Food-Service-Manual-for-Health-Care-Institutions

Food Service Manual for Health Care Institutions
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Creating a CQI Culture
To create a culture that fosters CQI, an organization or department must adhere to the principles
for creating a participative culture as described in Chapter 2. Culture, identified as the way
things get done in an organization, influences not only how employees view and perform their
jobs and how they work with colleagues but also how they view their customers and how they
view quality.
Principles That Drive a CQI Culture
CQI requires the integration of quality and change management methods, practices, concepts,
and beliefs into an organization’s current culture. Adopting any CQI process means integrating
a focus on quality into all aspects of the organization, making it everyone’s priority. Three
principles are essential to establishing a CQI culture:
• Leadership and commitment from the top
• Customer orientation and focus
• Involvement of the total organization in improving quality for customer satisfaction
Leadership and Commitment from the Top
Ideally, an organizational culture that promotes CQI has commitment from top leadership,
including the board and other management staff. CEOs who were interviewed spent an average
of 17 percent of their workweek time directing or reviewing their organization’s CQI
efforts. Each decade this percentage increases, mainly due to patients’ demands and surveying
agencies’ standards. This type of commitment from upper leadership is necessary to sustain
CQI. Leaders in CQI organizations recognize the need for employee participation and team
building. Their role consists of coaching, teaching, facilitating, and empowering.
Creating a CQI environment takes structure, planning, training, trust, patience, rewarding
positive change, and most important, time. Developing a CQI culture can take five to ten years,
which is not surprising considering the complexity of most health care organizations. For suggestions
on creating a participative environment that empowers employees and fosters teamwork,
see chapters 2 and 6.
Gauging commitment from the top may include assembling leadership profiles of all managers
and their leadership philosophies and practices. Once the profiles are completed and
assessed, training sessions can be developed to address specific areas and move managers
toward participative leadership. Some of these areas may include team building, change management,
coaching for quality-oriented performance, and developing a customer orientation.
Starting at the management level before introducing CQI to an entire organization is important;
without top-level commitment and support, employees become frustrated in their
attempts to practice CQI.
Leadership commitment must be ongoing, even after employee CQI practices have been
implemented. Employees need time to attend scheduled team meetings and carry out improvement
plans. Nutrition and food service managers may find it difficult to encourage employee
involvement without first leading a few teams as success models. Management is responsible
for providing structure by ensuring that all employees participate in training sessions and
understand their role in achieving customer satisfaction.
Customer Orientation and Focus
A customer-focused organization recognizes the need to identify and exceed customers’ expectations.
An organization focused on quality improvement recognizes that the purpose of
improvement is to provide the best service at the lowest possible cost and that without this
value-driven goal, customer orientation is futile. Potential customers—individual patients,
physicians, and managed care organizations—have choices when it comes to selecting health