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  1. Practically, given the identified core TQM predictors in this study, it is evident that hospitals’ management should consider entrenchment of continuous quality improvement, education and training, patient focus/satisfaction top management commitment and teamwork in the implementation of TQM, which will consequently enhance hospital performance.

  2. Objectives: The aims of the study were to explore the extent of Total Quality Management (TQM) implementation in hospitals and its association with demographic variables. Methods: This cross-sectional study collected data from 332 nurses using a self-developed questionnaire.

  3. Key principles of TQM include top management support, customer focus, continuous improvement, employee education and participation, along with statistical reporting (Powell et al 2009a).

  4. 23 Σεπ 2019 · As depicted in Table 2, education and training, continuous quality improvement, patient focus/satisfaction, top management commitment and teamwork appear to be the core predictors (CSFs) in this review. This finding validates how important these variables are in the successful implementation of TQM in the health-care context.

  5. The necessity for quality and safety improvement initiatives permeates health care. 1, 2 Quality health care is defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” 3 (p. 1161).

  6. Implementation of TQM in service hospitals will require Quality Management awareness, training and framework development as well as development of customer awareness. TQM has been widely applied in clinical field with successful outcome. TQM is not a short-term solution, it has to be understood and practised as a long-term strategic commitment.

  7. Eight supporting TQM practices, such as top-management commitment, teamwork and participation, process management, customer focus and satisfaction, resource management, organization behavior and culture, continuous improvement, and training and education were identified as best practices for TQM implementation in any health care setting.

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