Professional Documents
Culture Documents
Taibah University
Original Article
Received 5 January 2015; revised 25 May 2015; accepted 30 May 2015; Available online 7 July 2015
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Abstract
Objectives: The aims of the study were to explore the
extent of Total Quality Management (TQM) implementation in hospitals and its association with demographic variables.
Corresponding address: College of Nursing, University of
Dammam, AD Dammam 31441, KSA.
E-mail: ealshdaifat@ud.edu.sa
Peer review under responsibility of Taibah University.
Introduction
Total Quality Management (TQM) is one of the most
prominent developments in management for the past two
decades. TQM started in Japan in the early 1980s and spread
462
E.A. Al-Shdaifat
Missing value.
Number
Percent
105
221
(32.2)
(67.8)
194
89
32
1
(61.4)
(28.2)
(10.1)
(0.3)
200
99
27
(61.2)
(30.4)
(8.3)
186
139
6
(56.2)
(42)
(1.8)
56
76
71
10
113
(17.2)
(23.3)
(21.8)
(3.1)
(34.7)
124
78
34
96
(37.3)
(23.5)
(10.2)
(28.9)
463
diploma-level education (56.2%), and 1.8% had postgraduate degrees. The nurses working departments were as
follows; 23.3% in surgical departments, 21.8% in the ICU
and 34.7% working in other departments, including maternity, paediatric dialysis units and others. Approximately
37% of the participants were from a university hospital,
28.9% from a military hospital and 23.5% from a government hospital.
Factor analysis
The principal components analysis had given the amount
of variance, explained by each factor and cumulatively (70%
was used). It provides the weight for each variable on each
factor. The weight (loading) expresses the extent to which the
variable is correlated with the factor. In Table 2, the numbers
that are in the same column related to one factor, which is
named by C1 or C2, etc.
Factor Analysis was applied to identify the principles of
Total Quality Management (TQM) applied in the Jordanian
hospitals. Five principles resulted from using Principal
Component by Varimax Rotation Method: continuous
improvement, teamwork, training, top management
commitment and customer focus. These five principles
explained 70% of the variance in the 40 items included in the
questionnaire.
The questionnaire items and factor loadings are presented
in Table 2. All items were loaded if the factor loading is
0.40. Using these criteria, twelve items were found to load
as continuous improvement. Eight items were loaded as
teamwork, and six items were loaded as training. Eight
items were loaded as top management commitment, and
six items were loaded as customer focus.
Nurses attitudes towards the implementation of TQM
concepts
The average scores that represent the extent of implementing TQM concepts were below 60% for all identified
principles, indicating poor implementation of TQM principles in Jordanian hospitals (Table 3).
Differences in the extent of TQM principles implementation
between hospitals
Analysis of variance (ANOVA) showed a significant difference (P < 0.01) in all principles of TQM among different
types of hospitals from the nurses perspective. The implementation was highest at the Irbid Specialist Hospital.
Differences due to the extent of implementing TQM
principles in the hospitals are shown in Table 3. Continuous
improvement, teamwork and customer focus were applied at
the Irbid Specialist hospital (a private hospital) to a greater
extent compared with other hospitals. Training and top
managerial commitments were applied to a greater extent
at ISH than at the university hospital and the government
hospital. All other hospitals applied TQM similarly, except
for top management commitment, which was applied more
in the military hospital compared to the government
hospital.
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E.A. Al-Shdaifat
C1 C2 C3 C4 C5
1
2
3
0.81
0.79
0.76
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
0.75
0.70
0.68
0.67
0.64
0.63
0.58
0.50
0.49
0.77
0.73
0.73
0.69
0.64
0.60
0.57
0.55
0.77
0.73
0.72
0.70
0.69
0.68
0.74
0.71
0.70
0.69
0.67
0.61
0.56
0.51
0.81
0.76
0.72
0.71
0.71
0.56
C1: Continuous improvement; C2: Teamwork; C3: Training; C4: Top management commitment; C5: Customer focus
465
Table 3: Descriptive data and variance analysis (F test) for the differences among the hospitals under study in implementing TQM.
Factor
Hospital
Min.
Max.
Mean S.D
Continuous improvement
University
Governmental
Private
Military
Total
University
Governmental
Private
Military
Total
University
Governmental
Private
Military
Total
University
Governmental
Private
Military
Total
University
Governmental
Private
Military
Total
0.00
0.00
10.4
0.00
89.6
79.2
100
83.3
0.00
0.00
18.8
0.00
96.9
100
100
100
0.00
0.00
0.00
0.00
100
91.7
83.3
83.3
0.00
0.00
12.5
0.00
90.6
96.9
100
96.9
0.00
0.00
29.2
0.00
100
95.8
95.8
75.0
36.5
38.7
57.9
44.6
41.6
48.1
46.3
69.1
51.6
51.0
42.8
40.0
57.2
47.3
44.9
45.2
41.5
58.5
50.9
47.1
52.8
51.5
68.81
52.3
53.9
Teamwork
Training
Customer focus
22.8
23.0
22.0
21.3
23.2
24.7
23.1
18.7
24.1
24.5
24.3
22.2
22.9
22.1
23.4
21.9
22.7
23.1
25.0
23.6
22.6
21.8
14.7
21.2
21.7
F-value
P-value
Pair difference
10.1
0.0001
3 vs. 1,2,4
9.0
0.0001
3 vs. 1,2,4
4.9
0.002
3 vs. 1,2
5.0
0.002
3 vs. 1,2
2 vs. 4
5.7
0.001
3 vs. 1,2,4
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E.A. Al-Shdaifat