Total Quality Management

This paper presents an overview of Total Quality Management (TQM). It starts with a historical review of TQM--when, where, and how it began--and then discusses the current state of TQM in today's marketplace, with emphasis on the health care industry, and concludes with a brief summary.

Managing for quality in the United States originated in the systems prevailing in Europe at the time North America became colonized. Those systems were rooted in craftsmanship and the associated regulations by the monopolistic guilds and political authorities (Juran, 1995, pp. 596-599). The Industrial Revolution and the factory system originated in Europe and were then exported to the United States. Reliance on craftsmanship was reduced, while reliance on inspection an testing increased.

The Taylor (1911) system of separating planning from execution resulted in giving top priority to productivity, but at the expense of quality. The managers tried to minimize the damage to quality by giving the inspection function an organization status that was not subordinate to production. An unintended by-product was the emergence of a belief that quality was now the responsibility of the inspection department. A further by-product was that the upper managers became detached from the quality function and thereby became progressively less and less informed on how to manage for quality.

During the twentieth century Americans enthusiastically accepted the benefits of technology. The volume of tec

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ng the long-term success of an organization. According to TQM, quality is defined as meeting or exceeding the customer's expectations at a price that is reasonable to the customer. The logic behind TQM is intuitively simple--if the entire organization is dedicated to meeting customer expectations, to continuously looking for new ways of exceeding customer expectations, and to delivering products and services at a competitive price, then success is virtually guaranteed (Graham, 1995, pp. 79-80). TQM combines a set of management principles with a set of tools and techniques that enable employees to carry out these management principles in their daily work activities. Individually the TQM principles are not particularly complex. Implementing them (and they all have to be implemented for TQM to work), however, is a real challenge. The principles and tools that define TQM include customer focus, quality first and foremost, teamwork, continuous improvement, and standardization (Jablonski, 1991, pp. 3-6; Shiba, et al., 1993, pp. 559-561). Within TQM, satisfying the customer is the key to success. The TQM definition of quality implies that meeting internally imposed specifications or standards may not be sufficient to satisfy th

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