This paper presents a literature-informed set of conclusions and recommendations for improving quality management at ResCare, a human services organization. It identifies the formation of a cross-functional steering committee as the foundational step, followed by adoption of a Total Quality Management (TQM) philosophy aimed at zero-defect service delivery. The paper also addresses employee empowerment, training program design, the cultivation of a learning culture, and reactive quality tools such as statistical process control and Enterprise Risk Management (ERM) frameworks. Together, these recommendations offer ResCare a layered, proactive and reactive approach to sustained organizational quality improvement.
The literature review identified multiple areas and ideas through which ResCare can address the quality issues present in the organization. Upholding a high level of quality assurance is a reasonable goal for any organization; however, the path to integrating such standards is often far from clear. Although there are several different quality systems and philosophies — such as Total Quality Management (TQM) and Six Sigma — selecting the right tool for an organization can be a complex process in itself. For example, the organizational culture may not be suited to a TQM system, and if such a system is imposed upon a resistant employee base, the effort could result in failure.
Therefore, knowledge of the organization, its culture, and its human resource capabilities must be part of the equation. Not all systems are suitable for all situations, and quality improvement efforts must be founded upon a realistic appraisal of the organization's current state. Quality goals should be challenging enough to push the organization past its comfort level, yet realistic enough to avoid overwhelming employees. There are many additional tools that can help the organization implement whatever course of action it decides upon, such as performance bonuses or other incentive awards. The recommendations that follow provide further insights into the process of implementing a quality improvement plan.
The first step that should be taken at ResCare is to form a steering committee. Although the steering committee was identified in the literature review in the context of implementing a COSO Enterprise Risk Management (ERM) framework, it applies equally to all major decisions the organization will face in the pursuit of quality improvement. The steering committee should be composed of cross-functional experts who can offer insights into improvements from many different perspectives. It is also recommended that the leader of the steering committee be fully trained in project management practices. Having a formally trained and experienced project manager can substantially improve an improvement project's chances of success.
The steering committee will essentially have three distinct objectives identified in the literature review. The first objective is a proactive attempt to improve quality before any errors occur, and involves choosing a quality philosophy to integrate into the organization and its culture. This is considered a proactive approach to management because it attempts to reduce the likelihood that quality problems will occur. The remaining objectives are more reactive, as they attempt to identify the root cause of quality issues after they occur. The proactive approach is, however, extremely valuable compared to reactive tools, because quality issues prevented from occurring are far less costly than those that manifest within organizational processes. Furthermore, when quality issues reach external customers, the organization is in its most expensive and damaging position.
Based on the literature review, it is recommended that the steering committee consider implementing a service TQM philosophy as the basis of the quality initiative. The ultimate goal of a TQM approach is to create a defect-free experience for consumers. Although this is an ambitious goal — especially when human performance is involved — it is the process of improvement itself that ultimately drives an organization to increase value. The mere pursuit of a zero-defect operation can lead an organization to significantly better overall performance. For instance, while achieving zero defects may be nearly impossible, the pursuit of that goal challenges employees at every level to improve their individual and collective performance indefinitely.
The pursuit of zero-defect performance represents a common denominator across many TQM initiatives. It has become especially prevalent in service industries, even though its roots lie in manufacturing. Service organizations have applied TQM concepts to advance organizational goals through an educational, empowering, and positively reinforcing relationship between management and their subordinates. The TQM approach provides a flexible and adaptable platform that is easily customizable based on specific organizational needs. Although it will ultimately be up to the steering committee to make the final decision, it is recommended that the TQM model be considered as the foundation of the entire improvement effort.
"Empowering staff and investing in skill development"
"Self-directed learning and organizational culture shift"
"Statistical tools and ERM dashboards for risk response"
Although many recommendations have been made, the importance of the steering committee's guidance should not be understated. Having cross-functional teams with expertise in many areas can offer insights into implementation requirements and also provide a clear picture of the organization's current state. This committee serves as the foundation for an effective quality response plan. It will ultimately be up to the steering committee to judge which route is most likely to be the most efficient and effective for improving ResCare's quality position.
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