25Mar 2019


  • Doctor of Business Administration, Senior Quality Officer, Quality and Excellence Department, Dubai Health Authority, Dubai, UAE.
  • Consultant,Head of Quality and Excellence Office, Quality and Excellence Department, Dubai Health Authority, Dubai, UAE.
  • Consultant, Chief Executive Officer, Primary Health Care Sector, Dubai Health Authority, Dubai, UAE.
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Purpose? the purpose of this paper is to assess the level of implementing total quality management (TQM) in the accredited primary healthcare centers in Dubai and investigate the relationship between TQM practices and patient satisfaction as perceived by senior employees? perspectives. Design/methodology/approach? The data were collected from senior employees across different healthcare centers in Dubai using a self-administered questionnaire which was distributed to 169 senior employees. Of the 169 drop off survey questionnaires, 92 usable questionnaires were returned, yielding a response rate of 65.1 per cent. A convenience sampling technique was used to obtain data from the twelve-targeted healthcare centers. The data was analyzed using factor analysis, Pearson?s product moment correlation and multiple regression analyses. Findings? The findings revealed that the level of TQM implementation in the primary healthcare centers in Dubai was very high. In addition, results revealed that leadership, human resource focus, information and analysis, strategic planning, and customer focus were found to have significant and positive effects on patient satisfaction. Research limitations/implications? The limitations identified for this paper are (First) this study was limited only to the healthcare service context; (Second) this study was conducted ata single point in time as a cross-sectional study; (Third) only one business performance key was identified in this study which is patient satisfaction. Finally, this study used only survey questionnaire as a main data collection tool. Practical implications? This paper can increase the awareness of the significance of TQM strategy, which could help healthcare managers to have a better understanding of the benefits of implementing TQM and therefore enable patient satisfaction within their organizations. Originality/value? This paper contributes to the current TQM literature by bridging the gap and highlighting the significance of TQM implementation in contributing to patient satisfaction within the healthcare industry.

  1. Abdulrahman, H., Susan M., David, A. and Karen J., 2015. TQM in the Saudi Health Care System: A National Cultural Perspective.? World Review of Business Research, 5(2), pp. 120 ? 136.
  2. Adsit, D.J., London, M., Crom, S. and Jones, D., 1996. Relationship between employee attitudes, customer satisfaction and departmental performance. Journal of Management Development, 15(1), pp. 62-75.
  3. Al Shdaifat, E.A., 2015. Implementation of total quality management in hospitals. Journal of Taibah University Medical Sciences, 10(4), pp. 461466.
  4. Antony, J., Leung, K., Knowles, G. and Gosh, S., 2002. Critical success factors of TQM implementation in Hong Kong industries. International Journal of Quality and Reliability Management, 19(5), pp. 551-556.
  5. Arumugam, V., Chang, H. W., Ooi, K.-B. andTeh, P.-L., 2009. Self-assessment of TQM practices: a case analysis. The TQM Journal, 21(1), pp. 46-58.
  6. Arumugam, V., Ooi, K. and Fong, T., 2008. TQM practices and quality management performance- an investigation of their relationship using data from ISO 9001:2000 firms in Malaysia. The TQM Magazine, 20(6), pp. 636-650.
  7. Baidoun, S.D., Mohammed, Z.S. and Omran, A.O., 2018. Assessment of TQM implementation level in Palestinian healthcare organizations: The case of Gaza Strip hospitals. The TQM Journal, 30(2), pp.98-115.
  8. Bergman, B. and Klefsj?, B., 2007. Quality from Customer Needs to Customer Satisfaction. 3rd Sweden: Studentlitteratur Lund.
  9. Brookshaw, T. and Terziovski, M., 1997. The relationship between strategic purchasing and customer satisfaction within a total quality management environment. Benchmarking: An International Journal, 4(4), pp. 244-58.
  10. Chiarini, A. and Baccarani, C., 2016. TQM and lean strategy deployment in Italian hospitals: Benefits related to patient satisfaction and encountered pitfalls. Leadership in Health Services, 29(4), pp.377-391.
  11. Ching, C.L., Jie, Y. and Li, M.Y., 2001. The knowledge value of customers and employees in product quality. Journal of Management Development, 20(8), pp. 691-704.
  12. Deros, B.M., Yusof, S.M., and Salleh, A.M., 2006. A benchmarking implementation framework for automotive manufacturing SMEs. Benchmarking: An International Journal, 13, pp.396?430.
  13. Dessler, G., 2000. Human Resource Management. 8th Prentice-Hall, Englewood Cliffs, NJ.
  14. Dimitriades, A.S., 2006. Customer satisfaction, loyalty and commitment in service organizations: some evidence from Greece. Management Research News, 29(12), pp. 782-800.
  15. Duggirala, M., Rajendran, C. and Anantharaman, R. N., 2008. Patient-perceived dimensions of total quality service in healthcare. Benchmarking: An International Journal, 15 (5), pp.560-583.
  16. Elfaituri, A., 2012. An assessment of TQM implementation, and the influence of organizational culture on TQM implementation in Libyan banks. Ph.D. The University of Gloucestershire. Available at: <http://eprints.glos.ac.uk/2127/1/Elfaituri%20Ashref%20final%20PhD%20copy.pdf>? [Accessed 8 March 2017].
  17. Fecıkova, I., 2004. An index method for measurement of customer satisfaction. The TQM Magazine, 16(1), pp. 57-66.
  18. Fitzpatrick, R., 2007. ?Patient satisfaction?, In Ayers, S., Baum, A., McManus, C., Newman, S., Wallston, K &Weinman, J., ed., Cambridge Handbook of Psychology, Health and Medicine. Cambridge: Cambridge University Press, pp. 477-482.
  19. Flynn, B. B., Schroeder, R. G. and Sakakibara, S., 1994. A framework for quality management research and an associated measurement instrument. Journal of Operations Management, 11(4), pp. 339-366.
  20. Hair, J., Bush, P. and Ortinau, D., 2004. Marketing research: within a changing information environment. 2nd New York: McGraw-Hill.
  21. Hair, J.F.J., Anderson, R.E., Tatham, R.L. and Black, W.C., 1998. Multivariate Data Analysis. 5th New Jersey: Prentice Hall, Upper Saddle River,
  22. Hamidi, Y. and Zamanparvar, , 2008. Quality management in health systems of developed and developing countries; which approaches and models are approporiate?.JRHS, 8(2), pp.40-50.
  23. Harvey, D. and Brown, D., 2001. An Experiential Approach to Organisation Development. 6th United States: Prentice Hall, Englewood Cliffs, NJ.
  24. Hellsten, U. and Klefsjo, B., 2000. TQM as a management system consisting of values, techniques and tools. The TQM Magazine, 12(4), pp.238-244.
  25. Hendricks, K. B. and Singhal, V. R., 2001. The long-run stock price performance of firms with effective TQM programs as proxied by quality award winners. Management Science, 47, pp. 359-368.
  26. Jaeger, M., Adair, D. and Al-Qudah, S., 2013. MBNQA criteria used in the GCC countries. The TQM Journal, 25(2), pp. 110-123.
  27. Jeffries, D., Evans, B. and Reynolds, P., 1996. Training for total quality management. London:Kogan Page Ltd.
  28. Kanji, G.K. and Yui, H., 1997. Total quality culture. Total Quality Management, 8(6),pp. 417-28.
  29. Kantabutra, S. and Avery, G.C., 2007. Vision effects in customer and staff satisfaction: an empirical investigation. Leadership & Organization Development Journal, 28(3), pp. 209-29.
  30. Kantabutra, S., 2008. Vision effects in Thai retail stores: practical implications. International Journal of Retail & Distribution Management, 36(4), pp. 323-42.
  31. Khadour, N., Durrah, O. and A?aqoulah, A., 2016. The Role of Applying Total Quality Management in Improving Incentives: A Comparative Study between Jordanian and United Arab Emirate Hospitals. International journal of Business and Management, 11(11), pp. 126-138.
  32. Kozak, M., Asunakutlu, T. and Safran, B., 2007. TQM implementation at public hospitals: A study in Turkey. International Journal of Productivity and Quality Management, 2(2), pp. 193?207.
  33. Kreitner, R., 2004. Management. 9th Boston: Houghton Mifflin. MA.
  34. Kristianto, Y., Mian, M. and Sandhu, A., 2012. Adopting TQM approach to achieve customer satisfaction. TQM Journal, 24(1), pp.29-46.
  35. Kumar, V., Smart, P.A., Maddern, H. and Maull, R.S., 2008. Alternative perspectives on service quality and customer satisfaction: the role of BPM. International Journal of Service Industry Management, 19(2), pp. 176-87.
  36. Laohasirichaikul, B., Chaipoopirutana, S. and Combs, H., 2010. Effective customer relationship of health care: a study of hospitals in Thailand. Journal of Management and Marketing Research, 17(1), pp. 1-12.
  37. Lashgari, M.H., Arefanian, S., Mohammadshahi, A. and Khoshdel, A.R., 2015. Effects of the Total Quality Management Implication on Patient Satisfaction in the Emergency Department of Military Hospitals. Arch Mil Med.Journal, 3(1), pp. 1-5.
  38. Lau, R.S.M., ?Zhao, X. and ?Xiao, M., 2004. Assessing quality management in China with MBNQA criteria.? International Journal of Quality & Reliability Management, 21(7), pp.699-713.
  39. Liu, C. T., Guo, Y. M. and Lee, C. H., 2011. The effects of relationship quality and switching barriers on customer loyalty. International Journal of Information Management, 31(1), pp. 71-79.
  40. Maddern, H., Maull, R., Smart, A. and Baker, P., 2007. Customer satisfaction and service quality in UK financial services. International Journal of Operations & Production Management, 27(9), pp. 998-1019.
  41. Manjunath, U., Metri, B.A. and Ramachandran, S., 2007. Quality management in a healthcare organization: a case of South Indian hospital. The TQM Magazine, 19(2), pp.129?139.
  42. Mehra, S. and Ranganathan, S., 2008. Implementing total quality management with a focus on enhancing customer satisfaction. International Journal of Quality & Reliability Management, 25(9), pp.913-927.
  43. Meyer, S. M., and Collier, D. A., 2001. An empirical test of the causal relationships in the Baldrige healthcare pilot criteria. Journal of Operations Management, 19, pp. 403?425.
  44. Min, H., Min, H. and Chung, K., 2002. Dynamic benchmarking of hotel service quality. Journal of Services Marketing,16(4), pp. 302-21.
  45. Miyonga, J. A., Namusonge, G. S. and? Sakwa, M. M., (2018). Effect of strategic leadership on customer retention commercial banks in Kenya. The strategic journal of business and change management. 5(1). pp 517- 550.
  46. Mosadeghrad, A. M., 2005. A survey of total quality management in Iran: Barriers to successful implementation in health care organizations. Leadership in Health Services, 18(3), pp. 12?34.
  47. Mosadeghrad, A., 2014. Essentials of total quality management: a meta-analysis. International Journal of Health Care Quality Assurance, 27 (6), pp.544-558.
  48. Mosadeghrad, A.M., 2006. The impact of organizational culture on the successful implementation of total quality management. TheTQM Magazine, 18(6), pp. 606-625.
  49. Mosadeghrad, A.M., 2012. Implementing strategic collaborative quality management in health care sector. International Journal of Strategic Change Management, 4(4), pp. 203-228.
  50. Mosadeghrad, A.M., 2013. Obstacles to TQM success in health care systems. International Journal of Health Care Quality Assurance, 26(2), pp. 147-173.
  51. Oakland, J.S., 2014. Total quality management and operational excellence. 4th New York: Routledge.
  52. Ooi, K.B., Lin, B., Tan, B.I. and Chong, A.Y.L., 2011. Are TQM Practices Supporting Customer Satisfaction and Service Quality?.Journal of Services Marketing, 25(6), pp. 410-419.
  53. Ott, M. and van Dijk, H., 2005. Effects of HRM on client satisfaction in nursing and care for the elderly. Employee Relations, 27(4), pp. 413-24.
  54. Pannirselvam, G.P. and Ferguson, L.A., 2001. A study of the relationships between the Baldrige categories. International Journal of Quality & Reliability Management, Vol. 18(1), pp. 14-34.
  55. Prajogo, D. I. and Sohal, A. S., 2006. The relationship between organization strategy, total quality management (TQM), and organization performance-the mediating role of TQM. European Journal of Operational Research, 168(1), pp. 35-50.
  56. Prajogo, D.I., 2005. The comparative analysis of TQM practices and quality performance between manufacturing and service firms. International Journal of Service Industry Management, 16(5), pp. 217?228.
  57. Rad, A.M.M., 2006. The impact of organizational culture on the successful implementation of total quality management. The TQM Magazine, 18(6), pp. 606-625.
  58. Sabella, A., Kashou, R. and Omran, O., 2014. Quality management practices and their relationship to organizational performance. International Journal of Operations & Production Management, 34(12), pp. 1487-1505.
  59. Sadikoglu, E. and Olcay, H., 2014. The Effects of Total Quality Management Practices on Performance and the Reasons of and the Barriers to TQM Practices in Turkey. Advances in Decision Sciences, 1-17.
  60. Salaheldin, I. Mukhalalati, B., 2009. The Implementation of TQM in the Qatari Healthcare Sector, Journal of Accounting ? Business & Management, 16 (2), pp. 1-14.
  61. Samat, N., Ramayah, T. and Saad, N. M., 2006. TQM practices, service quality, and market orientation: Some empirical evidence from a developing country. Management Research News, 29(11), pp. 713-728.
  62. Schakaki, O. and Watson, A., 2017. A Study on the Effectiveness of Total Quality Management in Dental Patient Satisfaction. EC Dental Science, 14(3), pp.114-149.
  63. Scotti, D. J., Harmon, J. and Behson, S.J., 2007. Links among high-performance workenvironment, service quality, and customer satisfaction: an extension to the healthcare sector. Journal of Healthcare Management, 52(2), pp. 109-124.
  64. Shenaway, E.E., Baker, T. and Lemak, D.J., 2007. A meta-analysis of the effect of TQM on competitive advantage. International Journal of Quality and Reliability Management, 25(5), pp. 442-471.
  65. Siddiqui, J. and Rahman, Z., 2007. TQM principles\\\' application on information systems for empirical goals: A study of Indian organizations. The TQM Magazine, 19(1), pp.76-87.
  66. Sila, I. and Ebrahimpour, M., 2002. An investigation of the total quality management survey based research published between 1989 and 2000: A literature review. International Journal of Quality & Reliability Management, 19(7), pp. 902-970.
  67. Singh, V., Kumar, A. and Singh, T., 2018. Impact of TQM on organizational performance: The case of Indian manufacturing and service industry. Operations Research Perspectives, [e-journal]. doi: 10.1016/j.orp.2018.07.004 [Accessed 3 March 2018].
  68. Sit, W-Y., Ooi, K-B., Lin, B. and Chong, A.Y-L., 2009. TQM and Customer satisfaction inMalaysia?s service sector. Industrial Management and Data Systems, 109(7), pp.957?975.
  69. Slack, N., Chambers, S. and Johnston, R., 2007. Operations Management. 5th London: Prentice Hall.
  70. Soltani, E., Lai, P.C., Der Meer, R.V. and Williams, T.M., 2008. Managerial approaches towards service quality: the case of three service organizations. The Service Industries Journal, 28(10), pp. 1399-414.
  71. Talib, F. and Faisal, M.N., 2016. Assessment of total quality management implementation in Indian service industries. Paper presented at 2016 Annual Meeting of the Decision Sciences Institute Conference, Austin, TX, USA, 19-22 November. Available at: <https://ssrn.com/abstract=2883555>[Accessed 20 may 2017].
  72. Talib, F., 2013. An overview of total quality management: understanding the fundamentals in service organization. International Journal of Advanced Quality Management, 1(1), pp. 1-20.
  73. Talib, F., Rahman, Z. and Azam, M., 2010. Total quality management implementation in the healthcare industry: a proposed framework. Paper presented at the 2nd International Conference on Production and Industrial Engineering, Punjab, India, 3-5 December 2010. Available at: <https://www.researchgate.net/publication/292592303_Total_quality_management_implementation_in_the_healthcare_industry_a_proposed_framework> [Accessed 18 March 2017].
  74. Talib, F., Rahman, Z. and Azam, M., 2012. Best Practices of Total Quality Management Implementation in Health Care Settings. Health Marketing Quarterly, 28(3), pp. 232-252.
  75. Talib, F., Rahman, Z. and Qureshi, M., 2011. Total quality management and service quality: an exploratory study of quality management practices and barriers in service industry. International Journal of Services and Operations Management, 10(1), pp.94-118.
  76. Talib, F., Rahman, Z. and Qureshi, M., 2013. An empirical investigation of relationship between total quality management practices and quality performance in Indian service companies. International Journal of Quality and Reliability Management, 30(3), pp. 280-318.
  77. Tari, J.J., 2005. Components of successful total quality management. The TQM Magazine, 17(2), pp.182?194.
  78. Terziovski, M., 2006. Quality management practices and their relationship with customer satisfaction and productivity improvement. Management Research News, 29(7), pp.414-424.
  79. Wardhani, V., Utarini, A., van Dijk, J., Post, D. and Groothoff, J., 2009. Determinants of quality management systems implementation in hospitals. Health Policy, 89(3), pp. 239-251.
  80. Wilson, D.D. and Collier, D.A., 2000. An Empirical Investigation of the Malcolm Baldrige National Quality Award Causal Model. Decision Sciences, 31(2), pp. 361-390.
  81. Yang, C.C., 2006. The impact of human resource management practices on the implementation of total quality management: an empirical study on high-tech firms. The TQM Magazine, 18(2), pp. 162-73.
  82. Yusuf, Y., Gunasekaran, A. and Dan, G., 2007. Implementation of TQM in China and organizational performance: an empirical investigation. Total Quality Management, 18(5), pp.509?530.
  83. Zakuan N.M., Yusof, S.M. and Shaharoun, L., 2010. Proposed relationship of TQM and organizational performance using structured equation modeling. Total Quality Management, 21(2), pp.185?203.
  84. Zhang, Z., 2001. Implementation of Total Quality Management on Overall Business Performance. Ph.D. A thesis submitted in partial fulfilment of the requirements of Groningen University for the Degree of Doctor of Philosophy. Netherlands: Groningen University.
  85. Zhang, Z., Waszink, A. and Wijngaard, J., 2000. An instrument for measuring TQM implementation for Chinese manufacturing companies. International Journal of Quality & Reliability Management, 17(7), pp. 730-55.

[Ahmad Aburayya, Dhoha Alawadhi and Manal Taryam. (2019); A CONCEPTUAL FRAMEWORK FOR IMPLEMENTING TQM IN THE PRIMARY HEALTHCARE CENTERS AND EXAMINING ITS IMPACT ON PATIENT SATISFACTION. Int. J. of Adv. Res. 7 (Mar). 1047-1065] (ISSN 2320-5407). www.journalijar.com

Ahmad Aburayya
Senior Quality Officer, Quality and Excellence Department, Dubai Health Authority, Dubai, UAE.


Article DOI: 10.21474/IJAR01/8735      
DOI URL: http://dx.doi.org/10.21474/IJAR01/8735