Abstract

Commitment of top management is vital for quality initiatives. Although few of the 6,000 hospitals in the United States have implemented total quality management (TQM), organizations like the Joint Commission on the Accreditation of Healthcare Organizations are urging that more be done. A survey of the literature of health care found that management support was the prime reason for success of TQM in health care, and lack of such support was the usual reason for failure. Other important factors for TQM implementation include resources, training, reward programs, and involvement of all employees. A study of 79 top and middle managers during TQM implementation at a Veterans Administration hospital confirmed that lack of management support is perceived as the major barrier to TQM success. Other barriers perceived by top managers dealt with organizational issues, like unclear TQM goals, while middle managers were concerned about operational barriers like turf battles and inadequate TQM training.