Total quality management (TQM), organizational characteristics and competitive advantage

A.S. H. Yousif, Najm A. Najm, Jasser A. Al-Ensour


We investigate two issues. The first is to determine the impact of TQM dimensions of a medical care system (quality system, quality leadership, medical and sanitary staff, relationship with patient, relationships with suppliers, and continuous improvement) on the hospital competitive advantage (innovation, competitive benchmarking) in sample Jordanian hospitals. The second is to explore the moderating effect of two basic organizational characteristics: the size and the age of a hospital, on the relationship between TQM dimensions and competitive advantage. Our finding indicates that five TQM dimensions (QS, QL, RP, RS, and CI) have a positive impact on hospital innovation and reputation. This result is compatible with the main findings of many previous field studies. (Prajogo and suhal, 2003; Hung et al., 2010; Abrunhosa and Sa, 2008; Bon and Mustafa, 2013, Silva et al., 2014). This result could be attributed to a continuous improvement of hospital services quality (the sixth of the main dimensions of TQM). Continuous improvement (CI) is synonymous to innovation because both imply changes and modifications to health service.


Accreditation; Competitive advantage; Innovation; ISO-9000; Reputation; Strategic quality vision; TQM dimensions.

Full Text:



Aboyassin, N. A., Najm, A. N., and Alhameidiyeen, M. M.S. (2017). Toward a Model for Managing and Measuring Intangibles, Volume: XIII, Issue: 1, pp. 84-110.

Abrunhosa, A. and Sa, P. M. 2008. Are TQM principles supporting innovation in the Portuguese footwear industry? Technovation, Vol. (28), 208-221

Barnes, F.C. (2000). ISO 9000 Myth and Reality. In: R.K. Shukla (Eds.), Production and Operations Management, Dushkin: McGraw-Hill.

Berger, A. (1997). Continuous improvement and kaizen: standardization and organizational designs. Journal of Integrated Manufacturing Systems, Vol 8 No 2, pp 110-117.

Birinshaw, J., Hamel, G. and Mol, M. J. (2008). Management Innovation, Academy of Management Review, 33 (4), 825–845.

Bon, A. T., and. Mustafa, E. M.A, (2013). Impact of Total Quality Management on Innovation in Service Organizations: Literature review and New Conceptual Framework. Procedia Engineering, (53, 516 – 529).

Crosby, P. B. (1979). Quality is free: the art of making quality certain. New York: McGraw-Hill.

Dahlgaard, J. J., Kristensen, K., and Kanji, G. K. (2007). Fundamentals of Total Quality Management, London: Taylor & Francis.

Dalton, J., and Croft, S. (2003). Managing Corporate Reputation, London: Thorogood.

Davies, G. C., Rosa, S., Rui V., and Roper S. (2003). Corporate Reputation and Competitiveness. London: Routledge.

Doorley, J., and Garcia, H. F. (2007). Reputation Management. New York: Taylor & Francis Group.

Evans, J. (1997). Operations Management. New York: West Publishing Co.

Feigenbaum, A.V. (1998). Total Quality Development into the 1990s; An International Perspective. In Chase R.L. (Eds.), Total Quality Management: An IFS Executive Briefing, New York: Springer.

Finch, B.J. (2007). Operations Boston: McGraw-Hill Higher Education.

Gatzert, N., and Schmit, J. (2016). Supporting strategic success through enterprise-wide reputation risk management. The Journal of Risk Finance, 17 (1), 26-45.

Goldhar, J.D., and Jelinek, M. (1983). Plan for Economies of Scope. Harvard Business Review, November.

Heizer, J., and Render, B. (2011). Operations Management. New Jersey: Prentice-Hall.

Holm, B. (2013). ISO 9001:2015 Draft International Standard Overview. Available at: (accessed at Jan 20, 2017).

Hoyle, D. (2011). ISO 9000 Quality Systems Handbook. Oxford: Butterworth-Heinemann.

Hung, R, Yu-Yuan, L., Bella Y., Fang, S., and McLean, G. N. (2010). Knowledge as a Facilitator for Enhancing Innovation Performance through Total Quality Management. The Quality Management and Business Excellence, 21(4), 425-438.

Iaquinto, A.L. (1999). Win a Quality Award and Lose Your Competitive Advantage. Strategic Change, Vol. (8), 95-101.<95:AID-JSC418>3.0.CO;2-K

ISO (2008). Quality management systems - Requirements (ISO 9001:2008), Geneva.

ISO (2015). ISO 9001:2015. How to Use It. Geneva.

Joint Commission International: JCI (2014). Joint Commission International Accreditation Standards for Hospitals. Available at: (accessed on July 25, 2017).

Juran, J. (1992). Made in USA: a renaissance in quality. Harvard Business Review, July-August, 42-50.

Juran, J., Godfrey, B., Hoogstoel, R.E., and Schilling, E.G. (1999). Juran's Quality Control Handbook. New York: McGraw-Hill.

Korankye, A.A. (2013). Total Quality Management (TQM): A Source of Competitive Advantage: A Comparative Study of Manufacturing and Service Firms in Ghana. International Journal of Asian Social Science, 2013, 3(6),1293-1305.

Marquina, P., Bahamonde, R.A., and Bellido, I.V.(2014). A New Approach for Measuring Corporate Reputation. Revista de Administracao Empresa, Jan-Feb, 53-66 (Article in English).

Mehmood, Shahid, Qadeer, Fairal, and Ahmad, A. (2014). Relationship between TQM Dimensions and Organizational Performance. Pakistan Journal of Commerce and Social Sciences, 8 (3), 662-679.

Mehra, S., Hoffman, J. M., and Sirias, D. (2001). TQM as a management strategy for the next millennia. International Journal of Operations & Production Management, 21 (5/6), 855-876.

Moreira, A. C., and Silva, P. M. (2015). The trust-commitment challenge in service quality-loyalty relationships. International Journal of Health Care Quality Assurance, 28 (3), 253 – 266.

Munizu, M. (2013). The Impact of Total Quality Management Practices towards Competitive Advantage and Organizational Performance: Case of Fishery Industry in South Sulawesi Province of Indonesia. Pakistan Journal of Commerce and Social Sciences, 7 (1), 184-197.

Mushtaq, N., Peng, W. W., and Lin, S. K.L. (2011). Exploring the Lost Link between TQM Innovation and Organization Financial Performance through Non- Measures. International Conference on Innovation. Management and Service, Singapore: IACSIT Press.

Parasuraman, A., Berry, L. L., and Zeithaml, V. A. (1991). Refinement and Reassessment of the SERVQUAL Scale. Journal of Retailing, 67 (4), 420-450.

Parasuraman, A., Berry, L. L. and Zeithaml, V. A., (1993). More on Improving Service Quality Measurement. Journal of Retailing, 69(2) ,140-147.

Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1994). Reassessment of Expectations as a Comparison Standard in Measuring Service Quality: Implications for Future Research. Journal of Marketing, 58 (1),111-124.

Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1988). SERVQUAL: A Multiple-item Scale for Measuring Customers Perceptions of Service Quality. Journal of Retailing, 64 (1), 12-40.

Parasuraman, A., Zeithaml, V. A. and Berry, L. L., (1985). A Conceptual Model of Service Quality and its Implications for Future Research. Journal of Marketing, 49 (4) ,41-50.

Powell, T.C. (1995). TQM as Competitive Advantage: A Review and Emprical Study. Strategic Management Journal, 16 (1), 15-37.

Prajogo, D.I., and Sohal. A.S. (2003). The relationship between TQM practices, quality performance, and innovation performance: An empirical examination. International Journal of Quality & Reliability Management, 20 (8) , 901-918.

Pramuka, B. A., and Adawiyah, W. R. (2012). The Human Related Dimensions of TQM in Service Settings. American International Journal of Contemporary Research, 2 (1) January 124-131.

Reed, R., Lemakb, D. J., and Meroc, N. P. (2000). Total quality management and sustainable competitive advantage. Journal of Quality Management 5, 5-26.

Reid, R.D., and Sanders, N.R. (2002). Operations Management: An Integrated Approach. New York: John Wiley and Sons.

Satish, K. P., and Srinivasan, R. (2010). Total quality Management and Innovation performance: An Empirical Study on the interrelationships and Effects. South Asian Journal of management, 17, (3), 8- 22.

Silva, G. Miranda, Gomes, Paulo J. L., Luís F., and Zulema L. P. (2014). The role of TQM in Strategic Product Innovation: An Empirical Assessment. International Journal of Operations & Production Management, 34 (10), 1307-1337.

Sparks, R., and Legault, R. (1993), A definition of quality for total customer satisfaction: the bridge between manufacturer and customer. SAM Advanced Management Journal, 58 (1), 16-21.

Stevenson, W.J. (2011). Operations Management. McGraw-Hill/Irwin, Boston.

Sun, H. et al. (2004). The trajectory of implementing ISO 9000 standards versus total quality management in Western Europe. The International Journal of Quality & Reliability Management, 21 (2/3), 131-153.

Tornow, W.W., and.Wiley, J.W. (1991). Service Quality and Management Practices. Human Resources Planning, 14 (2), 105-115.

Tricker, R. (2010). ISO 9001: 2008 for Small Businesses, Oxford: Elsevier Ltd.

Zaggl, A. (2017). Manipulation of explicit reputation in innovation and knowledge exchange communities: The example of referencing in science Michael. Research Policy 46, 970–983. 2017.02.009


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


  • There are currently no refbacks.

Copyright (c) 2017 Najm A. Najm, A.S. H. Yousif, Jasser A. Al-Ensour


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


If you find difficulties in submitting manuscript please forward your doc file to Our support team will assist you in submission process and other technical matters. Please note that documents uploaded by yourself are reviewed more quickly than replies by e-mail.

In order to get notifications on inbox please add  this domain in your email safe list.


ISSN 2379-9463(Print)
ISSN 2379-9471(Online)