Principles of Total Quality


The total quality or the so-called total quality management is a methodology whose goal is to achieve the organizational effectiveness of the work team. Pillars of total quality are the three underlying principles of customer focus, continuous improvement, and teamwork. Understanding, applying, and following these three aspects allow the organization to eliminate workflow errors, improve general and personal professional qualities, and achieve a common goal. This is especially true in our time when healthcare services are becoming more expensive all over the world, and new types of diseases and viruses are appearing. The material for this work was scholarly articles from sources such as the American Journal of Nursing, the International Journal of Pharmacy Practice, and The American Journal of Emergency Medicine from South University Online Library. This paper will examine three principles of total quality, how they are illustrated in the articles, their interconnections, and universality.

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Customer Focus in Pharmacy Practices

The first principle is customer focus, and it means meeting the needs of the client with benefits for the organization. This concept within the framework of healthcare implies providing the client with various types of care and medications. These services not only provide an inflow of cash profit but also increase customer loyalty to the medical institution. One such service is the practice of community interventions by pharmacologists to monitor patients’ medication adherence, which is described in an article by Milosavljevic, Aspden, and Harrison (2018). These procedures have helped prevent many health complications that usually arise from irregular medication and side effects. Also, according to Milosavljevic, Aspden, and Harrison (2018), “this regular contact also enables … a trusting therapeutic relationship to be fostered, between the pharmacist and the patient” (p. 388). The analysis carried out in the article shows the financial feasibility and effectiveness of such community interventions.

Continuous Improvement of Intensive Care

The concept of continuous improvement means the ongoing correction and elimination of errors of all operations, activities, and processes to achieve benefits and reputation. The ultimate goal of this principle is to execute flawlessly from start to finish the first time. In healthcare, one of the primary methods for eliminating errors and improving care practices is tracking patients. Solano et al. (2017) “investigate the utility of tracking patients transferred to the ICU within 24 h of admission from the ED as a marker of preventable errors and adverse events” (p. 753). The data obtained helped to identify the real number of errors and their belonging to the emergency department or the intensive care unit. Information was transmitted to the committee for quality assurance, which further took measures to improve caring procedures and teamwork.

Principle of Teamwork among Staff Nursing

Teamwork in the framework of total quality is the method of building the most comfortable and productive relationships between employees of the institution or company. The study of this principle allows the leader to correctly distribute employees into groups, set goals and objectives, analyze the performance and results of the team as a whole, and each employee in particular. The work efficiency of employees increases when they know their tasks and organizational structure. Kamel and Aref proved this in their study by analyzing the perception of corporate culture among nurses (2017). Researchers note that “the highest mean score of nurses perception regarding organizational culture was related to organizational learning…” (Kamel and Aref, 2017, p. 251). Awareness of the norms of work in the organization contributes to a positive perception of the working environment among employees and the introduction of new approaches to care practices.

Relationships of Principles and Their Universality

Customer focus, continuous improvement, and teamwork are directly interconnected, forming a kind of Uroboros. Compliance with customer requests, coupled with a desire to make a profit, forces management to analyze mistakes and misses in work operations, as well as improve current and develop new practices. Improvements and corrections require a labor resource and motivational reformation of the working collective. When a team achieves its objectives, the results achieved open new horizons that also require more organizational innovations. However, it is also essential to understand when and which of the principles of total quality should be used. The above cases of client focus and continuous improvement are too narrow and not applicable to each other. But an example of the organizational perception of nurses can be applied to the other two. Corporate culture training of pharmacy specialists will lead to their role expansion, which will allow them to better meet customer needs (Milosavljevic, Aspden & Harrison, 2018). Similar educational practices will also help prevent emergencies in the area of intensive care.


This work discussed three aspects of total quality, namely customer focus, continuous improvement, and teamwork. Examples of the application of these three principles in healthcare institutions were also provided. They were cases of community interventions by pharmacists, tracking of emergency department patients, and nurses’ perception of the hospital’s culture. The nature of the correlation between all three points of total quality is cyclical. It was also revealed that the described teamwork practice is theoretically applicable to other examples.


Kamel, F. F., & Aref, M. A. E. (2017). Staff nurse’s perception toward organizational culture and its relation to innovative work behavior at critical care units. American Journal of Nursing, 6(3), 251-260. Web.

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Milosavljevic, A., Aspden, T., & Harrison, J. (2018). Community pharmacist‐led interventions and their impact on patients’ medication adherence and other health outcomes: a systematic review. International Journal of Pharmacy Practice, 26(5), 387-397. Web.

Solano, J. J., Dubosh, N. M., Anderson, P. D., Wolfe, R. E., Edlow, J. A., & Grossman, S. A. (2017). Hospital ward transfer to intensive care unit as a quality marker in emergency medicine. The American Journal of Emergency Medicine, 35(5), 753-756. Web.

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