This study is (a) to describe the history of Total Quality Management(TQM) generated in the industry, health care service, and nursing society ; (b) to define the concept, total quality management including the definition of quality ; (c) to explain the each principle of TQM theory developed by main theorists, E. Deming, J. Juran, and B. Crosby ; (d) to give the examples related to TQM implementation at the health care organization ; and (e) to mention the extent to which the health care organizations are able to evaluate their cultural organization toward TQM ,and have had the way to measure the effect of TQM implementation. TQM referred to Continuous Quality Improvement(CQI), Quality Improvement (QI ), and Total Quality Improvement (TQI ), was not recognized by experts in the United States industry, but by economists in Japan until the end of the 1970´s. However, the United States´ government led to introduce the principles of TQM to general industry as well as health care servicearea so that TQM became a main philosophy to manage the organizations in health care service.
TQM is a structured, systematic process for creating organizationwide participation in planning and implementing continuous improvement in quality, E. Deming established the "Chain reaction in Quality" and the fourteen point of TQM. The Chain reaction in quality is to describe the relationship among the reduction of waste, rework, and delay, quality improvement, customer satisfaction, and productivity. There are fourteen points to explain the principles of TQM by E. Deming. Juran defined the "Quality Trilogy" to improve the level of quality in any organization. Quality Trilogy has three steps such as quality planning, quality control, and quality improvement for implementing the TQM projects. Crosby describes his TQM theory by establishing "Four Absolutes" and "Fourteen steps in TQM" implementation.
Until now, most healthcare organizations have made efforts to organize the TQM task team and to implement TQM principles with various issues. There are three priorities to select the TQM issues : Highvolume, High` risk, and Problemprone. However, there is no absolute, credible measurement yet to evaluate the effects of TQM implementation in health care organization regard-less of the classification of health care organizations, geographical background, and social influence. Thus, developing the evaluation way in terms of TQM is the foremost task in health service area. The most important thing for TQM implementation in the organization is to settle up the concept, cultural transformation from traditional management toward guality.
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