Keys for successful implementation of total quality management in hospitals

Determinants of quality management systems implementation in hospitals

“…Our review identified a positive association between prospector and analyzer strategic types and the degree of QMS implementation [1,9,16]. However, according to Carman et al the prospector strategy was related to hierarchical culture, which has a negative correlation with the degree of QMS implementation [10].…”

“…The role of the organization culture and organization design factor with the degree of QMS implementation, summarized in Fig. 2, has been noted in several publications [1,[8][9][10][11][12][13], but only a few projects were based on empirical investigations. Four empirical studies tested the association between four organization culture types (group, developmental, rational and hierarchy) with the degree of QMS based on Malcolm Baldrige National Quality Award Criteria (MBNQAC) in different aspects and assessors [1,9,10,12].…”

“…Three empirical studies [9,10,12] found that group and developmental culture variables explain more than 50% of the variance. Organization having group or developmental culture associated with affiliation and teamwork and assumption of change and risk taking demonstrate a positive correlation with the degree of QMS implementation, producing precisely the opposite results compared with a hierarchical culture.…”

“…Two empirical studies [9,10] identified a negative association between hospital size and organizational culture. A hierarchical structure is a hindrance to QMS success and larger hospitals seem to have such a structure.…”

“…Carman et al's [10] and Weiner et al's [19] studies identified the dominant role of physicians in the hospital. Physician involvement measured as clinical emphasis and number of active physicians in governance has a significant effect on the success of QMS implementation and quality improvement [19,21,22].…”