Quality Improvement in Healthcare - Differences in Deming and Crosbys Concepts of Quality Theories – Term Paper Example
QUALITY IMPROVEMENT IN HEALTHCARE (Theories of Deming and Crosby) of (affiliation) Location of March 25,2014
The word “quality” is synonymous with a good product or service to the buyers and the consumers of these things yet the word itself can mean different things to different people. In the business corporate world, quality can mean the absence of defects or it can mean an acceptable level of defective products (meaning, within certain tolerable limits or allowances). Quality can be quite subjective too, as some people consider what is good as already a quality output product yet other people may consider the same thing as defective, to an extent of non-conformance to its original specifications. Quality can be used as a strategic tool for any business organization to gain a lasting competitive advantage; but on the other hand, quality can also be very illusive and ethereal in the sense it sometimes defies easy definition or clear-cut categorization. Management of quality has been extended to many industries including the health care industry.
Quality in the health care industry is of paramount importance because of lives that are at stake. A simple mistake or error can result in a legal suit, costly litigation, revocation of license, and even serious harm or injury to a patient, and in extreme cases, the death of that patient. This precarious situation makes it imperative health care professionals who render service should be always aware of how quality can affect the lives of people under their care. However, it is also a sad fact that errors in health care delivery cannot be avoided due to a number of human factors such as fatigue, lack of expertise, incomplete knowledge, and inadequate training in their field. It has been estimated about 100,000 lives are lost annually due to errors committed by practitioners such as in wrong dosages, wrong medication, wrong diagnosis, and wrong surgical procedures. Quality management has been introduced into the health care industry to prevent such errors.
Management experts have come up with many theories about quality in terms of making improvements or even eliminating defects completely. The two foremost management of quality theories are the ones propounded by Dr. W. Edwards Deming and by Philip Crosby who had published a best-selling book on quality management entitled “Quality is Free” but both of them exerted profound influences on how management today tackles issues of quality control. Deming is considered as the father and to have started the quality revolution especially in Japan although it is only recently the United States of America recognized his work (Deming, 2000, p. vii).
Demings whole body of work on quality can be encapsulated in what is called as the “System of Profound Knowledge” or SoPK which is the culmination of a lifetimes work on the issue of quality improvement and management. In essence, what his theory emphasizes is that all organizations (whether for profit or not, whether private or public) are actually a whole system that consists of a network of interdependent components that need to work smoothly together to achieve whatever the aim of that organization is. In other words, it is a holistic approach to the issue of quality by making quality an issue with the whole system and just with one department at the expense of another department (The W. Edwards Deming Institute, 2014, para. 4).
On the other hand, the quality control theory by Philip Crosby differs from the theory of Deming in that Mr. Crosby believed in the prevention of defects from ever happening in the first place by doing things right the first time around. He does not believe in solving quality problems by looking for situations of where, why, and how the defect happened but instead look for ways to prevent defect from happening in the first place. Stated differently, what Deming advocated is an incremental method for correcting defects while the theory of Crosby is quite revolutionary in the sense it advocates for a new way of thinking, a paradigm shift, that any defect is a failure.
Demings theory is more inclined toward quality improvement and that of Crosby is more towards quality management (total control of defects by prevention). In this regard, the theory of Crosby is more suitable to health care management because Crosby does not allow for defects to happen at all; any defect is evidence of a failure somewhere (The British Library Board, n.d., para. 3) by management. It is difficult to compute an acceptable level of failures or defects in the delivery of health care because people are involved and patients could possibly die thereof. The need for quality control is greater in health care than in any other comparable industry. His “zero defect” (Crosby, 1980, p. 116) is the best suited because medical errors are often preventable.
Hospitals and other health care institutions have empowered their employees only to a limited extent because of variability in the delivery of health care and the threats of litigation by which the hospital or institution is sued for negligence under tort laws. One way to empower employees is to appoint a chief medical officer (CMO) knowledgeable about all operations of a hospital and trains all the employees on the extent of their delegated responsibilities. In this way, there is clear demarcation of authority and responsibilities to avoid confusion and avoid the all-too common finger pointing or shifting the blame to someone else for any mistakes.
Management can empower employees by emphasizing the value of team efforts. In this instance, the theory of Deming is more appropriate as he stated that everybody should gain and not at the expense of anybody or any department. Taking the systems approach of Deming can be translated to employee empowerment because everyone is involved and this will raise morale among the employees by working together to attain a common objective or shared aim. The fear that goes with empowerment is the fear by management of losing control (Kinlaw, 1995, p. 28).
Crosby, P. (1980). Quality is free: The art of making quality certain. New York, NY, USA: The Penguin Classics.
Deming, W. E. (2000). Out of the crisis. Cambridge, MA, USA: Massachusetts Institute of Technology Press.
Kinlaw, D. C. (1995). The practice of empowerment: Making the most of human competence. Burlington, VT, USA: Ashgate Publishing.
The British Library Board (n. d.). Philip Crosby. Retrieved March 25, 2014 from http://www.mbsportal.bl.uk/taster/subjareas/busmanhist/mgmtthinkers/crosby.aspx
The W. Edwards Deming Institute (2014). The system of profound knowledge. Retrieved March 24, 2014 from https://www.deming.org/theman/theories/profoundknowledge