Abstract

Health care institutions in Montreal are faced with dramatic changes that are taking place in the external environment. Budget tightening and more accountability at the governmental level have translated to an increased competition for scarce resources among various health care institutions. Motivated by the need to achieve higher levels of economic efficiency and client satisfaction, many health care institutions are deciding to introduce Total Quality Management programs. This paper investigates the adoption of a quality philosophy in a medium sized Montreal based health care organization. It includes the factors that would enable the organization to sustain a desired level of service delivery and guarantee improvements in quality of service when faced with externally imposed resource constraints. The focus will be on understanding the role of organizational culture and structure in the implementation of a TQM philosophy as the basis for managing change. A brief literature review of the importance of culture, its measurement, and its role in organization wide change will be conducted. Towards these ends, an example of a culture-assessing instrument, customized specifically for the needs of a health care institution, will be offered. Once this culture is measured, the next step will be to examine the results to explore how the absence or presence of a TQM approach may have affected that institution's performance. The implications of these findings for health care organizations, TQM theory, and practice are discussed. Future research suggestions are also provided.