If these three factors are present, there is also a high probability that there is a hospital-wide TQM initiative already in place. The research results state that many academic teaching hospitals do not have as high of a level of performance using TQM as non-teaching hospitals. This variation could be explained by the significantly different process bases in hospitals where there is instruction and treatment happening at the same time, and therefore there is a high level of variability in each process. TQM is best used in processes that can be standardized; hence the higher level of performance in non-teaching hospitals. The use of TQM in Johns Hopkins Emergency Department illustrates how the same types of companies can have significantly different results using TQM as a strategy for being more aligned with customers. The first and most significant insight is that the greater the variability of individual processes, the more difficult it is to gain major gains using TQM as an approach for enhancing quality while serving customers more efficiently. In those hospitals with more consistent processes, with trained employees, strong leadership at the upper management levels and a track record of five or more years of performance, TQM is delivering significant results.

Government

The use of TQM is rapidly expanding throughout the entire U.S. Government, with the Internal Revenue Service (IRS) adopting TQM strategies to overcome the many inefficient and wasteful processes the government agency has today. It is estimated three of the four tax preparer questions go unanswered, and that there are literally millions of dollars in inaccurate tax refunds mailed every year. According to the Journal of Accountancy (1994) the IRS is focused on modernizing tax document input and processing, minimizing paper processing, making taxpayer information readily available to IRDS employees, reducing recordkeeping and tax administration costs, and increasing the security and privacy of sensitive taxpayer information.

The highly process-centric nature of the IRS, the implications of managing...

Through the use of TQM, the agency has been able to move away from a myopic perception of tax policy definition and collection, to take into account how the many variations in taxpayer conditions would impact their ability to serve them. The change in processes within the IRS forced the agency to be more customer-centric in many more of their tasks, and as a result, there has been a significant decline in unanswered questions and better management of the auditing process. The role of IRS agents and the ability to analyze and interpret tax returns has become much more streamlined and focused on performance over simply compliance. The IRS's lessons learned include the ability to identify with the needs and expectations of their customers, and in doing so, justify the investment in TQM using fact-based decision processes. The IRS as an agency has a wealth of information; the use of the information to better serve taxpayers has been made possible using TQM as the foundation for change.