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Quality Management and Organisational Strategic Objectives in Hospitals.

By Reason Chivaka

Quality management is used by most organisations to improve every aspect of their

operations. The emphasis is on ensuring that, things are being done properly at every

level of the organisation. In hospitals the focus on quality management is aimed at

improving patient care from the point of entry right through to the point of exist. The

idea is to minimise errors, wastages, poor communication and inefficiency at each

level of the organisation. According to Hall (2006), the patient's journey from the

point they enter the healthcare system to the point of discharge is like a pipe line, the

less clogged and the shorter it is, the better.

However, it is important to stress that, quality initiatives should be from the hospital's

top management and should be part of the hospital's strategic objectives. According

to Dalley et al (1990), the role of operations personnel is to turn those initiatives into

reality through designing and implementation of executable plans. The role of staff at

the service delivery level, is critical to the contribution of quality to the hospital's

strategic objectives. The hospital's main objectives should be, provision of quality

patient care, minimising clinical errors, ensuring patient safety and reducing waiting

times . At ward level managers are responsible for designing operational plans that

focus on quality patient care detailing what needs to be done to achieve this.

Managers should communicate to staff the operational objectives to be met and staff

are give them the opportunity to discuss the quality initiatives and what they think

needs to be done to achieve the desired results.

The perception of staff on the motivation of management on quality performance has

a major impact on the final outcome. If staff perception is that, there is lack of

commitment, then that will have a negative effect on the desired and actual outcome

of quality initiatives (Armstrong: 2006). The attitude of staff will be, why bother

when managers do not pay attention to what we do or accommodate our views. Such

attitudes renders the whole quality performance process ineffective and a waste of

time as there is negative contribution to the organisational strategies (Dalley et al:


It is important that, if staff is appreciated, valued and productively criticised, quality

performance process will produce flourishing results ( Bacal: 1998). This is because

there will be positive contribution to the organisation's strategic objectives. Quality

performance in hospital's can be improved if there are adequate resources,

management commitment, good communication and effective co-ordination.

-Resources Availability

-the commitment and attitudes of management should change if quality performance

is to improve. In most cases management do little if nothing to address the problem

of staff shortages, yet adequate staffing is critical for the provision of quality patient

care and meeting hospitals major objectives. Ronen et al (2006) said that, reducing

waiting times and lists for patients requires more personnel and equipment.

-Management Commitment

-unless there is total commitment from top management, quality performance in

hospitals will remain a distant reality. Management should lead and support

operational staff and motivate them (Armstrong: 2006).


-communication is vital for the dissemination of the hospitals strategic operational

objectives and departmental operational objectives. Staff should be given all the

information necessary for them to understand what needs to be achieved, the tools

and techniques to be used as well as the time frames.


-given the complex nature of hospital operations, coordination is critical to quality

performance. There should be productive and sustainable coordination between the

various healthcare professionals such as GP surgeries, Consultants, Occupational

Therapists, Physio Therapists, Radiographers, and Social Workers. Strong

coordination promotes quality performance whilst poor coordination leads to rivalry

among the various organs of the hospital and that will erode the quality of patient



The role of management is vital is quality management and meeting of hospitals

objectives. Staff who are vital for executing the plans and are at the forefront of

provision of quality patient care should be consulted and valued.


1-Armstrong M (2006), Performance management: Key Strategies and Practical

Guidelines: Thomson-Shore: Philadelphia.

2-Bacal R (1998), Performance Management: McGraw Hill Publishers: New York.

3-Dalley G (1990), Quality Management initiatives in the NHS: Strategic Approach

to Improving Quality: Centre for Health Economics: York.

4-Hall R W (2006), Patient Flow: Reducing delay in Healthcare Delivery: Springer.

5-Ronen B, Pliskin J S and Pass S (2006), Focused Operations Management for

Health Services Organisations: John Wiley and Sons Inc: San Francisco