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ry of management, which emphasizes the role played by training and development, rigorous performance standards, the use of protocols to assess all aspects of care, and clear, consistent documentation of activities. Subsumed within the quality paradigm shaping administrative and managerial efforts in public hospitals is the so-called quality paradigm which focuses on continuous improvement, has a strong customer orientation, and involves the reengineering of service delivery (Berman, 1998).

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