Quality Improvement Theory Research Articles

Understanding performance of public hospitals: operational strategies approach in Kajiado County, Kenya

The performance of the healthcare sector is crucial for delivering optimal patients care and creating efficient healthcare systems. However, Kajiado County in Kenya faces various challenges that obstruct effective performance. This paper aims to assess the impact of operational strategies on performances of public hospitals in Kajiado County, Kenya. Specifically, it aimed to investigate the effect of information management strategy, continuous quality improvement strategy, innovation strategy, and resources management strategy on hospital performance. This study was anchored on balanced scorecard model, resource-based theory, quality improvement theory, and technology acceptance model, and employed a descriptive research design. Primary data was gathered through questionnaires distributed to full-time healthcare workers, following a successful pilot study in Narok County. Data collection utilized the drop-and-pick later method. Statistical Package for the Social Sciences software was used to analyze the data, involving descriptive statistics such as percentages, frequencies, means, and standard deviations while multiple regression model was used to test the relationship between independent variables and the dependent variable. Main findings of the study revealed that there exists a statistically significant relation between information management strategy and hospital performance, as well as continuous quality improvement strategy, innovation strategy, and resource management strategy, respectively. Consequently, the study recommended that the County Health Department should initiate a comprehensive training program for healthcare professionals, collaborate with hospital management to adopt innovative technologies, and identify and address skill gaps while promoting a positive work environment within public hospitals in Kajiado County. These actions aim to enhance hospital performance and ultimately improve patient care in the region.

Economic aspects of innovative strategy of enterprise development in the conditions of macroeconomic instability

Methods. When conducting the study of the economic aspects of the innovative strategy of the enterprise development in conditions of macroeconomic instability, the method of scientific abstraction is used – in determining the theoretical and methodological approaches regarding the essence of the innovative type of development of production and economic systems; system approach - when using a methodical approach to the components of the innovative development management mechanism at the micro- and meso-levels. Results. The algorithm for the implementation of an innovative strategy for the development of production and economic systems at the micro- and macro-levels is defined, it is proposed to use V.E. Deming’s theory of quality improvement within the framework of the assessment of qualitative changes in development based on the innovative strategy and, based on a systemic approach, to conduct an assessment using a comprehensive indicator of innovative development; taking into account the concept of management to coordinate all phases of the mechanism of innovative development using the principles of the rule of five logistics. Novelty. The methodical approach to the assessment of the innovative development of production and economic systems at the micro- and macro-levels in the conditions of macroeconomic instability is proposed, the essence of which is reduced to the study of the algorithm for the implementation of an innovative strategy using V. E. Deming’s theory of quality improvement, which involves planning, implementation, verification and adjustment of plans; using a systematic approach to the study of the innovative model of the development of production and economic systems, it is proposed to take into account the logistic approach using quality indicators: demand, timeliness, satisfaction, deadlines, preservation, environmental friendliness, complexity, etc., and to calculate the assessment of innovative development based on a comprehensive indicator of quality improvement; within the framework of the concept of management, which includes four phases: planning, execution, control and adjustment, it is possible to coordinate all components of the mechanism of innovative development of the enterprise with the help of a whole complex of scientifically based principles. Practical value. Based on the results of the scientific research, the author proposes economic guidelines for managing the intellectual potential of an innovative enterprise, which will help to resolve the existing contradictions in the implementation of production and economic activities and will contribute to the development of innovative areas of work.

The impact of mutual recognition of geographical indications on the quality upgrading of China’s agricultural exports

Improving the quality of agricultural exports and increasing value–added trade is crucial for shaping new competitive advantages of agricultural exports, building a strong trading nation and achieving high–quality agricultural development. This study constructed a multi–time point difference–in–differences model to empirically test the effect and mechanism of the mutual recognition of geographical indications (GIs) between China and the European Union (EU) on the quality upgrading of China’s exported agricultural products from 2000 to 2016 based on theoretical analysis of the effect mechanism of GIs on agricultural product exports. The study determined that mutual GI recognition between China and the EU has effectively improved the quality of agricultural exports, with a greater effect on upgrading the quality of products from countries with high GIs endowment, quality frontier and large and medium–sized enterprises and labour–intensive products. The mechanism analysis revealed that mutual GI recognition between China and the EU can improve the quality of agricultural exports through specialisation agglomeration and cost-saving effects on the supply side and domestic demand upgrading and product recognition effects on the demand side. This study has important implications for further enriching quality improvement theory regarding agricultural products and presents a new approach for enhancing the quality improvement path of exported agricultural products that lack supply–side resources.

Exploring the roles of special schools' principals in teacher quality improvement: A case study of special schools

Concern about the role of school principals in improving the quality of special schools remains one of the challenges in realizing better quality education in Indonesia. However, some obstacles to the role of the principal in improving the quality of special schools still exist. Principals of special schools are still faced with obstacles to improving school quality, such as the quality of teachers. Therefore, this qualitative study aims to explore the role of the principal of the Southwest Aceh public special school in improving teacher quality. In particular, it discusses the main challenges faced by the Southwest Aceh public special school principals and the roles and strategies they use to improve teacher quality. This qualitative research is to investigate the role of the head of the Southwest Aceh public special school in Indonesia, asking the main research question, what is the role of the principal in improving teacher quality? This research was conducted using a case study design. Data was collected through in-depth interviews with school principals, observation, and secondary data, including official documents and existing literature on the role of school principals. Data analysis was used using data analysis techniques according to Miles and Huberman: data collection, data presentation, data reduction, and conclusions. The interconnected theoretical framework built through the role of the principal and the theory of quality improvement is the most suitable because it helps to understand the experience, working conditions, and challenges of exploring the role of the principal in improving school quality critically. The research findings reveal the role of the school principal in improving the quality of teachers; that is, the principal conducts guidance, coaching, and supervision, grants study permits for schools to a higher level, and conducts training to increase teacher competence. Besides that, the principal explores new ideas from teachers according to the times in the world of education and creates harmonious relationships, openness, adjustments to the curriculum, division of teaching tasks or additional assignments, and differential learning, and provides rewards and punishments to teachers who break the rules. In giving the workload of main tasks and additional assignments to teachers, the average is high, and the school program is not related to each other.

A theoretical and practical approach to quality improvement education

Quality Improvement (QI) knowledge and skills are required at all levels of physician training. System improvement efforts need to include understanding of health disparities and design of interventions to reduce those disparities, thus health equity needs to be integrated into QI education. Payors, accreditation bodies and health systems’ emphases on QI result in the need for QI curricula that meet the needs of diverse learners. This article presents a theoretical background and practical tools for designing, implementing, and evaluating a QI educational program across the spectrum of physician training with an emphasis on competency-based education and a goal of continuous practice improvement. Practice-based learning and improvement and systems-based practice are two core domains of competencies for readiness to practice. These competencies can be met through the health systems science framework for studying improvement in patient care and health care delivery coupled with QI science. Curricula should incorporate interactive learning of theory and principles of QI as well as mentored, experiential QI project work with multidisciplinary teams. QI projects often develop ideas and implement changes but are often inconsistent in studying intervention impacts or reaching the level of patient outcomes. Curriculum design should incorporate adult learning principles, competency based medical education, environmental and audience factors, and formats for content delivery. Key QI topics and how they fit into the clinical environment and teaching resources are provided, as well as options for faculty development. Approaches to evaluation are presented, along with tools for assessing learner's beliefs and attitudes, knowledge and application of QI principles, project evaluation, competency and curriculum evaluation. If the goal is to empower the next generation of change agents, there remains a need for development of scientific methodology and scholarly work, as well as faculty development and support by institutions.

Analysis of Quality Cycles on Performance of Tea Processing Firms in Kenya

Aim of Study: The aim of the study was to assess how quality cycles impact the performance of tea processing companies in Kenya. The research was guided by Deming's quality improvement theory. Pragmatism research philosophy was employed in this research.
 Study Design: Further, explanatory research design was deemed appropriate for the research.
 Methodology: The study population under consideration was 66 operations managers of all the tea producing companies. A census of all the 66 operations managers was conducted. Utilizing structured questionnaires, both quantitative and qualitative data was gathered for analysis. Data analysis was undertaken utilizing SPSS Version 23.0.
 Results: The findings revealed that quality cycles had positive and significant relationship with performance of tea processing firms in Kenya where (β =.335) and p=.011). The study concludes that quality cycles are critically important in the production of tea. Tea processing firms need to cultivate culture of team work among their workers by emphasizing virtues of unity and togetherness. The study recommends for periodic diagnostic and maintenance of firm machines and equipment through well trained firm personnel. Thus, training of personnel on the maintenance of tea production equipment is essentially important in ensuring that costs arising from breakdowns are minimized. Organizational dynamic capability moderates the relationship between Kaizen Systems and performance of tea processing firms. Also, tea processing firms should invest in research and development, training, networking capability and innovation since it affects performance positively.

Discussion on the ecological theory and technological approaches of ecosystem quality improvement and stability enhancement.

Improving ecosystem quality and stability is one of the urgent tasks of national ecological environment construction. However, the ecological theory of ecosystem quality and stability has not been well clarified. Based on the summary of influencing factors and interaction between ecosystem quality and stability, we discussed the ecolo-gical theory on the evolution of ecosystem quality and stability from the perspectives of self-organization of biological agglomeration and structure nesting, correlation of ecological elements and coupling of ecological processes, ecosystem integrity and function emergence, ecological service spillover and efficiency tradeoff, synergy and interactions between resource supply capacity and environmental suitability, as well as interactions between spontaneous change and human activities. Technologies approaches and management strategies were proposed from the aspects of ecosystem macro-pattern adjustment, protected natural areas system construction, regional complex ecosystem comprehensive management, degraded ecosystem restoration, damaged ecosystem reestablishment, typical ecosystem process management.

Learning of quality improvement theory – experiences with reflective learning from a student perspective

PurposeThe purpose of this study is to investigate how professionals who are continuing their education rate a higher education quality management course with an emphasis on reflective learning and real problem-solving. The audited course consists of module-based teaching, while students work on an improvement project at their workplace between course sessions. This study has a twofold aim: to contribute to the design of quality improvement courses based on doing as we learn and to offer insight into the use of a final grading method that consist of a folder with reports from the intermediate work steps and a final report.Design/methodology/approachAfter completing the course, students received a survey with questions and statements about the course content, delivery and final grading methods. They answered these questions on a seven-point Likert scale and also answered open-ended questions.FindingsIt is clear that professional students value the interweaving of theory with real-life training, and they value module-based teaching in which theory is reviewed and applied to practical problems. Reflective learning was achieved through feedback from both teachers and fellow students on various interim reports. Students’ employers benefit from the course, as students gain experience with quality improvement. The grading of a final report on the improvement project based on three sub-assignments was highly appreciated.Practical implicationsDevelopers in courses in quality improvement benefit from learning how this course is structured, assessed and how participants perceived its components.Originality/valueThe course design with modules and intermediate work steps, where the students apply theory in quality improvement to a real project at their workplace, is an original concept. The modules correspond to the plan, do, check and act (PDCA) methodology.

An Evaluation of Barriers and Facilitators for a Pressure Injury Prevention Link Nurse Role: A Mixed-Methods Study in New Zealand.

The purpose of this study was to identify barriers and facilitators for nurses in a pressure injury prevention (PIP) link nurse role. Mixed-methods study that used nominal group technique with focus groups, followed by online surveys. The PIP link nurse project recruited 52 RNs; 32 completed the PIP educational program and participated in data collection. The sample was drawn from PIP link nurses, who were invited to participate in focus groups at the end of the project to identify perceived facilitators and barriers to their role. Focus groups were specific to work areas: aged care and community visiting, and hospital. Two were in an urban setting and one in a rural environment. Twenty-two PIP link nurses participated across 3 groups. To ensure comprehensive data from all involved in the project, online surveys were created using focus group priorities as the basis for questions to send to all PIP link nurses, their managers, and workplace colleagues. Participants were invited to participate in focus groups to identify perceived facilitators and barriers to their role. These focus groups were organized around care settings: aged care, community visiting, and hospital. Using a nominal group technique focus group process, participants were asked to identify barriers and facilitators to their role. These were shared with the group until all answers were declared and understood. Voting on order of priority then took place, with majority voting leading to a prioritized list of facilitators and barriers for each group. Considering the similarities and differences across group priorities, researchers developed online surveys representing the main facilitators and barriers from the focus groups. Surveys were then distributed to all PIP link nurses, their managers, and colleagues. Survey data were collected and analyzed in REDCap and reported as percentages of agreement to the questions for each group of respondents. Focus group data indicated facilitating priorities included PIP link nurses' commitment to the role, the support they received from their managers and colleagues, and time release to complete the role. Barriers included lack of time-when other work pressures took priority, and PIP link nurses felt the focus on applying quality improvement theory was more challenging than they had anticipated. Surveys from all groups reiterated the importance of the support of the workplace team in facilitating the role, and the time pressures for the PIP link nurse were a barrier to the role. While the funding of such projects is advantageous, it should be carefully and generously considered how much time is required if the project is to succeed so that lack of time to complete the role does not become a barrier to successful completion.

Improving Student Quality Through Extracurricular Programs: Case Study on Ma’had IAIN Padangsidimpuan

This research was motivated by the increasing learning outcomes obtained by some students after joining the ma'had program. Especially in semester III, there were many students who took lectures to semester IV, due to the GPA (Grade Point Average) they obtained and also the participation of students in scientific forums both locally and nationally. The research problem formulations were what ma'had programs in improving the quality of students, how to do it and how the evaluation system was. This study aimed to determine ma'had programs in improving the quality of students, how to do it and the evaluation system. The purpose of this research was to broaden the knowledge about student coaching. The discussion of this research related to the theory of quality improvement, extracurricular programs and ma'had or boarding schools. The research used descriptive method, the number of respondents was 25 from ma'had coaches, the instrument used observation and interviews, while the analysis of data by compiling data editors, selecting data, describing data and drawing conclusions. The results of this study therewere six ma'had programs in improving the quality of students at IAIN Padangsidimpuan. The ways to do the program were arranging the daily, weekly schedule and doing the program. The evaluation system was carried out following odd and even semester examinations. The forms of the test were oral, written and practical. If it was related with improving the quality of students, there was clearly an increase in quality that classified as high, medium and low

“Concrete ways we can make a difference”: A multi-centre, multi-professional evaluation of sustainability in quality improvement education

Quality improvement (QI) projects are a mandatory part of postgraduate medical training in the UK and graduating medical students must be competent in QI theory. We evaluated an educational toolkit that links concepts of sustainable healthcare with established quality improvement methodologies (the SusQI approach, available at www.susqi.org). The SusQI approach was implemented across a range of undergraduate and postgraduate nursing and medical education contexts. Educational strategies included guided online learning, live interactive webinars, small group activities and scaffolded project work. The evaluation strategy was informed by theories of academic motivation, educational value within communities of practice and behaviour change. A simultaneous nested design was tested using a mixed methods survey with input from learners and teachers. 177 survey responses were analysed to quantify and compare self-rated impacts of teaching across different audiences. Qualitative data were inductively coded into themes that were categorised according to above theoretical frameworks. Participants felt that this was ‘time well spent’ and many described transformative impacts that guided their daily professional practice beyond learning about QI. We suggest that meaningful space is found within both undergraduate and postgraduate healthcare curricula for SusQI, as a way of engaging and motivating learners to contribute to the creation of a sustainable healthcare system.

Total Quality Management Practices and Supply Chain Performance among Manufacturing and Allied Companies Listed at Nairobi Securities Exchange, Kenya

The state of organizational supply chain performance has attracted great attention to organizations in their endeavour to create superior structures and systems to guarantee shareholder wealth maximization. An efficient and effective supply chain framework will reduce wastages and optimally grasp opportunities in the best interest of investors. Poor supply chain performance represents over 60% of the challenges facing the global and local manufacturing industry and remain a major hurdle in securing superior firm performance. The study assessed the influence of TQM on supply chain performance for manufacturing and Allied firms listed at NSE, Kenya. Specifically, the study sought to assess the effect of strategic quality planning, supplier relations management, management commitment and customer focus on Supply Chain Performance. The guiding theories included Deming’s Quality Improvement Theory, Goldratt’s Theory of Constraints and Supply Chain Operations Reference (SCOR) Model. The descriptive survey research approach was used to carry out the study. A semi structured questionnaire helped in primary data collection. On the other hand, secondary data was reviewed using a document review guide. Data collection covered the period between 2013/2014 and 2017/2018 financial years. Quantitative and qualitative analysis techniques were employed. Quantitative techniques were included descriptive and inferential statistics. In particular, the multiple regression analysis aided in testing the hypotheses. From the regression analysis results, all the null hypotheses were rejected as all the TQM variables were found to influence supply chain performance. The p-value for strategic quality planning (p=0.014) is less than 0.05 level of significance which informs a conclusion that strategic quality planning has a positive effect on supply chain performance. The p- value for supplier relations management (p=0.005) is less than 0.05 level of significance which informs a conclusion that supplier relations management has a positive effect on supply chain performance. The p value for customer focus (p=0.017) is less than 0.05 level of significance which informs a conclusion that customer focus has a positive effect on supply chain performance. The p value for management commitment (p=0.004) is less than 0.05 level of significance which informs a conclusion that management commitment has a positive effect on supply chain performance. The Coefficient of Determination (R Square) stood at 0765. This meant that 76.5% of variation in supply chain performance was influenced by variation in the independent variable that is total quality management practices and its constituent variables: Strategic Quality Planning, Supplier Relations Management, Customer Focus and Management Commitment. To that effect, only 23.50% of variation in supply chain performance was explained by other factors not included in the model. Although supplier relations management was deeply entrenched, the study recommends further improvement of the framework of supplier engagement to quality initiatives which was found to be only moderately practiced. The study recommends further improvement of customer relations management function to ensure timely and effective handling of customers concerns and feedback to suppliers. The study recommends regular market research to effectively monitor and respond to new market needs as they arise.

Quality as strategy, the evolution of co-production in the Region Jönköping health system, Sweden: a descriptive qualitative study

BackgroundPursuing the vision ‘for a good life in an attractive region,’ the Region Jönköping County (RJC) in Sweden oversees public health and health-care services for its 360 000 residents. For more than three decades, RJC has applied ‘quality as strategy,’ which has included increasing involvement of patients, family and friends and citizens. This practice has evolved, coinciding with the growing recognition of co-production as a fundamental feature in health-care services. This study views co-production as an umbrella term including different methods, initiatives and organizational levels. When learning about co-production in health-care services, it can be helpful to approach it as a dynamic and reflective process.ObjectiveThis study aims to describe the examples of key developmental steps toward co-production as a system property and to highlight ‘lessons learned’ from a Swedish health system’s journey.MethodThis qualitative descriptive study draws on interviews with key stakeholders and on documents, such as local policy documents, project reports, meeting protocols and presentations. Co-production initiatives were defined as strategies, projects, quality improvement (QI) programs or other efforts, which included persons with patient experience and/or their next of kin (PPE). We used directed manifest content analysis to identify initiatives, timelines and methods and inductive conventional content analysis to capture lessons learned over time.ResultsThe directed content analyses identified 22 co-production initiatives from 1997 until today. Methods and approaches to facilitate co-production included development of personas, storytelling, person-centered care approaches, various co-design methods, QI interventions, harnessing of PPEs in different staff roles, and PPE-driven improvement and networks. The lessons learned included the following aspects of co-production: relations and structure; micro-, meso- and macro-level approaches; attitudes and roles; drivers for development; diversity; facilitating change; new perspectives on current work; consequences; uncertainties; theories and outcomes; and regulations and frames.ConclusionsCo-production evolved as an increasingly significant aspect of services in the RJC health system. The initiatives examined in this study provide a broad overview and understanding of some of the RJC co-production journey, illustrating a health system’s approach to co-production within a context of long-standing application of QI and microsystem theories. The main lessons include the constancy of direction, the strategy for improvement, engaged leaders, continuous learning and development from practical experience, and the importance of relationships with national and international experts in the pursuit of system-wide health-care co-production.

Developing a Unit-Based Quality Improvement Program in a Large Neonatal ICU.

Quality improvement (QI) methods have been widely adopted in health care. Although theoretical frameworks and models for organizing successful QI programs have been described, few reports have provided practical examples to link existing QI theory to building a unit-based QI program. The purpose of this report is to describe the authors' experience in building QI infrastructure in a large neonatal ICU (NICU). A unit-based QI program was developed with the goal of fostering the growth of high-functioning QI teams. This program was based on six pillars: shared vision for QI, QI team capacity, QI team capability, actionable data for improvement, culture of improvement, and QI team integration with external collaboratives. Multiple interventions were developed, including a QI dashboard to align NICU metrics with unit and hospital quality goals, formal training for QI leaders, QI coaches imbedded in project teams, a day-long QI educational workshop to introduce QI methodology to unit staff, and a secure, Web-based QI data infrastructure. Over a five-year period, this QI infrastructure brought organization and support for individual QI project teams and improved patient outcomes in the unit. Two case studies are presented, describing teams that used support from the QI infrastructure. The Infection Prevention team reduced central line-associated bloodstream infections from 0.89 to 0.36 infections per 1,000 central line-days. The Nutrition team decreased the percentage of very low birth weight infants discharged with weights less than the 10th percentile from 51% to 40%. The clinicians provide a pragmatic example of incorporating QI organizational and contextual theory into practice to support the development of high-functioning QI teams and build a unit-based QI program.

Tahl?lu kull?yati al-jaudah al-id?r?yah (TQM) li al-‘amal?y?ti al-id?r?yati al-tasyg?l?yati f? daurah al-lugah al-arabiyah al-Azh?r Pare

???? ????? ??????? ??????? ?? ????? ????????? ?????? ????? ?????? ???. ????? ????? ??????? ??????? ????? ?? ????? ?????? ???? ??? ?? ??????.?? ?? ??? ???????? ??????? ???? ????? ???????? ?? ??? ???????? ????? ?? ???? ????????? ?????? ???????????? ?????? ?? ????? ???????.????? ???? ??? ??????? ???????????? ?? ????? ????? ?????? ????????? ?? ???????? ????? ???? ???? ?????? ????????(TQM)? ?? ???? ?????? ?? ????????? ???????? ???????? ?????? ???? ?????? ????????? ??? ??????? ???????? ?????? ??????? ?????? ?????? ?? ????? ?????? ???????. ????? ???? ?????? ???????? (TQM) ?? ???????? ???????? ?? ???? ????? ??????? ??????????? ???????? ?????? ????? ?? ????? ??????? ???? ???????? ?????? ?????? ???????? ???????? ???????? ??????? ?????? ????? ?????? ????? ????? ??? ?????? ????? ???????? ?? ?????? ??????? ???????? ????????? ???????? ???????? ??????? ?????? ????? ?????? ????? ????. ?????? ?????????? ???? ?????? ???? ??? ?????? ???? ?????? ????????? ????? ?????????? ???? ?????? ??? ???????????? ?? ??? ??? ?????? ???? ??????? ??? ?? ??? ????? ?????? ???? ??????? ????????? ?????? ? ????? ?????? ????? ?????????? ???? ?????? ??? ????? ?????? ???????. ?????? ???? ????? ?????? ????? ?????? ???? ??? ????? ??????? ?? ?????? ???????? ???????? ????????? ????? ????? ??????? ????????. Abstract The changes within globalization are very dynamic and difficult to be predicted. For this reason it requires an organization or institution to provide maximum service. In this, Indonesia should be prepared for different strategies in various working areas. One of them is the implementation of Integrated Quality Management or also known as Total Quality Management (TQM). There are many key terms related to the study of Total Quality Management such as joint improvement and quality improvement i.e. continuous quality improvement. In this research, the researcher focuses on how to analyze Total Quality Management (TQM) in operational management witihin the Arabic language course Al-Azhar. This study aimed to determine the extent of applying TQM in the Al-Azhar course in improving the quality of students. This study implemented the qualitative research. To collect data, the researcher used interviews, notes, field notes, and documentation which includes personal documents, official documents, and data sources. The results of this study suggested that the floral cycle Barry carried out the total quality management in some of these ways such as; first, the customer value strategy, providing value to customers including product characteristics, delivery methods, and services; secondly, the organizational systems theory, focusing on providing value to customers; third, the theory of quality improvement, emphasizing on how to deal with the constantly changing external environment, especially the changing tastes of customers.

Tahl?lu kull?yati al-jaudah al-id?r?yah (TQM) li al-‘amal?y?ti al-id?r?yati al-tasyg?l?yati f? daurah al-lugah al-arabiyah al-Azh?r Pare

???? ????? ??????? ??????? ?? ????? ????????? ?????? ????? ?????? ???. ????? ????? ??????? ??????? ????? ?? ????? ?????? ???? ??? ?? ??????.?? ?? ??? ???????? ??????? ???? ????? ???????? ?? ??? ???????? ????? ?? ???? ????????? ?????? ???????????? ?????? ?? ????? ???????.????? ???? ??? ??????? ???????????? ?? ????? ????? ?????? ????????? ?? ???????? ????? ???? ???? ?????? ????????(TQM)? ?? ???? ?????? ?? ????????? ???????? ???????? ?????? ???? ?????? ????????? ??? ??????? ???????? ?????? ??????? ?????? ?????? ?? ????? ?????? ???????. ????? ???? ?????? ???????? (TQM) ?? ???????? ???????? ?? ???? ????? ??????? ??????????? ???????? ?????? ????? ?? ????? ??????? ???? ???????? ?????? ?????? ???????? ???????? ???????? ??????? ?????? ????? ?????? ????? ????? ??? ?????? ????? ???????? ?? ?????? ??????? ???????? ????????? ???????? ???????? ??????? ?????? ????? ?????? ????? ????. ?????? ?????????? ???? ?????? ???? ??? ?????? ???? ?????? ????????? ????? ?????????? ???? ?????? ??? ???????????? ?? ??? ??? ?????? ???? ??????? ??? ?? ??? ????? ?????? ???? ??????? ????????? ?????? ? ????? ?????? ????? ?????????? ???? ?????? ??? ????? ?????? ???????. ?????? ???? ????? ?????? ????? ?????? ???? ??? ????? ??????? ?? ?????? ???????? ???????? ????????? ????? ????? ??????? ???????? The changes within globalization are very dynamic and difficult to be predicted. For this reason it requires an organization or institution to provide maximum service. In this, Indonesia should be prepared for different strategies in various working areas. One of them is the implementation of Integrated Quality Management or also known as Total Quality Management (TQM). There are many key terms related to the study of Total Quality Management such as joint improvement and quality improvement i.e. continuous quality improvement. In this research, the researcher focuses on how to analyze Total Quality Management (TQM) in operational management witihin the Arabic language course Al-Azhar. This study aimed to determine the extent of applying TQM in the Al-Azhar course in improving the quality of students. This study implemented the qualitative research. To collect data, the researcher used interviews, notes, field notes, and documentation which includes personal documents, official documents, and data sources. The results of this study suggested that the floral cycle Barry carried out the total quality management in some of these ways such as; first, the customer value strategy, providing value to customers including product characteristics, delivery methods, and services; secondly, the organizational systems theory, focusing on providing value to customers; third, the theory of quality improvement, emphasizing on how to deal with the constantly changing external environment, especially the changing tastes of customers.

Total Quality Management Practices and Performance of Deposit Taking Savings and Credit Cooperatives in Mombasa County, Kenya

Savings and credit cooperatives are a crucial part of Kenya’s financial system. Compared to commercial banks, this is smaller but its significance is far much greater. Despite their important contribution towards the growth of the economy, many challenges are faced by the Saccos. Key among the drawbacks facing Savings and credit cooperatives is increased level of competition in the financial sector. The Savings and credit cooperatives to remain driven and focused in achieving their objectives, they have re-strategize their direction. The study sought to how Mombasa County deposit taking Saccos are impacted by TQM practices. Particularly, the study sought to examine how Mombasa deposit taking saccos’ performance was affected by Customer focus, employee involvement, supplier partnerships and commitment of top management. Performance was addressed from increased market share and revenue growth point of view. Quality improvement theory, Knowledge-based theory and RBV theories guided the research. A descriptive research design was employed. Board members and top managers of all the thirteen deposit taking Savings and credit cooperatives in Mombasa County were targeted. A census approach was used in identifying and subjecting all the County’s operational and registered Saccos. The preferred study respondents were then purposively selected CEOs, Branch managers, Operations Managers, Credit Managers and 4 Executive Board Members. As a result, the total respondents of the study were104, eight from each deposit taking Sacco. Primary data collection was by questionnaires and secondary data gotten from the Saccos’ financial statements and other reports. Analysis was by inferential and descriptive statistics and the primary analytical models were regression and correlation analysis. A wide performance disparity in the Saccos was discovered. It was demonstrated that Mombasa deposit taking saccos’ performance was affected by Customer focus, employee involvement, supplier partnerships and commitment of top management. The Determination Coefficient is at 0.785 implying that a variation of 78.5% in the SACCOs’ performance is explained by independent variables’ variability; customer focus, employee involvement, supplier partnership and commitment of top management. Pearson Correlation Analysis indicated that all TQM practices variables studied i.e customer focus, employee involvement, supplier partnership and commitment of top management and performance of deposit taking SACCOs positively related. Given that the study focused only on deposit taking saccos in Mombasa county, the results may not apply to all Saccos across Kenya. Therefore, it is recommended that a study is done cutting across all the Saccos in Kenya that would allow for broader generalization of findings. The findings will be beneficial to Managers, academicians, Investors, researchers, and the government as it will inform their decisions regarding the important subject of performance.

The Rise of Black Feminist Intellectual Thought and Political Activism in Perinatal Quality Improvement: A Righteous Rage about Racism, Resistance, Resilience, and Rigor

AbstractIn this description of her work in perinatal quality improvement, obstetrician and crunk public health scholar Dr. Karen A. Scott describes the ways in which perinatal quality improvement has typically prioritized the deaths or near deaths of Black women at the exclusion of the lived experiences of Black women and people as patient, community, and content experts. Drawn into the work to apply a Black women‐centered and liberatory analytic, Dr. Scott turned to Black feminist anthropology to transform perinatal quality improvement ethics and theories of change. The work of Leith Mullings, particularly her excursus on the Sojourner Syndrome, was at the center of Dr. Scott's approach to abating Black perinatal death and redesigning perinatal quality improvement.

The undervalued role of communication in healthcare improvement and its critical contribution to engaging staff and saving lives

ABSTRACT Implementation of quality improvement (QI) approaches in healthcare is widespread, yet healthcare services are still not reliably safe. Many QI approaches aim to change human behaviour to improve patient care, yet communication, a key component of change, does not feature prominently in QI theory and practice. We elaborate here on potential reasons for this oversight and how the role of communication can be clarified and enhanced. We also argue for the need of new theoretical models to overcome such issues and reflect on a few topics for consideration and inclusion in potential new theoretical models to address this issue. The question is not whether communication should be part of improvement activity, but how best it should be embedded and on what theoretical basis such decisions are taken.

Employee Empowerment and Service Delivery in the National Hospital Insurance Fund in Wajir County, Kenya

National Hospital insurance fund has faced so many challenges regarding customer satisfaction and service delivery. Majority of the National Hospital Insurance Fund accredited facilities in Wajir County have failed to satisfy the customers or members. The problem has escalated to Mashaalah nursing home and even to Jeddah nursing home which are situated in Wajir County. Therefore the aim of this study was to investigate the effect of employee empowerment on service delivery in national hospital insurance fund Wajir County, Kenya. The study was guided by quality improvement theory. Descriptive research design was used and data collected from five accredited nat ional ho spital insu rance fu nd facilities located in Wajir Cou nty. Th e respondents of the study will be 114 members. The study used the primary data which was collected through the use of questionnaire. Data was analysed with the help of SPSS and presented in tables and figures. The findings on employee empowerment found that the NHIF builds on the capacity of the employees for it enables employees to participate in decision-making. The respondents moderately agreed that the organisation encourages compliance and commitment both within and among the employers. The results on the relationship between employee empowerment and service delivery in NHIF was positive and significant. The County Governtment of Wajir should consider improving on the communication and information related to the benefits of being a member of NHIF.