Managing Quality Safety and Individual Performance in Healthcare Essay

With the ever-changing health care sector, reimbursement has increasingly been tied to care quality and health care outcomes. The Centers for Medicare and Medicaid Services (CMS) have particularly been changing the way hospitals are reimbursed, with hospitals that deliver high quality care and report better health outcomes getting higher reimbursements than those that perform poorly. This has led to increasing prominence of the pay-for-performance approach. Under this approach, hospitals that report greater patient satisfaction, reduced error rates, lower readmission rates, and higher recovery rates for chronic illness get higher reimbursements than their poorly-performing counterparts. The implication is that health care organizations must pay greater attention to performance, especially in terms of quality, safety, and individual performance. Measurement and models used in the commercial world for these three aspects are considerably relevant to the health care sector. This paper discusses the usefulness of the total quality management (TQM) model, the Organization for Economic Cooperation and Development (OECD) Safety Performance Management Framework, and the balanced scorecard in the health care sector.

Total Quality Management

TQM is a management philosophy that advocates for organization-wide and continuous improvement of an organization's products and processes. The philosophy espouses five major principles: customer focus, management commitment, employee empowerment, continuous improvement, and evidence-based decision making (Kaynak & Rogers, 2013). The element of customer-focus means that every decision an organization makes and process it undertakes is geared towards creating value for the customer. From strategic planning and personnel management to product decisions, the organization places the customer above everything else. Management commitment is about the management of the organization mobilizing and providing the necessary resources as well as creating and maintaining a culture of quality improvement. Indeed, a culture of quality improvement is an important element of quality management. The organization continuously measures quality, builds on successes, and improves on weaknesses. Ongoing measurement of quality means that the organization makes every decision based on authentic data as opposed to intuition. Finally, the element of employee empowerment means that employees are involved in decision making and motivated properly.



With its origin in the Japanese manufacturing industry in the 1960s, TQM has over the years found relevance in other industries and sectors. Organizations, large and small, and across the public and private sectors, have increasingly embraced TQM in an attempt to improve their products, services, and/or processes. One of the contexts where TQM has become ever more relevant is healthcare. Customer focus is one of the major concepts of TQM. In the health care sector, quality care is a vital driver of patient satisfaction. This explains why the notion of patient-centered care has gained immense popularity in the health care sector. Another aspect of TQM is fact-based decision making. Evidence-based care is integral for health care effectiveness and efficiency, further substantiating the relevance of TQM to the health care sector. The usefulness of TQM in health care further stems from the concept of employee empowerment. Issues such as understaffing, job dissatisfaction, overstretched work schedules, and employee turnover remain major concerns in the health care sector, meaning deficiencies in employee empowerment. Without addressing these issues, achieving the desired health outcomes can be quite difficult.



In practice, TQM has indeed been applied in the health care sector, and the outcomes have been quite impressive. TQM has been effective in improving patient satisfaction, reducing medical errors, shortening wait times, promoting patient-centeredness, improving productivity, as well as fostering evidence-based practice, continuous quality improvement, and interdisciplinary teamwork (Balasubramanian, 2016). Nonetheless, the implementation of TQM in the health care sector has its fair share of challenges, largely due to resource constraints and lack of proper understanding of the philosophy and specifically how it applies to the sector (Balasubramanian, 2016).

OECD Safety Performance Management Framework

Workplace safety is an important aspect of management framework. Creating and maintaining a workplace that is secure for everyone within the organization can prevent the loss of property, injuries, loss of productivity, morbidities, mortalities, legal claims, and associated costs. One widely used tool for safety performance is the OECD Safety Performance Management Framework. Business enterprises, public sector organizations, and communities can utilize the model to ensure health and safety at the workplace. The model involves specifying the acceptable level of safety performance, gathering data, evaluating performance against the specified performance level, and taking remedial action to achieve the desired performance level (Janicak, 2010).



Though the OECD framework was originally developed for business enterprises,…