Background and Objectives: One of the most popular systems for creating structural changes in hospitals is total quality management; Which is known as one of the most important philosophies to increase the effectiveness of the organization and competitive advantage. This study aimed to investigate the barriers to the establishment of TQM in hospitals in Kerman Methods This descriptive-correlational study examined the barriers to the establishment of TQM in hospitals in Kerman in 2019-2020. 377 managers and experts, medical, administrative and financial staff of the hospitals (188 Educational and 189 non-educational), entered the study through simple random sampling. Niga Barriers to implementing TQM questionnaire, Hershey & Blanchard Leadership Styles Questionnaire and Staff Maturity Questionnaire was used for data collection. Descriptive statistics (frequency, mean and standard deviation) and analytical statistics (Chi-square, independent t-test, analysis of variance and Tukey) were used to analyze the data. The significance level was 0.05. ResultsThe average total barriers to the implementation of TQM in Educational hospitals was more than non-Educational (P=0.046). The highest mean was related to cultural barriers and staff and imperative leadership and the professional organizational maturity of staff. There was a significant difference between the barriers to the implementation of TQM and leadership style and organizational maturity of staff (P<0.05). Conclusion According to the results, the most obstacles to establishing TQM in Kerman hospitals were cultural barriers and staff, which were created due to the command leadership style. It is better for hospital managers to recognize the obstacles to the implementation of TQM, in order to remove these obstacles.

Received: March 2016, Accepted: June 2016 Background: Determining quality requirements and quality dimensions is one of the most reliable ways of providing high quality services. The objective of the present study was to investigate the association between quality requirements and quality dimensions according to the points of view of physicians, nurses, and patients. Materials and Methods: This descriptive study was carried out in hospitals under supervision of Medical Sciences Universities, in 4 provinces of Tehran, Fars, Lorestan, and Yazd (Iran). A group of 432 physicians and nurses answered the Quality Requirements Questionnaire which includes the 4 components of competitive, ethical, professional, and accountability requirements. Furthermore, 500 patients answered the Quality Dimensions Questionnaire, including the 11 dimensions of security (safety), professionalism, empathy (friendship), politeness, reliability, accountability, working speed, competency, accessibility, flexibility, and tangibles. The Pearson correlation coefficient and multiple regression method were used to analyze the data in SPSS software. Results: The mean quality requirements and quality dimensions scores in the studied hospitals were, respectively, 3.75 and 3.61, both of which were at a higher than medium level. Moreover, the results of Pearson correlation coefficient suggested that the competitive, professional, and ethical components of quality requirement had a significant and direct association with quality dimensions. However, there was no significant association between the accountability component and quality dimensions variables. Furthermore, based on the results of multiple regression and the determination coefficient, it is possible to claim that approximately 13% of variance in quality dimensions depend upon the mean of components of quality requirements. Conclusions: It can be concluded that work commitment, attention to work, respect for ethical principles, and fair competition at the work place between physicians and nurses lead to the provision of safe and high quality services in hospitals.

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