FLOW CHART Six-sigma is normally used by the organizations to identify the problem where is.

Shifa International Hospital uses the Flow Chart to identify the problem and root cause of this problem. Flow charts are used normally in laboratories where the management sets the standards of the tests, the results of reports compared with standards and if these are not matched then flow chart is used to identify where is problem exist. Performance Measurement To check the performance of the organization service the management use different strategies such as feedback and compare the results with standards set by the organization. Normally, performance measurement is made through customers feedback. Shifas used different ways to get feedback from their clients or customers. These are: 1 2 3 4 Comment cards Complaint boxes Directly face to face Online feedback These complaints made by the customers are handled by PFD (Patient Facilitation Department). Whose responsibilities are to satisfy the clients and forward the complaint to relevant department? Make sure the same complaint will not make by the clients next time Impacts on quality improvement: Customer and society: Customers and society get benefited by quality of organization products by enhancing customer satisfaction and delight. The higher the quality, the better the civilization. The improved quality products and organized services make the society and customers more dependent on them. Companies performance:

Through quality improvement there will be spectacular growth in the net profits of the organization. Quality facilitates the reduction of waste which results in increased quality output and reduced use of inventory. Nations economy: The national economy becomes stronger and stronger as a result of exports and earning foreign exchange brought by quality. Quality helps in raising the living standards of all the people in the country and helps in improving science and technology. Result in partnership: Relationships between an organization and its suppliers have traditionally been characterized by adversarial activities such as the lowbid process, in which at least one and often both parties lose. To understand the rational for partnering with suppliers, one must understand the goal. The goal is to create and maintain a loyal, trusting, reliable relationship that will allow both partners to win, while promoting the continuous improvement of quality, productivity, and competitiveness. Supplier partnering at Shifa: As we talking to management of Shifa, they said that we research the market then examine the supplier which can provide us timely and quality products (medicines). They said that they dont make partnership with suppliers and they get supply from multiple suppliers. The management of Shifa offers to their suppliers to attend their training program in which can know about new technology and advancement in products which customers wants. Ask the supplier are they able to supply those quality products which they needed then made contract for supply of those products or services with them. Supplier selection criteria:

There are no specific criteria developed by the senior management of Shifa International to select from the available supplier in the market. They usually arrange meetings with multiple suppliers and tell them about the organization requirement, if some of them are able to fulfill their requirement with high quality at reasonable cost, will be the organizations supplier. Shifa does not rely on single supplier. The management always seeking for new and advanced material supplier, those can helps to improve their quality service of the organization. OBSTACLES: An obstacle is an object, a thing, an action or a situation that causes an obstruction. Obstacles can be physical, social, economic, technological or political. There are a number of barriers that face the process of TQM implementation. Discussed below are some of the barriers or obstacles that total quality management face during implementation 1. Competitive markets: A competitive market is a driving force behind many of the other obstacles to quality. If the quality of tasks performed is poor, unnecessary cost is incurred by the company and, ultimately, passed to the customer. 2. Bad attitudes/abdication of responsibility/management infallibility:

poor management practice, and a general lack of higher expectations have contributed to unproductive and unhealthy attitudes. These attitudes often are expressed in popular sayings, such as Its not my job and If I am not broke, dont fix it.

3. Lack of leadership for quality:

Excess layers of management quite often lead to duplication of duty and responsibility. This has made the lower employees of an organization to leave the quality implementation to be a managements job. 4. Deficiency of cultural dynamism: Every organization has its own unique way of doing things. This is defined in terms of culture of the organization. In adequate cultural dynamism has made total quality implementation difficult because most of the top level management of many organizations are rigid in their ways of doing things. 5. Lack of management commitment: When management talks TQM, but its actions fail to support the effort, it will ultimately fail to meet expectations. The result is cynicism and mistrustand difficulty launching another attempt. 6. Lack of customer focus: Most strategic plans of organizations are not customer driven. They tend to concentrate much on profit-oriented objectives within a given time frame. thus little concern is shown to quality improvement for consumer satisfaction.

7. Changing organizational culture: Changing an organizations culture is extremely difficult and timeconsuming. Fear of change must be addressed, past labor-management conflicts must be resolved, and the organizations focus must change from maintaining the status quo. 8. Poor Planning: The absence of a sound strategy has often contributed to ineffective quality improvement. 9. Lack of proper training/Inadequate Human Resource Development:

There is evidence that lack of understanding and proper training exists at all levels of any organization, and that it is a large contributor to worker resistance. TQM requires a well-educated workforce. Reomendations Create consistency of purpose toward improvement of the product and service so as to become competitive, stay in business and provide jobs. Cease dependence on mass inspection; require, instead, statistical evidence that quality is built on. Focus on employee empowerment rather than every decision taken by upper management. It helps to take immediate decision and no waste of time. They have to focus on customers retention rather than profits. Because in fact customeImprovements in their services have to be acquired according to good quality based. They have to focus on supplier partnership rather than choosing supplier randomly from the market because a committed supplier can provide better quality instead of others. CONCLUSION The overall response of the management of SHIFA INTERNATIONAL towards our research is much positive. As far as our project is concerned, we tried our best to take out all the necessary information as to Total Quality Management in order to finish our research comprehensively. In previous slide we recommended some points which we observe at visiting the organization, the management should have to follow them. No doubt, management is well experienced of Shifa, but they must know their weak points which we try to point out, and recommended some suggestion of them