Question

OM in the News: Nurses, Ebola, and the Subject of Quality

OCTOBER 17, 2014

by Barry Render

With Ebola leading the news every day, I am reminded of the words of Dr. Edwards Deming: management needs to accept responsibility for quality in building systems. Deming believed an employee could not, on average, exceed the quality of a process’ capability. (His famous 14 points are summarized in Table 6.2 on page 212). Now with some nurses being blamed for the lax Ebola virus procedures in Texas, we are seeing a response from the leading nursing association.

Following news that the first U.S. nurse has now tested positive for the Ebola virus, National Nurses United (NNU, Oct.12, 2014) called for all hospitals to have in place the highest standard of optimal protections, including Hazmat suits, and hands-on training to protect all RNs, other hospital personnel to confront Ebola . NNU’s new survey of 2,000 nurses shows:

• 76% still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
• 85% say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
• 37% say their hospital has insufficient current supplies of eye protection for daily use on their unit; 36% say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital
• 39% say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; only 8% said they were aware their hospital does have such a plan in place.

Not having supplies; not having equipment; not educating employees; not having a plan. All of these are systems problems, not employee problems, Deming would say.

Discussion questions:

1. Who in your opinion is responsible for setting quality standards and processes for the treatment and prevention of novel diseases such as Ebola at the time and COVID-19 at present?

2. Which of Dr. Deming’s 14 points particularly apply in this situation?

3. What do you understand by the term Total Quality Management (TQM)

4. List and describe 3 concepts of TQM

Answer 1

1. Novel diseases such as Ebola and COVID-19 are dangerously harmful to the human beings. To control the spread of such diseases, strict actions and strict guidelines must be followed so that people do not contract such a virus in them which may lead to thousands of deaths in future.

To identify who is responsible, i will try the framework of "WHYS" and reach to the underlying problem for the same.

Why do such diseases spread? Well, the main reason behind the spread of such diseases is the uncontrolled crowds of people who contract the disease from one person and spread it in communities.

Why can we not control the community spread?

The strictness is not being followed by the government to contain the virus.

Why is strictness the cause?

Supplies, equipments, plans and training are missing from the community of doctors. Also, no proper information is available to people about the same or they are not serious enough about the disease.

Who is the responsible authority?

The responsible authority is the Healthcare Department of the countries which do not aware the population about such diseases or if they do then the government who tries to ignore the situation in exactly the same way doen in USA and Great Britain.

According to me, Leadership and the healthcare department of the country are the majorly responsible pople for the same.

2. Deming's principle which apply to the same :

a. Creating constancy of purpose - This will help us in improving for any future situation such as COVID-19 after Ebola.

b. Adopt the new philosophy - Ventilators are the most needed equipments, however, many new models with less costs are available which should be used now.

c. Improve constantly and forever - Every case of such a disease lets doctors learn something new. Hence, improvement must be done with those feedbacks.

d. Using training on job - Doctors and Healthcare professional must be trained enough in order to improve the process.

e. Implement Leadership - Leadership is important and should be implemented on each level in these diseases.

f. Eliminate fear - It will let people open up with their innovative ideas to contain the diseases.

g. Breakdown barriers - Barriers between countries, states, cities, religions, communities must be broken down to improve such scenarios.

h. Eliminating management by objectives - Process is a major focus point hence, numerical targets must be carried out.

i. Remove barrier to pride of workmanships - doctors are the major workmen here.

j. Implement education and self improvement - Doctors must feedback themselves and also people should feedback themselves and educate themselves to acty accordingly.

k. Make transformation everyone's job - Every citizen in the country is going through the same situation and everyone should have a feeling to transform the situation. Everyone should follow regulations.

3. Total Quality Management - TQM is defined as a continual process or a management approach to achieve long term success through customer satisfacton. It is a continual process of detecting and eliminating the errors from any process. The focus is to improve the organization as a whole and not just one or other part of the organization. It is a process to involve almost all parties of the organization to improve in a continual manner. The basic principles of TQM are -

a. Customer focussed

b. Total employee Involvement

c. Process centered

d. Integrated system

e. Strategic and systematic approach

f. Continual improvement

g. Fact based decision making

h. Communication

4. Three concepts of TQM are defined below:

a. Continuous Improvements of quality - Fundamental concept of TQM is to continuous improvement of quality of products and services provided by any organization. It results in greater productivity and less variability. It focusses on never limiting the improvement in an organization.

b. Customer Satisfaction - TQM says that the quality improvement is done so as to provide better value to the customers and satisfy them as the end result. If customers are not satisfied with the products and services in terms of quality, improvements must be made with better plans and processes.

c. Total Involvement - TQM deals with the involvement of whole organization in improving the quality. It states that just one person or department cannot be held responsible for the quality of the value creation in the organization. It has to be the organization as a whole.