that a quality management program can lead to improved quality in health care (Banham, 1993).
The basic concepts of approaches to quality management are compatible with the philosophical beliefs long and widely held by health professionals (Jeffer, 1991). Thus, health care professionals are not being asked to adopt something that is alien to their disciplines when it is suggested that health care may benefit from quality management.
Nevertheless, the issue of quality management tends to be divisive among some groups of health care professionals (Solovy, 1993). There is every reason to believe, however, that health care delivery institutions may benefit from the implementation of quality management programs, and that patient satisfaction at such institutions will be improved through the adoption of such programs.
In the pursuit of care quality, organizations "redesigning their patient care delivery operations are formulating new work processes, exploiting the capabilities of technology, and remodeling facilities to support process and organizational innovations with an expectation that they are gaining competitive advantages for a changing marketplace" (Schweikart, 1996, p. 25). Competitive advantage is a term derived from the concept of comparative advantage in the discipline of economics. Within the context of this current research project, competitive advantage refers to the capability of a hospital emergency department to offer something the health care payer or consumer that either cannot be offered by another health care provider or that cannot be offered as efficiently by another health care provider.
"Emerging models of patient care delivery are designed to fit an organization's unique market, physician relationships, employee base, and other competitive strengths. Those undertaking patient care restructuring initiatives expect improved performance in a number of areas including patient satisfaction, patient o...