ABSTRACT

In the service industry, the success or failure of the organisation depends on how they fulfill consumers’ needs and wants. The main purpose of this study is to determine the impact human resource management on total quality management. This study in an assessment of the purpose used deductive approach in which qualitative and quantitative surveys were carried out on the employees and patients in the U.I.T.H. The survey was intended to get their responses on what they feel about the quality of services they get from the hospital. In this light, the study sets to identify the perception of employees and patients about the implementation of TQM by HRM.

A sample size of 100 respondents comprising both in and outpatients was chosen from  whom information to measure their perception about services quality in the UITH as a result of impact of human resource management on total quality management were captured. Similarly, a sample of 50 staffers of the institution was also selected to elicit data on the views of employees towards the implementation of total quality management through human resource management. A biased sample of one hundred patients, i.e. fifty in and out patients was selected until the desired sample size is reached depending on the condition and disposition of the patients. While fifty staffers were randomly selected from the staff population. Simple random sampling involves selecting cases (staffers) until the desired sample size is reached.

The result of the study indicates that there is a positive linear relationship between sex of patients has effect on their perception towards the quality of service received. The co-efficient of correlation(r=0.098) is weak. Though, the relationship is weak but it is positive, HRM on Total Quality Management  raises the level service received by patient variance is being explained only 1% (r2 = 0.010), though significant at  < 0.05.

The analysis from the empirical findings showed that irrespective of cadre of the employee, it does not affect their perception about the impact of HRM on TQM. It was also discovered that the area of specialty of employee had effect on their perception on the impact HRM has on TQM. Patients, irrespective of their status i.e. inpatients or outpatients has no effect on how they perceive the impact of HRM on TQM. Most patients agree to the fact that service quality has improved in the hospital when compared to previous years before the implementation of TQM through HRM. It was also discovered that the mortality rate had drastically reduced when comparing mortality rates from previous years to rates obtainable since the implementation of TQM through HRM. From the analysis of the survey results, some recommendations for University of Ilorin Teaching Hospital Service Improvement  program will be made to help the organization manage its brand better and to sustain and improve the quality of its services.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The concept of quality has existed for many years, though it’s meaning has changed and evolved over time. In the early twentieth century, quality management meant inspecting products to ensure that they met specifications. In the 1940s, during World War II, quality became more statistical in nature. Statistical sampling techniques were used to evaluate quality, and quality control charts were used to monitor the production process. In the 1960s, with the help of so-called "quality gurus," the concept took on a broader meaning. Quality began to be viewed as something that encompassed the entire organization, not only the production process. Since all functional were responsible for product quality and all shared the costs of poor quality, quality was seen as a concept that affected the entire organization.      

Wilkinson (2008), the meaning of quality for businesses changed dramatically in the late 1970s. Before  then,  quality  was  still  viewed  as  something  that  needed  to  be  inspected  and corrected. However, in the 1970s and 1980s many U.S. industries lost market share to foreign competition for examples in the auto industry, manufacturers such as Toyota and Honda became major players. In the consumer goods market, companies such as Toshiba and Sony led the way. These foreign competitors were producing lower-priced products with considerably higher quality.

The term used for today's new concept of quality is total quality management or TQM. You can see that the old concept is reactive, designed to correct quality problems after they occur.

Employees in a service organization and particularly, those who have frequent contacts with the customer usually serve as representatives of both the organization and their products or services to the customer at contact point. The quality of the service and the satisfaction the customer may derive will be an assessment of the entire service experience.

Employees who are empowered in an organization can either portray a positive or negative picture to the customers. Considering that, a satisfied customer and employee are of important value to the organization; it therefore, becomes the duty of the management to put in place a system that would ultimately generate either satisfaction, or dissatisfaction from their customers and employees.

Since the employees have a major role to play in determining, whether a customer would enjoy the experience or turn to their competitors for better solutions.

This according to Baruch (1998), forces organizations to re-think their strategy”  because as Zeithaml (2006) points out, companies today recognize that they can compete more effectively by distinguishing themselves with respect to service quality and improved customer satisfaction.

Developments in clinical procedures, technologies, laws have called for hospitals to search for new strategies and structures. Decreasing markets, increasing demands, and changed customer attitudes, regulations, as well as the growing global competition in recent years, make up the causes of change in the markets hospitals are competing on.

Product and  service  quality  are  ranked  high,  private  and  public  companies  providing  quality certificates  and  total  quality  management  deriving  from  this  development.  Wilkinson (1998). Others have expressed the quality development as the end of mass and the start of a new production paradigm, based upon flexible specialization Piore and Sabel (1984). In view of the prevailing trend, increased service quality and a higher degree of liability towards customers no longer remain a mere possibility but are essential if market shares are to be retained and further developed.

According to Oakland (1993), quality management is driven by the competitive environment and is universal for all types of organizations:” Whatever type of organizations you are working in

–        a  hospital,  universities,  bank,  insurance  company,  airline  company,  students,  or  whatever company  you are working in – competition is common: Competition among customers, resources etc. Very few organizations do not see quality as a most important element in the battle for competitive advantages.”

The management interest in quality is not new but using quality as a key element in the battle for competitive advantages is of recent date. Oakland (1989) claims that after the industrial revolution, and the computer revolution in the beginning of the 1980’s, we are now in the midst of a quality revolution.  Surveys  conducted  by  various  organizations  have  revealed  an  increase  in  quality movements. These include the movement best known as total quality management; this has been widely acknowledged as a major innovation in management theory. The approach to or the philosophy of total quality management is, however, not obvious. Even Deming acknowledged that he did not know what it meant precisely Boje (1993). There are a number of reasons for this ambiguity. The first problem is to define the concept quality. Secondly, the large variation in activities, practice, and techniques renders it hard to define what total quality management really means. Knutton (1994) claims that even though the introduction of total quality management may be similar in different organizations, organizations may well have very different ways of working with total quality management.

1.2    STATEMENT OF THE PROBLEM

When service interaction are not properly controlled and handled, or not even handled at all, the outcome is poor perception or service quality and customer dissatisfaction, Hence the need for properly managed total quality management frame. Hence what role has human resource management to play in the implementation of total quality management and improving the service quality in the university of Ilorin teaching hospital?

1.   What are the perceptions of employees towards the impact of human resources management on total quality management in the hospital?

2.   What are the perceptions of patients towards the impact of human resources management on total quality management in the hospital?

3.   What are the perception of patients towards the quality of services they receive in the hospital as compared to the before the implementation of TQM?

4.   Have the human resources management strategies implemented in the hospital led to improvement in service delivery in the hospital?

5.   What strategic role did the human resource management play in the implementation?

1.3   OBJECTIVES OF THE STUDY

The aim of this research is to ascertain the extent to which total quality management has being attained through human resource management in the University of Ilorin Teaching Hospital.

The specific objectives of the study are to:

1.         To determine the importance of Total quality management in University of Ilorin teaching hospital.

2.         To examine the impact of human resources management on employee through the use of Total quality management.

3.         To study the role play by human resource management in the implementation of TQM.

4.         To investigate the impact of TQM on patients in University of Ilorin Teaching hospital.

5.         To make suggestion on Human resources management patterns with the view of improving employee’s performance.

1.4  JUSTIFICATION FOR THE STUDY

The research work focused on the impact of human resources management on total quality management in the university of Ilorin teaching hospital. Although Oakland (1993, p.2-3) defines total quality management as the way for the management to improve effectiveness, flexibility, and competitive advantages for the organization as a whole because it complies with the internal and external customer requirements and the role of human resources in Nigeria hospital. With the help of total quality management in University of Ilorin teaching hospital it improves the quality and efficiency of service rendered.

1.5     HYPOTHESIS OF THE STUDY

The University of Ilorin Teaching Hospital is a fully fledged teaching hospital that provides healthcare services to both people within the state and its environs.

The hypothesis of the study includes;

Ho:        Area of specialization of employees has no effect on perception towards the impact of human resource management on total quality management.

Ho:        Cadre of employee has no effect on perception towards the impact of human resource management on total quality management.

Ho:        Number of years in service has no effect on perception towards the impact of human resource management   on total quality management.

Ho:        Sex of employees has no effect on perception towards the impact of human resource management on total quality management.

Ho:        Type of patient has no effect on their perception towards the quality of service received.

Ho:         Sex of patients has no effect on their perception towards the quality of service received.

1.6  SIGNIFICANCE OF THE STUDY

The case study showed how the human resource department had played different roles as facilitator, internal contractor, and hidden persuader at different stages of the implementation of total quality management in the U.I.T.H. They assisted the top management in aligning human resource polices and quality policies, creating and  communicating the total quality management concept, preparing the organization as well as the staff for the implementation of total quality management, generating quality awareness among the employees across the levels, functions, and departments, developing management support to quality action teams, organizing quality workshops, formulating quality friendly policies, systems and procedures, changing the conventional mind set of employees, organizing   total   quality   management   training   programs,   devising   different   communication exercises,   encouraging   team  building   activities,   promoting   employee   involvement   through suggestion schemes, quality circles, and other participative types of forum.

This thesis has aimed to contribute to the understanding of the human resource management and implementation aspects of total quality management. More specifically, the aims were those of analyzing the data collected and examining the perception of both employee and patients towards total quality management and of generating knowledge on the human resource management task with regards to an implementation of total quality management.

1.7   SCOPE OF THE STUDY

In healthcare institutions, the general offering in a particular industry is averagely similar, even though they may engage in different approaches to achieving a differentiation from the others, to be able to gain more market share and customers in the industry. According to Grönroos (2001), “that almost any health institution can provide an individual with healthcare services, "but not every health institution manages to treat customers in a way that they are pleased with.” Service providers therefore seek to differentiate themselves from their rivals by offering customers higher quality of services than their competitors’, which makes the basis of their competition to be defined by their services.

The nature of services as being intangible, heterogeneous, perishable, produced, and consumed at same time makes it peculiar to deliver, and challenging to organizations to achieve a differentiation from the others.

Following therefore all the qualities of service, and with respect to the health sector, a hospital cannot inspect its services and products to weed out unsatisfactory ones before they are presented to the customer Ashis K Sen. (2008). Employees therefore become the voice and face of the organization, but it is not enough that they are trained to provide quality service; the whole system (organization) must be geared towards the attainment of providing quality services at all times.

According to Looy (2003) with reference to the specific nature of service delivery, “empowerment becomes a very important issue to organizations producing services.” In that, the customers and the employees are engaged simultaneously in the production of the service. This inseparability is what is considered by the organization in choosing how best to serve its customers. The inability of the management to control the service encounter makes the employees responsible for the quality of service delivered to the customers. In order for the management to trust that total quality management is attained, the management has to give the employees the authority and necessary support to succeed, Support systems must be in place, good management policies, technology, and information must be relevant and timely.

In matters concerning health services, patients not only need reassurance on the quality of service received, but also that they are valued for committing their stakes with a particular health institution. Customers of a health institution rely on the services delivered to them by the hospital whether they are on admission, receiving outpatient consultations, purchasing drugs from the hospital’s pharmacy or receiving medical social services, they count on the employees responsible for handling issues relating to them, to deliver high service quality in other to increase their satisfaction. When service interaction are not properly controlled and handled, or not even handled at all, the outcome is poor perception or service quality and customer dissatisfaction, Hence the need for properly managed total quality management frame.

1.8     LIMITATION OF THE RESEARCH

This research is limited to the activities of one hospital; this is consequent to the constraint on the duration of this research. This project will cover the concept of effective use of Total quality management in the University of Ilorin Teaching Hospital.

        The limitation of this study will include; limited time available on the part of the researcher to carry out an extensive investigation and high cost of acquiring needed material. Another constraint which serves as limiting factors is the unwillingness of the staffs in the hospital to release the vital information.

The research is further delimited to the extent and impact of human resources management on the implementation of total quality management. Hence the result of the research cannot be generalized to other hospitals.

1.9  DEFINATION OF TERMS

i.             Total Quality Management: Total Quality Management (or TQM) is a management concept coined by W. Edwards Deming.The basis of TQM is to reduce the errors produced during the manufacturing or service process, increase customer satisfaction, streamline supply chain managemrnt, aim for modernization of equipment and ensure workers have the highest level of training. From Wikipedia, the free encyclopedia (April 19, 2010).

ii.            Quality is one of the most commonly misunderstood words in management. What is a high- quality pair of shoes or a high-quality bank account? It is meaningless to make statements about the degree of quality of a product or service without reference to its intended use or purpose.

---

---