The Development and Adoption of an Innovative, Sustainable Quality Improvement Model in a Private Healthcare Firm
Currently, UK healthcare is encountering an unprecedented quality crisis, especially considering the overwhelming challenge of improving patient care in the face of growing demands and limited resources. Although past efforts to adopt Total Quality Management (TQM) initiatives have failed to produce desired results, this thesis investigates the limitations of TQM applicability and explores the development of an innovative Quality Improvement model germane to a healthcare context. By integrating TQM with concepts from Corporate Social Responsibility (CSR), Complexity Theory (CT) and Knowledge Management (KM) a novel TQM conceptual framework, called EALIM—Ethical, Adaptive, Learning and Improvement Model—was devised. Using an Action Research (AR) study, EALIM was implemented within a private healthcare firm by working collaboratively with organisational members over a period of eighteen months. The study included gathering qualitative data in three AR cycles: 1) pre-implementation, 2) implementation and 3) post-implementation. The first cycle involved gathering data to form a baseline assessment of the organisation, which was used to provide feedback to top management on areas for improvement. In the second cycle, an action plan was developed with top managers and EALIM’s implementation was examined. In the third cycle, further data were gathered and findings were evaluated against the baseline assessment from the first cycle to identify the overall impact of EALIM on the organisation. Findings indicated that EALIM’s adoption generated a moral perception of the organisation, a learning culture, increased organisational commitment and an improvement in patient self-advocacy and independence. Factors that contributed to these outcomes were top management commitment, employee empowerment, the use of trans-disciplinary groups and practice-based training. However, other findings indicated that poor leadership and staff nurses’ use of managerial control created variability in service quality. These findings suggest that while EALIM can lead to organisational improvement, the commitment of all internal stakeholders is required to achieve sustainable quality patient care.