Review of the literature on CQI/TQM in both health care and non-health care settings reveals some evidence of a positive impact for selected dimensions of CQI/TQM. There is little research, however, that examines CQI/TQM as a holistic integrated approach to quality improvement, nor are there many studies that go beyond single or small sample case studies. Using a conceptual framework involving cultural, technical, strategic, and structural dimensions, a number of barriers to CQI implementation are identified along with suggestions for high-priority areas of research.
Address correspondence and requests for reprints to Stephen M. Shortell, Ph.D., FACHE, Professor, J. L. Kellogg Graduate School of Management, Northwestern University, Leverone Hall, 2001 Sheridan Road, Evanston, IL 60208-2007.
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