First Advisor

Dan O'Toole

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Public Administration and Policy


Public Affairs and Policy




Total quality management, Health facilities -- Administration, Public institutions -- Management



Physical Description

1 online resource (2, iv, 349 pages)


Total quality management [TQM] is an approach to improving the competitiveness, effectiveness and flexibility of the whole organization through the improvement of the organizational processes and those who perform them. There has been a rising interest among public sector professionals in examining the applicability and usefulness of TQM methods to public organizations. This research provides descriptive information about the experience of three health care organizations that vary in terms of ownership, whether being publicly or privately owned, with implementing TQM. Participants at these organizations were interviewed, and/or surveyed and observed. The study provides a narrative description of each organization's experience with TQM (their Quality Story) and it compares the implementation of TQM in the three organizations. Moreover, the study explores what role, if any, does ownership have on the implementation of TQM. Finally, the study presents some lessons that could be derived from the experience of these organizations. Conclusions are drawn that TQM could be successfully implemented in both sectors, provided that the process of implementation follows the specific guidelines and principles established in the field. Moreover, difference in ownership between public and private organizations, though important, is not the major factor influencing the implementation and any possible outcomes of a TQM innovation effort. It is rather the involvement and commitment of top management that seem to have the upper hand in influencing the implementation and any possible outcomes of TQM, in public as well as private organizations. However, the research suggests that public sector organizations are more challenged in implementing TQM, due to the multiplicity of their customers and more scrutiny of the tax payer and the media.


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