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FILE: 1-S2.0-S2212567113001755-HEALTH SERVICE QUALITY WITH MEASURING

SERVQUAL SCALE (E: FOLDER RUBEL TQM)

FILE: BANGLADESH HEALTH FACILITY REPORT PAGE

FIGURE 2 WHO.
OPERATIONAL DEFINITION
TQM:
The way of managing organization to achieve excellence
Total everything
Quality degree of excellence
Management art, act or way of organizing, controlling, planning, directing to
achieve certain goals
A management philosophy embracing all activities through which the needs and
expectations of the customer and community, and the objectives of the organization
are satisfied in the most efficient and cost effective manner by maximising the
potential of all employees in a continuing drive for improvement
Perceptive Quality: is the aspect of care which is perceived/judged by the recipient of
care.
Service: Service as activities, performance that are offered or provided, performed by
people, machine, people with machine, directed at people and users rendered by profit
and non-profit.
Perceived Service Quality
Perceived Service Quality is a concept that measures the discrepency between customers
expectations and their perceptions regarding a certain service

Benchmarking:
Measuring our performance against that of best in class companies determining how
the best in time achieve those performance levels and using the information as a basic
for hospitals strategies, planning, and implementation.
Perception:
The philosophy of perception is the action of the mind by which it refers its sensation
to an external object as their cause. It is the distinction from sensation, conception or
imagination and judgement or inference.
The two principle action of the mind are perception of thinking and volition of
willing. The whole apparatus of vision or of perception by any other of our senses.

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

External things and their attributes are objects of perception. Relation among things
are objects of conception.

Patient: a person who is under medical care or treatment

Quality: Meeting of customers needs
Quality also may be a manner, style, an attribute, property or special feature in kind or
character of something. Hence the quality is the degree or grade of excellence or
superiority of profession, occupation or business.
Measurable Quality: is the aspect of care which can be judged by the provider
through comparative measures between the actual performance versus the standard
one
Appreciative Quality: is the aspect of care which can be judged by the experienced
practitioners who rely not only on standards but on their personal judgments and
experiences as well. Peer review is an example

(Please Turn Over)

Perceptive Quality: is the aspect of care which is perceived/judged by the recipient
of care.
Service: Service as activities, performance that are offered or provided, performed by
people, machine, people with machine, directed at people and users rendered by profit
and non-profit.
An assessment of how well a delivered service conforms to the clients expectations.
Service business operators often assess the service quality provided to their customers
in order to improve their service, to quickly identify problems, and to better assess
client satisfaction.
Care:
Ordinarily care means the special attention but it can be defined as serious mental
attention, concern, charge or oversight with a view to protection, preservation with
interest. Sometimes care is felt as concern or interest to take care or thought in respect
of regard to liking.

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

Illiterate: Those who could not read or write only language

Primary: Those who had formal education i.e. class I to Class V
Secondary : Those who passed the secondary school certificate examination
Higher secondary and above: Those who had passed the higher secondary school
certificate examination or who had take graduate or post graduate degree.
Hospital: WHO has defined a Hospital as an integral part of the society, the function
of which is to provide for the population complete health care, both curative as well as
preventive, and whose out-patient services reach out to the family in its home
environment

Research question:
What is the total quality management of three Upazila Hospitals ?

General objectives:
To assess the total quality management of three Upazila Hospital

Specific objectives:
to assess the quality management of clinical services of doctor and nurses.
to review or determine the quality of management supporting services
to determine the strength and weakness of general administration services
to assess the quality management of utility services.
to assess the quality as perceived by the health care receipient.

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

List of variables
A. Independent variables.

a.

b.

c.

d.

Clinical and nursing services

a. out patient services
b. inpatient services
c. emergency and casualty services
d. operation theatre.
Supporting services
a. laboratory services blood bank
b. imaging services
c. drug and dispensary services
d. central sterile
General administration services
a. personnel management
b. financial management
c. material management
Utility services:
a. communication
b. transportation
c. public relation
d. fire and security services
e. dietary services
f. laundry, linen & have keeping emergency and maintenance

e. the quality as perceived by the health care receipient

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

Tangibles,
Reliability
Responsiveness
Assurance
Attitude
Receiption
consultation time
cooperation
Cordiality
Communication
Knowing and understanding the customer
Customer satisfaction

B. Dependent variable
Total quality management

Literature Review:

Total Quality Management is not just an admirable phenomenon but it is any

clients right and can be done through contribution of the staff and the managers

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

as well as the clients of an organization. The purpose of the present study is to

investigate the feasibility of TQM model and the attitude
of the managers of health field of Yazd medical sciences university towards it.
The present study was a descriptive and analytical one which was cross-section
ally conducted from 2010 to 2011. The population under study consisted of the
managers of the unit of staff vice-chancellor for health and treatment, the
managers of health system and centers of cities and also the managers
of Yazds public hospitals. 64 people were chosen using the formula for
calculating the number of samples. A questionnaire with 48 questions was used.
The questionnaires validity was approved by the faculty members whose major
is management and its reliability by using -cronbach 87%.
To analyze the data, the software SPSS V.17 was used. Scoring method was
based on likert. The findings of the study show that, considering feasibility of
TQM, there is a significant relation between the awareness and attitude of the
managers of health and treatment field on one side and the variables, age and
University degree, on the other side p = 0.001. Considering binary logistic
regression and the results obtained in the form of inter and backward stepwise,
the most important factors affecting the feasibility of TQM among the managers
of health and treatment field are the level of awareness and attitude with the
predicted accuracy 79.3% and 87.9% respectively. (F. Farzianpour et
al.2015)

=============------------------------Kamla-Raj 2011 Ethno Med, 5(1): 17-23 (2011)

Total Quality Management (TQM) Factors:

An Empirical Study of Kwara State
Government Hospitals
Johnson Olabode Adeoti

Nigeria

Business Administration Department, University of Ilorin, Ilorin,

Telephone: +2348035846546, E-mail: drpastorjoadeoti@yahoo.com

Factors. Empirical. Government Hospitals. Factor Analysis

KEYWORDS TQM
ABSTRACT The decay and paralysis in Nigerians health care delivery system has been

Variable Explained Percentages

Factor 1 Employee involvement and funding 11.2
Factor 2 Environmental factors 9.6

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

Factor 3 Organizational factors 7.0

Factor 4 Facilities factors 6.8
Factor 5 Interpersonal factors 6.4
Factor 6 Inventory of drugs 6.0
Factor 7 Information Technology 6.0
Factor 8 Personnel quality

Funding
V 28 Variance in patients expectation and actual service delivered
communicated to employees.
V 38 Participation of employees in decision making.
V 12 The state of the art technology.
V 17 Facilities in the hospital leads to achievement of TQM.
V 24 Method of feedback to ensure quality grades are achieved.
V 31 Description of service with the public.
V 33 Competence of employees./
V 17 Facilities in the hospital leads to achievement of TQM.
V 25 Adequate funding and pricing by government.
Factor 2 (Environmental Factors)

V20 Functional laundry department.

V11 Management commitment to philosophy of TQM.
V21 Conformity to standard.
V36 Employees attitude to work.
V15 Management motivational program for the staff.
V33 Competence of employees.
V17 Facilities in the hospital leads to achievement of TQM.
Table 3: Rotated component matrix by quartimax

The objective of this study is to present the findings of TQM practices of UHC.

It

includes establishing the principal elements of

TQM for a hospital setting, general information
about UHC, healthcare delivery. and financing
system, future developments and challenges.
Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

Quality Control comprises the qualitative or quantitative measurements or tests of performance and
the determination of adequacy and acceptability of performance.

Qualily assurance is the

application of a series of quality control steps at

multiple stages of a procedure to verify that all aspects of the procedure are of
acceptable quality.
In TQM everyone strives to get things right the first time, everytime.

The main objectives of TQM are:

(a) Customer Focus
(b) Scientific approach
(c) Continuous improvement
(d) Participation by everyone at all levels
Traditional QA
I. Caregiver primary object of review
2. Focus primarily 011 clinical issues
3. Content when the care delivered meets local, national or international
standards.
TQM

Systems of patients care focus of review

Examines all services clinical, non-clinical
Attempts to improve services! Processes even if level of ..: are within existing
standards

Elements of quality
The important elements of quality are:
(a) Clinical quality
(b) Service quality
(c) Cost efficiency
(d) Continuity of care.
The focus of all the above activities is the patients.

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015

The basic tenets of TQM are:

(a) Quality is customer driven.
(b) Quality improvement focus on preventing problems.
(c) TQM focuses on process optimization.
(d) TQM is a never ending process of continuous
improvement.

Ref: Total Quality Management and Accreditation Strategic

Essentials for the next Millennium,
Shakti Gupta, Sunil Kant

Mohammad Harun Or Rashid, HM, 01711703387, Date: 16-8-2015