Total quality management in health services: historical development, conceptual meaning, and comprehensive model.

Today's health care environment is characterized by burgeoning costs and increasing concern about service quality. Not surprisingly, researchers and practitioners are turning to Total Quality Management (TQM) in their quest for creating high quality health care delivery systems. Despite the central importance of TQM, there is practically no common definition of total quality in medical care research. In this paper, we trace the historical development of the quality concept, offer a valid definition of "total quality," and detail a comprehensive model of TQM for health care research. Implications of our model for academicians and practitioners are discussed.