Quality Management in Health and Welness Tourism

1. Quality Management in Health and Welness Tourism Thitinut Akkadechanunt

2. Chapter 1 Concepts and Principles of Quality Management

3. Quality-related terminology • Past: Quality assurance (QA) • Present: Continuous quality improvement (CQI) • Evolving term: Quality improvement (QI) Past: Quality control (QC) Present: Total quality management (TQM) Evolving term: Quality management (QM)

4. Definition of TQM • “TQM is all activities of the overall management function that determine the quality policy, objectives and responsibilities and implement them by means such as quality planning, quality control, quality assurance and • quality improvement within the quality system” (International Organization for Standard: ISO, 1994)

5. Definition of TQM • "A management philosophy and company practices that aim to harness the human and material resources of an organization in the most effective way to achieve the objectives of the organization.“ (British Standards Institution, 1992)

6. Definition of TQM • "A management approach of an organisation centred on quality, based on the participation of all its members and aiming at long term success through customer satisfaction and benefits to all members of the organisation and society.“ (International Organization for Standardization standard ISO 8402:1994)

7. Definition of TQM • "A management approach to long-term success through customer satisfaction. TQM is based on all members of an organization participating in improving processes, products, services and the culture in which they work. (The American Society for Quality)  • "TQM is a philosophy for managing an organisation in a way which enables it to meet stakeholder needs and expectations efficiently and effectively, without compromising ethical values.“ (The Chartered Quality Institute)

8. Notes • The expression “all its members” designates personnel in all departments and at all levels of the organizational structure. • The strong and persistent leadership of top management and the education and training of all members of the organization are essential for the success of this approach. • In total quality management, the concept of quality relates to the achievement of all managerial objectives.

9. Notes • The concept “benefits to society” implies, as needed, fulfillment of the requirements of society. • Total quality management (TQM) or parts of it are sometimes called “total quality”, “CWQC” (company-wide quality control), “TQC” (total quality control) and so on.

10. Definition of TQM All Persons Of all division System At every Level/Stratum Management Methods Method Analytical Methods Quality improvement Purpose Cost reduction Delivery execution Safety maintenance Environment protection Morale boosting

11. The goal of quality in tourism

12. Historical Review of Quality Management • In 1924, W.A.Shewhart of Bell Telephone Labs developed a statistical chart for the control of product variables • In 1946,the American Society for Quality Control was formed. • In 1950, W. Edwards Deming, who learnt QC from Shewhart, taught SPC & SQC to Japanese engineers and CEO’s • In 1954,Joseph M.Juran taught Japanese managements their responsibility to achieve quality .

13. Historical Review of Quality Management • In 1960, the first quality control circles were formed. SQC techniques were being applied by Japanese workers. • 1970’s US managers were learning from Japan Quality implementation miracles. • In 1980’s TQM principles and methods became popular.(also in auto industry) • In 1990’s ,the ISO 9000 model became the world-wide standard for QMS.

14. LeaderofQM • Dr. W.Edwards Deming: Deming Circle and 14 points • Dr. J.M. Juran: The Juran Trilogy Diagram to manage quality-quality planing, quality control and quality improvement • Philip B. Crosby: QM Maturity Grid, Zero Defects, Do it Right the First Time and 14 steps in QM • K.Ishikawa: Cause and Effect Diagram or Fishbone Diagram

15. TQM goal • Do the right things right the first time, every time. • Customer satisfaction through quality products and services • Seek business excellence and competitive leadership to satisfy our competitive leadership to satisfy our customers expectations. • Continuous improvements to processes, systems, people, suppliers, partners, products, and services

16. Total quality management (TQM) philosophy • The TQM philosophy is a long-term endeavor that links people and processes in a system that alters the corporate culture to become one where quality is the core aspect of business strategy • strategy implementation must involve a focused effort on the part of every employee within the organization. It cannot be applied successfully on a piecemeal basis.

17. Total quality management (TQM) philosophy • TQM requires that management, and eventually every member of the organization, commit to the need for continual improvement in the way work is accomplished.

18. Total quality management (TQM) philosophy • Total quality management (TQM) philosophy • Business plans, strategies, and management actions require continual rethinking in order to develop a culture that reinforces the TQM perspective.

19. Total quality management (TQM) philosophy • Total quality management (TQM) philosophy • Clarifying what products and services will provide maximum customer satisfaction, measuring satisfaction, and continually monitoring and improving the level of customer satisfaction

20. Basic Principles of TQM • 1. Focus on customers' needs - customer first" orientation • 2. Focus on problem prevention, not correction • 3. Make continuous improvements: seek to meet customers' requirements on time, the first time, every time • 4. Train employees in ways to improve quality; and, • 5. Apply the team approach to problem solving.

21. Principlesofqualitymanagement • Customer focus • Process improvement • Variation • Leadership • Employee involvement • Scientific method • Benchmarking

22. Concepts of Total Quality Management • TQM concepts undertaken by the Navy in the 1980s • Quality is defined by customers' requirements • Top management has direct responsibility for quality improvement • Increased quality comes from systematic analysis and improvement of work processes

23. Techniques of TQM • Quality improvement is a continuous effort and conducted throughout the organization • The PDCA cycle to drive issues to resolution • Ad hoc cross-functional teams (similar to quality circles) responsible for addressing immediate process issues

24. Techniques of TQM • Standing cross-functional teams responsible for the improvement of processes over the long term • Active management participation through steering committees • Use of the Seven Basic Tools of Quality to analyze quality-related issues

25. Evolution of Quality Management

26. Major Elements of TQM (Lau, 1998)

27. TQM Process • Deming’s 14 Points are as follows: • Create constancy of purpose for improving products and services. • Adopt the new philosophy. • Cease dependence on inspection to achieve quality. • End the practice of awarding business on price alone; instead, minimize total cost by working with a single supplier. • Improve constantly and forever every process for planning, production and service.

28. TQM Process • Deming’s 14 Points are as follows: • Institute training on the job. • Adopt and institute leadership. • Drive out fear. • Break down barriers between staff areas. • Eliminate slogans, exhortations and targets for the workforce.

29. TQM Process • Deming’s 14 Points are as follows: • Eliminate numerical quotas for the workforce and numerical goals for management. • Remove barriers that rob people of pride of workmanship, and eliminate the annual rating or merit system. • Institute a vigorous program of education and self-improvement for everyone. • Put everybody in the company to work accomplishing the transformation.

30. TQM Process • Juran 7 Steps of TQM • Establish quality policies and guides • Establish quality goals • Design quality plans to reach theses goals • Assign responsibility for the plan • Provide necessary resources • Review progress against goals • Evaluate manager performance vs. goals

31. Total Quality Management Process

32. Elements for Success • • Management Support • • Mission Statement • • Proper Planning • • Customer and Bottom Line Focus

33. Elements for Success • • Measurement • • Empowerment • • Teamwork/Effective Meetings • • Continuous Process Improvement • • Dedicated Resources

34. Juran7successfactors • 1. Senior manager led quality process • 2. Managers applies QI to business and traditional operational processes • 3. Annual QI • 4. Managers involvement • 5. Manager used modern quality method • 6. Managers trained the workforce • 7. Senior managers included QI in the strategic planing

35. Obstacles to Implementing TQM • • Lack of a company‐wide definition of quality. • • Lack of a formalized strategic plan for change. • • Lack of a customer focus. • • Poor inter‐organizational communication. • • Lack of real employee empowerment.

36. Obstacles to Implementing TQM • • Lack of employee trust in senior management. • • View of the quality program as a quick fix. • • Drive for short‐term financial results. • • Politics issues.

37. Benefits of quality management • Control cost of care • Decrease malpractice • Employee participation • Customer satisfaction

38. Chapter2 Product and Service Quality

39. Product and service • Product is anything that can be offered to a market for attention, acquisition, use, or consumption that might satisfy a need or want. • It includes physical objects, services, physical objects, services, persons, places, organizations, ideas, and services. • Services are activities or benefits offered for sale that are essentially intangible and do not result in the ownership of anything.

40. Definition: Health and Wellness Tourism • Health and wellness tourism includes travelling both nationally and internationally to places and facilities, such as hospitals, clinics, thermae, thalasso, wellness SPAs, and fitness centers and wellness resorts. • Wellness tourism includes consumers who travel to maintain their well-being and life satisfaction through the experiences of healthy treatments. Wellness has to do with quality of life. In a holistic approach to health (Chinese, ayurvedic and integrative medicines), wellness treatments and therapies restore the vital balance among bodies, mind, and spirit toward equilibrium and health harmony. This harmony re-balances and restores the energy flow bringing about overall well-being.

41. Definition: Health and Wellness Tourism • Health tourism refers to patients who travel nationally or internationally for healing therapies in hospitals and clinics. Health tourism includes medical tourism, aesthetical/plastic tourism, thermal tourism and thalassotherapy tourism.

42. The touristic products • From many points of view, the concept of the touristic product has a considerable abstract character, being difficult to quantify, as the tourist sector implies the interconnectivity of all other components of a scale economy

43. The touristic products • The touristic product presents specific features and characteristics: • it is a touristic package services formed of various components, commercialized throughout the tourism agencies; • it needs a specific distribution and an accurate synchronization of performances chain; • characterized through immobility, due to its specific engaged attraction, determined by the natural and anthropological resources of environment; • due to of the necessity to ensure touristic satisfaction, the tourism product must have specific quality characteristics.

44. Themeaningofquality • The meaning of quality in health and tourism: • 1. Efficacy-the ability of the science and art to bring about improvement in health and well-being • 2. Effectiveness-the improvement in health that is achieved or can be expected to be achieved, under the ordinary circumstances of everyday practice • 3. Efficiency- a measure of the cost at which any given improvement of health is achieved

45. Themeaningofquality • 4. Optimality - the ability to obtain the most desirable balance of the costs of care against the consequences • 5. Acceptability-adaptation of care to the wishes, expectations, and values of customers and their families

46. Themeaningofquality(cont.) • 6. Legitimacy- conformity to social preferences as expressed in ethical principles, values, norms, laws, and regulation • 7. Equity - the principle by which one determines what is just or fair in the distribution of services and its benefits among members of a population

47. Perspective of quality • Perfection • Consistency • Eliminating waste • Speed of delivery • Compliance with policy and procedures • Doing it right the first time • Delighting or pleasing customer • Total customer satisfaction and service

48. Quality in the tourism • Quality in tourism is the satisfaction of all the legitimate product and service needs, requirements and expectations of the consumer, at an acceptable price, in conformity with the underlying quality determinants such as safety and security, hygiene, accessibility, transparency, authenticity and harmony of the tourism activity concerned with its human and natural environment. • Quality in the hospitality industry is defined as “the consistent delivery of products and guest services according to expected standards”