Parvaneh Esfahani, Ali Mohammad Mosadeghrad and Ali Akbarisari
Although strategic planning promised to boost organizational performance, many health care managers found it difficult to implement it successfully. The purpose of this paper is…
Abstract
Purpose
Although strategic planning promised to boost organizational performance, many health care managers found it difficult to implement it successfully. The purpose of this paper is to investigate the success of strategic planning in health care organizations of Iran.
Design/methodology/approach
This descriptive and cross-sectional study was conducted in 2016 using a valid and reliable questionnaire completed by 99 health care managers in Tehran province, Iran.
Findings
Strategic planning was positively related to organizational performance including employees’ and patients’ satisfaction and organizational productivity. However, strategic planning was moderately successful in enhancing organizational performance of Iranian health care organizations (score of 2.84 out of 5). The most and least success was observed in the planning and employee management constructs of organizational performance. Process management, organizational culture and customer management constructs had the most effect on the success of strategic plans in health care organizations.
Practical implications
Strategic planning is effective and provides a clear focused direction for health care organizations. Understanding the success factors of strategic planning would enable managers to develop more effective methods for developing, implementing and evaluating strategic plans in health care organizations.
Originality/value
This paper highlights the relationship between strategic planning and organizational performance and offers suggestions on how to develop and implement strategic plans to achieve higher organizational performance.
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Ali Mohammad Mosadeghrad and Mahnaz Afshari
The operating theater (OT) is resource-intensive, costly and assuring its productivity is a high priority. This study aimed to examine a quality management model's effects on a…
Abstract
Purpose
The operating theater (OT) is resource-intensive, costly and assuring its productivity is a high priority. This study aimed to examine a quality management model's effects on a hospital's OT productivity.
Design/methodology/approach
The participatory action research approach was used for the intervention. A multidisciplinary quality improvement team was formed. The team improved OT operational processes using an eight-step quality management model. OT’s key performance indicators such as surgical cases, surgical cancellation, bill deductions, successful cardiopulmonary resuscitation, patients' complaints and employees' job satisfaction were collected before the intervention and compared with those of after intervention to determine the efficacy of the quality management model.
Findings
Applying a quality management strategy increased surgical patients' number by 14.96%, reduced surgery operations cancellation by 14.6 %, and decreased bill deduction by 44.9%. Besides, successful cardiopulmonary resuscitation increased by 21.17%, patients' complaints reduced by 61.5% and, finally, staff satisfaction increased by 15.6 %. Improved OT productivity resulted in improved financial performance. As a result, the OT revenue has risen by 68.8%.
Originality/value
This study highlights that implementing the right quality management model properly enhances hospitals' productivity. It also offers suggestions on how to implement a quality management model successfully in a hospital setting.
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Ali Mohammad Mosadeghrad and Arezoo Mojbafan
Hospitals are complex and complicated organizations and are prone to the conflict. The purpose of this paper is to identify the intensity and type of conflict experienced by…
Abstract
Purpose
Hospitals are complex and complicated organizations and are prone to the conflict. The purpose of this paper is to identify the intensity and type of conflict experienced by hospital managers and explore their conflict management strategies in hospitals affiliated with Tehran University of Medical Sciences.
Design/methodology/approach
This quantitative, descriptive and cross-sectional study was conducted in 2015. A self-administered questionnaire was used to collect data from top, middle and front line managers. In total, 563 managers from 14 hospitals responded to the questionnaires. Data were analyzed using SPSS software version 19.
Findings
Hospital managers reported average level of conflict (2.73 score out of 5). Organizational factors produced more conflict for managers than personal factors. High workload, resource shortage, bureaucracy and differences in managers’ personality, knowledge, capabilities and skills were the main causes of organizational and personal conflict. Top managers experienced more conflict than middle and front line managers. Conflict was higher in specialized hospitals compared to general hospitals. Less conflict was observed in administrative and support departments than diagnostic and therapeutic departments. Conflict was meaningfully associated with management level, education, size of hospital, number of employees and willingness to leave the hospital. The dominant conflict management style of managers was collaborating. There were significant relationships between collaborating style and management level, manager’s age, work experience and management experience.
Practical implications
The nature of hospitals requires that managers use collaborating, compromising and accommodating styles to interact better with different stakeholders. Managers by acquiring necessary training and using the right conflict resolution strategies should keep the conflict in a constructive level in hospitals.
Originality/value
This is the first study conducted in Iran examining the level of conflict, its types and identifying managers’ dominant conflict resolution strategies at front line, middle and top management levels.
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Ebrahim Jaafaripooyan, Ali Mohammad Mosadeghrad, Maryam Ghiasipour and Iyad Ibrahim Shaqura
Leadership is the ability to influence, guide and encourage employees to achieve organizational goals. Leadership has a significant role in organizations’ success or failure…
Abstract
Purpose
Leadership is the ability to influence, guide and encourage employees to achieve organizational goals. Leadership has a significant role in organizations’ success or failure. Thus, this paper aims to develop a model to elucidate leadership practices in the Iranian health-care organizations (HCOs).
Design/methodology/approach
Qualitative approach was used in this study due to its explorative nature. Semi-structured interviews were conducted with 32 key managers and 30 professionals working at different HCOs. Inductive analysis was carried out using the grounded theory approach to develop an initial leadership model for HCOs. The proposed model subsequently was verified by an experts’ panel.
Findings
The proposed leadership model emerged from the Iranian HCOs encompasses six main categories: leader, followers, high-ups and peers, context, processes and outcomes. Leader, followers and contexts as main categories did also have further sub-categories.
Research limitations/implications
Study findings are cautiously transferrable as it reflects the Iranian context. While the model was verified, it might still benefit from more and diverse views.
Practical implications
This model can be used by health-care policymakers and managers for improving managers’ leadership competencies and practices and enhancing health outcomes through motivating and mobilizing health-care resources toward achieving organizational goals.
Originality/value
This study aims to give an answer for “what is the current status of leadership in Iranian HCOs?” and “how can we reinforce the strengths and address the weaknesses?”
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– The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation.
Abstract
Purpose
The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation.
Design/methodology/approach
A literature review was conducted to explore the critical successful factors for TQM implementation between 1980 and 2010.
Findings
A successful TQM implementation need sufficient education and training, supportive leadership, consistent support of top management, customer focus, employee involvement, process management and continuous improvement of processes.
Research limitations/implications
The review was limited to articles written in English language during the past 30 years.
Practical implications
From a practical point of view, the findings of this paper provide managers with a practical understanding of the factors that are likely to facilitate TQM implementation in organisations.
Originality/value
Understanding the factors that are likely to promote TQM implementation would enable managers to develop more effective strategies that will enhance the chances of achieving business excellence.
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Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful…
Abstract
Purpose
Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful implementation in the healthcare sector.
Design/methodology/approach
This paper reports a literature review exploring the major reasons for the failure of TQM programmes in healthcare organisations.
Findings
TQM implementation and its impact depend heavily on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in healthcare organisations can be attributed to the strongly departmentalised, bureaucratic and hierarchical structure, professional autonomy, tensions between managers and professionals and the difficulties involved in evaluating healthcare processes and outcomes. Other obstacles to TQM success include lack of consistent managers' and employees' commitment to and involvement in TQM implementation, poor leadership and management, lack of a quality‐oriented culture, insufficient training, and inadequate resources. The review was limited to empirical articles written in the English language during the past 30 years (1980‐2010).
Practical implications
The findings of this article provide policy makers and managers with a practical understanding of the factors that are likely to obstruct TQM implementation in the healthcare sector.
Originality/value
Understanding the factors that obstruct TQM implementation would enable managers to develop more effective strategies for implementing TQM successfully in healthcare organisations.
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Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to…
Abstract
Purpose
Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran.
Design/methodology/approach
This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation.
Findings
TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers’ about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers’ and employees’ commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively.
Practical implications
Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence.
Originality/value
Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.
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Implementing total quality management (TQM) is not without difficulties and achieving its promised benefits is not easy. The purpose of this paper is to identify the barriers to…
Abstract
Purpose
Implementing total quality management (TQM) is not without difficulties and achieving its promised benefits is not easy. The purpose of this paper is to identify the barriers to TQM successful implementation.
Design/methodology/approach
A literature review has been done to explore the major reasons for the failure of TQM programmes.
Findings
An examination of 54 TQM empirical studies identified 54 obstacles to successful TQM implementation. There are both theoretical and practical difficulties in applying TQM in organisations. An ineffective TQM package, inappropriate TQM implementation methods and an inappropriate environment for implementing TQM are the main reasons for TQM failure. The most frequently mentioned reasons for TQM implementation failures include insufficient education and training, lack of employees’ involvement, lack of top management support, inadequate resources, deficient leadership, lack of a quality-oriented culture, poor communication, lack of a plan for change and employee resistance to the change programme.
Research limitations/implications
The review was limited to articles written in English language during the past 30 years (1980-2010).
Practical implications
TQM does deliver better performance when an appropriate model of TQM is appropriately implemented in a supportive environment. The findings of this paper provide managers with a practical understanding of the factors that are likely to obstruct TQM implementation. Managers should overcome these barriers to achieve the TQM benefits.
Originality/value
Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.
Details
Keywords
– The purpose of this paper is to develop a total quality management (TQM) model for healthcare organisations and validate it using a sample of Iranian healthcare organisations.
Abstract
Purpose
The purpose of this paper is to develop a total quality management (TQM) model for healthcare organisations and validate it using a sample of Iranian healthcare organisations.
Design/methodology/approach
A validated questionnaire was used to collect data from all healthcare organisations that implemented TQM in Isfahan province, Iran.
Findings
Using the proposed model, TQM implementation was measured in healthcare organisations. The level of TQM success in Isfahan healthcare organisations was medium. The highest score was achieved in the dimension of “customer management”, followed by “leadership” and “employee management”. Employee management, information management, customer management, process management and leadership had the most positive effect on TQM success. Using a series of quality management techniques had “synergistic” effect on TQM success.
Practical implications
Top management support, effective management of human resources, full involvement of the entire workforce including physicians, education and training, team working, continuous improvement, a corporate quality culture, customer focus and using a combination of management techniques under a quality management system are necessary for TQM successful implementation.
Originality/value
A healthcare context-specific model of TQM was developed and tested and suggestions were provided for its successful implementation.
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This study aims to identify the status of occupational stress among a sample of hospital employees in Iran. It further intended to reveal the harmful effects of occupational…
Abstract
Purpose
This study aims to identify the status of occupational stress among a sample of hospital employees in Iran. It further intended to reveal the harmful effects of occupational stress on employees’ health and well-being.
Design/methodology/approach
The study used a cross-sectional research design. A validated questionnaire was used to collect data from hospital employees.
Findings
Job-related, working environment, interpersonal and organisational factors were related to occupational stress. One-fourth of employees rated their occupational stress high. The major sources of occupational stress were inadequate pay, inequality at work, too much work, staff shortage, poor recognition and promotion, time pressure, job insecurity and lack of management support. High levels of occupational stress have been linked to an increased risk of physical injuries, cardiovascular disease, high blood pressure, depression and increases in negative personal behaviours such as anger, anxiety and irritability. Occupational stress was positively associated with employees’ turnover intentions.
Research limitations/implications
The findings of this study are not generalisable to the wider population of hospital employees in Iran due to the small sample size. Thus, future research should involve additional samples.
Practical implications
The study has practical relevance for designing and implementing strategies to decrease occupational stress among hospital employees.
Originality/value
This article contributes to health care theory and practise by identifying factors contributing to employees’ occupational stress and examining the association between occupational stress and two important employee outcomes – health status and turnover intention.