We investigate two issues. The first is to determine the impact of TQM dimensions of a medical care system (quality system, quality leadership, medical and sanitary staff, relationship with patient, relationships with suppliers, and continuous improvement) on the hospital competitive advantage (innovation, competitive benchmarking) in sample Jordanian hospitals. The second is to explore the moderating effect of two basic organizational characteristics: the size and the age of a hospital, on the relationship between TQM dimensions and competitive advantage. Our finding indicates that five TQM dimensions (QS, QL, RP, RS, and CI) have a positive impact on hospital innovation and reputation. This result is compatible with the main findings of many previous field studies. (Prajogo and suhal, 2003;Hung et al., 2010;Abrunhosa and Sa, 2008;Bon and Mustafa, 2013, Silva et al., 2014). This result could be attributed to a continuous improvement of hospital services quality (the sixth of the main dimensions of TQM). Continuous improvement (CI) is synonymous to innovation because both imply changes and modifications to health service.
IntroductionHistorically, the interest in productivity and efficiency concepts was precedent to that of the quality concept. Therefore, the progress that was achieved during the past decades concerning production size was much greater than that of the quality field. This fact may be the main reason behind Jouran's statement that he has released in his study published by Harvard Business Review (1992) when he argued that "the 20 th century is the productivity century and the 21 st century is the quality century". Consistent with that it might be rational to add that the last quarter of the 20 th century has witnessed the early interest in quality concept of the manufacturing sector. The 40s of the last century has witness the emergence of service quality concept, while the 80s of that century has witness the appearing of electronic service quality concept.Relying upon the previously mentioned evolution, it might be rational to say that the 21 st century will witness the concern in new patterns of quality at the top of which: the quality of knowledge, intangible assets, human capital and perhaps spiritual assets. The past five decades has testified a radical shifting from interest in quality concept. This was plainly appearing especially during the 80's of the last century when the American and the European companies were badly affected by many dramatic developments in the business environment such as: quality based comprehensive competition, the Japanese quality-based competition success. These developments have seriously sidetracked attention toward new quality perspectives, objectives and improvement relying upon a new strategic vision that replacing the old practices of operational plans. This was plainly confirmed by Jouran when he distinguished between two quality perspectives: "big and little quality". This is simply meant that the interest in quality has been expanded to comprised servi...
