Modern Organizations must be high performing to sustain and grow their operations. This is particularly true for healthcare organizations as they have complex and sensitive operations. One way to improve organizational performance is to adopt Quality Management Systems (QMSs). QMSs organize and improve the effectiveness of all processes to meet stakeholder requirements and achieve organizational performance improvements in alignment with strategic goals. However, the value of QMSs is dependent on successful implementation, which is reportedly quite challenging. This doctoral research examines the factors that affect the successful implementation of QMSs in healthcare. First, a systematic analysis of the published literature revealed that this area is at a relatively early to moderate stage of maturity with many significant opportunities to advance the research area. After that Thematic Analysis of the factors studied in the literature identified ten success factors and one implementation outcome. The ten emergent factors interrelationships and effect on the outcomes was investigated using multiple linear regression and correlation analysis. The result revealed three Critical Success Factors (CSFs), Implementation Culture, Structure, and Management Training. The research found that the Implementation culture requires understanding the working environment with all stakeholders to recognize quality as a routine rooted in all the processes. A systematic embedding of quality within the structure of the organization includes reviewing processes and measure their quality. Management training entitles that change toward QMS requires proper knowledge and expertise; otherwise, it will lead to failure. Hence, decision-makers' ability to understanding the QMS is crucial for success. The study also revealed that a full understanding of the interaction among emergent factors is essential to fully improve the chances of QMSs' implementation success in healthcare, making the potential benefits of these systems more broadly accessible to support this critical industry.


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Graduation Date





Keathley, Heather


Doctor of Philosophy (Ph.D.)


College of Engineering and Computer Science


Industrial Engineering and Management Systems

Degree Program

Industrial Engineering




CFE0008519; DP0024195





Release Date

May 2022

Length of Campus-only Access

1 year

Access Status

Doctoral Dissertation (Open Access)