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Appreciative Inquiry for Total Quality Management in Hospital


It was immense pleasure when I got the call from Mr. Sudhir Thakur the executive director of Eastern Region Eye Care Center (EREC). Hello Mr. RC, I am Sudhir Thakur from EREC Birtatnagar, do you remember ? we met in Dhulikhel in CBM training on Proposal Writing and Fund raising. Oh yes sir, how are you? how is everything going on? I replied.  Everything is alright and we are thinking to conduct the Total Quality Management Training, how is your time? Mr. Sudhir asked. Well, I am fine and that will be my pleasure to conduct the TQM training in such a glorious organization, I replied. Well, we are thinking to conduct the training for senior level staff for both hospitals in Biratnagar and Lahan, Mr. Kuram from Biratnagar and Mr. Rakesh from Lahan will contact you for further process  he said and kept the phone.


I have been conducting TQM training for various organizations including hospitals and department of health for last 10 years. This training package was already tested in Kathamdnu Model Hospital, Kathamdnu Model Hospital Nursing Campus, TU Maharjaganj Nursing Campus, Department of Health Management Department, The Don Bosco College, Trinity College, Xavier International College and etc. Then I got a call from Mr. Kuram Prithu the Manager of the EREC. After the detail conversation with him I started to design the training course. I have gone several round of the telephone conversation with Mr. Sudhir, Kumar and other 10 staff members of different departments. I called as guardian of patents in some departments to know the dealing style of the hospital staff. I flew to Biratnagar in one-day advance of the training and observed the hospital as patient supporters. I talked with guard, reception, OPD, visited canteen and walked in general ward and talked to the patients. That day I walked all the three stories building. I met Mr. Sudhir and Kumar and shared my observation experiences and also took their interview. I met Dr. Labh the Medical super tended and took his interview. Now I had enough firsthand information to revise the training course.

I went to the hospital guest hose. I took the shower, the room was well-furnished air conditioned However, it was summer and the temperature in Biratnagar was 380c outside the room.   I open my lap top and started to revise the content what I had designed in Kathmandu. I re-designed all the content and make new content and power points slides. The next day we started the training at 9 “O” clock and gone for 6 PM. Likewise, we also did the same in the next day. In the training, we felt magic inside the hall. So many new stories, new and creative ideas, total inclusion of the all participants in training process and commitment for quality services and patient care in the hospital activities were sprout up.  


I overwhelmed, when I see the dream of all departments and hospital management. At the end of the second day, they developed the breakthrough action plan to achieve the dream.  During the reflection and closing session of the training Dr. Rajiv Labh the medical super tended of the hospital expressed overwhelming response of the training. According to him, the training became able to change the perception of all training participants and now all participants have new desire and understanding about the total quality management. He believed that understanding will definitely bring the positive result in the hospital service and patient care. Likewise, Mr. Sudhir Thankur said, this training is also important for the other staff members of the hospital so that we all have same kind of the vision for the quality service and quality management. He asked me to manage the time for the next sessions of the training for other staff members. Next week, I flew to Jnakpur and drove for Lahan and conducted same training for the Lahan Chaudhary Eye Hospital senior staff members. In this training session the Chairperson of the management committee Mr. Rabindra Chaudhary also joined for the two whole days. I felt honored with his response and presence as participant for whole two days. He also travelled to Lahan to Janakpur Airport for see off me.


This year I was eager to visit EREC Biratnagar when I got a call from Mr. Kumar Prithu. He called me and said Dr. RC, this year we are thinking for two trainings for the department head and mid-level staff members. Please manage the time for four days. I said ok and flew to Biratnagar. Before leaving for Biratnagar, I have gone several round of telephone conversation with department head, HR head and prepared the content. When we conducted the training to the first batch I felt thrill with the responses of the participants.  We cut the tea break and kept discussed with tea in table. The participants wanted to utilize the every second of the day and worked up-to 6.30 PM. We conducted the training for 44 staff members in two batches.


After the training we went in reflection session and more than 90% training of the both batches said that this training clearly helped them to understand what is total quality and how the single staff can play the role for that. According to them, now each and every staff has clear idea how they can contribute for the total quality of the hospital services. They said this training not only changed their understanding but also changed the thinking pattern, which is going to change their life. All contents, examples, stories shared in the training was very much enlightening, practical and applicable in daily personal and professional life.


When I reflect myself and searched the positive core of the training, I found the design part has played vital roles. However, the participants shown excellent satisfaction on presentation as well.  I applied Appreciative Inquiry approach in whole designing and delivery process. However, I didn’t pronounce the single alphabet of Ai during the training delivery process. What my experiences are teaching me is, the Appreciative Inquiry is not only simple methodology or tools. It is an approach that can be used in each and every step of the life. It doesn’t limit on what but empower for why and how. It is a life changing approach and I have witness from various field. I have applied this approach to empower the HIV infected illiterate rural women of Doti, Asham and former drug users, the high level government and I/NGOs officers, medical doctor, engineers, executive managers, professors, Disasters victims, media persons, counselors and politicians. I used all the learning from different trainings, interactions, workshops of the past in every training.  Same thing I did in TQM training in Biratnagar.

I am very much thankful to Mr. Sudhir, Mr. Kumar and all training participants for the cooperation and trust.


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Comment by Rituu B. Nanda on May 24, 2017 at 5:12am

Please share how you used AI in this training. Thanks Ram!

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