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

healthcare staff to promote patient safety [31]. Claridge et al. [32] found in-service education
promotes patient safety. This study found nursing leaders not only can promote patient safety
through education and training, but can impact nurses in their service quality. When nursing
managers promote total quality care, through education and training, they can also enhance
nursing staff’s competency and influence their service quality to the patients. This research,
through statistical analysis, found a significant, positive relationship between TQM and
patient safety management, which supports the theory of Claridge et al. [32] .
Some scholars thought that, because frontline nursing staff provides care to the patients,
the nursing managers should empower their nursing staff to provide timely care [14] .
Richardson and Storr [14] thought empowerment of nursing staff by nursing leaders helps
nurses provide timely care and improves service quality. Armellino et al. [11] also found that
an employee empowerment and patient safety management culture are significantly
positively related. This study concluded that nursing leaders’ empowering nurses is one of the
factors in nursing leaders’ enhancing TQM; TQM and patient safety management are
statistically positively correlated. This conclusion supported the argument that TQM and
patient safety management are positively correlated. This study also found among the
research samples, high TQM samples demonstrated higher service quality for high patient
safety management group than low patient safety group. The finding supported the argument
that “patient safety management is the moderating variable between TQM and service
quality.” When nursing leaders promote TQM to impact the nursing staff’s service quality, it
is suggested that they can integrate patient safety management for a more efficient outcome.
Previous studies have shown that staff characteristics influence service quality. Marjorie
and Cattaneo [25] found that employee characteristics (including age, position, and gender)
can impact service quality. Tsai and Wu [26] indicated that nursing staff’s age affects service
quality. Therefore, in testing H4, gender, age, and position are considered as control variables.
Statistical analyses further validated the impact of TQM on patient safety management, with
patient safety management as the moderating variable between TQM and service quality. This
means that the level of the hospital’s patient safety practices will influence how TQM affects
service quality. When hospitals promote greater patient safety, TQM has a larger effect on
service quality. This conclusion verified our hypothesis; i.e. patient safety management and
TQM are complementary.
CONSLUSIONS
Patient safety is a complicated phenomenon. Nursing managers should understand the impact
that patient safety management practices have on nursing care, on the healthcare environment,
or even on nursing management[33]. Runciman et al. [34] conducted epidemiological
research on patient safety and suggested that future research should explore how to
implement patient safety practices in healthcare. The present empirical, hospital-based study
linked patient safety management with TQM concepts and explored its impacts on the quality
of healthcare service outcomes. This study found that patient safety management can
moderate the impact of TQM on service quality. It is suggested that nursing managers, when
implementing quality improvement activities to improve nursing care quality, also
incorporate patient safety practices to optimize the results.
REFERENCES
[1]Batalden P, Davidoff F. What is “quality improvement” and how can it transform
healthcare? Quality and Safety in Health Care 2007; 16: 2-3.
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