TQM
TQM offers the following benefits:

 Less product defects. An objective of TQM is to create

products and services correctly the first time. This means that
products ship with fewer defects, reducing product recalls,
future customer support overhead and product fixes.

 Satisfied customers. High-quality products that meet

customers' needs result in higher customer satisfaction. High
customer satisfaction, in turn, can lead to increased market
 share, revenue growth via upselling and word-of-mouth
marketing initiated by customers.

 Lower costs. As a result of less product defects, companies

save money on customer support, product replacements, field
service and creating product fixes. The cost savings flow to the
bottom line, creating higher profit margins.

 Well-defined cultural values. Organizations that practice TQM

develop and nurture core values around quality management
and continuous improvement. The TQM mindset pervades
across all aspects of an organization, from hiring to internal
processes to product development.
Disadvantages of TQM
The downsides of TQM include the following:

 Planning and resources. TQM needs a significant amount of

planning and resources over time to be properly allocated to the
change.

 Companywide commitment. Continuous improvement in TQM

means the organizational culture must focus on improving
processes. All management levels must be supportive.

 Added costs. TQM might add training, infrastructure and team

development costs.

 Time. It might take years for an organization to fully show

intended results.

 Partial efforts. Because of the effort involved in implementing

TQM, a partial move toward it can result in failure.
Examples of TQM
Automobile manufacturer Toyota exemplifies TQM. The adoption of
TQM and Kaizen at Toyota led to higher product and work quality at all
levels of the organization. Toyota adopted a related practice
called statistical quality control in 1949. In 1951, Toyota launched the
Creative Idea Suggestion System, which was based on a suggestion
system used at Ford.

In 1965, Toyota was awarded the Deming Application Prize for major
advances in quality improvement. In 1994, the "Toyota Group Executive
TQM Training Course" was established, providing TQM training for new
executives. Toyota's TQM initiatives continue to the present day. In
2011, Toyota announced that its Creative Idea Suggestion System had
generated more than 40 million suggestions to date.

Another example of TQM occurred at Tata Steel, a steel-making

company based in India and a subsidiary of Tata Group. Tata Steel
adopted TQM in the 1980s. The company was awarded the Deming
Application Prize in 2008. Tata Steel used TQM methodologies to gain a
deep understanding of customers. They sought to ensure value creation
in a system that covered customers and suppliers.

In 2008, Tata Steel created the Performance Improvement Committee to

drive continuous performance improvement. Performance Improvement
Groups were established for iron making, steel making, flat rolling, long
rolling, maintenance and more.

As part of its 2008-2009 annual report, Tata Steel reported that its TQM
initiatives resulted in a $150 million bottom-line effect on its business.

What is lean management?

Lean management is an approach to managing an organization that
supports the concept of continuous improvement, a long-term approach
to work that systematically seeks to achieve small, incremental changes
in processes to improve efficiency and quality.

The primary purpose of lean management is to produce value for the

customer by optimizing resources and creating a steady workflow based
on real customer demands. It seeks to eliminate any waste of time, effort
or money by identifying each step in a business process and then
revising or cutting out steps that do not create value. The philosophy has
its roots in manufacturing.

Lean management focuses on the following:

 Defining value from the standpoint of the end customer.

 Eliminating all waste in the business processes.

 Continuously improving all work processes, purposes and

people.

Lean management facilitates shared leadership and responsibility;

continuous improvement ensures that every employee contributes to the
improvement process. The management method acts as a guide to
building a successful and solid organization that is constantly
progressing, identifying real problems and resolving them.

Lean management is based on the Toyota production system which was

established in the late 1940s. Toyota put into practice the five principles
of lean management with the goal being to decrease the amount of
processes that were not producing value; this became known as
the Toyota Way. By implementing the five principles, they found that
significant improvements were made in efficiency, productivity, cost
efficiency and cycle time.

5 principles of lean management

Lean management incorporates five guiding principles that are used by
managers within an organization as the guidelines to the lean
methodology. The five principles are the following:

1. Identify value.

2. Value stream mapping.

3. Create a continuous workflow.

 4. Establish a pull system.

5. Facilitate continuous improvement.

Identifying value, the first step in lean management, means finding the
problem that the customer needs solved and making the product the
solution. Specifically, the product must be the part of the solution that the
customer will readily pay for. Any process or activity that does not add
value -- meaning it does not add usefulness, importance or worth -- to
the final product is considered waste and should be eliminated.

Value stream mapping refers to the process of mapping out the

company's workflow, including all actions and people who contribute to
the process of creating and delivering the end product to the consumer.
Value stream mapping helps managers visualize which processes are
led by what teams and identify the people responsible for measuring,
evaluating and improving the process. This visualization helps managers
determine which parts of the system do not bring value to the workflow.

Creating a continuous workflow means ensuring each team's

workflow progresses smoothly and preventing any interruptions
or bottlenecks that may occur with cross-functional teamwork. Kanban, a
lean management technique that utilizes a visual cue to trigger action, is
used to enable easy communication between teams so they can address
what needs to be done and when it needs to be done by. Breaking the
total work process into a collection of smaller parts and visualizing the
workflow facilitates removing process interruptions and roadblocks.

Developing a pull system ensures that the continuous workflow

remains stable and guarantees that the teams deliver work assignments
faster and with less effort. A pull system is a specific lean technique that
decreases the waste of any production process. It ensures that new
work is only started if there is a demand for it, thus providing the
advantage of minimizing overhead and optimizing storage costs.
These four principles build the lean management system. However, the
last principle -- continuous improvement -- is the most important step in
the lean management method.

Facilitating continuous improvement refers to a variety of techniques

that are used to identify what an organization has done, what it needs to
do, any possible obstacles that may arise and how all members of the
organization can make their work processes better. The lean
management system is neither isolated nor unchanging and, therefore,
issues may occur within any of the other four steps. Ensuring all
employees contribute to the continuous improvement of the workflow
protects the organization whenever problems emerge.

Examples of lean management

The lean management principles can be used as a universal
management tool to improve companies' overall performance.

Some examples of specific business and production processes that are

based on the lean management concept include:

 Lean manufacturing

 Lean software development

 Lean six sigma

 Lean startup

 Value-based healthcare

Benefits of lean management

Lean management benefits organizations by focusing on improving all
parts of the work process throughout every level of the company's
hierarchy. Specifically, managers benefit from advantages such as:
  A more intelligent business process. The pull system
ensures work is only carried out when there is an actual
demand and need for it.

 Improved use of resources. The pull system also ensures the

organization is only using resources when they are needed
since it operates based on real customer demand.

 Improved focus. Lean management decreases the number of

wasteful activities, therefore allowing the workforce to increase
their focus on tasks that produce value.

 Enhanced productivity and efficiency. Improved focus leads

to a more productive and efficient workforce since attention is
not given to unnecessary activities.

These major benefits work together to create a company that is more

flexible and has the ability to address customer requirements in an
improved and faster manner. Overall, the lean management system
creates a solid production system that has a higher chance of improving
a company's total performance.

Concepts TOTAL QUALITY LEAN MANAGEMENT

MANAGEMENT
Origin The quality evolution in The quality evolution i
Japan Japan and Toyota
Theory Focus on customers Remove waste

Process view Improve and uniform Improve flow in proces

processes
Approach Let everybody be committed Project management

Methodologies Plan, do, study, act Understanding custom

 value, value stream,
analysis, flow, pull,
perfection
Tools Analytical and statistical Analytical tools
tools
Primary effects Increase customer Reduce lead time
satisfaction
Secondary effects Achieves customer loyalty Reduces inventory,
and improves performance increases productivity
customer satisfaction
Criticism No tangible improvements, Reduces flexibility, cau
resource-demanding, congestion in the supp
unclear notion chain, not applicable i
industries