[Influencing factors on implementation of total quality management at teaching hospitals affiliated with Iran university of medical sciences]

Perspective to retrieval of equity, access to services, effectiveness, efficiency, social acceptability, and strive for continuous improvement of services, Total Quality Management [TQM] has broadened new horizons in health sector. Hence it can result in efficiency and renovation of health services delivery system. Therefore we aimed to determine the influencing factors on implementation of TQM at teaching hospitals affiliated with Iran University of Medical Sciences in Tehran, Iran. We assessed the views of all the 90 managers and supervisors of the hospitals under investigation about the eight factors influencing on implementation of TQM. In a descriptive cross-sectional study, we used an eight-part questionnaire with 75 Likert-type questions for data collection. Validity of the questionnaire was verified with Delphi method. Chi square and t tests and analysis of variance were used for statistical analysis. We assumed an average of 50% for responses indicative of desirability as the minimum acceptable level in each of the eight factors. Of the eight factors studied customer orientation [59.7%], organizational communication [55%], and appropriate organizational structure [50%] proved to be acceptable. The other five factors ranked average [40-50%]. There was significant difference among the total means of influencing factors in the studies hospitals [p = 0.001]. After five years have passed since the implementation of TQM in the studied hospitals, attention of managers to organizational culture, staff participation, human resources development, teamwork, and leadership commitment can result in improvement of the services, effectiveness of the activities, and social acceptability of hospitals