Abstract This paper examines the use of quality of life measures in health care. Topics covered include: How quality of life is determined, the criteria assessed and who determines the criteria. The political and ethical implications for patient care are also discussed. The paper concludes that despite the ethical concerns and poor quality of measurement related to quality of life indices, they are indeed being used today to make both political and clinical decisions across a wide variety of medical conditions and situations. The paper includes articles referred to in the text.
From the Paper "Several ethical issues are associated with quality of life measures, the first and most important one being whether any decisions should be made using quality of life considerations given the very serious limitations regarding data accuracy. In other words, if clinicians can't trust that they have measured what their instruments purport to measure in an accurate and stable manner, why would they even want to make any decisions using these measures as a foundation? And if they do make decisions on the basis of such measures, the question of whether such decisions are ethical or moral must be raised."
Abstract Gives a description of the concept of Quality of Work Life and TQM. This paper reviews some of the ways Saturn created an ideal work place where employees felt proud of what they were doing. It also looks at why corporations are turning to "greenfield projects" when wanting to implement a change in management styles.
From the Paper "People want to experience meaningfulness in and from their work. When it occurs employees are more likely to experience increased motivation to work, greater productivity, and job satisfaction. Employers benefit by increased production, less absenteeism and turnover, and higher-quality of work as well as having a more effective organization. (Fenner, Elizabeth 2004) The concept of Quality of Work Life and Total Quality Management is not new; but it is difficult to trace back to when the concept was first developed. The ideal is that individuals are paid and treated according to their individual worth; to develop one-on-one equal relationships between workers and management; (Braun, 1995, p. 18) to treat employees as an asset, not a burden."
Abstract This paper reviews the idea of the term humanization of work or quality of work life (QWL), which refer specifically to changes that enhance the human experience at work and decrease the social and psychological costs incurred in producing goods and services. The paper further discusses the criteria of QWL and the effect the implementation of such a concept has on the workplace.
From the Paper "The term humanization of work or quality of work life (QWL), refer specifically to changes that enhance the human experience at work or, on the other hand, decrease the social and psychological costs incurred in producing goods and services. A definition of QWL criteria first proposed by Walton in 1973 still appears relevant today: (a) adequate and fair pay; (b) safe environment; (c) bill of rights, including equity and due process; (d) development of human capacities; (e) advancement opportunities; (f) human relations; (g)
total life space, for example, balance of work and family; (h) social relevance of employer; and (i) employees' influence over decisions that affect them. Quality of work life can also be defined by several principles: security, equity, democracy, and individuation."
Abstract This paper explores the controversial topic of prolonging life through extraordinary means beyond the ability to provide meaning to that life. It centered around several themes for discussion.
From the Paper "Medical science has brought remarkable change to our lives. Because of advances in medical technology, more people live longer, and more productively, than any generation in history" (Newman, 1992). But is that necessarily a good thing? Newman (1992) believes we are suffering from "diseases of medical progress" as we are seeing complications of diseases we had never seen before as medical technology can prolong life beyond previous lethal disease states, such as cancer patients living longer, etc. According to Newman, we're seeing the natural history of the disease advancement, trying to fight new aspects of a disease because the medical profession believes that technologies must be used (1992). What happens now, when it's purely science and technology maintaining the life of a person in a constant vegetative state?"
An analysis of the factors that impact on the quality of the family's experience in the withdrawal of life support from a loved one in ICU (intensive care unit).
Abstract This paper discusses families' experiences with the withdrawal of life support from a loved one in ICU (intensive care unit) and how it is not uniform for all families because of the operation of certain factors which influence the decision-making process. Finally, the paper discusses the impact of the support that these families receive and how it is the major factor that influences the quality of the family's experience.
Table of Contents:
Statement of the Problem and Purpose
Literature Review
Research Question
Theoretical Framework
Hypothesis #1
Data Collection
Research Design #1
Statistical Analysis #1
Hypothesis #2
Sampling Strategy #2
Data Collection #2
Research Design #2
Statistical Analysis #2
Conclusion
From the Paper "Making decisions related to the withdrawal of life support in the ICU is one of the most demanding experiences the family will ever face. Nurses play a key role in the effectiveness of the decision making process and it is their understanding of the stages involved in that process which can determine the quality of the outcome. As McHale Wiegand (2006) maintains, as more families become involved in end-of-life decisions, it is essential that current research be assessed, the gaps in knowledge be identified, and that new directions for ongoing research should be established. Little is actually known about the interaction of nurses with families in this situation; what is certain is that the interaction is not uniform and that nurses need to realize what will be most effective with families who are experiencing high levels of stress."
Abstract This paper explores the experience of family members who are engaged in decision-making related to the withdrawal or withholding of life-sustaining interventions from another family member. It explains that the methodology used consists of a sample of four to five families who are contacted through ICU family conferences in one or two hospitals in which the conferences are concerned with the withholding or withdrawal of life support from a family member. The paper looks at how certain factors may be identified from family members' experiences that help to determine why the decision-making process is subject to wide variation.
The paper also notes that it is expected that certain family members engage in more effective decision making than others and that particular families engage in more effective decision making than other families. The paper highlights the fact that family decisions are rendered easier or more problematic by such variables as the person's prognosis, whether an acute or chronic illness is involved, perceived quality of life, degree of suffering, and the presence of an advance directive. The paper concludes that preparation for death most especially needs to be based in a team approach, and the emphasis should be upon the relationship between nurses and families and that the future needs of the family should be proactively considered once death has occurred.
From the Paper "Nurses and other healthcare providers normally initiate the discussion that lead to withdrawal of life-support but patients and families make the final decision. The experience of decision making is different for family members when an acute illness is involved from a situation of chronic illness. After a period of denial, families of patients with acute illness or injury can recognize the need for withdrawal of support much more quickly (McHale Wiegand, 2006). Certain behaviors by healthcare providers can increase the level of distress experienced by the patient's family."
Abstract This paper defines the concept of quality and the role quality plays in shaping a customer's satisfaction. The author points out that quality is an integral part of business. The paper relates the participation of management in the production of customer-driven quality.
From the Paper "Quality is an integral part of any business and yet the term itself has many different interpretations. There is the quality of the product itself as it relates to performance and durability. There is the more difficult relationship between quality and price consumers may accept poorer quality for lower cost. There is the quality of the purchasing experience the payment experience and the after-sale experience. Quality enters the picture in the area of customer service and a company's Website and marketing materials also have issues."
Abstract This paper is a conference report on the principle of Total Quality Management, an American perception of managing quality. The report highlights the importance and the irrevocable relationship between Total Quality Management, and various Standards of quality being used at present. The paper introduces and defines TQM as well as describes each of its principles in a very detailed manner.It has thoroughly examined the various systems of quality standards that are prevalent in the global management at present. It has examined its principles and regulations, as well the different impacts of project management with respect to the changing environment. It also gives a historical overview of the Deming prize and its purpose. It uses the examples of Power Systems and AT&T in order to enhance the importance of TQM in businesses today.
From the Paper "Total Quality Management is an American perception of managing quality. Using the literature we can form a measure of the maturity of Total Quality Management relative to Total Quality Control (TQC), it's predecessor and competitor. Many companies are working very hard to achieve good quality goods and services and using them as competitive advantages in their business. In the 1990s, there are two main subjects on quality that capture the attention of most businesses in the world, namely the International Quality Management Standard ISO 9000 and Total Quality Management (Total Quality Management). Much publicity and promotions have been made on these two subjects. It is like a fire in the forest amongst the industrialized nations. The aim of this conference is to find out what is so special about ISO 9000 and Total Quality Management and why it is necessary for industries and businesses to acquire them. In order to facilitate the development of new ideas and sharing of experience, the conference is divided into a number of sub-themes. The Speakers (in brackets) will be trying to build a 'bridge' between ISO 9000 and Total Quality Management within their own expertise."
Abstract This paper discusses quality and the need to have effective quality measures in the healthcare industry. It examines the lack of a proper definition for quality, instead focusing on lack of quality and what that means. It also discusses government interventions and commissions and then finally discusses the ways, often futile and self defeating, that consumers can educate themselves and lead to their own better quality care.
From the Paper "This paper examines the importance of quality healthcare from a number of perspectives, including governmental interaction and personal responsibility. These perspectives will help answer the questions: What is Quality? Why is it important to measure quality and what are the most effective measures of quality? When examining the overall concept of quality healthcare, what was most interesting and perhaps revealing, was that there was no clear definition presented to define quality healthcare. What was available, in abundance, were definitions of what quality healthcare wasn't. According to the Department of Health and Human Services Report, The Challenge and Potential for Assuming Quality Health Care for the 21st Century (Agency for Healthcare Research and Quality [AHRQ], 1998), quality healthcare does not include: a failure to provide necessary healthcare resulting in needless complications, increased costs and increased and premature mortality rates. "
Abstract In this paper the author argues that one quality management philosophy is not better than the other but rather each one can complement another. Several of the current popular methods of quality management are presented and evaluated. The paper includes a list of quality standards as published by the International Organization of Standardization. The author concludes by stating that despite the effectiveness of quality management philosophies, especially in health care, the culture where the quality management process is implemented determines its success.
From the Paper "Applying these three basic rules to primary health care management in terms of health promotion, illness prevention, sick care, advocacy and community development, we can see that the "processes of care are usefully distinguished from organizational processes, rather than being combined with them, because there are many important organisational processes worthy of identification and monitoring that do not involve direct patient care. (Sibthorpe, 2004)" This is related to the Customer Focus approach of Six Sigma (iSixSigma LLC, 2006). "The separation also allows a primary health care provider to identify and monitor care processes linked to particular priority health issues and conditions. Such processes of care - e.g. monitoring HbA1c levels in the management of diabetes - would however, need to be underpinned by organisational processes, such as the establishment and use of evidence-based protocols for the management of chronic diseases. (Sibthorpe, 2004)" This is related to the Data Driven approach of Six Sigma (iSixSigma LLC, 2006). "Separating out the processes of care involved in primary health care makes explicit the advocacy and community development roles that characterize care within this model. In this setting these activities are ultimately about improving the health of patients, families and communities. (Sibthorpe, 2004)" This is related to the Robust Methodology approach of Six Sigma (iSixSigma LLC, 2006)."
Abstract This paper reviews the evolution of quality initiatives in health care delivery. It also examines the role of the Joint Commission on the Accreditation of Healthcare Organization (JCAHO) in promoting quality in health care delivery.
From the Paper "This paper reviews the evolution of quality initiatives in American health care. Within the context of the evolution of ..."
Abstract "This paper discusses the efforts being made in order to improve healthcare quality in hospitals and the various agencies involved in these efforts. The paper discusses Malcolm Baldrige and his contributions to management of quality improvement. It also discusses the roles of various organizations in trying to improve quality healthcare.
From the Paper Abstract This paper looks at quality improvement in hospital healthcare in theUnited States and what is being done to promote it It first discusses thecontributions of Malcolm Baldrige in his establishment of methodologies forquality improvement then looks at the efforts of Quality ImprovementOrganizations QIO and the Centers for Medicare and Medicaid Services CMS to develop unified systems of quality care reporting by hospitalswhich is standardized nation-wide Some of its achievements are noted andplans for the future discussed The paper also examines a
Abstract This paper discusses total quality management (TQM) and its various attributes. Quality, a definable and quantifiable characteristic is first examined in relation to an organization. Systems theory is then applied to quality management within an organization and finally, TQM as a philosophical approach to management is discussed. TQM implementation is given some final examination.
From the Paper "The basic assumptions regarding the nature of quality, and by extension, poor quality, have been variously approached by researchers in the management field. The best way to define poor quality is to examine what researchers have identified as quality. Authors such as Deming have defined quality as non-faulty systems while others approach it from a motivational perspective and insist that quality is merely conformance to requirements, whatever they may be (Beckford, 2002). One essential aspect of quality that resounds through all its various definitions is that quality, at its most basic level, is defined by the customer or the consumer (Kuratko, Goodale & Hornsby, 2001). Therefore, poor quality consists of faulty systems, does not meet performance requirements, and fails to meet customer expectations. The effects of poor quality ultimately have a negative impact on an enterprise's revenues if it is a sales oriented organization and a negative effect on an organization's service ..."
Abstract This paper discusses the character of total quality (TQ). Beginning with a brief analysis of TQ training measures and techniques it then segues into what defines a quality culture. In this respect it is determined that quality culture is best introduced simultaneously at all four levels of an organization: operational, administrative, strategic, and normative. Finally, some comparison of TQM principles across industries is undertaken with the conclusion being that although emphasis on some principles within TQ may change, the principles themselves do not.
From the Paper "Training for total quality (TQ) involves a different approach than typical work-related training. TQ requires a complete cultural overhaul of the organization. This broad cultural overhaul must then be focused down to actual employee application of the tools within TQ, primarily the quantitative aspects, to the employees' individual job functions. Such an educational process cannot be completed by the typical organizational training methods such as sticking a video in and checking off each training competency on an employee's personnel record as the video finishes. TQ training is thorough and based on sound educational principles, such as an understanding that the learning process is hierarchical consisting of a series of objectives: 1) knowledge, 2) comprehension, 3) application,
4) analysis, 5) synthesis, and 6) evaluation. To that end, TQ training and indoctrination must begin prior to any TQ implementation in order to reeducate the workforce and to acquaint them with the major principles.."
Abstract This document discusses the relationship of customer satisfaction to an organization's quality initiatives. It examines three organizations from different sectors: manufacturing, service, and government, focusing on leadership and the strategic role that TQM can and does play in the organizations themselves. The paper views leadership as extremely important within a quality environment because without leadership support and guidance quality initiatives are often stillborn.
From the Paper "Quality, customers or constituent satisfaction, and leadership are all integrally related within organizations and can determine an organization's long-term success or failure in its market. Through the examination of three separate organizations within three distinct sectors: manufacturing, service, and government, the integrated relationship that quality, customer satisfaction, and leadership have within a progressive organization leads to a more definitive conceptual paradigm of how these principles are acted upon. "
