Quality management practices and their effects on the performance of public hospitals

Purpose To face profound changes from decreasing funding, growing patient expectations and increasing competition in the health-care market, public hospitals began to implement effective quality management (QM) practices following manufacturing and other service industries. However, there was little knowledge relevant to the impact of QM practices on the performance of public hospitals. The study aims to shed some further light on this issue. Design/methodology/approach The paper extends the previous empirical research to the health-care sectors and suggests the research framework of QM practice-performance relationships in public hospitals. For validation purposes, a cross-sectional survey involving 204 quality managers and directors of large public hospitals was carried out between April and October 2013 in Zhejiang Province, China. Structural equation modeling was used to test the hypothesized relationship between QM practices and hospital performance. Findings Empirical results support that the implementation of QM practices can bring many benefits to sample hospitals. The dimensions of employee relations and process management are directly related to the health-care and non-health-care performance of public hospitals. Originality/value It explores the relationship between QM practices and hospital performance based on empirical results from Chinese public hospitals, whereas few studies have been conducted within the context of public health-care sectors in developing countries. The empirical results could enhance hospital managers’ understanding of the nature of QM practice-performance relationship and help mangers re-allocate more resources to those elements of the QM systems that have the most significant impact on hospital performance.