In the last decade, the rapid development in the Kingdom of Saudi Arabia (KSA) has forced its government to implement modern management styles such as Total Quality Management (TQM) to ensure continuous improvement in the provision of healthcare. There is a considerable body of literature that shows the benefits of implementing TQM in hospitals, but there are few empirical studies that show TQM implementation efforts in the healthcare sector. Furthermore, the healthcare literature did not explore the implementation of TQM in a context of gender segregated environment such as the case in KSA. This research project is an exploratory investigation assessing the impact of TQM in a gender segregated healthcare environment such as KSA. The research design used triangulation methods to investigate the problem at hand. A combination of quantitative and qualitative methodologies were used through field-work and external comparisons. The approach was based on the following: (1) Assessing the level of perception and understanding of TQM principles in several KSA hospitals, taking into account the differences and similarities between the different gender population, (2) Examining the approach to TQM implementation and its degree of effectiveness in four Saudi hospitals to highlight critical factors for effective implementations using the Baldrige assessment method; (3) Benchmarking the Saudi hospital experiences to UK and USA hospitals to highlight key facilitating and inhibiting factors; (4) Using key findings from the previous steps to identify the critical factors and propose a model for TQM implementations in a segregated healthcare environment such as the case in the KSA. The survey research findings show a weak appreciation, awareness and understanding of TQM in managing healthcare organisations by the respondents in the KSA. It clearly shows that many employees in the organisations do riot understand TQM. The degree of emphasis for each quality activity varied and thus more research needs to be done to investigate the importance of each quality activity to a TQM implementation process, as there are varying degrees of emphasis across the board. The KSA case studies show that in implementing organisations, TQM intentions and TQM policy frameworks are generally acceptable. However, the implementation process is generally weak and lacks coordination in the majority of these organisations. It is clear that the majority of the KSA cases have not succeeded in total commitment towards a total quality culture. When compared to the UK and USA hospitals, the majority of the KSA cases show deficiencies in most of the critical activities that form the foundation of a successful quality process. Furthermore, the study indicates three critical factors in KSA hospitals that either did not exist or were not given full attention. The importance of these factors were further validated in the literature. The factors were continuous top management commitment, continuous education and training, and culture awareness. These factors were then used to develop a model for TQM implementation for a segregated healthcare environment.King Saud Universit
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