Unique contributions to the quality

Module 2 – Case


Assignment Overview

In this module, you learned about 4 approaches to quality assurance- TQM, CQI, Lean & Six Sigma. For this module’s case assignment, you will select TWO of these approaches and:

Compare and contrast the two approaches that you select- focus on what is “similar” and what is “different” between the two approaches.

Describe what unique contributions to quality each of the two approaches bring.

Discuss whether or not either of the approaches are more useful to a given patient care setting as opposed to another (for instance, is one better applied to the ambulatory care setting as opposed to the emergency department setting).

Give an opinion as to which approach is preferential and why.

Assignment Expectations

Length: Case Assignment Module assignments should be at least 4-5 pages in length.

References: At least two references should be included from academic sources (e.g. peer-reviewed journal articles). Use your own words and build on the ideas of others. When material is copied verbatim from external sources, it MUST be enclosed in quotes. The references should be cited within the text and also listed at the end of the assignment in the References section (preferably in APA format).

Organization: Subheadings should be used to organize your paper according to question

Format: APA format is recommended (but not required) for this assignment. See Syllabus page for more information on APA format.

The following items will be assessed in particular:

Relevance (e.g. all content is connected to the question)

Precision (e.g. specific question is addressed. Statements, facts, and statistics are specific and accurate).

Depth of discussion (e.g. present and integrate points that lead to deeper issues)

Breadth (e.g. multiple perspectives and references, multiple issues/factors considered)

Evidence (e.g. points are well-supported with facts, statistics and references)

Logic (e.g. presented discussion makes sense, conclusions are logically supported by premises, statements, or factual information)

Clarity (e.g. writing is concise, understandable, and contains sufficient detail or examples)

Objectivity (e.g. avoid use of first person and subjective bias)

Approaches to quality assurance in healthcare

            TQM (Total Quality Management) is the first philosophy that was quality-oriented to be adopted for transition in healthcare. It is based on three major principles; teamwork, customer focus, and continuous quality improvement. For TQM to be effective in healthcare, there is a need for support from healthcare professionals, leadership commitment, as well as the tendency to consider it at the institution’s strategy core as opposed to isolating it. Moreover, different powerful subcultures including the physician’s and manager’s subculture should come to an agreement regarding what quality should entail as well as how everything should be accomplished as opposed to having varying perspectives.

            The second approach that will be analyzed in this paper is CQI (Continuous Quality Improvement). This basically involves a principle where improvement is sought continually in a system or process. This is founded on the underlying belief that it is possible to improve any system’s or process’s aspect.

Compare and contrast two approaches

            TQM is acknowledged as a strategic initiative that has the ability of transforming the culture of every organization over time. As such, the principle is more responsive and customer-centric. Therefore, it is extremely effective in achieving its objectives. On the other hand, CQI focuses on utilizing a series of statistical analysis and routines in predicting the future quality improvements (Stahl, 2004). This is based on previous data from processes aimed at streamlining or improvement. As such, CQI is more focused towards a chain of data-centric techniques and tools. This includes the use of parent and flow charts, cause-and-effect diagrams, control charts, histograms, and scatter diagrams. This also includes the techniques and tools that are utilized in SPC (Statistical Process Control). CQI is often acknowledged as more future- or forward-based when compared to TQM. TQM largely focuses on a chain of initiatives and techniques aimed at unifying organizations around a similar theme of performance and quality to the customers’ expectations (Powell, 2008).

The two approaches are aimed at improving quality in an institution. TQM has a principal aim of improving quality through ensuring conformance to the internal requirements. Some of the strategies through which this can be achieved is minimizing the errors that are produced during service or manufacturing processes, increasing customer satisfaction, streamlining supply chain management, modernization of equipment, and ensuring that employees and workers possess the highest training level possible. On the same note, the application of CQI identifies both external and internal customers. Moreover, there is an emphasis on internal objective data to improve and analyze processes. Therefore, the internal components in an organization are very vital in both TQM and CQI.

Unique contributions to quality

            Ideally, TQM is utilized in cases where there are enterprise-wide shifts in strategy so that they can be more customer- and quality driven. On the other hand, CQI is oriented more towards a particular strategy or process area in which statistical analysis can be utilized in defining parameters as well as predicting outcomes based on better quality. A keen analysis of the two principles makes it clear that CQI has the ability of delivering more immediate effects in a healthcare organization. This is founded on the fact that it defines a particular strategy within a specific process area. On the other side, TQM is more proficient in redefining a whole corporate culture as well as rendering it more quality-based (Stahl, 2004).

Usefulness in patient care settings

            CQI is more suitable for ambulatory care as well as the continued and progressive betterment of future treatment procedures and processes. Through the use of statistical analysis, it is possible to isolate the areas of a particular ambulatory care department’s part that requires the most improvement. However, TQM’s role is better in bigger and more diverse departments which need extremely huge levels of cross-functional support and coordination. In addition, the TQM’s quality management approach would be effective in creating greater shared responsibility and synchronization across a whole practice are (McLaughlin & Kaluzny, 2004).

The preferable approach

            TQM is more preferably used in healthcare since it has immense benefits compared to CQI. TQM is very effective in reducing costs. This is by both minimizing underuses and overuses that occur in services as well as the errors in the services, and shortening time consuming long procedures. Hospitals that utilize TQM have a great reference for employee and customer satisfaction, and this is very vital in the present day competitive world. Through TQM, healthcare organizations get a chance to permit both customers and employees to better healthcare services’ quality (Croxall, 2003). There are several approaches that can be used in promoting employee participation. TQM is acknowledged as a systematic and participative approach for implementing and planning continuous organizational improvement procedures. The approach keenly focuses on fulfilling the customers’ expectations, promoting open-decision making, building commitment, and identifying problems. Moreover, there is use of several analytical tools which are useful in gathering data regarding activities taking place in the organization. TQM also facilitates process techniques that facilitate decision making and communication.


Croxall, C. L. (2003). 2001 Michigan hospital CQI/TQM study.

McLaughlin, C. P., & Kaluzny, A. D. (2004). Continuous quality improvement in health care: Theory, implementation, and applications. Sudbury, Mass: Jones and Bartlett.

Powell, C. L. (2008). Developing and implementing quality programs in healthcare organizations.

Stahl, M. J. (2004). Encyclopedia of health care management. Thousand Oaks, Calif: Sage Publications.

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