Total quality management and operational flexibility impact on hospitals performance: a structural modelling approach

The study aims is to determine the impact of total quality management (TQM) and operational flexibility (OF) on a hospital's performance. A model is proposed that links TQM and OF constructs to the hospital's performance construct. The underlying dimensions of TQM, OF and hospital's performance were empirically verified and validated through the confirmatory factor analysis (CFA), the reliability analysis procedure, and the construct validity procedures. A structural equation modelling (SEM) was employed to test the model, drawing on a sample of 231 medical leaders. Data analysis revealed that, the TQM has a significant impact on the extent of the OF, and on the hospital's performance. A significant relationship was also found between the level of the OF and the hospital's performance results. Further, the TQM's significant impact on the hospital's performance was determined to be realised through the mediating role of the OF. The significant impact of the TQM on the operational flexibility and the hospital's performance has been argued to be positive.