Wakefield D S, Wakefield B J
Graduate Program in Hospital and Health Administration, University of Iowa, Iowa City 52242.
QRB Qual Rev Bull. 1993 Mar;19(3):83-8. doi: 10.1016/s0097-5990(16)30597-8.
Many health care organizations are attempting to rapidly implement total quality management (TQM) and continuous quality improvement (CQI) philosophies and concepts. In the case of hospitals, a number of issues resulting from traditional organizational design and management practices as well as the characteristics of health care professionals pose significant challenges to rapid implementation. Recognizing and developing strategies to address these challenges, along with realizing that TQM and CQI represent viable processes for conducting organizational "preventive maintenance," may help in changing the focus of quality assessment and enhancement initiatives from processes that are "broken" to processes that should be "fixed" before they "break." This article discusses strategies for overcoming some of the major barriers and challenges to successful TQM and CQI implementation to the hospital setting.
许多医疗保健组织正试图迅速实施全面质量管理（TQM）和持续质量改进（CQI）理念及概念。就医院而言，传统组织设计与管理实践所产生的一些问题以及医疗保健专业人员的特点，给快速实施带来了重大挑战。认识并制定应对这些挑战的策略，同时意识到TQM和CQI是进行组织“预防性维护”的可行流程，可能有助于将质量评估与提升举措的重点从“出现故障”的流程转变为在“出现故障”之前就应“修复”的流程。本文讨论了在医院环境中克服成功实施TQM和CQI的一些主要障碍与挑战的策略。
