Chapter 23 Quality Control 555 margins and a financially healthier organization. The 14 quality
management principles of
TQM as outlined by Deming (1986) are summarized in Display 23.6.
The Toyota Production System
Another more contemporary, customer-focused QI model is the TPS. TPS is a production system
built on the complete elimination of waste and focused on the pursuit of the most efficient
production method possible (Toyota Motor Company, n.d.). “Toyota members seek to
continually improve their standard processes and procedures in order to ensure maximum
quality, improve efficiency and eliminate waste. This is known as kaizen and is applied to every
sphere of the company’s activities” (para 3).
Health-care organizations that use TPS would have caregivers not only attempt to directly solve
problems at the time they occur, but it would also have them determine the root cause of the
problem, so that the likelihood of the problem recurring would be minimized. TPS argues that
solving individual problems this way, one at a time and where, when, and with whom they occur,
prevents larger problems. Thus, management decisions are based on a long-term philosophy,
even at the expense of short-term financial goals.
Implementing TPS, however, is not easy. It usually requires a change in organizational culture,
values, and roles since responsibility and accountability for solving problems is so decentralized.
In addition, eliminating problems at their root is far different from solving an immediate problem
at hand. Thus, adopting TPS in an organization requires a substantial commitment of leadership
time and resources. It also requires a tremendous amount of staff preparation and involvement.
DISPLAY 23.6
Total Quality Management Principles
1. Create a constancy of purpose for the improvement of products and service. 2. adopt a
philosophy of continual improvement. 3. Focus on improving processes, not on inspection of
product. 4. end the practice of awarding business on price alone; instead, minimize total cost by
working
with a single supplier. 5. Constantly improve every process for planning, production, and service.
6. institute job training and retraining. 7. develop the leadership in the organization. 8. drive out
fear by encouraging employees to participate actively in the process. 9. Foster interdepartmental
cooperation, and break down barriers between departments.
10. eliminate slogans, exhortations, and targets for the workforce. 11. Focus on quality and not
just quantity; eliminate quota systems if they are in place. 12. promote teamwork rather than
individual accomplishments. eliminate the annual rating or merit system. 13. educate/train employees to maximize personal development. 14. Charge all employees with carrying out the
tQM package.
Source: Deming, W. E. (1986). Out of the crisis. Cambridge, MA: MIT Press.
LEARNING EXERCISE 23.3
Deming’s 14 Total Quality Management Principles
think back to the organization for which you have worked the longest. How many of deming’s 14
principles for tQM are used in that organization? do you believe some of the 14 principles are
more important than others? Why or why not? Could an organization have a successful quality
management program if only some of the principles are used?

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