Implementing Quality Management Systems

Implementi ng Quality Manageme nt Systems Mid-term Case Study

Contents Management Philosophies.........................................................................................................3 Control Based Management Philosophy................................................................................3 Commitment Based Management Philosophy.......................................................................3 First:...................................................................................................................................3 Second:...............................................................................................................................3 Two main differences between Management Philosophies.......................................................3 First Difference......................................................................................................................3 Second Difference..................................................................................................................4 Underlying assumptions leading to commitment based management philosophy....................4 Implementation cornerstones of the model................................................................................4 Hierarchical and Status Differences.......................................................................................4 Involvement and Communication..........................................................................................4 Fair Management Practices....................................................................................................5 Transformational Leadership.................................................................................................5 Key challenges to Implementation.............................................................................................5 Culture and Systems of Health care industry.........................................................................5 Increased Regulations............................................................................................................6 Positive and possible negative outcomes of the commitment based management philosophy. 6 Positive Outcomes..................................................................................................................6 High Quality of Care..........................................................................................................6 Safe Patient Care................................................................................................................6 Reduce Medical Errors.......................................................................................................6 Negative outcomes.................................................................................................................6

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Management Philosophies The following two management philosophies on human motivation were used to reduce medical errors and increase the quality of patient care.

Control Based Management Philosophy The control based management philosophy assumes that employees are incapable of managing their behaviour and work themselves and they need to be regulated by a manager. Eventually control based management control is exerted on the employees to finished they required task while maintaining the quality. Control based management philosophy advocates the use of different control mechanics to monitor the employee behaviour.

Commitment Based Management Philosophy The commitment based management has two assumptions which are: First: People are capable of self discipline and when ever given a responsibility they will fulfil the expectations. Second: People commit to organization when they are trusted and they work best when they are committed to organization and allowed to work independently. Therefore the commitment based management philosophy advocates that employees are reliable and they can manage their self behaviour.

Two main differences between Management Philosophies The two main differences between the management philosophies are as follows:

First Difference The major difference between the psychologies is the fact that people can manage their behaviour and self discipline. The Control Based Management supports the fact that people need to be controlled and cannot be trusted. The commitment based management supports the

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fact that people perform best when they are independent to work and they commit to the organization when trusted and they do not require control mechanics.

Second Difference The second difference between the two management philosophies is the motivation factor, the control based management supports the fact that money is the only motivator for the workers, whereas commitment based management advocates that money is one of the factors but not the only factor which employees seek from an organization. Control based management focuses on lower level needs and ignores the higher level needs.

Underlying assumptions leading to commitment based management philosophy The underlying assumptions leading to commitment based management are: 1. Lower Medical Errors: It promotes employees to learn from their mistakes, as there is no culture of blaming and exerting pressure for control. Commitment based management has fewer layers making it more decentralized and easier for employees to discuss the problems with seniors. Consequently more emphasis is on searching the cause of mistakes and learning from then in an open and trusting environment. 2. High Employee Morale & Involvement: Commitment based management also increases the motivation level of employees given them more sense of belongingness and responsibility eventually increasing the positive energy in the organization. Such positive atmosphere is required to increase the patient care and reduce medical errors.

Implementation cornerstones of the model Hierarchical and Status Differences In the current control based health care system there are rigid hierarchies and un-necessary privileges which are a limitation for the implementation of an error reporting system. Consequently the medical error reporting systems fail and doctors have to rely on control based mechanisms to deal with errors. Therefore to implement commitment based management philosophy the hierarchies will have to be broken down into fewer layers.

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Involvement and Communication Employee involvement and communication is also a challenge as in the current control based system the employees are de-motivated and show no involvement in the organization. Lack of involvement is also because of the lack of communication with seniors due to hierarchical layers. Employee involvement and communication has two effects on the employees which are work harder and work smarter. Due to these to effects of commitment based management the cost incurred to apply strict control mechanism could be saved.

Fair Management Practices To reduce errors and increase patient care just management practices are an integral part of the system, which will also create a sense of commitment in the employees. Eventually employees take more responsibility and help to bring down the medical errors. In the current control based system a lack of fair appraisal systems and rewards also contributes in lack of commitment and motivation in employees. Thus ensuring fair appraisal system and management practices are vital in increasing the performance and patient care quality.

Transformational Leadership Application of commitment based management requires transformational leadership where leaders are more adaptive to human behaviour. Commitment based management requires leaders who can create a sense of responsibility and spark the need to change for continuous development. Transformational Leaders are people who can hire managers with required skills and promote doctors and nurses on basis of fair appraisals. Contrary to current control based systems where nurses and doctors are not promoted on basis of fair performance appraisals.

Key challenges to Implementation Culture and Systems of Health care industry One of the key challenges in implementing commitment based management philosophy is the prevailing culture in the health care industry. The culture promotes lack of commitment and irresponsibility to the job. Implementing commitment based management would be a challenge in such environment. Consequently the current culture and systems of health care

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industry are a key challenge in implementing commitment based management philosophy and reducing medical errors to increase patient care.

Increased Regulations Increased regulations also promote the control based psychology increase the control mechanisms and exerting control based management. Increased regulations also are a key challenge in implementation of commitment based management philosophy.

Positive and possible negative outcomes of the commitment based management philosophy Positive Outcomes High Quality of Care Commitment Based management increase the quality of care by reducing the medical errors because employees work in close collaboration and with sense of responsibility. Also the leaders and managers help their subordinates to learn from errors and resolve the cause of errors ultimately increasing the quality of care. Safe Patient Care Commitment based management also promotes safe management practices, which increases the sense of responsibility among employees and eventually ensures safe care patient. Reduce Medical Errors Commitment based management philosophy also helps to reduce medical errors with the help of application of medical error reporting systems.

Negative outcomes Commitment based management makes employees independent in terms of control over their job which could be taken for granted by employees and may result in irresponsibility. Such working atmosphere will also promote lack of initiative and motivation.

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