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Hospitals’ Total Quality Management and Leadership Report


Hospitals are under pressure to change and adopt new leadership models. The changes are geared towards reducing cost incurred during the provision of health care and improve services provided to patients (Kennedy & Fiss 2009). Effective leadership in medical institutions aims at identifying the areas that are responsible for low quality care and increased costs (Lakshman 2006). After the identification process, leadership attempts to reduce these factors so that individuals seeking health care could be satisfied. Satisfaction among patients and lean operation costs ensures that facilities providing health care could make reasonable profits and keep in business. The topic of leadership in medical institutions and how TQM promotes it is essential in the management of health institutions at a time when there are challenges from different sources affecting the institutions (Miller, Sumner & Deane 2009).

Key research questions, aims and objectives of the report

This report will address issues in leadership and TQM in hospitals from a holistic perspective. It will address the following research questions:

  1. What is the role of effective leadership in hospitals?
  2. What role does TQM play in leadership in hospitals?
  3. How does TQM promote leadership in hospitals?

The aims of the report will be the following:

  1. To identify management approaches in hospitals.
  2. To compare leadership and TQM in management.
  3. To define the conceptual framework of leadership and TQM in hospitals.

The objectives of the report will be the following:

  1. To determine the challenges facing implementation of TQM in hospital leadership.
  2. To propose ways and strategies to foster sound hospital leadership by integrating TQM.
  3. To suggest ways of training leaders to adopt new leadership styles that incorporate TQM in hospital management.

Literature review

TQM approaches were first formulated by organisational behaviour researchers. The management approaches have been used in many organisations to improve efficiency and outcomes of operations (Lakshman 2006). TQM focuses on managing systems within organisations and improving service quality. Service quality in hospitals is measured by patient satisfaction upon receiving health care from hospital. Effective leaders who adopt TQM in their management incorporate the concepts of involvement and delegation in their leadership styles (Lakshman 2006). Such leaders have sound strategic management and planning, and are good at handling changes and crises in hospitals.

Challenges in hospitals may be as a result of patient dissatisfaction, increased costs, increased competition, and increased demand from third party payers (Rad 2005). Research demonstrates that health care can be enhanced in hospitals by conducting research to understand the impeding factors.

TQM theoretical model fits in the hospital leadership because it incorporates research and broad decision making paradigms in its conceptual framework. The conceptual framework is essential because successful hospitals need to have sound decision making and strategic planning leaders to perform well. TQM is based on integration of several theories and approaches that make up an organisational management system. The current TQM being used by organisations is based on performance evaluation, statistical analysis, decision making approaches and project management. These aspects are crucial in sound management of hospitals because they help to promote hospital outcomes. Hospital leadership within TQM ensures that hospital leadership is focused on information, goals, decision making models and change management models (Rad 2005).

Strategic leaders in hospitals are required to adopt TQM approaches to management because TQM attempts to align internal systems within organisations with external surroundings (Svensson 2005). The alignment is important in benchmarking and evaluation strategies. TQM aims at enabling personnel within an organisation to share information and work towards achieving goals of the organisation. It places emphasis on rewarding stakeholders to promote creativity and innovation within organisations.

Within hospital settings, TQM could be used to foster creativity and innovation by rewarding personnel based on their performance (Easton & Jarrell1998). The benefits realised by an organisation as a result of increased innovation and creativity are essential for the long-term operations of the organisation. TQM approaches empower employees to work in teams that are keen on time and customer satisfaction. This approach endeavours to have all employees assume leadership roles so that they could be in charge of their decisions for the benefits of the organisation (Easton & Jarrell1998).

Poor leadership has been blamed for failure of TQM in organisations. Several studies have shown a positive correlation between performance in organisations and adoption of TQM approaches. It has been suggested that quality management could be realised in organisations with sound leadership in managing quality (Svensson 2005).

The three models in TQM are the biological model, mechanical model and social model (Vera & Crossan 2004). In the biological model an organisation is viewed as a living thing, its components are the employees within that organisation. The mechanical model of management views an organisation as a machine. The parts of the machine are employees of an organisation. Perhaps the best model that is adopted by the current TQM approaches is the social model which views an organisation as a complete society with its members. The members in this model are the employees in an organisation. They are assumed to have their own brains and capable of making their decisions.


Leadership in hospitals should adopt the social model of management because it shows that employees are crucial stakeholders who can make their decisions for the benefits of an organisation. The model allows participation by workers in formulating vision and mission of an organisation (Han, Chiang & Chang 2010). This enables employees to work towards realising their vision and accomplishing mission they formulated. This could be reflected by customer satisfaction. The model also allows employees to plan. The advantages of planning by workers in an organisation would be learning that happens (Vera & Crossan 2004). The learning by the workers will be key to individual and group performance within the organisation (Han et al 2010).

Leadership in hospitals should adopt TQM with the aim of fostering good performance and patient satisfaction. TQM could also reduces costs incurred by hospitals because the management system within the TQM concentrates on sound financial management and responsibility among employees. Leaders in hospital settings should involve employees in decision making process within the organisations to ensure that they work towards achieving some of the goals and objectives they formulated. If the leaders are not competent in implementing TQM, they should hire consultants who could train teams in the organisation on how to execute TQM system. TQM promotes leadership in hospitals by greatly increasing customer experience and reducing costs (Kennedy & Fiss 2009). Modern hospitals should endeavour towards adopting the TQM system for efficiency, strategic planning and strategic decision making (Han et al 2010).


Easton, GS, & Jarrell, SL, 1998 “The Effects of Total Quality Management on Corporate Performance: An Empirical Investigation”, The Journal of Business, Vol. 71, No. 2, pp. 253-307.

Han, TS, Chiang, HH, & Chang, A, 2010, “Employee participation in decision making, psychological ownership and knowledge sharing: Mediating role of organizational commitment in Taiwanese high-tech organizations”, The International Journal of Human Resource Management, Vol. 21, No.12, pp. 2218-2233.

Kennedy, MT, & Fiss, PC, 2009, “Institutionalization, framing, and diffusion: The logic of TQM adoption and implementation decisions among US hospitals”, Academy of Management Journal, Vol. 52, No. 5, pp. 897-918.

Lakshman, C, 2006, “A theory of leadership for quality: Lessons from TQM for leadership theory 1”, Total Quality Management & Business Excellence, Vol. 17, No.1, pp. 41-60.

Miller, WJ, Sumner, AT, & Deane, RH, 2009, “Assessment of quality management practices within the healthcare industry”, American Journal of Economics and Business Administration, Vol.1, No. 2, pp. 105.

Rad, AMM, 2005, “ A survey of total quality management in Iran: barriers to successful implementation in health care organizations”, Leadership in Health Services, Vol. 18, No. 3, pp. 12-34.

Svensson, G, 2005, “Leadership performance in TQM: a contingency approach”, The TQM Magazine, Vol. 17, No. 6, pp. 527-536.

Vera, D, & Crossan, M, 2004, “Strategic leadership and organizational learning. Academy of Management Review, Vol. 29, No. 2, pp. 222-240.

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