Implementing total quality management and reshaping delivery systems in a community hospital.

In today's healthcare marketplace, leadership requires more than the delivery of technologically sophisticated patient care. Leadership can be accomplished only by an organization energized with a mission that focuses on providing high-quality, technologically sophisticated, and cost-effective primary healthcare. The paradigm shift to total quality management at the authors' not-for-profit community hospital involved not only the adoption of the philosophy, tools, and techniques espoused by quality experts, but also a restructuring of the organization from a hierarchical format to one focused on the patient.