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Background: Many of the total quality management (TQM) implementation challenges substantiated in the literature seem oriented towards various facets, including organisation, management, or clients, casting doubts about the effectiveness of the concept in service delivery. The ever-increasing demand for quality services solicits more attention to the desired performance outcomes that define and reflect more of clients' needs. Such demand presents quality management concerns for many healthcare organisations targeting service delivery. Aim: The TQM concept gets less logical given the increasing challenges in its implementation for service delivery. This research aimed to determine the significance of such challenges. Setting: Queen 'Mamohato Memorial Hospital (QMMH), Lesotho. Methods: Based on a questionnaire survey of 297 participants, comprising 98 staff and 199 clients, the study obtains survey data from a 5-year result of TQM implementation attempts at Queen 'Mamohato Memorial Hospital (QMMH), Lesotho. Results: TQM demonstrates great potential to support service delivery as a strategic approach. The study isolates the management-oriented facet of TQM implementation challenges and finds them considerably influenced by the various TQM components. Conclusion: This study establishes and classifies the TQM implementation challenges in QMMH, which are mostly organization, management, and client-oriented. It further addresses assumptions relating to their classifications. Overall, the result suggests that the significance of the underlying challenges in service delivery is more management-oriented. Contribution: The study provides directions that strengthen the effectiveness of the TQM concept and its implementation. It suggests the capacity-building of a hospital's management team drives TQM implementation.
Moholoholo et al. (Wed,) studied this question.