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Total Quality Management
Presenter: Attar Firoj Isahak & Arif Fakirmahammad Nadaf
F.Y. M. Pharmacy (Pharmaceutics)
Guide: Zeenat Iqbal Ma’am
SPER, Jamia Hamdard University, New Delhi
Contents:
 Total Quality Management
 Definition
 History
 Categories
 Principles
 Elements
 Managing TQM
 Advantages
TQM in Pharmaceutics
 Pharma industry is is one of the pillars of health care system, which is regulated heavily.
Any mistake in product formulation, manufacture or design may cause serious issues
for patients. It may be fatal.
 The poor quality products not only causes loss of Government and patients, but also
causes damage to the reputation of company.
 So quality management is important in the scenario. Continuous improvement should
be done.
 From this concept “Total Quality Management” came into existence.
 TQM focuses on prevention of the defects and flaws.
 So TQM is very important in health care system as it helps to produce a better product
along with ensured safety and protects waste of life and money.
Total Quality Management(TQM) refers to:
 Satisfying every need of customer
 Enabling the employees to solve problems
 Eliminating wastage of money
 Prevention of defects and flaws
 Trying for continuous improvement
 Ensure safety
Definition
1. TQM is the management approach of an organization, centered on quality, based on me
participation of all its members and aiming at long-term success through customer
satisfaction. and benefits to all members of me organization and to society.- ISO
2. TQM is an integrated organizational approach in delighting customers (both internal and
external) by meeting their expectations on a continuous basis through every one involved
with the organization working on continuous improvement in all products, services, and
processes along with proper problem solving methodology - INDIAN STATISTICAL
INSTITUTE ( ISI )
3. TQM is a. people - focused management system that aims at continual increase in customer
satisfaction at continually lower cost. TQM is a total system approach (not a separate area of
program ), and an integral part of high level strategy. It works horizontally across functions
and departments, involving all employees, top to bottom, and exceeds backwards and
forward to include the supply chain and the customer chain – TOTAL QUALITY FORUM OF
USA
TQM model:
History
 One of the important issues that business has focused on in the last two decades is
“quality”. The other issues are cost and delivery.
 Quality has been widely considered as a key element for success in business in the
present competitive market.
 It is important to understand that quality is about more than a product simply working
properly. Quality refers to certain standards and the ways and means by which those
standards are achieved, maintained and improved.
 Quality is not just confined to products and services. It is a homogeneous element of
any aspect of doing things with high degree of perfection. For example Business
success depends on the quality decision making.
 The exact origin of the term is uncertain.
 The need for improved product quality emerged in 1980’s.
Categories Of TQM:
TQM is divided into 4 categories:
 P lan
 D o
 C heck
 A ct
It is also called as PDCA cycle.
Planning Phase:
 It is the most crucial step.
 Employees must come up with problems they face. Queries should come up.
 Then they must find the root cause of the problems and various challenges they
face in the operation.
 Employees should do the research and should collect the data regarding their
problems which would help them to find solutions of their problems.
Doing Phase:
 In this phase, employees develop solutions for their problems defined in planning
phase.
 Then strategies are made to resolve the problems and challenges.
 In this phase the effectiveness is also measured for the strategies and solutions.
Checking Phase:
 In this phase the results obtained are compared with data obtained before
using solutions.
 Effectiveness is measured and results are confirmed.
ActingPhase:
 In this phase employees do the documentation of their results and and prepare
themselves to address other problems.
Principles of TQM:-
 The principles of the TQM approach are:
1. Focus on the Customer:
 It is important to identify the organization’s customers.
 External customers consume the organization’s product or service.
 Internal customers are employees who receive the output of other employees.
2. Employee Involvement:
 Since quality is considered as the job of all employees, employees should be involved in
quality initiatives.
 Front line employees are likely to have the closest contact with external customers and
thus can make the most valuable contribution to quality.
 Therefore, employees must have the authority to innovate and improve quality.
Principles of TQM:-
3. Process-centred:
 A fundamental part of TQM is a focus on process thinking.
 A process is a series of steps that take inputs from suppliers (internal or external) and
transforms them into outputs that are delivered to customers (either internal or
external).
4. Integrated System:
 Every organization has a unique work culture, and it is virtually impossible to achieve
excellence in its products and services unless a good quality culture has been fostered.
 Thus, an integrated system connects business improvement elements in an attempt to
continually improve and exceed the expectations of customers, employees and other
stakeholders.
Principles of TQM:-
5. Strategic and Systematic Approach
 A critical part of the management quality is the strategic and systematic approach to
achieving an organization’s vision, mission and goals.
 This process, called strategic planning or strategic management, includes the
formulation of a strategic plan that integrates quality as a core component.
6. Continuous Improvement:
 The quest for quality is a never ending process in which people are continuously
working to improve the performance, speed and number of features of the product or
service.
 Continuous improvement means that small, incremental improvement that occurs on a
regular basis will eventually add to a vast improvement in quality.
Principles of TQM:-
7. Fact-based Decision Making:
 In order to know how well an organization is performing, data on performance
measures are necessary.
 TQM requires that an organization continually collect and analyse data in order to
improve decision making accuracy, achieving consensus, and allow prediction based
on past history.
8. Communications:
 During times of organizational change, as well as part of day to day operation, effective
communications plays a large part in maintaining morale and in motivating employees
at all levels.
 Communications involve strategies, method and timelines.
Elements of TQM
To be successful implementing TQM, an organization must concentrate on the eight key
elements:
1. Ethics
2. Integrity
3. Trust
4. Training
5. Teamwork
6. Leadership
7. Recognition
8. Communication
Key Elements
 TQM has been coined to describe a philosophy that makes quality the driving force behind
leadership, design, planning, and improvement initiatives.
 For this, TQM requires the help of those eight key elements. These elements can be divided
into four groups according to their function.
 The groups are:
1.Foundatio
n
• It includes:
Ethics,
Integrity and
Trust.
2. Building
Bricks
• It includes:
Training,
Teamwork and
Leadership.
3. Binding
Mortar
• It includes:
Communication.
4. Roof
• It includes:
Recognition.
Key
Elements
Elements of TQM
I. Foundation
 TQM is built on a foundation of ethics, integrity and trust.
 It fosters openness, fairness and sincerity and allows involvement by everyone.
 This is the key to unlocking the ultimate potential of TQM.
 These three elements move together, however, each element offers something different to the
TQM concept.
1. Ethics:
 Ethics is the discipline concerned with good and bad in any situation.
 It is a two-faceted subject represented by organizational and individual ethics.
 Organizational ethics establish a business code of ethics that outlines guidelines that all
employees are to adhere to in the performance of their work.
 Individual ethics include personal rights or wrongs.
Elements of TQM
2. Integrity:
 Integrity implies honesty, morals, values, fairness, and adherence to the facts and sincerity.
 The characteristic is what customers (internal or external) expect and deserve to receive.
 People see the opposite of integrity as duplicity.
 TQM will not work in an atmosphere of duplicity.
3. Trust:
 Trust is a by-product of integrity and ethical conduct.
 Without trust, the framework of TQM cannot be built.
 Trust fosters full participation of all members.
 It allows empowerment that encourages pride ownership and it encourages commitment.
 It allows decision making at appropriate levels in the organization, fosters individual risk-taking
for continuous improvement and helps to ensure that measurements focus on improvement of
process and are not used to contend people.
 Trust is essential to ensure customer satisfaction. So, trust builds the cooperative environment
essential for TQM.
Elements of TQM
II. Bricks:
 Basing on the strong foundation of trust, ethics and integrity, bricks are placed to
reach the roof of recognition.
 It includes:
4. Training:
 Training is very important for employees to be highly productive.
 Supervisors are solely responsible for implementing TQM within their departments,
and teaching their employees the philosophies of TQM.
 During the creation and formation of TQM, employees are trained so that they can
become effective employees for the company.
Elements of TQM
5. Teamwork:
 To become successful in business, teamwork is also a key element of TQM.
 With the use of teams, the business will receive quicker and better solutions to problems.
 Teams also provide more permanent improvements in processes and operations.
 In teams, people feel more comfortable bringing up problems that may occur, and can get help from other
workers to find a solution and put into place.
 There are mainly three types of teams that TQM organizations adopt:
A. Quality improvement teams or excellence teams (QITs):
 These are temporary teams with the purpose of dealing with specific problems that often recur.
 These teams are set up for period of three to twelve months.
B. Problem solving teams (PSTs):
 These are temporary teams to solve certain problems and also to identify and overcome causes of problems.
 They generally last from one week to three months.
C. Natural work teams (NWTs):
 These teams consist of small groups of skilled workers who share tasks and responsibilities.
 These teams use concepts such as employee involvement teams, self-managing teams and quality circles.
 These teams generally work for one to two hours a week.
Elements of TQM
6. Leadership:
 It is possibly the most important element in TQM.
 It appears everywhere in organization.
 Leadership in TQM requires the manager to provide an inspiring vision,
make strategic directions that are understood by all and to instil values that
guide subordinates.
 For TQM to be successful in the business, the supervisor must be committed
in leading his employees.
 A supervisor must understand TQM, believe in it and then demonstrate their
belief and commitment through their daily practices of TQM.
Elements of TQM
III. Binding Mortar:
7. Communication :
 It binds everything together.
 Starting from foundation to roof of the TQM house, everything is bound by strong mortar of
communication.
 It acts as a vital link between all elements of TQM.
 Communication means a common understanding of ideas between the sender and the receiver.
 The success of TQM demands communication with and among all the organization members,
suppliers and customers.
 There are different ways of communication such as:
• This is the dominant form
of communication in an
organization.
• Presentations and
discussions basically do it.
• By this the supervisors are
able to make the
employees clear about
TQM.
• By this the lower level of employees
are able to provide suggestions to
upper management of the affects of
TQM.
• As employees provide insight and
constructive criticism, supervisors
must listen effectively to correct the
situation that comes about through
the use of TQM.
• This forms a level of trust between
supervisors and employees.
• This is also similar to empowering
communication, where supervisors
keep open ears and listen to others.
• This type of
communication is
important because it
breaks down barriers
between departments.
• It also allows dealing with
customers and suppliers in
a more professional
manner.
There are different ways of communication such as:
Elements of TQM
IV. Roof:
8. Recognition:
 Recognition is the last and final element in the entire system.
 It should be provided for both suggestions and achievements for teams as well as individuals.
 Employees strive to receive recognition for themselves and their teams.
 Detecting and recognizing contributors is the most important job of a supervisor.
 As people are recognized, there can be huge changes in self-esteem, productivity, quality and
the amount of effort exhorted to the task at hand.
 Recognition comes in its best form when it is immediately following an action that an
employee has performed.
• It can be by way of personal letter from top management. Also by
award banquets, plaques, trophies etc.
• Good performers can be recognized in front of departments, on
performance boards and also in front of top management.
• Recognition can given at any time like in staff meeting, annual award
banquets, etc.
Recognition comes in different ways, places and time such as:
Managing TQM
1. Strategic Commitment:
 The start point for TQM is a strategic commitment by the management.
 Firstly, the organizational culture must change to recognize that quality is not just an ideal
but is instead an objective goal that must be pursued.
 Secondly, a decision to pursue the goal of quality carries with it some real costs- for
expenditures such as new equipment and facilities.
 Thus, without a commitment from the top management, quality improvement will prove to
be just a slogan or gimmick.
2. Employee Involvement:
 Employee involvement is another critical ingredient in TQM.
 Virtually all successful quality enhancement programs involve making the person
responsible for doing the job responsible for making sure it is done right.
 By definition, then employee involvement is critical component in improving quality.
Managing
TQM
3. Materials:
 Another important part of TQM is improving the quality of the materials that
organizations use.
4. Technology:
 New forms of technology are also useful in TQM programs.
 Investing in higher grade machine capable of doing jobs more precisely and reliably
often improves quality.
5. Methods:
 Improved methods can improve product and service quality.
 Methods are operating systems used by the organization during the actual
transformation process.
Managing TQM
Advantages of TQM:
The advantages of implementing TQM are:
 Strengthened competitive position
 Adaptability to changing or emerging market conditions and to environmental and other government
regulations
 Higher productivity
 Enhanced market image
 Elimination of defects and waste
 Reduced costs and better cost management
 Higher profitability
 Improved customer focus and satisfaction
 Increased customer loyalty and retention
 Increased job security
 Improved employee morale
 Enhanced shareholder and stakeholder value
 Improved and innovative processes
References:
1. https://en.wikipedia.org/wiki/Total_quality_management
2. https://managementhelp.org/quality/total-quality-management.htm
3. https://www.isixsigma.com/methodology/total-quality-management-tqm/eight-
elements-tqm/
4. http://aboutthree.com/blog/five-important-factors-in-total-quality-management/

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Total quality management

  • 1. Total Quality Management Presenter: Attar Firoj Isahak & Arif Fakirmahammad Nadaf F.Y. M. Pharmacy (Pharmaceutics) Guide: Zeenat Iqbal Ma’am SPER, Jamia Hamdard University, New Delhi
  • 2. Contents:  Total Quality Management  Definition  History  Categories  Principles  Elements  Managing TQM  Advantages
  • 3. TQM in Pharmaceutics  Pharma industry is is one of the pillars of health care system, which is regulated heavily. Any mistake in product formulation, manufacture or design may cause serious issues for patients. It may be fatal.  The poor quality products not only causes loss of Government and patients, but also causes damage to the reputation of company.  So quality management is important in the scenario. Continuous improvement should be done.  From this concept “Total Quality Management” came into existence.  TQM focuses on prevention of the defects and flaws.  So TQM is very important in health care system as it helps to produce a better product along with ensured safety and protects waste of life and money.
  • 4. Total Quality Management(TQM) refers to:  Satisfying every need of customer  Enabling the employees to solve problems  Eliminating wastage of money  Prevention of defects and flaws  Trying for continuous improvement  Ensure safety
  • 5. Definition 1. TQM is the management approach of an organization, centered on quality, based on me participation of all its members and aiming at long-term success through customer satisfaction. and benefits to all members of me organization and to society.- ISO 2. TQM is an integrated organizational approach in delighting customers (both internal and external) by meeting their expectations on a continuous basis through every one involved with the organization working on continuous improvement in all products, services, and processes along with proper problem solving methodology - INDIAN STATISTICAL INSTITUTE ( ISI ) 3. TQM is a. people - focused management system that aims at continual increase in customer satisfaction at continually lower cost. TQM is a total system approach (not a separate area of program ), and an integral part of high level strategy. It works horizontally across functions and departments, involving all employees, top to bottom, and exceeds backwards and forward to include the supply chain and the customer chain – TOTAL QUALITY FORUM OF USA
  • 6.
  • 8. History  One of the important issues that business has focused on in the last two decades is “quality”. The other issues are cost and delivery.  Quality has been widely considered as a key element for success in business in the present competitive market.  It is important to understand that quality is about more than a product simply working properly. Quality refers to certain standards and the ways and means by which those standards are achieved, maintained and improved.  Quality is not just confined to products and services. It is a homogeneous element of any aspect of doing things with high degree of perfection. For example Business success depends on the quality decision making.
  • 9.  The exact origin of the term is uncertain.  The need for improved product quality emerged in 1980’s.
  • 10.
  • 11.
  • 12. Categories Of TQM: TQM is divided into 4 categories:  P lan  D o  C heck  A ct It is also called as PDCA cycle.
  • 13. Planning Phase:  It is the most crucial step.  Employees must come up with problems they face. Queries should come up.  Then they must find the root cause of the problems and various challenges they face in the operation.  Employees should do the research and should collect the data regarding their problems which would help them to find solutions of their problems.
  • 14. Doing Phase:  In this phase, employees develop solutions for their problems defined in planning phase.  Then strategies are made to resolve the problems and challenges.  In this phase the effectiveness is also measured for the strategies and solutions.
  • 15. Checking Phase:  In this phase the results obtained are compared with data obtained before using solutions.  Effectiveness is measured and results are confirmed. ActingPhase:  In this phase employees do the documentation of their results and and prepare themselves to address other problems.
  • 16.
  • 17. Principles of TQM:-  The principles of the TQM approach are: 1. Focus on the Customer:  It is important to identify the organization’s customers.  External customers consume the organization’s product or service.  Internal customers are employees who receive the output of other employees. 2. Employee Involvement:  Since quality is considered as the job of all employees, employees should be involved in quality initiatives.  Front line employees are likely to have the closest contact with external customers and thus can make the most valuable contribution to quality.  Therefore, employees must have the authority to innovate and improve quality.
  • 18. Principles of TQM:- 3. Process-centred:  A fundamental part of TQM is a focus on process thinking.  A process is a series of steps that take inputs from suppliers (internal or external) and transforms them into outputs that are delivered to customers (either internal or external). 4. Integrated System:  Every organization has a unique work culture, and it is virtually impossible to achieve excellence in its products and services unless a good quality culture has been fostered.  Thus, an integrated system connects business improvement elements in an attempt to continually improve and exceed the expectations of customers, employees and other stakeholders.
  • 19. Principles of TQM:- 5. Strategic and Systematic Approach  A critical part of the management quality is the strategic and systematic approach to achieving an organization’s vision, mission and goals.  This process, called strategic planning or strategic management, includes the formulation of a strategic plan that integrates quality as a core component. 6. Continuous Improvement:  The quest for quality is a never ending process in which people are continuously working to improve the performance, speed and number of features of the product or service.  Continuous improvement means that small, incremental improvement that occurs on a regular basis will eventually add to a vast improvement in quality.
  • 20. Principles of TQM:- 7. Fact-based Decision Making:  In order to know how well an organization is performing, data on performance measures are necessary.  TQM requires that an organization continually collect and analyse data in order to improve decision making accuracy, achieving consensus, and allow prediction based on past history. 8. Communications:  During times of organizational change, as well as part of day to day operation, effective communications plays a large part in maintaining morale and in motivating employees at all levels.  Communications involve strategies, method and timelines.
  • 21. Elements of TQM To be successful implementing TQM, an organization must concentrate on the eight key elements: 1. Ethics 2. Integrity 3. Trust 4. Training 5. Teamwork 6. Leadership 7. Recognition 8. Communication
  • 22. Key Elements  TQM has been coined to describe a philosophy that makes quality the driving force behind leadership, design, planning, and improvement initiatives.  For this, TQM requires the help of those eight key elements. These elements can be divided into four groups according to their function.  The groups are: 1.Foundatio n • It includes: Ethics, Integrity and Trust. 2. Building Bricks • It includes: Training, Teamwork and Leadership. 3. Binding Mortar • It includes: Communication. 4. Roof • It includes: Recognition.
  • 24. Elements of TQM I. Foundation  TQM is built on a foundation of ethics, integrity and trust.  It fosters openness, fairness and sincerity and allows involvement by everyone.  This is the key to unlocking the ultimate potential of TQM.  These three elements move together, however, each element offers something different to the TQM concept. 1. Ethics:  Ethics is the discipline concerned with good and bad in any situation.  It is a two-faceted subject represented by organizational and individual ethics.  Organizational ethics establish a business code of ethics that outlines guidelines that all employees are to adhere to in the performance of their work.  Individual ethics include personal rights or wrongs.
  • 25. Elements of TQM 2. Integrity:  Integrity implies honesty, morals, values, fairness, and adherence to the facts and sincerity.  The characteristic is what customers (internal or external) expect and deserve to receive.  People see the opposite of integrity as duplicity.  TQM will not work in an atmosphere of duplicity. 3. Trust:  Trust is a by-product of integrity and ethical conduct.  Without trust, the framework of TQM cannot be built.  Trust fosters full participation of all members.  It allows empowerment that encourages pride ownership and it encourages commitment.  It allows decision making at appropriate levels in the organization, fosters individual risk-taking for continuous improvement and helps to ensure that measurements focus on improvement of process and are not used to contend people.  Trust is essential to ensure customer satisfaction. So, trust builds the cooperative environment essential for TQM.
  • 26. Elements of TQM II. Bricks:  Basing on the strong foundation of trust, ethics and integrity, bricks are placed to reach the roof of recognition.  It includes: 4. Training:  Training is very important for employees to be highly productive.  Supervisors are solely responsible for implementing TQM within their departments, and teaching their employees the philosophies of TQM.  During the creation and formation of TQM, employees are trained so that they can become effective employees for the company.
  • 27. Elements of TQM 5. Teamwork:  To become successful in business, teamwork is also a key element of TQM.  With the use of teams, the business will receive quicker and better solutions to problems.  Teams also provide more permanent improvements in processes and operations.  In teams, people feel more comfortable bringing up problems that may occur, and can get help from other workers to find a solution and put into place.  There are mainly three types of teams that TQM organizations adopt: A. Quality improvement teams or excellence teams (QITs):  These are temporary teams with the purpose of dealing with specific problems that often recur.  These teams are set up for period of three to twelve months. B. Problem solving teams (PSTs):  These are temporary teams to solve certain problems and also to identify and overcome causes of problems.  They generally last from one week to three months. C. Natural work teams (NWTs):  These teams consist of small groups of skilled workers who share tasks and responsibilities.  These teams use concepts such as employee involvement teams, self-managing teams and quality circles.  These teams generally work for one to two hours a week.
  • 28. Elements of TQM 6. Leadership:  It is possibly the most important element in TQM.  It appears everywhere in organization.  Leadership in TQM requires the manager to provide an inspiring vision, make strategic directions that are understood by all and to instil values that guide subordinates.  For TQM to be successful in the business, the supervisor must be committed in leading his employees.  A supervisor must understand TQM, believe in it and then demonstrate their belief and commitment through their daily practices of TQM.
  • 29. Elements of TQM III. Binding Mortar: 7. Communication :  It binds everything together.  Starting from foundation to roof of the TQM house, everything is bound by strong mortar of communication.  It acts as a vital link between all elements of TQM.  Communication means a common understanding of ideas between the sender and the receiver.  The success of TQM demands communication with and among all the organization members, suppliers and customers.  There are different ways of communication such as:
  • 30. • This is the dominant form of communication in an organization. • Presentations and discussions basically do it. • By this the supervisors are able to make the employees clear about TQM. • By this the lower level of employees are able to provide suggestions to upper management of the affects of TQM. • As employees provide insight and constructive criticism, supervisors must listen effectively to correct the situation that comes about through the use of TQM. • This forms a level of trust between supervisors and employees. • This is also similar to empowering communication, where supervisors keep open ears and listen to others. • This type of communication is important because it breaks down barriers between departments. • It also allows dealing with customers and suppliers in a more professional manner. There are different ways of communication such as:
  • 31. Elements of TQM IV. Roof: 8. Recognition:  Recognition is the last and final element in the entire system.  It should be provided for both suggestions and achievements for teams as well as individuals.  Employees strive to receive recognition for themselves and their teams.  Detecting and recognizing contributors is the most important job of a supervisor.  As people are recognized, there can be huge changes in self-esteem, productivity, quality and the amount of effort exhorted to the task at hand.  Recognition comes in its best form when it is immediately following an action that an employee has performed.
  • 32. • It can be by way of personal letter from top management. Also by award banquets, plaques, trophies etc. • Good performers can be recognized in front of departments, on performance boards and also in front of top management. • Recognition can given at any time like in staff meeting, annual award banquets, etc. Recognition comes in different ways, places and time such as:
  • 34. 1. Strategic Commitment:  The start point for TQM is a strategic commitment by the management.  Firstly, the organizational culture must change to recognize that quality is not just an ideal but is instead an objective goal that must be pursued.  Secondly, a decision to pursue the goal of quality carries with it some real costs- for expenditures such as new equipment and facilities.  Thus, without a commitment from the top management, quality improvement will prove to be just a slogan or gimmick. 2. Employee Involvement:  Employee involvement is another critical ingredient in TQM.  Virtually all successful quality enhancement programs involve making the person responsible for doing the job responsible for making sure it is done right.  By definition, then employee involvement is critical component in improving quality. Managing TQM
  • 35. 3. Materials:  Another important part of TQM is improving the quality of the materials that organizations use. 4. Technology:  New forms of technology are also useful in TQM programs.  Investing in higher grade machine capable of doing jobs more precisely and reliably often improves quality. 5. Methods:  Improved methods can improve product and service quality.  Methods are operating systems used by the organization during the actual transformation process. Managing TQM
  • 36.
  • 37. Advantages of TQM: The advantages of implementing TQM are:  Strengthened competitive position  Adaptability to changing or emerging market conditions and to environmental and other government regulations  Higher productivity  Enhanced market image  Elimination of defects and waste  Reduced costs and better cost management  Higher profitability  Improved customer focus and satisfaction  Increased customer loyalty and retention  Increased job security  Improved employee morale  Enhanced shareholder and stakeholder value  Improved and innovative processes
  • 38. References: 1. https://en.wikipedia.org/wiki/Total_quality_management 2. https://managementhelp.org/quality/total-quality-management.htm 3. https://www.isixsigma.com/methodology/total-quality-management-tqm/eight- elements-tqm/ 4. http://aboutthree.com/blog/five-important-factors-in-total-quality-management/