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PubMed1994

Five years of total quality management: Campbelltown Hospital.

There are many articles in the health literature outlining either a framework for total quality management (TQM) or a success story. There is a dearth of literature reflecting the shortcomings of total quality management during implementation. Yet many of the world's most successful companies learn by reflecting about their past, for example, British Petroleum, IBM, Boeing, Xerox. This paper describes, from a general manager's perspective, the practical application of total quality management to a hospital setting over five years. The paper outlines the important ingredients to success and the shortcomings encountered along the way. Supporting literature is cited where appropriate. Strategies that were implemented contrary to common total quality management thinking are highlighted. The paper concludes with an outline of the four key lessons learnt over the five-year period.

Decision Making, Organizational↗
PubMed1995

Culture, chaos, and refounding. How leaders can refound the Catholic health ministry.

Culture provides us with what we so desperately need in human life--a set of felt meanings in an orderly pattern. A group creates a culture as a way to cope with life's challenges and teach members the correct way to feel, think, and behave. No group is ever without a culture. If culture has a built-in tendency to resist change, how does change take place at all? The process of change involves separation, chaos, and reentry--the letting go of the old and familiar and the embracing of the uncertain new. The way to use chaos constructively is for people to return to the sacred time of their founding in order to identify, relive, and reown the heart of their creation mythology, liberated from the accidental and historical accretions that hold back creativity. For healthcare workers today, this means reidentifying with Christ's actions such as healing the sick or giving sight to the blind. Through this reidentification, healthcare givers can be fired up to form a new cultural integration adapted to changing needs. The chaos that our healthcare ministry is experiencing today offers us unparalleled opportunities for refounding. By acknowledging the chaos of the healthcare system, we thus lock in on the healing and reconciliatory power of God, and from this comes the energy to journey through the refounding process--the process whereby we struggle to enter collaboratively into the paschal mystery with Christ for his mission of healing; thus energized, we work to challenge systems and to create responses to the most urgent needs confronting the health of the people we serve.

Catholicism↗
PubMed1995

Cost reduction using patient-focused care concepts.

The latest wave of hospital reengineering has been based on the concepts of patient-focused care (PFC). PFC concepts include decentralizing low-scale activities to the point-of-care, cross-training employees to minimize hand-offs, simplifying processes to eliminate unnecessary complexity, redesigning the organization structure to focus on the care continuum, and adopting empowerment and teamwork to change individual behavior. Three innovative health systems have begun to reap the benefits of their PFC implementation efforts. Based on these three case study organizations, PFC is not only cost-justified, but also drives increases in quality and service levels. Each of the three case study organizations chose significantly different routes to implement these concepts due to various internal and external factors. Size of cost savings was the result of three main factors: level of change implemented, size of investment required to effect change, and time frame for implementation. Article includes results of economic analysis.

Attitude of Health Personnel↗