The quality journey in a comprehensive mental health center: A case study

Background: In early 1992 the chief executive officer (CEO) and consequently the senior leadership of Shawnee Hills, a mental health care organization comprising more than 65 facilities in West Virginia, decided to begin the journey toward total quality management (TQM). TQM provided guidance for establishing an infrastructure for planned organizational change and continuous improvement while maintaining the CEO's responsibility to set the vision and provide direction. TQM's impact: Absenteeism and turnover rates have decreased, which are felt to reflect increasingly high levels of staff satisfaction. The tripling of the operating budget from 1993 to 1995 is also considered a byproduct of TQM. TQM has increased the potential for this organization's success in the new health care environment by providing an infrastructure for ''managing'' managed care. Implementing TQM: Setting forth the vision, purpose, mission, and goals required a focus on customer satisfaction and the development of partnerships, empowerment, and teamwork. The leadership identified strategic indicators for critical success factors-customer satisfaction, positioning for future success, financial viability, and safe and professional environments-and teams were formed to address how improvements can be made. Benchmarking and reengineering: If a problem is minimal or average, processes are improved. If it is severe, reengineering is indicated. For example, each program at Shawnee Hills had its own intake procedure. To simplify access to service, it was determined that a single point of entry was needed, requiring a total redesign of current operations. Conclusion: Although not a panacea for all the problems an organization might be experiencing, TQM does provide guidance and direction to organizations in an ever-changing environment.