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Total quality management: three case studies from around the world

With organisations to run and big orders to fill, it’s easy to see how some ceos inadvertently sacrifice quality for quantity. by integrating a system of total quality management it’s possible to have both.

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There are few boardrooms in the world whose inhabitants don’t salivate at the thought of engaging in a little aggressive expansion. After all, there’s little room in a contemporary, fast-paced business environment for any firm whose leaders don’t subscribe to ambitions of bigger factories, healthier accounts and stronger turnarounds. Yet too often such tales of excess go hand-in-hand with complaints of a severe drop in quality.

Food and entertainment markets are riddled with cautionary tales, but service sectors such as health and education aren’t immune to the disappointing by-products of unsustainable growth either. As always, the first steps in avoiding a catastrophic forsaking of quality begins with good management.

There are plenty of methods and models geared at managing the quality of a particular company’s goods or services. Yet very few of those models take into consideration the widely held belief that any company is only as strong as its weakest link. With that in mind, management consultant William Deming developed an entirely new set of methods with which to address quality.

Deming, whose managerial work revolutionised the titanic Japanese manufacturing industry, perceived quality management to be more of a philosophy than anything else. Top-to-bottom improvement, he reckoned, required uninterrupted participation of all key employees and stakeholders. Thus, the total quality management (TQM) approach was born.

All in Similar to the Six Sigma improvement process, TQM ensures long-term success by enforcing all-encompassing internal guidelines and process standards to reduce errors. By way of serious, in-depth auditing – as well as some well-orchestrated soul-searching – TQM ensures firms meet stakeholder needs and expectations efficiently and effectively, without forsaking ethical values.

By opting to reframe the way employees think about the company’s goals and processes, TQM allows CEOs to make sure certain things are done right from day one. According to Teresa Whitacre, of international consulting firm ASQ , proper quality management also boosts a company’s profitability.

“Total quality management allows the company to look at their management system as a whole entity — not just an output of the quality department,” she says. “Total quality means the organisation looks at all inputs, human resources, engineering, production, service, distribution, sales, finance, all functions, and their impact on the quality of all products or services of the organisation. TQM can improve a company’s processes and bottom line.”

Embracing the entire process sees companies strive to improve in several core areas, including: customer focus, total employee involvement, process-centred thinking, systematic approaches, good communication and leadership and integrated systems. Yet Whitacre is quick to point out that companies stand to gain very little from TQM unless they’re willing to go all-in.

“Companies need to consider the inputs of each department and determine which inputs relate to its governance system. Then, the company needs to look at the same inputs and determine if those inputs are yielding the desired results,” she says. “For example, ISO 9001 requires management reviews occur at least annually. Aside from minimum standard requirements, the company is free to review what they feel is best for them. While implementing TQM, they can add to their management review the most critical metrics for their business, such as customer complaints, returns, cost of products, and more.”

The customer knows best: AtlantiCare TQM isn’t an easy management strategy to introduce into a business; in fact, many attempts tend to fall flat. More often than not, it’s because firms maintain natural barriers to full involvement. Middle managers, for example, tend to complain their authority is being challenged when boots on the ground are encouraged to speak up in the early stages of TQM. Yet in a culture of constant quality enhancement, the views of any given workforce are invaluable.

AtlantiCare in numbers

5,000 Employees

$280m Profits before quality improvement strategy was implemented

$650m Profits after quality improvement strategy

One firm that’s proven the merit of TQM is New Jersey-based healthcare provider AtlantiCare . Managing 5,000 employees at 25 locations, AtlantiCare is a serious business that’s boasted a respectable turnaround for nearly two decades. Yet in order to increase that margin further still, managers wanted to implement improvements across the board. Because patient satisfaction is the single-most important aspect of the healthcare industry, engaging in a renewed campaign of TQM proved a natural fit. The firm chose to adopt a ‘plan-do-check-act’ cycle, revealing gaps in staff communication – which subsequently meant longer patient waiting times and more complaints. To tackle this, managers explored a sideways method of internal communications. Instead of information trickling down from top-to-bottom, all of the company’s employees were given freedom to provide vital feedback at each and every level.

AtlantiCare decided to ensure all new employees understood this quality culture from the onset. At orientation, staff now receive a crash course in the company’s performance excellence framework – a management system that organises the firm’s processes into five key areas: quality, customer service, people and workplace, growth and financial performance. As employees rise through the ranks, this emphasis on improvement follows, so managers can operate within the company’s tight-loose-tight process management style.

After creating benchmark goals for employees to achieve at all levels – including better engagement at the point of delivery, increasing clinical communication and identifying and prioritising service opportunities – AtlantiCare was able to thrive. The number of repeat customers at the firm tripled, and its market share hit a six-year high. Profits unsurprisingly followed. The firm’s revenues shot up from $280m to $650m after implementing the quality improvement strategies, and the number of patients being serviced dwarfed state numbers.

Hitting the right notes: Santa Cruz Guitar Co For companies further removed from the long-term satisfaction of customers, it’s easier to let quality control slide. Yet there are plenty of ways in which growing manufacturers can pursue both quality and sales volumes simultaneously. Artisan instrument makers the Santa Cruz Guitar Co (SCGC) prove a salient example. Although the California-based company is still a small-scale manufacturing operation, SCGC has grown in recent years from a basement operation to a serious business.

SCGC in numbers

14 Craftsmen employed by SCGC

800 Custom guitars produced each year

Owner Dan Roberts now employs 14 expert craftsmen, who create over 800 custom guitars each year. In order to ensure the continued quality of his instruments, Roberts has created an environment that improves with each sale. To keep things efficient (as TQM must), the shop floor is divided into six workstations in which guitars are partially assembled and then moved to the next station. Each bench is manned by a senior craftsman, and no guitar leaves that builder’s station until he is 100 percent happy with its quality. This product quality is akin to a traditional assembly line; however, unlike a traditional, top-to-bottom factory, Roberts is intimately involved in all phases of instrument construction.

Utilising this doting method of quality management, it’s difficult to see how customers wouldn’t be satisfied with the artists’ work. Yet even if there were issues, Roberts and other senior management also spend much of their days personally answering web queries about the instruments. According to the managers, customers tend to be pleasantly surprised to find the company’s senior leaders are the ones answering their technical questions and concerns. While Roberts has no intentions of taking his manufacturing company to industrial heights, the quality of his instruments and high levels of customer satisfaction speak for themselves; the company currently boasts one lengthy backlog of orders.

A quality education: Ramaiah Institute of Management Studies Although it may appear easier to find success with TQM at a boutique-sized endeavour, the philosophy’s principles hold true in virtually every sector. Educational institutions, for example, have utilised quality management in much the same way – albeit to tackle decidedly different problems.

The global financial crisis hit higher education harder than many might have expected, and nowhere have the odds stacked higher than in India. The nation plays home to one of the world’s fastest-growing markets for business education. Yet over recent years, the relevance of business education in India has come into question. A report by one recruiter recently asserted just one in four Indian MBAs were adequately prepared for the business world.

RIMS in numbers

9% Increase in test scores post total quality management strategy

22% Increase in number of recruiters hiring from the school

20,000 Increase in the salary offered to graduates

50,000 Rise in placement revenue

At the Ramaiah Institute of Management Studies (RIMS) in Bangalore, recruiters and accreditation bodies specifically called into question the quality of students’ educations. Although the relatively small school has always struggled to compete with India’s renowned Xavier Labour Research Institute, the faculty finally began to notice clear hindrances in the success of graduates. The RIMS board decided it was time for a serious reassessment of quality management.

The school nominated Chief Academic Advisor Dr Krishnamurthy to head a volunteer team that would audit, analyse and implement process changes that would improve quality throughout (all in a particularly academic fashion). The team was tasked with looking at three key dimensions: assurance of learning, research and productivity, and quality of placements. Each member underwent extensive training to learn about action plans, quality auditing skills and continuous improvement tools – such as the ‘plan-do-study-act’ cycle.

Once faculty members were trained, the team’s first task was to identify the school’s key stakeholders, processes and their importance at the institute. Unsurprisingly, the most vital processes were identified as student intake, research, knowledge dissemination, outcomes evaluation and recruiter acceptance. From there, Krishnamurthy’s team used a fishbone diagram to help identify potential root causes of the issues plaguing these vital processes. To illustrate just how bad things were at the school, the team selected control groups and administered domain-based knowledge tests.

The deficits were disappointing. A RIMS students’ knowledge base was rated at just 36 percent, while students at Harvard rated 95 percent. Likewise, students’ critical thinking abilities rated nine percent, versus 93 percent at MIT. Worse yet, the mean salaries of graduating students averaged $36,000, versus $150,000 for students from Kellogg. Krishnamurthy’s team had their work cut out.

To tackle these issues, Krishnamurthy created an employability team, developed strategic architecture and designed pilot studies to improve the school’s curriculum and make it more competitive. In order to do so, he needed absolutely every employee and student on board – and there was some resistance at the onset. Yet the educator asserted it didn’t actually take long to convince the school’s stakeholders the changes were extremely beneficial.

“Once students started seeing the results, buy-in became complete and unconditional,” he says. Acceptance was also achieved by maintaining clearer levels of communication with stakeholders. The school actually started to provide shareholders with detailed plans and projections. Then, it proceeded with a variety of new methods, such as incorporating case studies into the curriculum, which increased general test scores by almost 10 percent. Administrators also introduced a mandate saying students must be certified in English by the British Council – increasing scores from 42 percent to 51 percent.

By improving those test scores, the perceived quality of RIMS skyrocketed. The number of top 100 businesses recruiting from the school shot up by 22 percent, while the average salary offers graduates were receiving increased by $20,000. Placement revenue rose by an impressive $50,000, and RIMS has since skyrocketed up domestic and international education tables.

No matter the business, total quality management can and will work. Yet this philosophical take on quality control will only impact firms that are in it for the long haul. Every employee must be in tune with the company’s ideologies and desires to improve, and customer satisfaction must reign supreme.

Contributors

• Industry Outlook

Implementation of Total Quality Management (TQM): Toyota Case Study

Introduction, implementation of tqm in toyota, tqm practices in toyota, benefits of tqm in toyota, examples of tqm in toyota, toyota quality management, toyota tqm implementation challenges.

The Toyota Corporation case study report is based on the implementation of total quality management (TQM) meant to improve the overall performance and operations of this automobile company. TQM involves the application of quality management standards to all elements of the business.

It requires that quality management standards be applied in all branches and at all levels of the organization. The characteristic of Toyota Corporation going through the total quality process is unambiguous and clear.

Toyota has limited interdepartmental barriers, excellent customer and supplier relations, spares time to be spent on training, and the recognition that quality is realized through offering excellent products as well as the quality of the entire firm, including personnel, finance, sales, and other functions.

The top management at Toyota Corporation has the responsibility for quality rather than the employees, and it is their role to provide commitment, support, and leadership to the human and technical processes (Kanji & Asher, 1996).

Whereas the TQM initiative is to succeed, the management has to foster the participation of Toyota Corporation workers in quality improvement and create a quality culture by altering attitudes and perceptions towards quality.

This research report assesses the implementation of TQM and how Toyota manages quality in all organization management systems while focusing on manufacturing quality. The report evaluates the organization management elements required when implementing TQM, identifies, and investigates the challenges facing Quality Managers or Executives in implementing Quality Management Systems.

In order to implement TQM, Toyota corporations focused on the following phases:

• The company extended the management responsibility past the instantaneous services and products
• Toyota examined how consumers applied the products generated, and this enabled the company to develop and improve its commodities
• Toyota focused on the insubstantial impacts on the procedures as well as how such effects could be minimized through optimization
• Toyota focused on the kaizen (incessant process development) in order to ensure that all procedures are measurable, repeatable, and visible.

The commitment from business executives is one of the key TQM implementation principles that make an organization successful. In fact, the organizational commitment present in the senior organizational staff ranges from top to lower administration. These occur through self-driven motives, motivation, and employee empowerment. Total Quality Management becomes achievable at Toyota by setting up the mission and vision statements, objectives, and organizational goals.

In addition, the TQM is achievable via the course of active participation in organizational follow-up actions. These actions denote the entire activities needed and involved during the implementation of the set-out ideologies of the organization. From Toyota Corporation’s report, TQM has been successful through the commitment of executive management and the organizational workforce (Toyota Motor Corporation, 2012).

Through inventory and half the bottlenecks at half cost and time, the adopters of TMS (Toyota Management System) are authorized to manufacture twice above the normal production. To manage the quality in all organizational management systems, the Toyota Production System incorporates different modernisms like strategy or Hoshin Kanri use, overall value supervision, and just-in-time assembly.

The amalgamation of these innovations enables Toyota to have a strong competitive advantage despite the fact that Toyota never originated from all of them. The 1914 Henry Ford invention relied on the just-in-time production model. The Ford system of production, from a grand perspective, warrants massive production, thus quality (Toyota Motor Corporation, 2012).

Kanji and Asher (1996) claim that to manage the minute set of production necessitated by the splintered and small post-war marketplaces, the JIT system focuses on the motion and elimination of waste materials. This reduces crave for work-in-process inventory by wrapping up the long production lines. Toyota Corp wraps the production lines into slashed change-over times, a multi-trained workforce that runs manifold machines, and new-fangled cells into a U shape.

When supplementing the just-in-cells, the system of kanban is employed by the Toyota Corporation to connect the cells that are unable to integrate physically. Equally, the system helps Toyota integrate with other external companies, consumers, and suppliers.

The TQM and the creativity of Toyota proprietors both support the quality at the source. The rectification and discovery of the production problems require the executives to be committed. At the forefront of Toyota operations, the managers integrate a number of forms of operational quality checks to ensure quality management at all levels.

The uninterrupted tests help the Toyota workforce engaging in the assembly course to scrutinize the value of apparatus, implements, and resources utilized in fabrication. The checks help in the scrutiny of the previously performed tasks by other workers. However, the corporation’s own test enables the workers to revise their personal advances in the assembly course.

The Toyota process owners set up the mistake-proofing (Poka-yoke) procedures and devices to capture the awareness of management and involuntarily correct and surface the augmenting problems. This is essential for the critical production circumstances and steps that prove impractical and tricky for Toyota employees to inspect.

Nevertheless, the policy deployment system decentralizes the process of decision-making at Toyota. This context of implementing Total Quality Management originates from Hoshin Kanri’s management by objective (MBO).

This aspect becomes more advantageous to Toyota when dealing with quality management. The system initially puts into practice the coordinated approach and provides a clear structure for the suppliers, producers, and consumers through inter-organizational cost administration. Moreover, Toyota executives can solve the concurrent delivery, cost, and quality bottlenecks, thus replacing and increasing the relatively slow accounting management mechanisms.

Customer focus that leads to the desired customer satisfaction at Toyota Company is one of the major success factors in TQM implementation. For every business to grow, it should have understanding, reliable, and trustworthy customers. The principle of customer satisfaction and focus has been the most presently well-thought-out aspect of Toyota’s manufacturing quality.

The TQM may characteristically involve total business focus towards meeting and exceeding customers’ expectations and requirements by considering their personal interests. The mission of improving and achieving customer satisfaction ought to stream from customer focus.

Thus, when focusing on manufacturing quality, this aspect enhances TQM implementation. The first priorities at Toyota are community satisfaction, employees, owners, consumers, and mission. The diverse consumer-related features from liberty. The concern to care is eminent in Toyota Corporation during manufacturing.

Toyota has three basic perspectives of TQM that are customer-oriented. These are based on its manufacturing process traced back to the 1950s. The strategies towards achieving quality manufacturing, planning, and having a culture towards quality accomplishment are paramount for TQM implementation to remain successful. To enhance and maintain quality through strategic planning schemes, all managers and employers must remain effectively driven.

This involves training workers on principles concerning quality culture and achievement. Scheduling and planning are analytical applications at Toyota Company that purposes in assessing customer demand, material availability, and plant capacity during manufacturing.

The Toyota Corporation has considerable approaches that rank it among the successful and renowned implementers of TQM. From the inherent and designed structure of Toyota, it becomes feasible to comprehend why quality manufacturing is gradually becoming effective. The inspection department is responsible for taking corrective measures, salvaging, and sorting the desired manufactured product or service quality.

The Toyota Corporation also has a quality control system that is involved in determining quality policies, reviewing statistics, and establishing quality manuals or presentation data. Furthermore, quality assurance is one of the integral principles in quality implementation that is practically present at Toyota. The quality assurance and quality inspectors throughout the Toyota Company structure also manage research and development concerning the quality of manufactured products and services.

The Toyota production and operations management system is similarly dubbed as the managerial system. In fact, in this corporation, operational management is also referred to as the production process, production management, or operations (Chary, 2009). These simply incorporate the actual production and delivery of products.

The managerial system involves product design and the associated product process, planning and implementing production, as well as acquiring and organizing resources. With this broad scope, the production and operation managers have a fundamental role to play in the company’s ability to reach the TQM implementation goals and objectives.

The Toyota Corporation operations managers are required to be conversant and familiar with the TQM implementation concepts and issues that surround this functional area. Toyota’s operation management system is focused on fulfilling the requirements of the customers.

The corporation realizes this by offering loyal and express commodities at logical fees and assisting dealers in progressing commodities proffered. As Slack et al. (2009) observed, the basic performance objectives, which pertain to all the Toyota’s operations, include quality, speed, flexibility, dependability, and cost. Toyota Company has been successful in meeting these objectives through its production and operation functions.

Over several decades, Toyota’s operational processes and management systems were streamlined, resulting in the popularly known Toyota Production System. Although the system had been extensively researched, many companies, such as Nissan, experienced difficulties in replicating TPS.

The TPS was conceived when the company realized that producing massive quantities from limited product lines and ensuring large components to achieve maximum economies of scale led to flaws. Its major objectives were to reduce cost, eliminate waste, and respond to the changing needs of the customers. The initial feature of this system was set-up time reduction, and this forms the basis of TQM implementation.

At Toyota Corporation, quality is considered as acting responsibly through the provision of blunder-gratis products that please the target clientele. Toyota vehicles are among the leading brands in customer satisfaction. Due to good quality, its success has kept growing, and in 2012, the company was the best worldwide. Moreover, Toyota has been keen on producing quality vehicles via the utilization of various technologies that improve the performance of the vehicles.

While implementing TQM, Toyota perceives speed as a key element. In this case, speed objective means doing things fast in order to reduce the time spent between ordering and availing the product to the customer.

The TPS method during processing concentrates on reducing intricacy via the use of minute and uncomplicated machinery that is elastic and full-bodied. The company’s human resources and managers are fond of reorganizing streams and designs to promote minimalism. This enhances the speed of production.

Another objective during TQM implementation is dependability. This means timely working to ensure that customers get their products within the promised time. Toyota has included a just-in-time production system comprised of multi-skilled employees who work in teams. The kanban control allows the workers to deliver goods and services as promised. Advancing value and effectiveness appears to be the distress for administrators, mechanical specialists, and other Toyota human resources.

During TQM implementation, Toyota responds to the demands by changing its products and the way of doing business. Chary (2009) argues that while implementing TQM, organizations must learn to like change and develop responsive and flexible organizations to deal with the changing business environment.

Within Toyota plants, this incorporates the ability to adopt the manufacturing resources to develop new models. The company is able to attain an elevated degree of suppleness, manufacturing fairly tiny bunches of products devoid of losses in excellence or output.

The organizational hierarchy and job descriptions also determine the successful implementation of the TQM. Toyota is amongst the few companies whose organizational structure and task allocation have proved viable in TQM implementation. The company has three levels of management. See the diagram below.

Management hierarchy

Despite the hierarchy and task specification, employees are able to make independent decisions and take corrective measures when necessary to ensure quality during production. Team working is highly encouraged at Toyota Corporation, and this plays a significant role during TQM implementation. All stakeholders are incorporated in quality control initiatives to ensure client demands are satisfied.

However, all employees are required to carry out their assigned tasks, and the management closely supervises the ways of interactions between workers. The management ensures that the manufacturing lines are well-built and all employees are motivated to learn how to improve the production processes.

Toyota is among the few manufacturers in the complete automobile industry that consistently profited during the oil crisis in 1974. The discovery was the unique team working of the Japanese that utilized scientific management rules (Huczynski & Buchanan, 2007).

The joint effort in Japan, usually dubbed Toyotaism, is a kind of job association emphasizing ‘lean-assembly.’ The technique merges just-in-time production, dilemma-answering groups, job equivalence, authoritative foremost-streak administration, and continued procedure perfection.

Just-in-time (JIT) assembly scheme attempts to accomplish all clients’ needs instantly, devoid of misuse but with ideal excellence. JIT appears to be dissimilar from the conventional functional performances in that it emphasizes speedy production and ravage purging that adds to stumpy supply.

Control and planning of many JIT approaches are concerned directly with pull scheduling, leveled scheduling, kanban control, synchronization of flow, and mixed-model scheduling (Slack et al., 2009).

Toyota appears to be amongst the principal participants in changing Japan to a kingpin in car production. Companies, which have adopted the company’s production system, have increased efficiency and productivity. The 2009 industrial survey of manufacturers indicates that many world-class firms have adopted continuous-flow or just-in-time production and many techniques Toyota has been developing many years ago.

In addition, the manufacturing examination of top plant victors illustrates that the mainstream them utilize lean production techniques widely. Thus, team-working TPS assists Toyota Corporation in the implementation of TQM.

Executives and Quality Managers face some challenges while implementing Quality Management Systems in organizations. In fact, with a lack of the implementation resources such as monetary and human resources in any organization, the implementation of TQM cannot be successful. Towards the implementation of programs and projects in organizations, financial and human resources have become the pillar stones.

The approach of TQM impels marketplace competence from all kinds of organizational proceeds to ensure profitability and productivity. To meet the desired results in TQM implementation, an organization ought to consider the availability of human and financial resources that are very important for the provision of an appropriate milieu for accomplishing organizational objectives.

In the case of Toyota, which originated and perfected the philosophy of TQM, the Executives, and Quality Managers met some intertwined problems during TQM implementation. The flaw in the new product development is increasingly becoming complicated for the managers to break and accelerate, thus creating reliability problems. Besides, secretive culture and dysfunctional organizational structure cause barriers in communication between the top management, thus, in turn, augmenting public outrage.

The top executives may fail to provide and scale up adequate training to the suppliers and new workforces. As a result, cracks are created in the rigorous TPS system. In addition, a lack of leadership at the top management might cause challenges in the implementation of TQM. Therefore, in designing the organizational structures and systems that impact quality, the senior executives and managers must be responsible, as elaborated in Figure 2 below.

Total Quality Management is a concept applied in the automobile industry, including the Toyota Corporation. It focuses on continuous improvement across all branches and levels of an organization. Being part of Toyota, the concept defines the way in which the organization can create value for its customers and other stakeholders. Through TQM, Toyota Corporation has been able to create value, which eventually leads to operation efficiencies.

These efficiencies have particularly been achieved by continuous correction of deficiencies identified in the process. A particular interest is the central role that information flow and management have played in enabling TQM initiatives to be implemented, especially through continuous learning and team working culture.

The Toyota way (kaizen), which aims at integrating the workforce suggestions while eliminating overproduction and manufacturing wastes, helps the company to respect all the stakeholders and give clients first priority. The objectives are realized through TPS.

Chary, D. 2009, Production and operations management , Tata McGraw-Hill Education Press, Mumbai.

Huczynski, A. & Buchanan, D. 2007, Organizational behavior; an introductory text, Prentice Hall, New York, NY.

Kanji, G. K. & Asher, M. 1996, 100 methods for total quality management , SAGE Thousands Oak, CA.

Slack, N. et al. 2009, Operations and process management: principles and practice for strategic management, Prentice Hall, New York, NY.

Toyota Motor Corporation 2012, Annual report 2012. Web.

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International Journal of Quality & Reliability Management

ISSN : 0265-671X

Article publication date: 1 May 1993

Most quality professionals recommend a core set of attributes as the nucleus of any quality improvement process. These attributes include: (1) clarifying job expectations; (2) setting quality standards; (3) measuring quality improvement; (4) effective super‐vision; (5) listening by management; (6) feedback by management; and (7) effective training. Based on a survey of employees at a medium‐sized manufacturing firm in the United States, it was found that management philosophy and actions can undermine even a proven total quality management (TQM) programme. For the many firms which hire outside consultants to set up a TQM programme, makes recommendations to management to ensure its successful implementation.

• MANAGEMENT PHILOSOPHY
• QUALITY ASSURANCE
• QUALITY MANAGEMENT

Longenecker, C.O. and Scazzero, J.A. (1993), "Total Quality Management from Theory to Practice: A Case Study", International Journal of Quality & Reliability Management , Vol. 10 No. 5. https://doi.org/10.1108/02656719310040114

Copyright © 1993, MCB UP Limited

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Organizational approach to Total Quality Management: a case study

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Ahamad Bahari

Maged Awwad

In the current market economy, companies are constantly struggling to achieve a sustained competitive advantage that will enable them to improve performance, which results in increased competitiveness, and of course, profit. Among the few competitive advantages that can become sustainable competitive advantages, quality plays a crucial role. Recent research shows that about 90% of buyers in the international market, consider quality as having at least equal importance with price in making the decision to purchase. In the opinion of some specialists in economic theory and practice, total quality refers to the holistic approach of quality, which actually means, addressing all aspects of economic and social development and technical of quality. Thus, the holistic approach of quality at organisation-wide involves procedural approach of quality, in this respect, the study focuses on this type of quality approach, i.e. the procedural approach, taking into account the strategic aspects of the continuous improvement of quality, which means in fact, the quality management. Total Quality Management is seen as a way to transform the economies of some countries to be more competitive than others. However, Total Quality Management brings not and will not produce results overnight, it is not a panacea for all the problems facing the organization. Total Quality Management requires a change in organizational culture, which must focus on meeting customer expectations and increasing the involvement of all employees to meet this objective, as an expression of the ethics of continuous improvement. In general, research on quality aiming identify why an organization should adopt the principles of total quality management, but attempts to identify the failing companies' attempts to implement total quality management principles are not so visible. Concerns companies to introduce quality management systems are becoming more pronounced, therefore, in this study we try to identify and present the main reasons that prevent achieving quality and implementation of total quality management system, in other words, we are interested in identify barriers to implementation and development of a quality management system.

Aliza Ramli

Haile Shitahun Mengistie

The main purpose of this paper was to investigate the effect of Total Quality Management practices on organizational performance the case of Bahir Dar Textile SC. It adopted an explanatory research design. The sample size of 71 respondents was drawn using stratified random sampling technique. The study findings of correlation analysis showed that all constructs of total quality management (customer focus, employee's empowerment, top management commitment, continuous empowerment, supplier quality management, process approach) were positively and significantly affect organizational performance. The findings of the multiple regressions analysis showed that the observed changes in organizational performance attributed by the elements of total quality management practice is 49.4% (adjusted r2=.494). The study also reveals from six major elements of total quality management practices, customer focus, top management commitment, continuous improvement, employee's empowerment, and supplier quality management has a positive effect on organizational performance, while process approach doesn't have a significant effect.

Dr. Faisal Talib

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• WGU C215: Pre-Assessment
• WGU C215: Pre-Assessment Questions and Answers Already Passed 2024

WGU C215: Pre-Assessment Questions and Answers Already Passed ✔Which definition used for quality evaluates how well a product performs its intended function? a. Psychological criteria b. Fitness for use c. Value for price paid d. Support services c ✔✔Which total quality management (TQM) process was developed to stress management's responsibility for quality? a. Statistical quality control charts b. Fitness quality for use c. 14 points for quality improvement d. Product design quality a ✔✔Which total quality management (TQM) process consists of 13 published standards and guidelines? a. ISO 9000 b. ISO 9001 c. ISO 1400 d. ISO 9002 a ✔✔A company manufactures shoes using a quality management system. The company needs to put a process in place to measure any defects. The company would like to measure the number of defects and observe the number of occurrences to isolate the particular defect. Which quality tool should the company use to focus on correcting this particular issue? a. Checklist b. Flowchart c. Scatter diagram d. Control chart d ✔✔Which quality con

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Artificial intelligence  is being used in healthcare for everything from answering patient questions to assisting with surgeries and developing new pharmaceuticals.

According to  Statista , the artificial intelligence (AI) healthcare market, which is valued at $11 billion in 2021, is projected to be worth $187 billion in 2030. That massive increase means we will likely continue to see considerable changes in how medical providers, hospitals, pharmaceutical and biotechnology companies, and others in the healthcare industry operate.

Better  machine learning (ML)  algorithms, more access to data, cheaper hardware, and the availability of 5G have contributed to the increasing application of AI in the healthcare industry, accelerating the pace of change. AI and ML technologies can sift through enormous volumes of health data—from health records and clinical studies to genetic information—and analyze it much faster than humans.

Healthcare organizations are using AI to improve the efficiency of all kinds of processes, from back-office tasks to patient care. The following are some examples of how AI might be used to benefit staff and patients:

• Administrative workflow:  Healthcare workers spend a lot of time doing paperwork and other administrative tasks. AI and automation can help perform many of those mundane tasks, freeing up employee time for other activities and giving them more face-to-face time with patients. For example, generative AI can help clinicians with note-taking and content summarization that can help keep medical records as thoroughly as possible. AI might also help with accurate coding and sharing of information between departments and billing.
• Virtual nursing assistants:  One study found that  64% of patients  are comfortable with the use of AI for around-the-clock access to answers that support nurses provide. AI virtual nurse assistants—which are AI-powered chatbots, apps, or other interfaces—can be used to help answer questions about medications, forward reports to doctors or surgeons and help patients schedule a visit with a physician. These sorts of routine tasks can help take work off the hands of clinical staff, who can then spend more time directly on patient care, where human judgment and interaction matter most.
• Dosage error reduction:  AI can be used to help identify errors in how a patient self-administers medication. One example comes from a study in  Nature Medicine , which found that up to 70% of patients don’t take insulin as prescribed. An AI-powered tool that sits in the patient’s background (much like a wifi router) might be used to flag errors in how the patient administers an insulin pen or inhaler.
• Less invasive surgeries:  AI-enabled robots might be used to work around sensitive organs and tissues to help reduce blood loss, infection risk and post-surgery pain.
• Fraud prevention:  Fraud in the healthcare industry is enormous, at $380 billion/year, and raises the cost of consumers’ medical premiums and out-of-pocket expenses. Implementing AI can help recognize unusual or suspicious patterns in insurance claims, such as billing for costly services or procedures that are not performed, unbundling (which is billing for the individual steps of a procedure as though they were separate procedures), and performing unnecessary tests to take advantage of insurance payments.

A recent study found that  83% of patients  report poor communication as the worst part of their experience, demonstrating a strong need for clearer communication between patients and providers. AI technologies like  natural language processing  (NLP), predictive analytics, and  speech recognition  might help healthcare providers have more effective communication with patients. AI might, for instance, deliver more specific information about a patient’s treatment options, allowing the healthcare provider to have more meaningful conversations with the patient for shared decision-making.

According to  Harvard’s School of Public Health , although it’s early days for this use, using AI to make diagnoses may reduce treatment costs by up to 50% and improve health outcomes by 40%.

One use case example is out of the  University of Hawaii , where a research team found that deploying  deep learning  AI technology can improve breast cancer risk prediction. More research is needed, but the lead researcher pointed out that an AI algorithm can be trained on a much larger set of images than a radiologist—as many as a million or more radiology images. Also, that algorithm can be replicated at no cost except for hardware.

An  MIT group  developed an ML algorithm to determine when a human expert is needed. In some instances, such as identifying cardiomegaly in chest X-rays, they found that a hybrid human-AI model produced the best results.

Another  published study  found that AI recognized skin cancer better than experienced doctors.  US, German and French researchers used deep learning on more than 100,000 images to identify skin cancer. Comparing the results of AI to those of 58 international dermatologists, they found AI did better.

As health and fitness monitors become more popular and more people use apps that track and analyze details about their health. They can share these real-time data sets with their doctors to monitor health issues and provide alerts in case of problems.

AI solutions—such as big data applications, machine learning algorithms and deep learning algorithms—might also be used to help humans analyze large data sets to help clinical and other decision-making. AI might also be used to help detect and track infectious diseases, such as COVID-19, tuberculosis, and malaria.

One benefit the use of AI brings to health systems is making gathering and sharing information easier. AI can help providers keep track of patient data more efficiently.

One example is diabetes. According to the  Centers for Disease Control and Prevention , 10% of the US population has diabetes. Patients can now use wearable and other monitoring devices that provide feedback about their glucose levels to themselves and their medical team. AI can help providers gather that information, store, and analyze it, and provide data-driven insights from vast numbers of people. Using this information can help healthcare professionals determine how to better treat and manage diseases.

Organizations are also starting to use AI to help improve drug safety. The company SELTA SQUARE, for example, is  innovating the pharmacovigilance (PV) process , a legally mandated discipline for detecting and reporting adverse effects from drugs, then assessing, understanding, and preventing those effects. PV demands significant effort and diligence from pharma producers because it’s performed from the clinical trials phase all the way through the drug’s lifetime availability. Selta Square uses a combination of AI and automation to make the PV process faster and more accurate, which helps make medicines safer for people worldwide.

Sometimes, AI might reduce the need to test potential drug compounds physically, which is an enormous cost-savings.  High-fidelity molecular simulations  can run on computers without incurring the high costs of traditional discovery methods.

AI also has the potential to help humans predict toxicity, bioactivity, and other characteristics of molecules or create previously unknown drug molecules from scratch.

As AI becomes more important in healthcare delivery and more AI medical applications are developed, ethical, and regulatory governance must be established. Issues that raise concern include the possibility of bias, lack of transparency, privacy concerns regarding data used for training AI models, and safety and liability issues.

“AI governance is necessary, especially for clinical applications of the technology,” said Laura Craft, VP Analyst at  Gartner . “However, because new AI techniques are largely new territory for most [health delivery organizations], there is a lack of common rules, processes, and guidelines for eager entrepreneurs to follow as they design their pilots.”

The World Health Organization (WHO) spent 18 months deliberating with leading experts in ethics, digital technology, law, and human rights and various Ministries of Health members to produce a report that is called  Ethics & Governance of Artificial Intelligence for Health . This report identifies ethical challenges to using AI in healthcare, identifies risks, and outlines six  consensus principles  to ensure AI works for the public’s benefit:

• Protecting autonomy
• Promoting human safety and well-being
• Ensuring transparency
• Fostering accountability
• Ensuring equity
• Promoting tools that are responsive and sustainable

The WHO report also provides recommendations that ensure governing AI for healthcare both maximizes the technology’s promise and holds healthcare workers accountable and responsive to the communities and people they work with.

AI provides opportunities to help reduce human error, assist medical professionals and staff, and provide patient services 24/7. As AI tools continue to develop, there is potential to use AI even more in reading medical images, X-rays and scans, diagnosing medical problems and creating treatment plans.

AI applications continue to help streamline various tasks, from answering phones to analyzing population health trends (and likely, applications yet to be considered). For instance, future AI tools may automate or augment more of the work of clinicians and staff members. That will free up humans to spend more time on more effective and compassionate face-to-face professional care.

When patients need help, they don’t want to (or can’t) wait on hold. Healthcare facilities’ resources are finite, so help isn’t always available instantaneously or 24/7—and even slight delays can create frustration and feelings of isolation or cause certain conditions to worsen.

IBM® watsonx Assistant™ AI healthcare chatbots  can help providers do two things: keep their time focused where it needs to be and empower patients who call in to get quick answers to simple questions.

IBM watsonx Assistant  is built on deep learning, machine learning and natural language processing (NLP) models to understand questions, search for the best answers and complete transactions by using conversational AI.

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