Application of Total Quality Management in Hospital Medical Quality and Safety Management: A Comparative Study

Abstract

Objective: To evaluate the practical effects of Total Quality Management (TQM) on the management of medical quality and patient safety in a tertiary hospital, and to provide evidence for optimizing hospital management models.
Methods: From January 2021 to December 2023, a Grade-A tertiary hospital (1200 beds; 1.8 million annual outpatient visits) implemented TQM as the experimental group. A comparable tertiary hospital in the same city (1180 beds; 1.75 million annual outpatient visits) maintained routine management and served as the control group. Three core interventions were introduced in the experimental group: (1) institution-wide quality improvement meetings; (2) intelligent alert systems in key areas; and (3) a 24-hour patient feedback mechanism. Eight performance indicators — postoperative infection rate, inpatient fall incidence, emergency CT waiting time, patient satisfaction, and four others — were collected via the hospital information system and a third-party questionnaire survey (21,000 valid responses). Statistical comparisons used chi-square tests for rates, independent‐samples t-tests for continuous measures, Mann–Whitney U tests for ordinal scores, and Poisson regression with Bonferroni correction (α = 0.05; adjusted P < 0.006) for multiple comparisons. Interrupted time-series analysis with 1,000 bootstrap replications assessed trends.
Results: In the experimental group, the postoperative infection rate declined from 2.1% to 0.9% (P = 0.008); annual inpatient falls decreased by 76.3%; emergency CT waiting time shortened by 47% (from 51 min to 27 min); and the proportion of “very satisfied” patients rose from 58% to 83%. In contrast, all indicators in the control group fluctuated by less than 8% with no statistically significant changes (P > 0.05).
Conclusion: TQM — through comprehensive staff engagement, process standardization, and real-time feedback — significantly enhances medical quality and safety in a tertiary hospital setting. We recommend prioritizing high-risk departments for TQM implementation and providing dedicated funding to reduce resistance. Further studies should extend this model to primary care institutions to test its generalizability.