Title: Enhancing Total Quality Management and Service ... - nedsi

Recommendations

Info

care quality through quality improvement measures, healthcare organization management must also avoid the incidents that may jeopardize care quality, leading to healthcare cost increase. The negligence of healthcare, other than the negative effect on healthcare quality, would also affect the image of healthcare organization and endanger patients’ life and safety [7]. Therefore, patient safety has become an issue of common concern for all healthcare organizations internationally. The extant studies that explored TQM [8, 9] or patient safety management [10,11] in healthcare organizations focused only on a single issue. To the nursing managers of a healthcare organization, how can they solve the managerial problems of promoting healthcare benefit to their patients and simultaneously cut back on healthcare costs? This study aims, through empirical study, to link TQM and patient safety management to further understand their impacts on service quality. Through theory confirmation, this study intends to provide nursing manager an effective managerial tool to solve the problem. The research framework is shown in Figure 1. BACKGROUND Total quality management (TQM) is defined as both an integrative philosophy of management for the continuous improvement of services and service delivery to achieve customer satisfaction [12]. Through vigorous approaches, it helps nursing management build a clear quality management strategy to urge nurses to take quality as the goal of health care. To ensure that the quality strategy set by the nursing management can be implemented by the nurses, it is necessary to have a supplementary management approach to facilitate the execution of quality strategy. Patient safety management has been defined as “the avoidance, prevention and amelioration of adverse outcomes or injuries stemming from the process of healthcare” [13]. By this definition, patient safety management is a service delivery approach [14] that can reduce the incidence of negative outcomes as a patient is exposed to infectious agents or undergoes procedures in the healthcare process [15]. It employs managerial functions to reduce the incidences affecting healthcare quality due to nurses’ negligence. Therefore, TQM and patient safety are positively correlated. The desired outcome of healthcare is the solution of the patient’s problems in health or illness. Because any accidents or errors may jeopardize the patient’s safety or health, there should be no accidents or errors during the healthcare delivery process that might cause the negative impact on healthcare outcomes. Patient safety management stresses that healthcare personnel should minimize exposing patients to infectious agents in healthcare environment or any adverse events during treatment. With the practice of patient safety management, nursing managers can adopt preventive measures to avoid any possible errors or accidents while providing nursing care. Therefore, patient safety management can ensure that nursing staff provides better service to their patients. Patient safety management and service quality are positively correlated. It is acknowledged that sustainable quality improving efforts help maintain healthcare quality [1]. TQM is a management philosophy that stresses the necessity of focusing on customer satisfaction through sustainable quality improvement activities. To fulfill patient satisfaction, nursing managers will, through quality improvement measures, advance nurses’ care quality in the process of providing health care. Thus, TQM and service quality are positively correlated. The advancing of technology made it much easier for the patients to have the access to health care related knowledge. Healthcare pattern is no longer a doctor-centered practice; patients also have higher expectation on healthcare quality. In recent years, some scholars 2
have promoted the pattern of consumer-driven healthcare[16]. TQM encourages continuing nursing staff education to ensure nursing staff are equipped with sufficient competency and knowledge to respond to the patient’s nursing care needs. TQM focuses on creating patient’s value through quality improving activities. By establishing quality improving managerial practices, the nursing staff should improve patient satisfaction. Patient safety management is a preventive approach taken by nursing staff to avoid negative nursing care consequences during the care process [17]. TQM supports nursing staff in maintaining and improving nursing care quality. When a nursing manager practices patient safety management, it decreases the possibility of negative events that lower service quality [18]. Therefore, patient safety management supports the nursing staff’s TQM efforts to promote better service quality. Patient safety management moderates the impact of TQM on service quality. METHODS This research employs a cross-sectional design to study nursing staff of various hospitals in Taiwan. A Questionnaire survey was employed for data gathering. The researchers first made phone enquiries of regional hospitals to determine their interest in participating in the investigation. Four medical centers agreed to allow their nursing staff to participate voluntarily. A total of 300 copies of the questionnaire were distributed, with 245 completed surveys returned. The period of the entire process of distribution and return were from June 1, 2011 to June 21, 2011. Given the subjective nature of the variables considered in the study, multi-item, five-point Likert scales were used (1=strongly disagree to 5=strongly agree). TQM refers to the Motwani [19] framework. Patient safety management drew upon the research of Sorra and Nieva[20] who noted that, if a list of items is too long, this will influence the responders’ completion of the questionnaire. Therefore, 15 items were selected. Service quality was measured with a modified version of Parasuraman et al. [21]. RESULTS Descriptive statistics and correlations Table 1 shows the descriptive statistics and correlation matrix for the study variables. Table 1 Descriptive statistics and inter-correlations among main variables (n=245) M SD 1 2 3 4 5 6 1. Gender a - - - 2. Age (decades) 3.00 0.82 -.18** - 3. Position b - - .02 .30** - 4. TQM 4.01 0.54 .07 .16* .09 - 5. Patient safety management 3.84 0.54 -.02 .14* .05 .75** - 6. Service quality 4.29 0.48 -.07 .34** .14* .53** .47** - Note: a Gender was coded as 1 = male and 0 = female; b Position was coded as 1 = manager and 0 = staff *p
Page 1: ENHANCING TOTAL QUALITY MANAGEMENT
Page 5 and 6: healthcare staff to promote patient
Page 7: [20] Sorra J, Nieva V. Pilot study:

Title: Enhancing Total Quality Management and Service ... - nedsi

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?