Multiattribute Decision-Making of TQM Performance of Hospitals Using TQM Digraphs

Total quality management (TQM) is a dynamic philosophy that incorporates gradual and uninterrupted improvements. The total quality is accomplished if all the desired goals including quality of product, reputation in market, services, low cost of product, employee and customer satisfaction, optimum utilization of resources, work environment, and so on are attained. As far as the Pakistani perspective is concerned, TQM as a strategic tool is not appropriately used to optimize its performance. Public healthcare in Pakistan is one of the most ignored sectors with regard to its service quality implementation and delivery. The public sector hospitals are one of the major primary healthcare providers, but the facilities they provide do not meet the desired requirement. This study addresses six TQM attributes to analyze the TQM performance of various public sector teaching hospitals in the province Punjab of Pakistan. The data was obtained from medical experts. The TQM performance to study the behavior of TQM implementation in hospitals is evaluated using TQM digraphs. The hospitals are ranked according to the TQM performance index, which is obtained from TQM digraphs. The technique to find the most effective attribute for a hospital is also proposed. The TQM digraph approach not only focuses on the significance of attributes independently but also incorporates the relative importance of one attribute over another. Also, this approach is very flexible that can incorporate new attributes and market variation so that continuous improvement may be possible. Moreover, the results obtained in this approach are not limited to beneficial for benchmarking of teaching hospitals in Punjab on the TQM basis, but these can also help indicate the particular attribute that is more needed to be improved for a particular hospital to increase its TQM performance.