The evolution to a Total Quality Management (TQM) or Continuous Quality Improvement (CQI) philosophy is particularly attractive in the health care industry in its search for better ways of doing business to ensure financial survival in the current competitive environment. This article, however, sug gests that some organizations may not benefit from attempting to implement methodology to achieve the widely accepted financial and operational benefits, not because of any weakness in the conceptual frame work, but because of the culture and/or lack of dedi cated resources required to ensure the acceptance and success of the approach. As a result, many providers are discovering that after a few years of implemen tation, benefits to the organization are not being rec ognized to the extent possible. Specific issues that have been identified as essential requirements to a successful implementation process or evolution to a continuous improvement culture are described in this article.
