Home⇛The PCMC Journal⇛vol. 12 no. 1 (2016)

Quality management system (QMS) at the Philippine Children's Medical Center: Basis for improvement towards organizational readiness for ISO certification

Julius A. Lecciones

Discipline: medicine by specialism

 

Abstract:

TQM/QMS can be a vital strategy for performance in government hospitals. The Philippine Children's Medical Center must provide the best health outcomes to patients and at the same time must be financially stable. TQM is not just a strategic tool for PCMC, but also a business philosophy aligned to the attainment of its business objectives. The study aims to investigate the role of the staff in the organization with regards to the implementation and maintenance of its quality management system, determine the impact of critical variables influencing success or failure of TQM and the quality improvement program, and make corrections and improvements based on the assessment results of this study. This will ascertain PCMC's readiness for ISO certification and guide management on the next steps to take. The study utilized a cross-sectional design, based on measurements of empirical data about Quality Improvement activities at PCMC gathered by a self-administered modified questionnaire. The questionnaires were answered by a first group of a 2-tiered sample population of PCMC employees consisting of management and rank-and-file personnel. The second group was patients/parents who filled-up questionnaires to assess customer satisfaction. Athird group of PCMC trained internal auditors who did the actual internal audit were requested to fill-up a questionnaire based on the Conca model modified from the EFQM construct. In-put structures consisting of physical facilities, equipment, policy guidelines and manuals of procedures, and personnel staffing were found very adequate. There were also a very satisfactory number of trained managers in QMS, but rank-and-file employees need to be given more formal training as well. There was no statistical difference in how the employees perceived the four critical success factors as to gender, age, educational attainment and QMS training received. However, there is significant difference observed on perceptions of the role of top management and quality policy with higher mean ratings when the participant is not single, and when participant is a member of top management itself respectively. There is a significant difference between the different professional groups to all four critical QMS factors. The physicians as one group consistently gave lower mean ratings than the other groups. Patients were generally very satisfied with the quality of personnel, quality of service, food, condition of the facifity, and they would come back as repeat customers. The Philippine Children's Medical Center is indeed ready for the third party ISO certification site visit and audit by March 2013. The hospital instituted a quality improvement system which will potentially result to customer satisfaction and improved financial results. To continuously sustain quality improvements, the physical facilities and equipment must be maintained well because they are the hard capital assets of PCMC to achieve quality services. Likewise, PCMC must conduct further training of employees on QMS as a foundation in achieving the desired organizational quality culture. Atraining plan should take into account involvement of the rank-and-file, and the cascading down of training to as many employees as appropriate. Problem-solving efforts should be instituted to correct non-conformities. Almost all problems can be solved with manualization of processes and procedures.



References:

  1. Aagja JP, Garg R. Measuring perceived service quality for public hospitals (PubHosQual) in the Indian context. Int J Pharm Healthc Mark. 2010;4(1):60–83.
  2. Ahire SL. TQM theory: Opportunities and strategies. Decis Line. 1996;28(5):1–6.
  3. Aktar MS, Upal M, Umme H. Service quality perception and satisfaction: A study over suburban public hospitals in Bangladesh. J Serv Res. 2008;Feb Special Issue:125–146.
  4. Amira E. Patient satisfaction in Japan. Int J Health Care Qual Assur. 2008;21(7):692–705.
  5. Arasli H, Haktan EE, Turan KS. Gearing service quality into public and private hospitals in small islands: Empirical evidence from Cyprus. Int J Health Care Qual Assur. 2008;21(1):8–23.
  6. Ahire SL, Golhar DY, Waller MA. Development and validation of TQM implementation constructs. Decis Sci. 1995;27(2):277–306.
  7. Andersen R, et al. The public’s view of the crisis in medical care: An impetus for changing delivery systems? Econ Bus Bull. 1971;24:44.
  8. Bates K, Bates H, Johnston R. Linking service to profit: The business case for service excellence. Int J Serv Ind Manag. 2003;14(2):173–183.
  9. Berman EM, Milakovich ME, West JP. Implementing TQM in state public health agencies. J Health Hum Serv Adm. 1996;Fall:182–205.
  10. Berry LL, Bendapudi N. Health care: A fertile field for service research. J Serv Res. 2007;10(2):111–122.
  11. Camison C. Total quality management in hospitality: An application of the EFQM model. Tour Manag. 1996;17(3):191–201.
  12. Carman JM, Shortell SM, Foster RW, et al. Keys for successful implementation of total quality management in hospitals. Health Care Manage Rev. 2010;35(4):283–293.
  13. Carter RE, Lonial SC, Raju PS. Impact of quality management on hospital performance: An empirical examination. Qual Manag J. 2010;17(4):8–24.
  14. Chase R. Quality—An essential for the 1990s. 1988.
  15. Cheeseman C, Tate A. TQM. TQM Mag. 1993;Feb.
  16. Cho WH, Lee H, Kim C, et al. The impact of visit frequency on the relationship between service quality and outpatient satisfaction: A South Korean study. Health Serv Res. 2004;39(1).
  17. Choo S, Bowley C. Using training and development to affect job satisfaction within franchising. J Small Bus Enterp Dev. 2007;14(2):339–352.
  18. Chowdhary N, Prakash M. Prioritizing service quality dimensions. Manag Serv Qual. 2007;17(5):493–509.
  19. Curry AC, Sinclair E. Assessing the quality of physiotherapy services using SERVQUAL. Int J Health Care Qual Assur. 2002;15(5):197–205.
  20. Das A, Paul H, Swierczek FW. Developing and validating total quality management (TQM) constructs in Thailand’s manufacturing industry. Benchmarking. 2008;15(1):52–72.
  21. Dilber M, Bayyurt N, Zaim S, Tarim M. Critical factors of TQM and its effect on performance in health care industry: A Turkish experience. Probl Perspect Manag. 2005;4:220–235.
  22. Duggirala M, Rajendran C, Anantharaman RN. Patient-perceived dimensions of total quality service in healthcare. Benchmarking. 2008;15(5):560–583.
  23. Ehigie BO, McAndrew EB. Innovation, diffusion and adoption of total quality management. Manag Decis. 2005;43(6):925–940.
  24. Eng Eng Q, Yusof SM. A survey of TQM practices in the Malaysian electrical and electronic industry. Total Qual Manag. 2003;14(1):63–77.
  25. Fleisher C, Nickel J. Attempting TQM in organizational staff areas. Can J Adm Sci. 1995;12(2):116–127.
  26. Flynn BB, Schroeder RG, Sakakibara A. A framework for quality management research and an associated instrument. J Oper Manag. 1994;11:339–366.
  27. Franklin CJ. Industry output and employment projections to 2006. Mon Labor Rev. 1997;120(11):39.
  28. Garvin DA. How the Baldrige Award really works. Harv Bus Rev. 1991;69(6):80–93.
  29. Goldstone L. A very ‘Pe’QA’liar practice. Nurs Times. 1991;87(20):41–43.
  30. Gorji AMH, Farooquie JA. A comparative study of TQM of health care systems in India and Iran. BMC Res Notes. 2011;4:566–570.
  31. Guven-Uslu P. Benchmarking in health services. Benchmarking. 2005;12(4):293–309.
  32. Hamidi Y, Zamanparvar A. Quality management in health systems of developed and developing countries. J Res Health Sci. 2008;8(2):40–50.
  33. Hampton T. Health agencies update. JAMA. 2006;296:384.
  34. Harrison DA, Newman DA, Roth PL. How important are job attitudes? Acad Manag J. 2006;49(2):305–325.
  35. Hoque Z. TQM and the balanced scorecard approach. Crit Perspect Account. 2003;14:553–566.
  36. Huq Z. Managing change: A barrier to TQM implementation in service industries. Manag Serv Qual. 2005;15(5):452–469.
  37. Ijaz A, Kee DMH, Irfan SM. Internal customer job satisfaction and role of TQM practices. Far East J Psychol Bus. 2012;6(2):1–14.
  38. Jeffries ID, Lee L. An approach to hospital quality improvement. Med Clin North Am. 1996;1:828–845.
  39. Johnson JG. Successful TQM is a question of leadership. J Qual Particip. 1990:16–20.
  40. Karassavidou E, Glaveli N, Papadopoulos CT. Quality in NHS hospitals: No one knows better than patients. Meas Bus Excell. 2009;13(1):34–46.
  41. Kumar V, Choisne F, de Grosbois D, Kumar U. Impact of TQM on company performance. Int J Qual Reliab Manag. 2009;26(1):23–37.
  42. Kunkel ST, Westerling R. Quality systems at a university hospital. Health Policy. 2006;76(2):125–133.
  43. Kruk ME, Freedman LP. Assessing health system performance in developing countries. Health Policy. 2008;85:263–276.
  44. Lim PC, Tang NKH. The development of a model for total quality healthcare. Manag Serv Qual. 2000;10(2):103–111.
  45. Lonial SC, Raju PS. Environment uncertainty and market orientation–performance relationship. J Econ Soc Res. 2001;3(1):5–27.
  46. Maleki MR, Izadi AR. Comparative study of two hospitals in Tehran based on excellence model. J Qazvin Univ Med Sci. 2008;12(2):63–68.
  47. Manjunath U, Metri BA, Ramachandran S. Quality management in health care organization: A case of South Indian hospital. TQM Mag. 2007;19(2):129–139.
  48. Martinez JA, Martinez L. Insights on conceptualizing and measuring service quality. J Retail Consum Serv. 2010;17(1):29–42.
  49. O’Connor EJ, Carman JM, Shortell SM, et al. Keys for successful implementation of TQM in hospitals. Health Care Manage Rev. 1996;21(1):48–60.
  50. O’Driscoll MP, Randall DM. Perceived organizational support and job involvement. Appl Psychol. 1999;48(2):197–209.
  51. Padma P, Rajendran C, Prakash LS. Conceptual framework of service quality in health care. Benchmarking. 2009;16(2):157–191.
  52. Pai Y, Chary S. Measuring hospital service quality: A conceptual framework. Proc Int Conf Humanit Econ Geogr. 2012.
  53. Patel G. Total quality management in healthcare. Midas J Med Imaging Comput. 2009;1:1–4.
  54. Prajogo DI, Cooper BK. People-related TQM practices and job satisfaction. Prod Plan Control. 2010;21(1):26–35.
  55. Pronovost P, Miller M, Wachter R. Tracking progress in patient safety. JAMA. 2006;296:696–699.
  56. Psychogios AG, Priporas CV. Understanding TQM in context. Qual Rep. 2007;12(1):40–66.
  57. Rad AMM. Survey of TQM in Iran: Barriers in health care organizations. Leadersh Health Serv. 2005;18(3):12–34.
  58. Rad AMM. Organizational culture and TQM implementation. TQM Mag. 2006;18(6):606–625.
  59. Raju PS, Lonial SC. Quality context and market orientation on performance. J Serv Res. 2001;4(2):140–154.
  60. Raju PS, Lonial SC. Service quality and marketing on financial performance. J Retail Consum Serv. 2002;9:335–348.
  61. Ramseook-Munhurrun P, Munhurrun V, Panchoo A. TQM adoption in a public hospital: Evidence from Mauritius. Glob J Bus Res. 2011;5(3):67–77.
  62. Ritu N. Measuring perceived quality of health care services in India. Int J Health Care Qual Assur. 2010;23(2):171–186.
  63. Salaheldin SI. Critical success factors for TQM implementation. Int J Product Perform Manag. 2009;58(3):215–237.
  64. Saraph JV, Benson PG, Schroeder RG. Instrument for measuring critical factors of quality management. Decis Sci. 1989;20(4):810–829.
  65. Schalk R, van Dijk W. Quality management and employee commitment in Dutch health care. Int J Health Care Qual Assur. 2005;18(3):170–178.
  66. Sluijs EM, Outinen M, Wagner C, et al. Legislative vs non-legislative policy in health care. Health Policy. 2001;2:99–119.
  67. Sluijs EM, Wagner C. Implementation of quality management in Dutch health care 1995–2000. Int J Qual Health Care. 2003;15:223–234.
  68. Smith AM. Consumer benchmarking criteria in service sector. Benchmarking. 2000;7(5):373–388.
  69. Tadiar FM. Medical records management in Philippine hospitals. UPIPHAS J. 1985;11(1).
  70. Talib F, Rahman Z, Qureshi MN. Relationship between TQM and quality performance in service industry. Int J Bus Manag Soc Sci. 2010;1(1):113–128.
  71. Taner T, Antony J. Comparing public and private hospital care service quality in Turkey. Leadersh Health Serv. 2006;19(2):i–x.
  72. Tari JJ, Sabater V. Human aspects in quality management. Int J Hum Resour Manag. 2006;17(3):484–503.
  73. Taylor WA, Wright GH. Senior managers’ commitment and TQM success. Int J Manpower. 2003;24(5):535–550.
  74. Vouzas F, Psychogios AG. Assessing managers’ awareness of TQM. TQM Mag. 2007;19(1):62–75.
  75. Wagner C, Groenewegen PP, de Bakker DH, et al. Environmental and organizational determinants of quality management. Qual Manag Health Care. 2001;4:63–76.
  76. Wagner C, Ikkink KK, van der Wal G. Quality management systems and clinical outcomes in Dutch nursing homes. Health Policy. 2006;75(2):230–240.
  77. Waldman DA. Leadership and total quality management. Leadersh Q. 1993;4:65–79.
  78. Weiner BJ, Alexander JA, Shortell SM, et al. Quality improvement implementation and hospital performance. Health Serv Res. 2006;41(2):307–334.
  79. Williams SJ. Patient satisfaction: A valid concept? Soc Sci Med. 1994;38(4):509–516.
  80. Yang CC. Establishment of a TQM system for the health care industry. TQM Mag. 2003;15(2):93–98.
  81. Yavas U, Bilgin B, Shemwell DJ. Service quality in the banking sector in an emerging economy. Int J Bank Mark. 1997;15(6):217–223.
  82. Yavas U, Shemwell DJ. Modified importance-performance analysis: Application to hospitals. Int J Health Care Qual Assur. 2001;14(3):104–110.
  83. Youssef FN, Nel D, Bovaird T. Healthcare quality in NHS hospitals. Int J Health Care Qual Assur. 1996;9(1):57–66.

Tools


Copyright © 2026  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic