Avoiding the quality assurance boondoggle in drug treatment programs through total quality management

This paper considers limitations to three often-used approaches for improving treatment quality in a drug abuse treatment program: supervisory review, internal program evaluations, and standard quality assurance. Total Quality Management (TQM) is then presented as a technique that maximizes the effectiveness of quality-improvement strategies and builds on them by establishing a more comprehensive approach to improving treatment quality. This paper recommends issues for treatment providers to consider in designing an efficacious TQM approach. Specific organizational characteristics are discussed that can either enhance or defeat TQM. The program should be goal oriented and have the broad commitment of staff and management to quality improvement. It should also have a well-defined and tailored system for monitoring, feedback, and change. Moreover, the program should delegate authority and responsibility to staff for improvements, possess organizational readiness, and contain an evaluative component that can determine whether TQM is meeting the program's needs.