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Total quality management is the systematic way of improving quality while containing costs. In the elderly care unit at a hospital, a framework for TQM was installed using the patient trail to understand processes of care delivery, and basing its foundations on the principles of putting patients first, getting the service right first time, meeting and exceeding needs, reducing the costs of poor quality and empowering staff. Identifies operational problems following staff interview, analysed into quality indicators; quality costs in terms of time and materials; and likely locally grown solutions. Using the tools of patient information, improving the environment, communication, training, standard setting, monitoring and auditing, quality improvement teams, patient feedback and quality costing, a clinical management group is ideally poised to enjoy the benefits of total quality management.

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