Structural, Normative and Clinical Positioning of Healthcare Quality Management Systems: A Comparative Analysis of ISO, EFQM, JCI, AND TÜSKA

Purpose: Quality management systems in healthcare are evolving within a multi-layered structure that includes general management standards, sector-specific adaptations, and accreditation frameworks. This study examines International Organization for Standardization standards (ISO 9001, ISO 15224, and ISO 7101), the European Foundation for Quality Management (EFQM) model, Joint Commission International (JCI), and Türkiye Sağlık Hizmetleri Kalite ve Akreditasyon Enstitüsü (TÜSKA) in terms of scope, conceptual orientation, clinical risk management, performance measurement, and external evaluation mechanisms.Material and Methods: The research used the qualitative document analysis method. Relevant standard texts and official documents were evaluated through thematic content analysis. Results:The results show that ISO 9001 provides a process architecture for quality management independent of the sector; ISO 7101 is a quality management system for healthcare organizations; ISO 15224 integrates clinical risk management into the core of the system; and accreditation systems in healthcare contain more detailed and operational clinical requirements. The EFQM model, on the other hand, offers a governance framework that provides a perspective on organizational maturity and sustainable performance rather than being a compliance-based certification standard. Conclusion:The study demonstrates that these systems are complementary, not contradictory, and that they create a layered quality architecture in healthcare organizations.