Analyzing the Total Quality Management Practices in the Healthcare Sector; Employee Perception

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1 pp Krishi Sanskriti Publications Analyzing the Quality Management Practices in the Healthcare Sector; Employee Perception Vishnu. A. S 1 and Dr. S. Jayadev 2 1 Research Scholar CET School of Management College of Engineering Trivandrum 2 Post Graduate Department of Commerce V.T.M.N.S.S. College, Dhanuvachapuram, Thiruvananthapuram 1 vishnuasokanchempaz@gmail.com, 2 dr.jayadevs@yahoo.com Abstract: Quality management has been one of the emerging managerial approaches not in manufacturing sector but also in service companies all over the world. Healthcare organizations have been implementing TQM practices since 1980s because of changing needs of customers, pressure from employees and to get accreditation from various associations. This paper is aimed to analyze the perception of employees on the total quality management practices in Kerala s healthcare sector. A well-structured questionnaire was used to collect the data from the employees who are working in different healthcare organizations in Kerala. Data analysis has been done with the help of Levene s Test of equality of error variance and Univariate general linear model. Findings have shown that there is no difference in the perception of employees regarding the TQM practices with respect to their age, gender and the interaction between gender and age. The results of this study can be used by the researchers who are doing research in quality management area and also the various healthcare organizations across the country. 1. INTRODUCTION The colossal impact of globalization is the key factor which contributed fruitfully in making radical changes in the social and economic development universally. Survival of the enterprises in this competitive business environment became difficult. The benefits of TQM can act as catalyst for solving new issues which are faced by the enterprises nowadays [1-4]. quality management shows a change from the traditional way of doing things, focusing customer satisfaction through continuous improvement of processes and systems. Studies showed that customer satisfaction, employee satisfaction, financial and operating performance can be achieved through TQM implementation. quality management has been one of the emerging management approaches not in manufacturing sector but also in service companies all over the world [5-9]. As a business strategy, leading manufacturing companies have implemented total quality management [10]. Since 1980 s onwards healthcare organizations have been adopting the concepts of TQM due to the changing needs of customers, pressure from employees and to get accreditation from various associations. TQM implementation is the one way to empower employees in the organization [11]. This empowerment can be achieved through training and education. Another study showed that employee capability in doing task and confidence can be enhanced with the help of TQM practice [12]. The present study is dealing with the following areas, 1. The perception of employees on total quality management practices in Kerala s healthcare sector. 2. Is there any difference in the perception of employees on TQM practices with respect to their age and gender 2. RESEARCH METHODOLOGY Many organizations in manufacturing and service sector across the world had successfully implemented total quality management as a management technique to achieve sustainable advantage [13]. quality management has been defined in many ways by different researchers and there is no standard set of quality management practices that can be used both in manufacturing and service industry [14-15]. The findings of Fotopoulos and Psomas [16] had shown some key practices (leadership, supplier management, strategic quality planning, customer focus, employee management and involvement, continuous improvement, process management, knowledge and education and also information and analysis) which are essential for the successful implementation of total quality management in the organization. Sadikoglu and Zehir conducted a study on relationship between TQM practices and innovation and employee performance and proposed eight quality management practices (leadership, continuous improvement, employee management, training, information and analysis, customer focus, supplier management, and process management) [17]. Talib et al. has identified 17 TQM practices (top-management commitment, customer focus, training and education, communication, continuous improvement and innovation, employee involvement, information and analysis, process management, supplier management, quality systems, benchmarking, quality culture, human resource management, strategic planning, employee encouragement, teamwork, and product and service design) for service sector all over the world [18-20]. And he explained the importance of these practices. This study used these 17 practices suggested by

2 Analyzing the Quality Management Practices in the Healthcare Sector; Employee Perception 97 Talib et al. because these are used by different researchers in quality management, applicability of these practices both in manufacturing and service sector and its association with service quality of the organization. For the convenience of data collection and analysis, these seventeen TQM practices have been classified into four groups such as TQM & Employees, TQM & Customer, TQM & Organization and TQM & Management. Table 1: Grouping of TQM practices TQM & Employee Employee involvement Employee encouragement Human resource management Training & education TQM & Customer Customer Focus Continuous improvement and innovation Product / service design TQM & Organization Quality Culture Teamwork Information and analysis Communication Quality systems TQM & Management Management Commitment Strategic planning Process Management Supplier Management Benchmarking 3. RESEARCH METHODOLOGY This paper has suggested certain objectives, and it can be accomplished with the help of proper research methodology. This division includes research design, sampling, data collection tools and procedures. Research Design The questionnaire survey was used for the study and it was distributed among the employees in various healthcare organizations by hand. Sample Design All the healthcare organizations in Kerala under different management such as private, government and charitable trust were included in the sampling frame. It also gives the complete information about the companies. The state of Kerala has been divided into three zones, northern, central and southern. With the help of convenient sampling, three organizations from each zone were selected for data collection. And 68 questionnaires were distributed among the selected organizations. Tools used for the study A well-structured questionnaire was developed for collecting the data. A pilot study has been conducted for validating the research instrument and it was revised with the help of quality experts, researchers and academicians. The questionnaire is classified into four groups. The first group consists of questions relating to TQM practices and employees. Second and third portion relating TQM practices with customers and organizational characteristics respectively. The last part consists of questions relating to TQM practices and management. The collected data was used to examine the perception of employees on TQM practices with respect to their age and gender. A five point Likert scale was used in the questionnaire with 5-strongly agree, 4-agree, 3-neutral, 2=disagree and 1-strongly disagree. 4. RESULTS AND ANALYSIS The questionnaire was distributed among 68 employees in various healthcare organizations in Kerala. Table 2 shows both the gender and age wise classification of respondents. Out of the 68 respondents 36(52.1%) were female. Here, the respondents were again classified into four age groups (18-25, 26-35, and above 45). Most of the respondents belong to the second age group 26-35(58.8%) Table 2: Classification of Respondents Gender Frequency Percent Female Male Age Frequency Percent above The mean and standard deviation of employee s responds regarding TQM practices were calculated. Table 3 is an example for the calculated mean and standard deviation of employee s opinion about the TQM practices under the group TQM & Employees and TQM & Customer. This study used Levene s test of equality of variance. This test assumes that the groups have equal variance, called homogeneity of variance. Table 4 shows the Levene s test result of TQM practices under four groups. Dependent variables under the head TQM & employees have violated the assumption of equality of variance. That is F value obtained is 2.436, and P=0.035 (P<0.05), meaning that null hypothesis formulated is rejected. That means the variance between the mean values obtained is different. This shows the fact that there is age wise and gender wise disparity of hospital employee s with

3 98 Vishnu. A. S and Dr. S. Jayadev reference to equality of variance for the variables under the head TQM & Employees. In the second case F value is 7.503, and P=.000 (P<.0.05), so null hypothesis is violated. In the third and fourth case also null hypothesis is rejected because F=6.516, F=5.454 and p=.000 (P<0.05). That means the variance between the mean values obtained is different. This shows the fact that there is age wise and gender wise disparity of hospital employee with reference to equality of variance for the variables under the heads TQM & Customer, TQM & Organization and TQM & Management Table 3: & Std. Deviation of Response TQM & Employees TQM & Customer N Gender Age Std Deviation Std Deviation Female Male Above Above Table 4: Levene s test of Equality of Variances F df1 df2 Sig. TQM & Employee TQM & Customer TQM & Organization TQM & Management Table 5: Univariate general linear model 1 Sum of Squares Df Corrected.946a Model Intercept Gender Age Gender * Age Error Corrected a. R Squared =.095 (Adjusted R Squared =.006) From the above table 5, it is clear that, when gender is concerned there is no significant difference in the employee perception on the TQM practices under the head TQM & Employee (employee involvement, employee encouragement, HRM and training and education), as the obtained F value is 0.041, P=0.839 (P>0.05). That means perception level of TQM practices under the head TQM & Employee of hospital employees with respect to their gender is same. Similarly, when age is concerned, there is no significant difference in the employee perception with respect to the variables in the group TQM & Employee, as the obtained F value is , P=0.243 (P>0.05). That means perception level of TQM practices of hospital employees with respect to the variables under the head TQM & employees is same for Kerala. Now it is imperative to know the interaction effect of gender with age, the result shows that there is no significant difference with respect to the practices in the group TQM & Employees, as the obtained F value is 0.012, P=0.988 (P>0.05). That means perception level of TQM practices in the group TQM & Employees of hospital employees is same for Kerala. Therefore, the null hypothesis is supported. That is both age and gender has no role to support or influence the perception level of employee s regarding the TQM practices under the head TQM & Employees. The R Squared Value (Partial Eta Squared) obtained for the same is 9.5%. This shows that the perception level of TQM practices in the group TQM & Employees have been uninfluenced by the interaction effect of age and gender of employee s by 9.5%. Table 6: Univariate general linear model 2 Squares Df Corrected Model 1.061a Intercept Gender Age Gender * Age Error Corrected a. R Squared =.163 (Adjusted R Squared =.080) This part (Table 6) is analyzing the perception of employees on the dependent variables; customer focus, continuous

4 Analyzing the Quality Management Practices in the Healthcare Sector; Employee Perception 99 improvement and innovation and product/service design under the head TQM & customer with respect to their age and gender. From the above table, when gender is considered, F value is 5.837, P=0.019 (P<0.05). That means perception level of hospital employees regarding TQM practices (customer focus, continuous improvement and innovation and product/service design) with respect to gender is different. But when age is considered there is no significant difference with respect to the variables under TQM & customer (F value is , P=0.189 (P>0.05)). This means the TQM practices such as customer focus, continuous improvement and innovation and product/service design are perceived similarly by the hospital employee s with respect to their age. When consider both age and gender together with the above mentioned three TQM practices, there is no significant difference in the perception of employees, as the obtained F value is 2.762, P=0.071 (P>0.05). Therefore, the null hypothesis is supported. That is interaction effect of both age and gender has no role to support or influence the perception level of TQM practices such as customer focus, continuous improvement and innovation and product/service design. The R Squared Value (Partial Eta Squared) obtained for the same is 16.3%. This shows that the perception of employee s regarding the practices under the head TQM & Customer have been uninfluenced by the interaction effect of age and gender by 16.3%. Table 7: Univariate general linear model 3 Squares df Corrected Model.257a Intercept Gender Age Gender * Age Error Corrected a. R Squared =.030 (Adjusted R Squared = -.065) Table 7 shows, F(0.136,0.191 and 0.362) and P(0.714, and 0.693) values obtained for the variables such as quality culture, teamwork, information and analysis, communication, quality systems with respect to gender, age and interaction between gender and age. In the above three cases P value obtained is greater than Therefore, the null hypothesis is accepted and it shows that the perception of employees regarding the TQM practices (quality culture, teamwork, information and analysis, communication, quality systems) are same with respect to gender, age and interaction between gender and age. The R Squared Value (Partial Eta Squared) obtained for the same is 3%. This shows that the perception level of TQM practices under the head TQM & Organization have been uninfluenced by the interaction effect of age and gender by 3%. It is clear from the table 8 that, when considering gender, age and interaction between gender and age, the employee perception is same for the TQM practices under the head TQM & Management (management commitment, strategic planning, process management, supplier management and benchmarking) because the P values obtained is greater than The R Squared Value (Partial Eta Squared) obtained for the same is 3.4%. This shows that the perception level of TQM practices such as management commitment, strategic planning, process management, supplier management and benchmarking have been uninfluenced by the interaction effect of age and gender by 3.4%. Table 8: Univariate general linear model 4 Squares df Corrected Model.286a Intercept Gender Age Gender * Age Error Corrected a. R Squared =.034 (Adjusted R Squared = -.061) From the analysis it is clear that, according to Levene s test of equality of variance, there is age wise and gender wise disparity in employee s perception on TQM practices. But the results of Univariate general linear model test show that the employee perception on TQM practices with respect to their gender, age and interaction between gender and age is same, except in the case of TQM practices such as customer focus, continuous improvement and innovation and product/service design which are differently perceived by hospital employees with respect to gender. 5. CONCLUSION This paper has stated some objectives regarding the employee s perception on total quality management practices in the healthcare sector in Kerala. Findings of this study show that the employee perception on TQM practices with respect to their gender and age are the same. But TQM practices such as customer focus, continuous improvement and innovation and product/service design are differently perceived by the hospital employees with respect to their gender.

5 100 Vishnu. A. S and Dr. S. Jayadev REFERENCES [1] Wali, Ayoob, A and Gupta, A.D, "Framework for TQM Performance Measurement System", Productivity, 2000, Vol. 41, No. 1, PP.7-9. [2] Thiagaragan, T., Zairi, M. and Dale, B.G., A proposed model of TQM implementation based on an empirical study of Malaysian industry, International Journal of Quality & Reliability Management, 2001, Vol. 18 No. 3, pp [3] Curkovic, S., Melnyk, S., Calantone, R. and Handfield, R, Validating the Malcolm Baldrige National Quality Award framework through structural equation modeling, International Journal of Production Research, 2000, Vol. 38, pp [4] Zakuan, N.M., Yusof, S.M., Laosirihongthong, T. and Shaharoun, A.M., Proposed relationship of TQM and organizational performance using structured equation modeling, Quality Management, 2010, Vol. 21 No. 2, pp [5] Brah, S.A. and Tee, S.S.L., Relationship between TQM and performance of Singapore companies, International Journal of Quality & Reliability Management, 2002, Vol. 19 No. 4, pp [6] Yang, C.C., The impact of human resource management practices on the implementation of total quality management, The TQM Magazine, 2006, Vol. 18 No. 2, pp [7] Kumar, V., Choisne, F., de Grosfoir, D. and Kumar, U., Impact of TQM on company s performance, International Journal of Quality & Reliability Management, 2009, Vol. 26 No. 1, pp [8] Fuentes, M.M.F., Montes, F.J.L. and Fernandez, L.M.M., quality management, strategic orientation and organizational performance: the case of Spanish companies, Quality Management, 2006, Vol. 17 No. 3, pp [9] Sila, I., Examining the effects of contextual factors on total quality management and performance through the lens of organizational theories: an empirical study, Journal of Operations Management, 2007, Vol. 25 No. 1, pp [10] Sohal, A.S., & Terzivski, M., "TQM in Australian manufacturing: factors critical to success", International Journal of Quality & Reliability Management, 2000, 17 (2), pp [11] Juran, J.M. and Gryna, F.M., "Quality Planning and Analysis", 3 rd ed., McGraw-Hill, New York, 1993, NY. [12] Shea, C.M. and Howell, J.M., "Organizational antecedents to the successful implementation of total quality management: a social cognitive perspective", Journal of Quality Management, 1998, Vol. 3 No. 1, pp [13] Trappey, C., TQM: where is it today and where will it is tomorrow? Mobius, 1995, 14( 2), pp [14] Prajogo, D.I. and McDermott, C.M., The relationship between TQM practices and organizational culture, International Journal of Operations & Production Management, 2005, Vol. 25 No. 11, pp [15] Dow, D., Samson, D. and Ford, S., Exploding the myth: do all quality management practices contribute to superior quality performance?, Production and Operations Management, 1999, Vol. 8 No. 1, pp [16] Fotopoulos, C.V. and Psomas, E.L., The structural relationships between total quality management factors and organizational performance, The TQM Journal, 2010, Vol. 22 No. 5, pp [17] Sadikoglu, E. and Zehir, C., Investigating the effects of innovation and employee performance on the relationship between TQM practices and firm performance: an empirical study of Turkish firms, International Journal of Production Economics, 2010, Vol. 127 No. 1, pp [18] Talib, F. and Rahman, Z., Critical success factors of total quality management in service organization: a proposed model, Service Marketing Quarterly, 2010, Vol. 31 No. 3, pp [19] Talib, F. and Rahman, Z., quality management practices in manufacturing and service industries: a comparative study, International Journal of Advanced Operations Management (IJAOM), 2012, Vol. 4 No. 3 (in press). [20] Talib, F., Rahman, Z. and Qureshi, M.N., An interpretive structural modeling approach for modeling the practices of total quality management in service sector, International Journal of Modeling in Operations Management, 2011a, Vol. 1 No. 3, pp [21] Talib, F., Rahman, Z., Qureshi, M.N. and Siddiqui, J., quality management and service quality: an exploratory study of management practices and barriers in service industries, International Journal of Services and Operations Management, 2011b, Vol. 10 No. 1, pp