An open mind is essential for the implementation and improvement of total q
uality management. Leadership, as such, is of no value without a vision con
cerning corporate culture and human resources. Therefore, constant communic
ation between partners within a corporate body is the cornerstone for empow
erment. The evaluation of ideas and complaints is considered to be essentia
l for the identification of strengths and weaknesses of a system, whereas,
competition and benchmarking may reveal surprising opportunities for improv
ement. We discuss the idea that customer-oriented efficiency in a hospital
environment may be classified as a critical success factor.