| Summary: | Background: The purpose of this study was to explore existing TQM practice in Saudi Arabian public hospitals, with the aim of improving quality of care, efficiency and productivity, and promoting strong patient satisfaction. Saudi Arabia has made significant investments in its healthcare system, but the country has not achieved desired returns in terms of quality outcomes and patient satisfaction. Considering that globally, regionally and domestically TQM, quality of care (customer service) and patient satisfaction (customer satisfaction) are receiving increasing attention in the healthcare sector, it is essential to evaluate TQM especially, in the services sector. Methodology: The mixed method approach was deployed to allow for the across-method triangulation of both qualitative and quantitative methods, to bring depth of insight and increase generalisability. Qualitative semi-structured interviews were the tool of choice to collect data from TQM managers and head nurses, while quantitative questionnaires gathered data from both nurses and patients at the main customer interface point. Data were collected at two public hospitals based in the capital city of Riyadh, Saudi Arabia. Findings: Qualitative findings reveal five themes: the need to create synergy between TQM practice and levels of understanding throughout the organisation, taking action to improve communications by establishing effective inter-institutional communication strategies (IICSs), placing greater targeted investment on enhanced competency development, training and the need for institutionalisation of transformational leadership throughout the hospitals. Quantitative findings showed that nurses and patients were dissatisfied with jobs and services, respectively, and that staff training and effective communication are critical factors in the delivery of quality care/TQM practice. Importance and Relevance: This is the first study to test and investigate the three levels of healthcare provider (governmental level, managerial level and operational level) in Saudi Arabia and to assess whether TQM can improve the quality of care in government hospitals. Conclusion: The successful implementation of TQM, and hence improved quality of care, depends on important success factors such as effective communication, employee training, transformational leadership, staff motivation, measuring, level of understanding and improving patient needs in the healthcare sector.
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