Expert advice for implementing Total Quality Management at non-profits

PUTTING CUSTOMERS FIRST ISN'T EASY

February 10, 1992|By LESTER A. PICKER

As I've pointed out before in this column, Total Quality Management is not for the faint-hearted. It takes exceptional dedication on the part of staff, hard work, persistence and a corporate culture that values and rewards teamwork.

If your non-profit organization is ready to institute a quality management plan -- making the customer the prime focus of business -- how should you go about it? I consulted several experts in the field for pointers.

"First the organization needs to look at their mission statement and their goals. Where are they now and where do they want to be in three years and in five years?" says Dr. Judy Broida, Associate Dean and Director of the Division of Business and Management, School of Continuing Studies at the Johns Hopkins University.

Next, do a strategic needs assessment, focusing on operations that you feel must improve. Sometimes this is spurred by competition -- an increasingly common occurrence even in the staid world of non-profits. For example, after economic and logistical crises, the blood services division of the regional American Red Cross found that competing for-profit and non-profit organizations were encroaching on what was formerly its exclusive province.

Once your organization identifies its needs, search for "benchmarks" -- other organizations or companies that have excelled in the functions that need improvement. Benchmarking is a key piece of jargon in TQM, but one that carries a great deal of significance. Without models of excellence, the process is much more difficult.

Once benchmarks are identified, learn as much about those organizations as possible. Often, if the benchmark firm is in another industry, its executives will help your organization achieve new standards. This was the case recently with the Johns Hopkins Health System. In developing its exciting Systemwide Quality Management program, it brought in companies like 3M and Federal Express to work with Hopkins staff.

Concurrently, your organization must gather lots of feedback about itself. As Dr. Broida points out, "it is important to recognize that your internal people are customers, too." TQM teams need to interview employees (internal customers), clients, vendors and end-users of the services and products of the non-profit.

With this initial examination now essentially complete, set high standards, as well as goals and a time line.

Yet, TQM is not a one-time program. It is a continuous, conscious process to achieve excellence in product, service and customer satisfaction. So, it must have absolute support from the top, "strong internal champions" in Dr. Broida's words.

Vivian Cary, president of The Cary Group, a New York-based health care and management firm specializing in TQM, echoes this sentiment. "In order to ensure future quality care, the culture of problem resolution must change. And the changes must be generated by top management," she said.

Finally, TQM requires that good evaluation systems be put into place from the beginning of the process.

Dr. Broida said employee teams must monitor the process throughout the organization, frequently bringing in vendors to embrace the TQM process.

Does TQM work?

It certainly does, said Jack Brown, senior vice president for Quality Management at the American Red Cross' regional blood services operation. Ms. Cary and Dr. Broida agree.

In the short term, costs may increase, due to staff training requirements.

"But," Ms. Cary points out, "the larger picture is of institutions operating more efficiently and offering better patient care at a lower cost. It stands to reason that better care leads to better relations between the health care community and the people it serves. A satisfied patient, like a satisfied customer anywhere, is likely to refer friends and relatives -- and much less likely to initiate costly malpractice suits, for example."

The people at Johns Hopkins Health Systems also praise TQM. In their most recent annual report they state, "Clearly [quality management] makes the Health System run better and improves the patient care environment. And that's the whole point. With the QM process helping us bring more mysteries of managing the Health System to light, everyone at Hopkins will have more opportunities to do what we do best even better."

Advice for any non-profit.

Les Picker, a consultant in the field of philanthropy, works with charitable organizations and for-profit companies.

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