Total quality management: panacea or placebo for hospital management?

Total Quality Management (TQM) has gained widespread acceptance and application in both the private and public sector organisations in Australia yet, for a number of complex reasons, the public health sector has not kept pace with these developments. Several attempts have been made recently to introduce TQM into public hospitals although with mixed results. This article examines one of the first of these to draw out the paradoxes and dilemmas confronting those seeking to implement TQM in public hospitals. It is argued that the implementation of TQM or quality programs in health care will require different management and organisational approaches to the ones commonly found in the TQM literature.     

Change,changes and changing: The views of public manages

As the traditional policy levers of the nation state are shaped by the forces of globalization, the proper role of government is increasingly being questioned. Governments at all levels are struggling to respond to the burgeoning demands for more effective policies and programs. In 1989, the federal government of Canada launched Public Service 2000 (PS 2000), a major organizational renewal cffort of the federal public service, aimed at revitalizing the institution in preparation for the challenges of the year 2000.

This article contends that despite the profile associated with its inception, PS 2000 has lacked an overriding implementation focus toward fundamental behavioral change. This deficiency has thwarted the progress of the initiative, and the transformation desired has not been achieved to this point in time. It is recommended that Total Quality Management (TQM) is a more suitable strategy for refurbishing departments and agencies as it directly focuses on continuous quality improvement. This approach is a significant shift in emphasis from PS 2000, and is more likely to encourage the immense management and organizational culture changes sought by renewal.     

TQM in the courts: Maybe so,maybe not

Courts are prime candidates for the application of Total Quality Management (TQM) but also difficult settings in which to implement it. The leadership structure of courts discourages strong leadership but also requires negotiation and mediation to install new programs, so an effective chief judge can bring most of the governing body--the other judges--along when a decision is made to adopt TQM. As turnover on the bench is slow, the governing body remains throughout the period needed to institutionalize TQM. Courts already have a valuable and useful tool for thinking about “customers” and using data effectively in the Trial Court Performance Standards. Courts have been slow to adopt TQM to date, but there is growing interest and several leadership courts using TQM to improve various court functions. Courts' work mostly is processed in assembly-line fashion; using TQM's principles can help courts improve productivity, recognize and respond to customer needs more readily, and generally be better able to obtain taxpayer support. The courts are at once prime candidates for Total Quality Management (TQM) and a setting in which TQM is a hard sell. This article will explore why both elements of this statement are true. Acknowledging the difficulties, this article nonetheless concludes that TQM can and should be sold and that the courts will be better for the effort. Most Americans do not understand how courts work.(') Even less do they understand how courts are managed or why courts should involve any different management issues from other public agencies. To understand both the difficulties in having TQM accepted in courts and the fertile ground they offer, it may help to explore briefly the management context.     

“Two roads diverged in a yellow wood:” Public administration,the management orthodoxy,and civic humanism

Public administration is confronted with a dilemma: whether to follow the course of the management orthodoxy; or to follow the course of civic humanism. It is argued that the profession should follow the latter path. Democratic public administration must be informed by a civic idealism, centering on civic virtue, that insures that morality will be realized in action. Yet in recent years, public administration has become overly entranced with the orthodoxy of the management sciences. The profession's ties with the management sciences have proven to be practically advantageous, but, overall, the association has been negative. Public administration has begun to lose its soul: its sense of civic idealism. The management orthodoxy adopts a more positivist stance, because virtue will not yield to the dominant methodology and is, hence, considered to be unreliable. A civic humanist approach to public administration requires a rather exalted notion of human potential, and a conception of political service as something both necessary and unique. Thus, in a correctly ordered republic, a public administration, guided by civic humanism, would consider the promotion of virtue among all citizens as a primary responsibility.

The 19th century brought about the creation of the modern organization. The early organizationalists argued that society would no longer need to rely upon the unpredictable virtue of its leaders and citizens. Instead, through scientific administration, all societal needs could be assessed and met by organizations. That assumption, in a more sophisticated guise, has carried over to the present day. Thus, the primary responsibility of organizational leadership is to ensure organizational survival. Such leaders are not required to be individuals of virtue; they only need to be effective motivators and managers.

If this argument is accepted, then the question becomes one of how public administration can recover its soul. First, the core of the public administration curriculum must be a political philosophy centering upon civic humanism. Second, public management goals and techniques must be modified to promulgate civic virtue. Granted, these recommendations are overtly idealistic, but, then, public administration should be an idealistic profession.     

Total quality management teams in the office of administrative services,u.s. department of the interior: a success story

Using a multiple case study research technique, this study investigates the hypothesis that Total Quality Management (TQM) teams that function within the Office of Administrative Services, U.S. Department of the Interior in Washington, D.C., successfully achieve their goals when either one of two conditions exist: a team has effective leadership and/or team members are motivated. Using an explanatory case study approach, four TQM teams were used as case studies to examine the various facets of causal arguments. The case study projects include: recognizing and rewarding TQM achievers; conference rooms and auditoriums scheduling/setup; improving Contracting Officer's Technical Representative understanding of the procurement process; and improving workplace services. Based on the findings and the analyses of the case studies, evidence generally supports the original hypothesis with the difference between the original hypothesis and findings being that the conditions of leadership and motivation are both required to successfully complete projects.     

Towards a public service blend of human resource management and TQM

The objective of this paper is to contemplate changes in personnel system infrastructure required to implement Total Quality Management (TQM) in public organizations (perhaps formal organization in general). By infrastructure we mean systems such as those for the design of work and positions, rewards, performance appraisal, selection, etc. We introduced the subject by summarizing many of the concepts from the quality literature which express philosophy, structural aspects and practices. Even the industrial context in which TQM has flowered has not adapted significantly to implications of TQM philosophy and structure. Instead, traditional personnel management systems prevail with some concern for needed specia1 training, and anguish about negative effects of performance appraisal, some reward systems, and work standards.

Because the government context is bound to present difficulties and pitfalls we summarized another body of literature, that of the reasons why the idea probably won't work in government.

Ultimately, we get to the point of the essay: a discussion of contemplated types of personnel system changes that ought to support organizations operating in a quality mode. Changes are considered under the subjects of: work design, recruitment and selection, performance appraisal, training, compensation and labor-management relations. We conclude with a. brief case study on the Pacer Share Project.     

THE INFLUENCE OF MANAGERIAL AND JOB VARIABLES ON ORGANIZATIONAL COMMITMENT IN THE POLICE

Like all public sector agencies police forces are under constant pressure to improve their performance through better management of existing resources. However, little research has been done that explains how officers' organizational commitment, an essential requirement for above average employee productivity, can be improved. Using a whole population survey of a county police force in the UK, managerial, job, and demographic variables are analysed that influence officers' organizational commitment. Experiences of the way officers are managed were found to have the strongest influence on their organizational commitment while job related variables were found to have a lesser influence. The decline in organizational commitment found in the early years of officers' careers should be a cause for concern for senior managers in the police. The paper concludes that much need to be done to make police policies more effective in achieving promotion of officers who have the managerial competences needed to engender higher levels of organizational commitment.     

Organizational development and change in Africa(1)

Little is known about organizational functioning and managerial behavior in Africa. The need for organizational development and change is urgent. Current attempts to reform African public sector organizations tend to focus on mechanistic measures, neglecting the complexity of organizational life. Western approaches to organizational development tend to reflect their cultural milieu and may contain elements which are irrelevant or inimical to African contexts. There is a need to develop concepts and approaches to organizational development and change which are effective and sensitive to African contexts.

Most African nations have been independent for less than four decades. Immense changes have taken place on the African continent during that time. ‘Development’ remains the most common word in the rubric of Africa. Many governments still claim to be ’revolutionary,’ although change since independence has generally not been radical. ’Change’ in education has meant more schools, more teachers, more colleges, more universities: more and more of the Western assumption that education and learning inevitably means schooling. ’Change’ in health provision has meant more hospitals, more imported drugs, more complex procedures, more university trained medical practitioners: more and more of the health arrangements which the rich countries of the West can afford less and less. ’Change’ in organizational arrangements has meant more -- and bigger -- bureaucracies, more ministries, more departments, more parastatal corporations, more bureaucrats, more procedures, more forms, more control mechanisms: more and more of the organizational structures and practices which are now seen to retard change and development.     

AFFECTIVE ORGANIZATIONAL COMMITMENT AND JOB SATISFACTION: A CROSS‐NATIONAL COMPARATIVE STUDY

Public managers across countries are faced with challenges of attracting and retaining high‐quality employees in the context of widespread financial constraints and increasing inter‐sectoral competition. These changing circumstances have reinforced the need to enhance public employees' affective organizational commitment, which is related to important outcomes such as employees' performance and retention. However, we know little about the factors that can positively influence affective organizational commitment in a cross‐national context. This study applies a cross‐national comparative approach using data from four US states (Oregon, Florida, Washington, and Utah) and India to examine the factors influencing affective organizational commitment. We focus mainly on the effects of job satisfaction, which is considered to be the most important antecedent of affective organizational commitment. Our findings indicate that, in both countries' contexts, job satisfaction has a significant positive impact on affective organizational commitment. We also examine the US–India differences in the levels of affective organizational commitment. Findings indicate that, compared to the four US states of Oregon, Florida, Washington, and Utah, affective organizational commitment is significantly higher among Indian public managers.     

Performance Management,Evaluation and Learning in ‘Modern’ Local Government

Public sector reforms throughout OECD member states are producing a new model of ‘public governance’ embodying a more modest role for the state and a strong emphasis on performance management. In the UK, the development of performance management in the context of the ‘new public management’ has been primarily ‘top‐down’ with a dominant concern for enhancing control and ‘upwards account‐ability’ rather than promoting learning and improvement. The development of performance management and evaluation in local government in the UK has been conditioned by external pressures, especially reforms imposed by central government, which have encouraged an ‘instrumental–managerial’ focus on performance measurement. The new Labour government's programme of ‘modernizing local government’ places considerable emphasis on performance review and evaluation as a driver of continuous improvement in promoting Best Value. However, recent research has indicated that the capacity for evaluation in local government is uneven and many obstacles to evaluation exist in organizational cultures. Local authorities need to go beyond the development of review systems and processes to ensure that the capacity for evaluation and learning is embedded as an attribute of ‘culture’ in order to achieve the purpose of Best Value.     

Stepping Out: Rhetorical Devices and Culture Change Management in the UK Civil Service

Organizational culture is the pattern of values and beliefs held by members of an organization and the management of culture is now one of the most frequently discussed of all organizational concepts. The excitement associated with culture is attributable to two factors. First, it is argued that culture is the key to organizational performance; simply stated, a strong organizational culture can be a source of competitive advantage. Second, culture is perceived as an alternative method of control to traditional and technocratic forms of management and can be manipulated to ensure that employees are enthusiastic and committed to organizational objectives.
Despite the extensive interest in this topic, culture remains an elusive concept. This paper investigates the nature of culture and considers strategies for introducing cultural change. Specifically, the aims of the paper are threefold. First, to locate and explain the interests and significance of culture change for the public sector. Second, using a case study of a newly created agency, to investigate the problems and issues affecting cultural change in the civil service. Third, to reassess and critically evaluate the claims for culture management made in the literature. Finally, this paper questions some of the assumptions in the literature, which with few exceptions are biased toward top management and the unitary conception of organization, an ideological frame of reference which is particularly problematic in the public sector.     

Character ethics and the transformation of governance

A focus on character ethics has the power to transform public adminstration, and transform governance as we know it. Virtue demands of us many things that professionalism, efficiency, effectiveness, and ordinary bureaucratic practices do not. It requires that we be perceptive and discerning, and that we have a predisposition to make judgments and act with courage. Focusing on character ethics would transform governance because a public service characterized by virtue and the attending fundamental respect for the dignity and worth of others, would not deny the public their rightful role in self-governance. A virtuous public servant will be an enabling and empowering force in our institutions of governance, helping reinvigorate civic virtue among both public administrators and the general citizenry. But if an ethic of character is to take hold in public administration, we need to design organizational environments and management practices more conducive to the development of virtuous habits. Fortunately such changes are also likely to foster productivity, creativity, and effectiveness.     

CAN TEACHING BE SAVED?

ABSTRACT

Future generations of professors may be harder to recruit and to retain compared to the current generation of nearly-retired senior faculty. This is especially the case in public colleges and universities. The condition of academic life in public higher education at the beginning of the twenty-first century was not enviable. Decades of sacking and pillaging by external and internal forces have left the professoriat stranded in purgatory, overrun by larger numbers of under prepared students and evaluated by pseudo processes. The professoriat has also contributed to the demise of liberal learning by substituting escapism for scholarship and by rolling over for various forms of coercion and financial seduction.

This essay discusses one person's teaching experience in the context of evolving cultural norms about learning, of professional standards pertinent to teaching, and of the psycho-social consequences for college teachers of the secular anti-intellectual drift in post-literate society. Public college and university teaching in the last decade of the twentieth century, for most workaday faculty not heavily endowed with external research funds or not capable of manipulating endless leaves of absence, has been a voyage of uncertainty. The combined effects of triumphant managerialism, techno-idolatry, political correctness and bureaucratic rationalization have subverted public higher education, and the subversion has occurred with the willing collusion of many “insiders” in the academic establishment. Worse: so engrained is the system of incentives for self-preservation (on the part of administrators and faculty) and evasion of accountability (on the part of students) that the system is unable and unwilling to correct its own dysfunctions. The absence of complaint from the “consumers” of higher education, students and their parents, is not the result of good institutional performance. It is, unhappily, the result of tacit collusion in the willingness to certify mediocrity and call it excellence.

Many volumes would be required to diagnose and prescribe remedies for the entire matrix in which public higher education now finds itself. Space does not permit comprehensiveness here. Instead, I offer admittedly selective perceptions of my own teaching experiences of more than two decades, as related to the problems cited in the preceding paragraph. However, I doubt that it is a singular view. More than a personal cri de coeur, it represents the frustration of a generation of educators who have seen public higher education seduced and sacked by some of the same forces that might have been expected to nourish and protect it: including the educators themselves.

Of course, the cynical saying of one of my colleagues remains true: “Institutions never lose: individuals always do.” And he is right–higher education will endure and prosper, even if those who still remember what education is forare marginalized or driven into another line of work. No one can doubt that American colleges and universities have succeeded as organizationsand in the pursuit of organizational values over the past two or three decades: many are richer, larger, and as marketing savvy as the most endowed Fortune 500 corporation. Whether American higher education still has anything useful to say about American society and culture is another, and more arguable, matter. There is significant risk that institutional value distortion has pushed the critical faculties of students and teachers into a Phantom Zone of indifference or even hostility, relative to what “really” matters to the governing boards and administrations of many institutions of higher learning. The commingling of academic institutional and organizational–corporatist values has another side: it has betrayed many students by asking of them as little as possible, and many professors by rewarding them for their entertainment value.     

Improving emergency management: A total quality management approach

We address the problem of managing emergencies in complex environments and examine the concepts of total quality management (TQM) as a means of increasing organisational capacity to reduce and/or respond to threatening events. The TQM approach initiates and integrates improvement in three fundamental areas of organisational design and operation: technical, organisational, and cultural. We apply this approach to the interactive environment of hazardous materials management and present an “action plan” for introducing TQM into community planning for risk reduction and response, focusing on the technical, organisational, and cultural components of the process. We present evidence of increased performance in reducing hazardous materials risk from field reports of communities that have adopted TQM practices. Finally, we conclude that TQM serves as a generative means of revitalising, renewing, and enabling community engagement in hazardous materials management.     

Strategic change,leadership and accounting: A triptych of organizational reform

Strategic change in public sector organizations has been well documented. This article suggests that public management research would benefit from a greater appreciation of how calculative practices are deeply imbricated with, and constitutive of, organizational life. In turn, the article argues that the field of interdisciplinary accounting has much to learn from public administration, especially in terms of leadership. The overarching argument is that understanding strategic change in public organizations can be enhanced by bringing together insights from the academic fields of public administration and interdisciplinary accounting. In this respect, organizational reform can be understood as a triptych, involving strategic change, leadership and accounting practices. We illustrate this thesis through a case study of strategic change in the world's largest public service broadcaster—the British Broadcasting Corporation (BBC). It is shown how, during the tenure of one organizational leader—John Birt—accounting became pivotal to his leadership.     

Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales

The National Health Service (NHS) in England and Wales has embarked upon a radical and far–reaching programme of change and reform. However, to date the results of organizational quality and service improvement initiatives in the public sector have been mixed, if not to say disappointing, with anticipated gains often failing to materialize or to be sustained in the longer term. This paper draws on the authors' recent extensive research into one of the principal methodologies for bringing about the sought after step change in the quality of health care in England and Wales. It explores how private sector knowledge management (KM) concepts and practices might contribute to the further development of public sector quality improvement initiatives in general and to the reform of the NHS in particular. Our analysis suggests there have been a number of problems and challenges in practice, not least a considerable naïvety around the issue of knowledge transfer and 'knowledge into practice' within health care organizations. We suggest four broad areas for possible development which also have important implications for other public sector organizations.     

Context matters: A Bayesian analysis of how organizational environments shape the strategic management of sustainable development

Public administration scholars have argued the need for a ‘general theory’ linking strategic management to the context in which public organizations operate. Understanding the interplay between organizational contexts and strategic management responses to urban sprawl and greenhouse gas (GHG) emissions remains an underexplored avenue for empirical advancement of this goal. Using 2015 survey data, we employ a novel Bayesian item response theory (IRT) approach to test how land use policy comprehensiveness, organizational capacities, leadership turnover, and environmental complexities affect the strategic management of smart growth policy in local governments. We find that public organizations harness political, administrative, and community capacities in varied combinations to better achieve their policy objectives, but these influences may not be complementary. Also, policy comprehensiveness generally relates to more strategic activity, while municipal executive turnover offers opportunities and threats to some smart growth strategies. Implications of this research are discussed.     

Ethnic versus organizational cultures: The bureaucratic alternative

It has been suggested that the common values and beliefs of an organization's culture can be used to control employee behavior. However, the use of organizational culture to control behavior assumes that employees either already have, or can be inculcated with common values and beliefs. The flow of immigrants across national borders increases the diversity of organization workforces. This diversity may include employees who hold values and beliefs associated with their membership in different ethnic cultures. It may be difficult or impossible to infuse common values and beliefs in such a diverse workforce. A more bureaucratic form of organizational governance, in which rules and expectations are made explicit, may be more appropriate when an organizations′ employees are members of diverse ethnic cultures.     

WHAT’S VALUED MOST? SIMILARITIES AND DIFFERENCES BETWEEN THE ORGANIZATIONAL VALUES OF THE PUBLIC AND PRIVATE SECTOR

In recent administrative and organizational literature much attention has been paid to values that guide organizational and managerial behaviour in the public and private domain. Comparative empirical research efforts, however, are sparse. This article reports the results of a comparative empirical survey of 382 managers from a variety of public and private sector organizations in The Netherlands. Contrary to much recent literature that presupposes the intermixing or convergence of value systems guiding governance in different kinds of organizations, the results of this study show two distinct and relatively classical value systems for government and business as well as a ‘common core’ of important organizational qualities. These are accountability, expertise, reliability, efficiency and effectiveness, all of which are considered crucial in both public and private sector organizations. Additional analysis shows that value preferences are primarily attached to sector rather than to age, gender, working experience, or previous employment in the other sector.     

Implementing Risk Management in the Italian Public Sector: Hybridization between Old and New Practices

Though Risk Management (RM) entered the public sector, the way RM is introduced within organizations is not empirically explored. Analyzing the Italian National Institute of Statistics (ISTAT) case study through the theoretical lens of institutional perspective, the paper responds to the call for more organizational studies of RM: nature and dynamics of RM are investigated, offering a valid contribution to the debate on practice of public management related to work practices and knowledge systems. The results show that RM is now embedded in ISTAT activities, processes, culture and individual behaviors, confirming the opportunity to improve both organizational performance and learning.