Total Quality Management in Practice: A Singapore Healthcare Study - Page 4

The Research Methodology

This paper is essentially a survey-based report on TQM practices of Singapore hospitals. It utilises the following approach. Firstly, a systematic review of major journal articles on quality management in the healthcare industry, together with acknowledged seminal books on TQM in healthcare and the analyses of Quality by various quality gurus. This affords the authors a better understanding of the past and current issues of quality in healthcare. A review of the guide to the Malcolm Baldridge Quality Award was also undertaken to ensure an understanding of where are the emphases of quality.

Secondly, the basic research method is the survey questionnaire. It was designed using references from "Total Quality in Healthcare" (Gaucher and Coffey, 1993), various journal articles and the guide to the Malcolm Baldridge Quality Award. The survey questionnaire consists of six sections, namely:

i. Particulars of Respondents
ii. General Information on the Hospital
iii. Strategic Planning
iv. Quality Management
v. Human Resources Management
vi. Information and Innovation Management

Thirdly, the questionnaires were sent to all the hospitals in Singapore. A list of the hospitals was obtained from the "Yellow Pages" of the Singapore Phone Book. Telephone calls were made to each hospital to enquire to whom the questionnaires should be sent. Based on the information received, the authors addressed the questionnaires to the following persons: CEOs, Quality Manager or Communications Manager. Only one copy of the questionnaire was sent to each hospital. There were altogether 20 hospitals. As the number of hospitals in Singapore is small, the objective is to target all the hospitals to respond to the survey

Finally, the data was collected and analysed. The data obtained from the survey was compiled into the required format for performing data analysis testing. The Statistical Package of Social Sciences (SPSS) was used for data analysis. The returns were analysed for descriptive statistics on all the questions/variables. A correlation analysis using the Kendall Tau (t) coefficient was used to determine the correlation among the variables. The Kendal Tau coefficient technique was chosen because of its wide application for ordinal correlation. Kendall's measure of correlation is given us:


where N c denotes the number of concordant pairs of observations out of the [n2] total possible pairs, N d is the total number of discordant pairs of observations. Because the n observations may be paired [n2] = n (n - 1)/2 different ways, the number of concordant pairs N c plus the number of discordant pairs N plus the number of pairs with ties should add up to n (n-1) /2 (Conover, 1980). Only those variables that correlate at 1 percent significance level are considered.

Description of the Survey Questionnaire

The questionnaire consists of Part I and Part II. Part I looks for the name and designation of the respondents and the demographic data of the hospital. Part II consists of four sections, Strategic Planning, Quality Management, Human Resource Management, Information and Innovation Management, which are meant to solicit different answers in each area of hospital management. A five-point Likert scale is used in all the four sections with a higher score indicating a better understanding or stronger importance in the statement.

Survey Response

There were altogether 20 survey questionnaires sent out to the CEO, Quality Manager or Communication Manager of the 20 hospitals. The number of responses was 18, giving a response rate of 90%. Out of the 18 respondents, two hospitals indicated their unwillingness to participate in the survey. Thus, the number of valid responses was 16.

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