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TQM in Corporate Hospitals -Using Six Sigma

TQM in Corporate Hospitals -Using Six Sigma

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TQM, Hospitals, Health care, Six sigma
TQM, Hospitals, Health care, Six sigma

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Published by: Apollo Institute of Hospital Administration on Oct 21, 2009
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03/11/2013

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Journal of the Academy of Hospital Administration
Title:
 A strategy for successful TQM in a Corporate Hospital - AStudy using Six Sigma
Author(s): B. Krishna Reddy*, M. Arundhathy**, GVRK. Acharyulu**Vol. 14, No. 2 (2002-07 - 2002-12)
Abstract:
Globalization and privatization of health insurance have changed the functioning of health care system ? old models need to be redesigned. As today's competitiveenvironment leaves no room for error, we need to delight our patients and customersrelentlessly and look for new ways to exceed their expectations with a focus oncontinuous improvement in technical skills, human skills and to develop cost effectivemethodologies. This is one of the reasons why six sigma is becoming a part of thehospital culture. The concept is still in its nascent stage in Indian health care system. sixsigma is a scientific concept, provides measurement of every activity in the hospital byusing various statistical tools. The strategic implementation of the concept would result indelighted customers; develop outside in thinking; leadership commitment; empoweredemployees and develop customer centric culture in the organisation. This paper attemptsto study six sigma aspects in the ultrasound department of a corporate hospital.
Keywords: Total quality management (TQM), six sigma, waiting time.Key Messages:
* In the current competitive environment, six sigma technique is becoming a part of thehospital culture.*Significant reduction in waiting time, leading to a substantial improvement in quality of service at the Ultrasound Unit of a Hospital can be achieved through Six Sigma approach.*Total Quality Management concepts and methodologies would help in strandardizingthe medical care activities across hospitals.
Introduction
Today, focusing on the customer has become absolutely essential. Of course, we allrecognize this, but do we really internalize the idea? Do we really believe that such afocus has the potential to drive business growth and show impact on the level of customer satisfaction, which we should come to expect?
 
Closely linked to the idea of customer satisfaction is the concept of operationalexcellence - the kingpin of success. Without the focus on excellence it may be easy toobtain 80-90 percent efficiency level and being the best means embracing change andreaching out for new and higher standards of performance.Another way of looking at this would be to say that our performance as a hospital isgoverned by the quality of our processes ? high quality process delivers high qualityservice, at the lowest possible cost and on time -the concept of Total QualityManagement(TQM). Therefore, a focus on operational excellence in everything we dotranslate the focus on the quality of the service provided.Trying to improve some thing when we don't have a standard to measure against andimprove a process without measuring the current status is like playing a game withoutknowing the score. Measurement and improvement of the processes are absolutelyessential if we are looking at operational excellence.If you can't express something in the form of numbers, you don't really know much aboutit. If you don't know much about it, you can't control it, and if you can't control it, you'reat the mercy of chance. From this perspective, the concept of six sigma plays a vital rolein achieving operational excellence in any organisation.
What is six sigma?
Sigma (o) is character of the Greek alphabet, which is used in Mathematical Statistics todefine Standard Deviation. Standard Deviation, a measure of dispersion (spread),indicates how far away a measured result is from the average (the center of data).Six Sigma is a business concept that answers customers' demand for high quality anddefect-free processes. The customer satisfaction and its improvement is usually assignedwith the top priority of any service activity. In other words,
Six Sigma is aboutabandoning the uncertainty of goals and forecasts.Six Sigma is a method for improving quality by removing defects and their causes invarious processes and activities
. It concentrates on those outputs, which are importantto customers. The method uses various statistical tools to measure service processes. Intechnical terms, Six Sigma means that there are 3.4 defects per million events. The maingoal is continuous improvement. It provides specific methods to recreate the process sothat defects and errors never arise in the first place.While six sigma is a long term and forward thinking initiative designed to fundamentallychange the way the hospital provide services, it is first and foremost designed to generateimmediate improvements to patient satisfaction as well as to increase profit margins.
 
Historical perspective
There have always been many statistical methods for measuring and improving quality.The concept of Six Sigma was developed first by Mikel J.Harry in connection withquality program at Motorola in 1987. The program gained importance when Motorolawon the Malcolm Baldrige quality award. Further development took place in the turn of the decade in ABB where Harry worked as a vice-president in-charge of quality systemsdevelopment.According to Jack Welch, General Electric's 1996 Annual Meeting - "GE Quality 2000will be the biggest, the most personally rewarding, and in the end, the most profitableundertaking in our history. We have set for ourselves the goal of becoming by the year 2000 a six-sigma quality company, which means a company virtually, defect-free products, services and transactions".The various other Companies adopting the concept of Six sigma for continuouslyimproving their performance include: Texas instruments 1988, Kodak 1995, Sony 1997, Nokia 1997 plus over 50 companies are sharing the best practices of six sigma.
Need and importance of six-sigma
According to Gemmel et al (1995), to survive in the next decade it becomes increasinglyimportant for the hospital managers to better manage their resources, whereby attentionwill focus on the issues of quality management and concepts of improving effectivenessof service delivery. The author notes that to achieve improvements, hospitals should notconcern themselves with spending money, but in reality identifying and meeting patientneeds. The most relevant TQM strategy to identify the customer requirements is throughthe process of Six Sigma, which focuses primarily on the voice of the customer.Over the last ten years there has been a tremendous increase in references and interest inquality assurance as it applies to health care. World Health Organization (WHO) workinggroup on quality assurance discerned four sets of reasons: Economic, Social, Political andProfessional (WHO,1995). Demand for health care is increasing. Not only are peopleliving longer and requiring care over a longer period and into a extended old age but alsoexpectations are rising through education and general interest. There is increasingemphasis on value for money and cost effective solutions.The traditional concerns and methods have changed in recent years because of changes inthe health care and in society.
Firstly
, health care has become more complex. A patientsuffering a heart attack will come in contact with many doctors and other professionals inthe episode of care.
Secondly
, change is evident in patient's expectations and traditionalauthority relations in society have changed and there is increasing consumerism wherethe patients expect to be told what is being provided for them and to have redress if theservice falls below standard.
Third
, those paying for health services have become moreconcerned about rising health care costs and possible inefficiencies.

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