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Purpose

The paper seeks to present findings from an evaluation of a quality management system implemented in a low‐income country hospital.

Design/methodology/approach

This is a single‐case before and after evaluation.

Findings

The quality system, although only 70 per cent implemented, resulted in increasing compliance with a few selected standards and produced modest improvements in patient satisfaction and utilisation. Hospital doctors and managers wanted to continue to develop the system and described conditions they thought important to spread to other hospitals.

Research limitations/implications

No objective, clinical outcomes data were gathered, and the short timescale meant that the system was not fully implemented at the time of the evaluation.

Practical implications

It is possible to improve patient care in rural hospitals with a few extra resources, in a culture not familiar with management processes, and to engage otherwise poorly motivated doctors in systematic improvement. However, certain conditions are necessary for introducing, sustaining and spreading quality improvement programmes.

Originality/value

This study and report is one of the first, detailed and systematic evaluations of a hospital quality management system in a highly resourced constrained situation in an Arabic country, which has implications for improving health care in other developing countries.

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