IMPROVING HOSPITAL PERFORMANCE - ISSUES IN ASSESSING THE IMPACT OF TQM ACTIVITIES

Despite numerous published reports of the need for TQM activities in h ealth care organizations and their widespread diffusion within the hea lth care industry, whether they make a difference remains an unresolve d issue. In this article, we discuss the major reasons why the impacts of TQM should be assessed, what needs to be measured during assessmen t activities, and significant methodological issues that can confound the evaluation of TQM effects. An audit framework is described that ca n be used to depict the types of effects that TQM may have on the perf ormance of health care organizations. Assessment guidelines are offere d that will hopefully benefit the future efforts of institutional mana gers and health services researchers in their attempts to determine wh ether TQM activities do in fact make a significant difference.