What is Total Quality Management (TQM)?

by: Yvette Crowell, Perspective Partners

In a previous article, “C-Level Accountability: “Leading with Purpose, Transparency, and Human Connection”, I briefly referenced TQM without an explanation as to what it is, so this article explains TQM. To further explore TQM, I have added authors who have influenced various sectors, including healthcare,and hopefully you will choose a book to explore.

Total Quality Management (TQM) is a comprehensive and structured approach to improving an organization’s processes, products, and services. It focuses on continuous improvement and achieving long-term success by maximizing customer satisfaction. The core principle of TQM is that quality should be embedded in every aspect of the organization and every employee’s role, not just in the final product or service but throughout the process—from design to delivery.

At its core, TQM is based on a few key principles:

1. Customer Focus: The primary goal of TQM is to meet or exceed customer expectations. This involves understanding the customer’s needs and continuously delivering high-quality products or services to satisfy them.
   
   
2. Continuous Improvement: TQM encourages an ongoing effort to improve processes, products, and services. It fosters an environment where feedback, data, and performance metrics are regularly used to identify areas for improvement.
   
   
3. Employee Involvement: TQM recognizes that quality is everyone’s responsibility. Employees at all levels are encouraged to participate in problem-solving and decision-making processes. Their involvement is crucial in identifying inefficiencies and implementing solutions.
   
   
4. Process-Centered: TQM focuses on improving the processes involved in production or service delivery. By refining processes, the overall quality of the output improves as well. This means that TQM is as much about improving internal operations as it is about the final product.
   
   
5. Integrated System: In TQM, all departments and functions of an organization are interconnected, and their processes must align toward the goal of continuous improvement. This requires an integrated approach where information flows freely between departments and teams.
   
   
6. Data-Driven Decision Making: Decisions should be based on data and measurable results. TQM emphasizes using metrics, analysis, and feedback to guide decision-making rather than relying on assumptions.
   
   
7. Supplier Quality Management: The quality of the input materials and services that an organization uses is crucial. TQM encourages strong relationships with suppliers to ensure that they also meet high-quality standards, contributing to the overall quality of the final product.
   
   
8. Fact-Based Decision Making: TQM uses data and analysis to identify areas for improvement, measure progress, and validate decisions. This helps organizations track their quality goals and maintain a focus on continuous progress.
   
   

Core of TQM

At the core of TQM is the belief that quality is not something that is checked at the end of a process but is embedded in every step of the operation. It is a philosophy that advocates for the entire organization to be committed to quality—from leadership to front-line employees. By focusing on customer satisfaction, continuous improvement, and employee involvement, TQM helps organizations systematically improve their performance and deliver consistent, high-quality results.

Well-Known Organizations Using TQM

Several global organizations have embraced TQM as part of their core strategies to improve efficiency, product quality, and customer satisfaction. Here are a few examples:

1. Toyota: Toyota is one of the most famous proponents of TQM, specifically through its Toyota Production System (TPS). TPS emphasizes continuous improvement (kaizen), employee involvement, and the importance of reducing waste. The principles of TQM are woven into every level of Toyota’s operations.
   
   
2. Motorola: Motorola is known for adopting TQM in the 1980s, which led to the development of Six Sigma—a methodology that focuses on reducing defects and variation in processes. Motorola’s commitment to TQM helped them achieve substantial improvements in product quality and operational efficiency.
   
   
3. Ford Motor Company: In the 1980s, Ford implemented TQM as a part of its efforts to improve quality and regain market share. Ford focused on employee training, process improvements, and creating a culture of continuous feedback to maintain high standards of quality.
   
   
4. Caterpillar: Caterpillar, the heavy equipment manufacturer, used TQM principles to enhance its manufacturing processes and customer service. By focusing on product quality and involving all employees in quality management, they have maintained their leadership in the industry.
   
   
5. PepsiCo: PepsiCo is another example of a company that has used TQM principles to improve its products and processes. PepsiCo uses continuous feedback from customers and employees to improve quality control and efficiency in its production processes.
   
   
6. Ritz-Carlton: Known for its commitment to customer service, Ritz-Carlton employs TQM principles by training employees to deliver consistent and high-quality service. The company uses customer feedback and quality audits to continuously enhance the guest experience.
   
   
7. Amazon: Amazon incorporates aspects of TQM in its supply chain management, customer service, and product offerings. Through its focus on continuous improvement and customer satisfaction, Amazon has revolutionized e-commerce and logistics, constantly improving its processes to maintain its competitive edge.
   
   

Conclusion

TQM is a philosophy that fosters a culture of continuous improvement, customer satisfaction, and employee engagement. Its principles—focusing on customer needs, data-driven decisions, process optimization, and collaboration—are critical for any organization that wants to remain competitive in today’s rapidly evolving marketplace. Well-known organizations like Toyota, Motorola, PepsiCo, and Ritz-Carlton have successfully implemented TQM to improve quality, streamline processes, and build customer loyalty. By adopting TQM principles, organizations can enhance their operational performance, drive innovation, and sustain long-term success.

Leaders in TQM

Several well-known authors have written extensively about Total Quality Management (TQM) in healthcare, focusing on its principles, implementation, and impact on improving healthcare quality and patient outcomes. Here are some influential authors and their contributions:

1. W. Edwards Deming

• Books: Out of the Crisis, The New Economics for Industry, Government, Education
  
  
• Contribution: W. Edwards Deming is considered one of the pioneers of quality management principles, including TQM. His work heavily influenced the healthcare industry’s adoption of TQM principles. Deming’s work on continuous improvement, statistical process control, and the Plan-Do-Check-Act (PDCA) cycle has been foundational in shaping healthcare quality improvement efforts.
  
  

2. Joseph M. Juran

• Books: Juran’s Quality Handbook, Managerial Breakthrough
  
  
• Contribution: Juran is another key figure in quality management, and his work has influenced healthcare organizations to focus on the quality planning, quality control, and quality improvement aspects of TQM. His emphasis on leadership and employee involvement in the process of quality improvement has been widely adopted in healthcare systems.
  
  

3. Armand V. Feigenbaum

• Books: Total Quality Control
  
  
• Contribution: Feigenbaum introduced the concept of Total Quality Control, which later evolved into Total Quality Management. His work on integrating quality management across all levels of an organization has been particularly impactful in healthcare, where a coordinated effort across departments is essential for improving patient care.
  
  

4. James P. Womack

• Books: Lean Thinking, The Machine That Changed the World
  
  
• Contribution: While Womack is best known for his work on lean manufacturing, his principles have been applied successfully in healthcare settings. His focus on eliminating waste, improving efficiency, and delivering value to customers (patients) aligns with TQM principles and has influenced healthcare organizations aiming to streamline operations and improve patient outcomes.
  
  

5. Gary R. Lichtenstein

• Books: Total Quality Management in Health Care
  
  
• Contribution: Lichtenstein’s work directly applies TQM principles to healthcare settings. His writings emphasize the importance of customer (patient) focus, employee involvement, and leadership commitment to improving healthcare quality through TQM. He also discusses the integration of TQM with other management systems in healthcare.
  
  

6. Paul Batalden

• Books: Improving Quality in American Health Care
  
  
• Contribution: Batalden has been a leader in the development of quality improvement techniques in healthcare. He is particularly known for his contributions to the understanding of how quality management processes, including TQM, can be integrated into healthcare organizations. His work emphasizes the importance of involving healthcare providers and patients in quality improvement initiatives.
  
  

7. John Seddon

• Books: Freedom from Command and Control, Systems Thinking in the Public Sector
  
  
• Contribution: Seddon’s work on systems thinking and lean management principles has influenced healthcare quality improvement strategies. He focuses on designing better systems that reduce waste and improve service delivery, which aligns with the goals of TQM.
  
  

8. Lori D. Johnson & John H. Grant

• Books: Implementing Total Quality Management in Health Care: A Process of Continuous Improvement
  
  
• Contribution: Johnson and Grant’s book offers a detailed framework for implementing TQM in healthcare settings. It emphasizes the use of data, process improvements, and employee training to achieve continuous quality improvements.
  
  

9. William D. McDaniel & Jeffrey L. Houghton

• Books: Total Quality Management for Hospital Administrators
  
  
• Contribution: McDaniel and Houghton focus specifically on hospital settings, addressing how TQM principles can be implemented to improve clinical outcomes, patient safety, and overall operational efficiency.
  
  

10. Robert L. Juran (Juran Institute)

• Books: Quality Control Handbook, Juran on Leadership for Quality
  
  
• Contribution: The Juran Institute has had a significant influence on healthcare organizations, particularly in terms of training and applying quality management principles. Robert Juran’s work has inspired healthcare leaders to prioritize quality improvement and customer satisfaction (patients) at all organizational levels.
  
  

These authors and their works have had a profound impact on how healthcare organizations approach quality management, patient satisfaction, and continuous improvement through TQM principles. Their research and practical frameworks continue to guide healthcare leaders in achieving better outcomes for patients and organizations alike.