Assessing the impact of total quality management and organisational culture on multiple outcomes of care for coronary artery bypass graft surgery patients

Total quality management (TQM) is a process increasingly used by hospitals to improve the quality and outcomes of care. It is defined as the systematic involvement of health care teams in identifying the underlying causes of unnecessary variation in processes and outcomes of care, and taking corrective and preventive action with the goal of continuous quality improvement in patient care delivery (Deming 1986; Juran 1990). While specific TQM interventions to improve quality and outcomes of care have met with some success, most of them have been limited to a single site and a narrow set of outcome indicators (Shortell et al. 1998).