Thesis (MBA (Business Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Purpose – The health care industry is faced with numerous challenges ranging from rising
medical costs, poor state of hospitals, deteriorating health care services and an increasing
number of hospital deaths. All these disparities present tremendous challenges for the
health care managers in charge of the health care services. As a result, they are forced to
try new management methods that will assist their organizations to remain cost effective
and efficient. Total Quality Management (TQM) constitutes an appropriate response to
these challenges and it has become the strategy of choice to improve organization’s
performance and patient satisfaction. However, in practice the implementation of TQM is
often unsuccessful. Certain barriers have been identified which prevent the successful
implementation of TQM in other industries as well as in the health care industry. The main
aim of this research is to investigate the barriers to the successful implementation of Total
Quality Management in Kraaifontein health care service organization in the Western Cape
Province, 2008.
Design/methodology/approach – The study employed a quasi-qualitative and quantitative
case study. For the quantitative section a questionnaire with a 5–point Likert style scale
was used to quantify the response (strongly disagree=1; strongly agree=5). For the
qualitative section a focus group discussion was conducted to verify the results obtained
from the questionnaire which addressed the challenges of TQM implementation. The
statistical population of this research consisted of all health care workers working the
pharmacy department who were involved in the implementation of TQM in their
organization. Data was analyzed using appropriate statistical procedures. The mean
score of each of the dimensions was used as a representative performance indicator and
the coefficient of variation (CV) was used as a general measure of standardized skewness
on the performance of each dimension. A high means score indicated desired outcomes
while low scores indicated poor outcomes.
Findings – Major barriers that were encountered during the implementation of TQM in this
case study included the lack of top management active involvement and full commitment
in the initiative, rigid organizational structure, culture towards quality changes that inhibited
communication between management and employees which in turn hindered employee
empowerment. Other obstacles that were encountered were lack of continuous
improvement processes and initiative, improper evaluation, the lack of a recognition and
reward system for team work, poor collection and analysis of data that resulted in
difficulty to convert this data into meaningful information to improve quality. The absence
of an integrated performance measurement system also exhibited a problem as
employees were not aware what was being assessed during performance appraisals. Lack
of evidence based decision making, poor communication and inflexible organizational
structure and culture were also viewed as barriers.
Research limitations/implications – Although conducted in Kraaifontein health care facility,
it is expected that the results of the study may be relevant on a broader scale to other
health care departments and facilities. The results could assist the health care managers
to develop a plan that addresses the barriers and challenges faced during the
implementation of TQM, yielding fruitful results which allow TQM to be implemented easily,
effectively, efficiently and successfully in health care facilities. / AFRIKAANSE OPSOMMING: Doel – Die gesondheidsorg sektor het vele uitdagings wat wissel van stygende mediese
kostes, lae standaarde in hospitale, die agteruitgang van gesondheidsorg dienste, en die
toename in sterftes in hospitale. Hierdie en ander probleme stel groot uitdagings aan
diegene verantwoordelik vir die lewering van gesondheidsorg, met die gevolg dat
diesulkes nuwe bestuursmetodes moet vind om te verseker dat hulle organisasies steeds
koste-effektief en doeltreffend funksioneer. Totale Gehalte Bestuur (TGB) is ‘n geskikte en
toepaslike alternatief om genoemde probleme aan te spreek, en word toenemend as
oplossing gesien om organisasies se dienslewering te verbeter, en pasiënt-tevredenheid
te verseker. Die implementering van TGB blyk egter nie altyd suksesvol te wees nie. Daar
is spesifieke struikelblokke geidentifiseer wat as redes aangevoer word vir die onsuksesvolle
implementering van TGB in verskeie sektore, insluitend die van gesondheidsorg. Die hoof
doel van hierdie navorsing was om die struikelblokke te ondersoek wat verhoed dat TGB
suskesvol toegepas word in Kraaifontein gesondheidsdienste in die Weskaap, 2008.
Ontwerp/Metode/Benadering – Die studie was ‘n kwasi kwalitatiewe en kwantitatiewe
gevallestudie; vir die kwantitatiewe komponent is ‘n 5 punt Likert tipe skaal gebruik om die
response (verskil beslis = 1; stem beslis saam = 5) te kwantifiseer. Die kwalitatiewe
komponent het ‘n fokusgroep bespreking behels, waartydends die resultate van die
vraelys geverifiëer is, wat die uitdagings van die implementering van TGB uitgewys het.
Die statistiese populasie vir hierdie navorsing was al die gesondheidsorg werknemers in
diens van die aptekers-departement, wat betrokke was in die implemetering van TGB in
hulle organisasie. Die data is geanaliseer met toepaslike statistiese metodes. Die
gemiddelde telling van elkeen van die dimensies was gebruik as ‘n verteenwoordigende
aanduiding van prestasie, en die koëfisiënt van veranderlikheid was gebruik as ‘n
algemene maatstaf van die gestandardiseerde skeefheid soos gemeet op elkeen van die
dimensies. ‘n Hoë gemiddelde telling was ‘n aanduiding van die beoogde uitkomste, en lae
tellings aanduidend van swak uitkomste.
Bevindinge – Belangrike uitdagings wat ondervind is tydens die implementering van die
TGB in hierdie gevallestudie sluit in, die gebrek aan aktiewe betrokkenheid en toewyding
van die topbestuur vir hierdie inisiatief, rigiede organisatoriese strukture, die kultuur
teenoor gehalte veranderinge wat kommunikasie tussen bestuur en werknemers
belemmer, wat op sy beurt werknemer-bemagtiging verhoed. Ander struikelblokke wat
geidentifiseer is, was ‘n afwesigheid van voortdurende verbeteringsprosesse en inisiatief,
swak evaluering, ‘n gebrek aan ‘n sisteem vir erkenning en vergoeding vir spanwerk, swak
data insameling en ontleding, wat tot probleme gelei het om die data in betekenisvolle
inligting te verwerk wat kon lei tot ‘n verbetering in gehalte. Die afwesigheid van ‘n
geintegreerde prestasie-beoordeling sisteem is ook as probleem geidentifiseer omdat
werknemers nie ingelig was oor wat die prestasie-beoordelings behels nie. Die gebrek aan
navorsingsgesteunde besluitneming, swak kommunikasie, en onbuigsame
organisatoriese strukture en kultuur, was ook gesien as struikelblokke.
Navorsing-beperkinge/implikasies – Alhoewel die studie in Kraaifontein gesondheidsorgfasiliteit
gedoen is, word dit aanvaar dat die bevindinge van hierdie studie ook van
toepassing is op ander gesondheidsorg departmente en fasiliteite. Die resultate kan
gesondheidsorgbestuurders help om die uitdagings en struikelblokke te identifiseer in die
implementering van TGB. Hierdie identifikasie kan lei tot ’n meer effektiewe en suksesvolle
implementering van TGB in gesondheidsorgfasiliteite.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/964 |
| Date | 12 1900 |
| Creators | Skiti, Vuyi |
| Contributors | Von Leipzig, Konrad, University of Stellenbosch. Faculty of Economic and Management Sciences. Graduate School of Business. |
| Publisher | Stellenbosch : University of Stellenbosch |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 66 leaves |
| Rights | University of Stellenbosch |
Page generated in 0.0029 seconds