Total Quality Management Principles as a Competitive Advantage in Hospitals within Nairobi, Kenya

Abstract

The study focused on total quality management (TQM) principles and their influence on competitive advantage in hospitals within Nairobi. Total Quality Management brings forth competitive advantage that results from high customer satisfaction levels, employee satisfaction and operations efficiency. The study was guided by the following objectives: to determine the influence of leadership commitment, process focus: customer focus: employee empowerment: and continuous quality improvement on competitive advantage in Nairobi based hospitals. The review of literature brought out the important theories that have established relationships between TQM and competitive advantage. This study adopted positivism philosophy and a descriptive correlational research design that entailed testing hypotheses. The target population comprised of 229 senior employees and stable, conscious patients of both private and public hospitals within Nairobi area. Stratified random sampling method was used to determine a sample size of 139 for both employees and patients, of which, 134 (71 percent) were successfully completed and returned. Data was analyzed and the findings were presented in tables and figures. Result revealed that application of TQM principles had a positive and significant influence on competitive advantage within hospitals in Nairobi. The first specific objective, sought to determine the influence of leadership commitment on competitive advantage within hospitals in Nairobi Three element of leadership commitment were examined visionary leadership, resource allocation, and strategic planning. Leadership commitment significantly and positively influenced competitive advantage. The second objective of the study sought to determine the influence of process focus on competitive advantage within hospitals in Nairobi. Three parameters of process focus were examined namely, design control and communication. The study showed that control and communication had a positive influence on competitive advantage while design alone did not influence competitive advantage. The findings of the third objective showed that all four parameters of patient focus (responsiveness and attitude, reliability, empathy, and assurance) had a positive and significant influence on competitive advantage within hospitals in Nairobi. The findings revealed that hospitals which got and responded to patient feedback had higher level of patient satisfaction as a competitive advantage. The fourth objective sought to explore the influence of employee empowerment on competitive advantage in hospitals within Nairobi. Three parameters of employee empowerment studied were competence, teamwork, motivation, and rewards and recognition. The study showed that employee empowerment significantly influenced competitive advantage within hospitals. However, employee competence alone did not indicate to influence the hospitals' competitive advantage. The fifth objective examined the influence of continuous quality improvement on competitive advantage within hospitals in Nairobi. The findings showed that continuous quality improvement had a significant influence on competitive advantage within hospitals in Nairobi. Finally, pursuit of the sixth research objective showed that organizational characteristics had a moderating influence on the relationship between total quality management principles and competitive advantage in hospitals within Nairobi. All the three parameter for organizational characteristics size and age of the hospital, and tangibility showed a significant moderating role that influence competitive advantage within hospitals in Nairobi. This led to the conclusion that the implementation of total quality management principles had a positive and significant influence on competitive advantage through patient satisfaction, high employee satisfaction and operations efficiency of the hospitals. From the findings of this study, it was concluded that leadership commitment benefits an organization to effectively achieve competitive advantage. High responsiveness and good attitude, reliability and empathy and assurance of the patients’ best interests enhance their satisfaction. Further, the study drew the conclusion that, continuous quality improvement enhanced patients' satisfaction, through implementation of innovation, monitoring of key performance indicators, information sharing, and risk management. The study findings guided the researcher to recommend, among other things, that leaders in the healthcare industry should draw customer and employee satisfaction through TQM application to achieve competitive advantage. While this study has considered the influences of only five TQM principles on competitive advantage, it recognizes that there are other TQM principles which the researcher suggests should also be studied. Because this study was conducted only in hospitals, the researcher suggests that further studies be carried out within other industries and sectors.