Total management, not total quality management.

Part I: "The Quality Problem is Real." Hospitals fail because of management. This failure is primarily a result of a lack of a total management (TM) approach. This leads to a crazy quilt of individual add-on programs and projects which struggle to survive in a management climate of constant crisis and reactivity. Worthy initiatives like total quality management (TQM) are at high risk in such organizations and run the risk of failure. Part II: "The Need for Total Management." In order for quality improvement efforts to succeed, there must first be a reorientation of the organization's management approach and culture. What is needed is organization development which reorients the hospital to TM. This New American Hospital creates the foundation for specific change tools such as TQM.