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Implementing TQM in the health care service
Eva Lindberg1, Urban Rosenqvist
1Center for Clinical Research, University of Uppsala-Gävleborg, and Department of Public Health and Caring Sciences, Health Service Research, University of Uppsala, Uppsala, Sweden.
Summary
Total quality management (TQM) implementation in an ICU led to increased workload and significantly higher sick leave, despite stable organizational factors. Adapting to ambiguity is crucial for quality development.
Area of Science:
- Healthcare Management
- Organizational Psychology
- Quality Improvement Science
Background:
- Total Quality Management (TQM) is a framework for enhancing organizational performance.
- Intensive Care Units (ICUs) face unique challenges in implementing quality improvement initiatives.
- Longitudinal studies are essential for understanding the long-term impact of organizational changes.
Purpose of the Study:
- To present a four-year case study on the implementation of TQM in an ICU.
- To analyze the consequences of TQM on organizational climate, workload, and staff well-being.
- To explore the relationship between TQM, organizational ambiguity, and staff health outcomes.
Main Methods:
- A longitudinal case study design was utilized.
- Data on organizational climate, workload, and staff well-being were collected over four years.
- Analysis incorporated organizational theories on complex adaptive systems and sensemaking.
Main Results:
- Workload increased by 20%, while organizational and individual variables remained stable.
- Sick leave increased dramatically, exceeding national averages.
- Organizational ambiguity emerged as a significant and growing problem, impacting management and quality development.
Conclusions:
- ICUs can adapt to increased workload by regulating working hours.
- The study suggests factors beyond common assumptions contribute to high sickness absence.
- Effective management of ambiguity and utilization of quality systems are vital for continuous improvement.