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Total management, not total quality management.

V C Sherman

    Journal of Quality Assurance : a Publication of the National Association of Quality Assurance Professionals
    |December 10, 1990
    PubMed
    Summary
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    Hospitals often fail due to a lack of a comprehensive total management (TM) approach, hindering initiatives like total quality management (TQM). Implementing TM is crucial for successful quality improvement in healthcare organizations.

    Area of Science:

    • Healthcare Management
    • Organizational Development
    • Quality Improvement Science

    Context:

    • Hospitals frequently face quality problems stemming from inadequate management practices.
    • Existing management approaches often result in fragmented, reactive problem-solving.
    • Initiatives such as Total Quality Management (TQM) are jeopardized in crisis-driven environments.

    Purpose:

    • To highlight the critical need for a Total Management (TM) framework in healthcare.
    • To emphasize that organizational reorientation towards TM is a prerequisite for quality success.
    • To establish TM as the foundational element for implementing specific change tools like TQM.

    Summary:

    • Hospitals fail due to a lack of a unified Total Management (TM) approach, leading to reactive, crisis-based operations.

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  • Individual quality improvement projects, including Total Quality Management (TQM), are unlikely to succeed without a TM foundation.
  • Successful quality enhancement requires an initial organizational development phase to adopt TM principles and culture.

    • Impact:

    • Adopting a Total Management (TM) approach can prevent hospital failures attributed to poor management.
    • TM provides the necessary organizational structure and culture for effective implementation of quality improvement tools like TQM.
    • This strategic reorientation fosters a proactive environment, enhancing the sustainability and success of quality initiatives.