This study investigates Total Quality Management in the Ministry of Health hospitals in Jeddah in Saudi Arabia as a method of continuous improvement in health services. The objective of the study is to determine the concept of quality, the characteristics of a quality system and the definition and importance of Total Quality Management. The hypotheses are based on the assumption that there are standards and indicators for quality in health services; that current quality plans lead to improving quality and the hospitals are applying Total Quality Management factors. These include commitment of top management to Total Quality Management, customer satisfaction, improvements in the process, changes in the culture, human resources management, containing the costs of quality and the use Total Quality Management tools. The theoretical chapters include the outline of the study, the health services in KSA; quality in health services; Total Quality Management and its factors in health services; how it could be applied in hospitals especially in the public hospitals; the critiques of Total Quality Management regarding theory and practice, in the public and private sectors and the problems that may be found in its application. The study was based on two questionnaire surveys dealing with patients and employees in the hospitals and the interviews with the managers of Total Quality Management departments. The results concluded that there are many factors that determine the concept of quality, and the definition of Total Quality Management. The characteristics of a traditional quality management system are still used and there is a need to implement a more comprehensive quality system such as Total Quality Management in hospitals in Jeddah. Also, the study concluded that most hospitals have not quality standards and indicators, just two plans have an effect on improving quality (plans relating to human resources management and culture environment)and there was a weakness in the application of the elements of Total Quality Management in hospitals. The elements relating to the top management are lower than expected, such as mission, vision, values and objectives of Total Quality Management. The level of health services quality does not meet the patients’ requirements and achieve employee’s satisfaction. The elements relating to the process of health services are lower than expected, such as systems and explicit work methods. The cultural environment in hospitals does not contribute to the achievement of the provision of a proper work environment for the programmes of Total Quality Management such as factors related to organizational environment, decision-making, prevention and information. There was a lack of human resources management in the implementation of Total Quality Management programmes in the variables related to the employees’ competence, involvement, teamwork, communication and system. Finally, Total Quality Management tools do not contribute to improving the quality of health services. There is a need for further study relating to quality costs. Also studies will need to carry out research of other dependent variables that are not included in the model suggested in the study related to the top management commitment, cultural environment and human resources management.
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