Introduction OhioHealth is one of the biggest organizations and the leading employer for patients in Ohio

Introduction
OhioHealth is one of the biggest organizations and the leading employer for patients in Ohio. OhioHealth is acknowledged as a not-for-profit, charitable, healthcare entity. There are approximately 29,000 associates, physicians and volunteers at OhioHealth. It is an organization that includes eleven hospitals, 200 plus ambulatory sites, hospice, home health, medical equipment and other health services spanning throughout 47 counties in Ohio (OhioHealth, 2018). OhioHealth offers many different specialties in their organization and through the specialties they offer experienced staff that helps to ensure the patients are treated appropriately. By doing so, OhioHealth has been able to grow and has been able to expand immensely over the last several years (OhioHealth, 2018).
OhioHealth must grasp on to the contemporary management technique, total quality management (TQM) to continue their series of success and to maintain their mission and vison statements. Blocher, Stout, Juras, & Cokins (2016) explains that TQM is a technique that assist organizations to “exceed customers’ expectations” (p. 13). TQM would be the suitable method for OhioHealth to utilize to keep their customers’ satisfied and to continue improvement in their organization. Much of the literature concerning TQM implementation programs suggests that there is a positive correlation between TQM practices and performance both operational and organizational and they bring numerous and varied benefits to the organizations that have successfully adopted them (Carmona-Marquez, Leal-Millan, Vazquez-Sanchez, Leal-Rodriguez, & Eldridge, 2016).

Technique Selection and Rationale
In order to keep an organization successful OhioHealth has recognized that there are numerous components to take into consideration. OhioHealth abides by their mission, which is to improve the health of those they serve (OhioHealth, 2018). OhioHealth also follows a vision: where people want to work, where physicians want to practice and, most importantly, where patients want to go when they need healthcare services (OhioHealth, 2018). In order to follow the mission and vision statements countless different aspects must continue to keep the patient satisfied. Quality management in healthcare is a crucial requirement for healthcare organizations. Making quality management patient-centric comes first. Adapting and implementing standards and tools is the next step towards this. Quality management in healthcare is of critical importance to the healthcare industry and the patient. Everyone in the loop -from physicians to practitioners to support staff -needs to be aware of the importance of quality management in healthcare. The most basic purpose of imparting high quality management in healthcare is to make sure that the patient is well taken care of. For this to happen, the healthcare setting has to implement systems and processes. Quality management centers on process management. If organizations have to ensure that meaningful quality management in healthcare is being implemented; they have to adhere to processes. Adapting standards and instilling processes into the healthcare system is how healthcare providers can assure quality in healthcare. Patient is at the center of quality management in healthcare.
Obviously, the first step in the direction of implementing quality management in healthcare is to make the healthcare setting’s care and processes patient-oriented and patient-centric. Quality management in healthcare begins with the patient and should be fully tuned to their needs. As patients’ requirements and expectations vary over time; quality management has to keep upgrading itself to keep up with the changing needs and demands. In line with this, the following means can go a long way in ensuring quality management in healthcare: the healthcare setting has to identify goals for ensuring quality management in healthcare. Each department has to be given measurable goals to reach. Implementing quality standards goes a long way in ensuring that quality management in healthcare is imparted in the organization. Six Sigma, ISO 9001 and ANOVA are some of the popular standards and tools that are used in the healthcare industry. Hiring the right professionals is another important step for healthcare organizations that are determined to implement quality management in healthcare. A Certified Professional in Healthcare Quality (CPHQ) is, for example, a person who has the right knowledge of leading the healthcare organization (Nwabueze, 2011).

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Management Technique
There are numerous contemporary management techniques that will ensure that an organization becomes successful but in the Healthcare field the patient is the main priority. To keep the patients satisfied then TQM should be implemented.
There are several elements for TQM to be a successful method. The first element is the work environment. The work environment must be flexible and contain teamwork, employees’ insights of safety come from the idea that work environment must be safe in order for the employees to remain committed with other signs of success (Kumar & Sharma, 2017). In order for the first element of TQM to be successful the second step must be implemented, which is complete employee participation. There should be mutual goals set for all employees to work toward. For employees to work toward these goals there must be a suitable atmosphere provided by management and encouragement must occur. It must begin at the top management and filter down to all the employees. There must also be a set of guidelines that lets organizations manage their technological basics in order to develop a competitive advantage. The responsibility of the technology management function is so that an organization can understand the worth of certain technology for the organization (Kumar & Sharma, 2017). Communication of all information is a very significant element of TQM (Kumar & Sharma, 2017). Effective communications is a very important part of the motivation that the employees must exercise (Kumar & Sharma, 2017). When there are changes that occur in an organization the employee morale will stay at a high level if communication happens, as well as the day to day operations (Mosadeghrad, 2015). Operating procedures is another component of TQM. TQM ISO 9000 (International Organization of Standardization) is a management program designed to help companies, it assists in maintaining process and quality control, and it remains competitive in a global business environment (Blocher, Stout, Juras, & Cokins, 2016). TQM programs designed to help organizations to maintain the process and quality control, and remain competitive in a worldwide business environment. TQM must also have accountability of sponsors. Sponsors work is dedicated to the development of a product, program, or project. It validates and allows a project to become formed that can oversee and preserves corporate accountability for successful management and the delivery of that project through the appropriate support of a qualified project manager (Kumar & Sharma, 2017). TQM must also have zero defects. It is a management tool intended to decrease the defects through prevention. It is aimed at motivating an employee to prevent mistakes and doing their job correctly the first time (Kumar & Sharma, 2017). Another element for TQM is inventory management. Companies that are implementing TQM attained a reduction in work-in-process inventory. Defenders have mass production so they need high inventory, and innovator and prospector are “make to order” or customer demand-type organization so their work in progress inventory is low (Kumar & Sharma, 2017). For an organization to know how well they are performing, fact-based decision making must take place. This is another element of TQM, and is a necessary step for TQM to work (Kumar & Sharma, 2017). This will include data on performance that is measured. The organization must constantly collect the data and analyze it for decision making accuracy to occur. Consensus can be achieved and future prediction can also be an outcome if measured correctly (Tena & Juan Car, 2001). There also must be competitiveness in order for TQM to work. It is stressed that the TQM concept helps to increase the competitiveness of organizations. This has resulted from the level of customer awareness, which assist them to select a product or service of high quality at a reasonable price (Kumar & Sharma, 2017). The results of the TQM generate competition among all businesses offering that item to satisfy their customer when considering buying a product or service. There is competition on the basis of approaches to attract customers, price, on time delivery, marketing and distribution, customer satisfaction, and the quality of the extra service provided, among other factors. Lastly there should always be continuous improvement. Continuous improvement deals with improving results and capabilities to produce better results, from high-level strategic planning and decision making to detailed execution of work elements on the shop floor. A plan is put into place and implemented on a small scale to see how it benefits the company. The results must be reviewed and analyzed to see where the plan is working and changes need to be made. Successful changes may then be implemented on a larger scale, and unsuccessful ones taken back to the drawing board for additional modifications (Kumar & Sharma, 2017).
The outcome of TQM practices can be significant. It was found that the highest effect in regards to a competitive advantage is the focus that the organization has on the patients. Management and leadership are followed after focusing on the patient when looking at TQM as a competitive advantage. If organizations should stay focused on the implementation and to ensure that it is successful and realize how important this technique is (Al-Qudah, 2012).

Implementation Process
A basic model for implementing a TQM system includes the following. Top management should learn and decide to commit to TQM. TQM is identified as one of the organizations strategies. The organization assesses current culture, satisfaction, and quality management systems. Top management identifies core values and principles to be used, and communicates that information to employees. A TQM plan is developed from step 1, 2, and 3. The organization identifies and prioritizes customers’ needs and aligns services to meet those needs. Management then maps the processes through which the organization meets its customers’ needs. Management oversees the formation of teams for process improvement efforts. The momentum if the TQM effort is managed by the steering committee. Managers contribute individually to the effort through planning, training, coaching and other methods. Daily process management and standardization take place. Progress is then evaluated and the plan is revised as needed. Constant employee awareness and feedback on status are provided and a reward/recognition process is established (Blocher, Stout, Juras, & Cokins, 2016).
A deeper look into TQM is as follows. As already explained, TQM should be focused on the patients and how to meet their needs. All employees need to be completely involved with this process by satisfying the patients internally and externally. Along with this should be continuous progress of developments that would lead to complex quality products and services. The first phase of implementing TQM would be to begin with setting short term and long term goals, to satisfy the patients, the employees and also the stockholders. After these goals are established there should be scorecards available for performance to be measured in key areas (Thomas, 2011). Objectives should be established and have a direct link with the scorecard goals.

Applicability of the Technique to OhioHealth
There are three different methods that can be used when implementing TQM. The first approach is the defender approach. This approach is in relation to quality assurance and improvement approaches that are already in motion. The physicians usually focus on the qualification requirements that are set to make sure that the quality assurance is up to date (Shortell, 1995). The second approach that is discussed is the analyzer approach, which follows an order of stages that begin at the higher management level and filter to the lower management level. Each project examined individually and evaluated before any type of initiation is started. Lastly, is the prospector approach, which is an approach that has no reaction until the organization realizes that an opportunity has emerged and then it is pursued (Shortell, 1995).
Shortell (1995) states “it appears that implementing quality improvement work in larger size hospitals with more bureaucratic cultures is a difficult task” (p. 397). After determining what approach will be used, management should evaluate the suggestion of the improvement and allow any support that would be associated with the quality improvements. Internal and external stakeholders should be involved with the projects for the implementation to be successful (Thomas, 2011).

Application by Other Organizations
TQM would not be what it is today without Toyota Motors. Graphs, extensive timelines and reports show the evolution of TQM and Quality Control (QC) throughout its 75-year history. For Toyota, TQM is based on the concept of “customer first”, kaizen meaning continuous improvement and “total participation” which means the involvement and input of all employees History of TQM at Toyota Understanding the magnitude of the company’s contribution to overall total quality management is a great feat. There is constant encouragement for further innovation, consensus and ideas for improvement. The Toyota Way also focuses on long-term improvements rather than short-term. The two main pillars of the Toyota Way are ‘Customer First’ and ‘Respect for people (Amasaka, 2008). A lot like Toyota the healthcare industry is the same on some levels. Their main priority is pleasing the customer just as OhioHealth strives to please the patient.
TQM has been used for many years in organizations but healthcare sectors are now starting to spectate the success of implementing TQM into their practices (Faloudah, Qasim & Bahumayd, 2015). “TQM enables healthcare organizations to identify customer requirements, benchmark for best practices and improve processes to deliver appropriate care and reduce the frequency and severity of medical errors” (Mosadeghrad, 2015). There are numerous mistakes that can happen in healthcare, because of this there are many questions that can come up about the quality of care.

Conclusion
Total quality is a description of the culture, attitude and the organization of a company
that seeks to provide excellent customer service to patients to satisfy their needs. It requires quality in all areas of operations, with processes being completed correctly the first time. It can be concluded that these elements are the key to safeguarding the success of TQM. Without these elements, the healthcare entities may not be successful. Leaders and team players must all participate by working together. Lack of communication can create a problem in the TQM process. It should be practiced to lead by example, train employees to provide excellent healthcare to patients. Leaders should recognize, train, and implement teamwork allowing integrity and ethics to be displayed within the organization. The main reason why TQM fails is because of the lack of knowledge about the proper TQM implementation.” While there is no consensus on the reasons leading to failures in TQM implementation there does appear to be widespread agreement that this situation results in organizations not achieving the desired outcomes with the associated waste of resources occasionally prompting the organization to abandon its implementation and development of a TQM philosophy (Idris and Zairi, 2006).
Healthcare organizations should be focused on total quality improvement and providing acceptable, quality health services to patients at affordable price within reasonable price, within in a reasonable time. The Health Care Industry is one of the most important industries if not the most important one. The purpose of a TQM program is to increase the effectiveness of the organization. The best way to measure TQM’s success is to establish quantitative benchmarking data. Healthcare needs to continue to provide the best TQM therefore this will mean zero errors to all patients we have to remember that learning from mistakes is not something that is accepted in health care.

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