Due to the growing prominence of quality management systems in health, this article presents the theoretical background and the results of an empirical study conducted among the Institutes of public health in the Republic of Croatia, with the aim to determine the level of implementation of TQM principles. The research was based on a questionnaire built on the Kanji model. According to the quality managers' perception, all analyzed TQM principles have been implemented at high level. Although in general a high level of implementation exists, certain TQM principles have been implemented to a larger extent than others. The research was also focused on finding if the difference among QM managers' perceptions exists depending on the status of ISO 9001 (implemented/not implemented/plan to implement). The differences were found in relation to the activities connected with people-based management and continuous improvement. Based on the research results, specific areas of improvement, i.e. activities that foster implementation of TQM principles, are emphasized.

The quality of service in the public health sector is an essential aspect that influences patient satisfaction. Providing quality in public health sector means delivering health service in an affordable, safe and effective manner, with minimal risk and harm for patients. In other words, it means fulfilling patients’ needs and surpassing their expectations. In order to provide patients with good-quality and satisfactory service, many public health organizations implement quality standards that contribute with many benefits and advantages, among which employee satisfaction stands out. The objective of the research was to evaluate the attitude of employees in public health institutes towards the dimensions of job satisfaction and their perception of the level of TQM implementation, with regard to the employees’ sociodemographic characteristics. In order to achieve this objective, ANOVA was used to test the hypotheses and determine the difference between observed sociodemographic characteristics with regard to the dimensions of job satisfaction and the application of TQM principles in research. Beside that, correlation coefficient was used to test the connection between overall job satisfaction and the level of TQM implementation (overall TQM principles). The findings suggest that level of education and the length of service have a significant effect on the differences in assessments among employees, while position in the workplace affects within certain dimensions of job satisfaction, as well as within their perception of the TQM implementation. Results have also shown that there is a statistically significant relationship between job satisfaction and the level of implementation of TQM principles. The present study provides valuable guidelines for public health sector managers since the results of the research indicate the level of perception of the implementation of TQM principles and job satisfaction dimensions with which employees are the most and the least satisfied, thus pointing out to management in public health sector institutions the areas in which certain improvement measures should be implemented. As this study focuses specifically on Institutes of Public Health, future research could be expanded to encompass other public health institutions such as hospitals and private clinics as well as other sectors.

Due to the growing prominence of quality management systems in health, this article presents the theoretical background and the results of an empirical study conducted among the Institutes of public health in the Republic of Croatia, with the aim to determine the level of implementation of TQM principles. The research was based on a questionnaire built on the Kanji model. According to the quality managers' perception, all analyzed TQM principles have been implemented at high level. Although in general a high level of implementation exists, certain TQM principles have been implemented to a larger extent than others. The research was also focused on finding if the difference among QM managers' perceptions exists depending on the status of ISO 9001 (implemented/not implemented/plan to implement). The differences were found in relation to the activities connected with people-based management and continuous improvement. Based on the research results, specific areas of improvement, i.e. activities that foster implementation of TQM principles, are emphasized.

Quality assurance in public health presents one of the key factors in the quality of health service. Accordingly, there is increasing awareness of the need to integrate quality systems and their principles into the healthcare system. Their role is important in the context of quality assurance in accordance with patient requirements as well as in the process of improving the quality of health care service. They are essential for the successful implementation of a quality management system and refer to customer focus, leadership, engagement of people, process approach, improvement, evidence–based decision making, and relationship management. This paper presents the results of a study among Croatian Institutes of Public Health with regard to the level of implementation of quality principles related to employee engagement, improvement and internal customer focus. Analysis focused on the relationship between focus on internal customer (employees) and improvements as well as the employee engagement and improvement respectively. Results show there is a strong positive relationship between employee engagement and improvements, while between internal customer focus and improvement the relationship has not been verified. In the context of standardization of quality of public health services, the paper aims to expand theoretical knowledge about TQM principles, with the emphasis on the employee engagement, internal customer focus (employees) and process improvement. The results can serve as a basis for improving the existing practice of quality management system implementation in the public health sector, with emphasis on employees.