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Quality management effects on operating theater's productivity: a participatory action research

Ali Mohammad Mosadeghrad (School of Public Health, Tehran University of Medical Sciences, Tehran, Iran)
Mahnaz Afshari (Iran University of Medical Sciences, Tehran, Iran)

The TQM Journal

ISSN: 1754-2731

Article publication date: 20 October 2020

Issue publication date: 24 May 2021




The operating theater (OT) is resource-intensive, costly and assuring its productivity is a high priority. This study aimed to examine a quality management model's effects on a hospital's OT productivity.


The participatory action research approach was used for the intervention. A multidisciplinary quality improvement team was formed. The team improved OT operational processes using an eight-step quality management model. OT’s key performance indicators such as surgical cases, surgical cancellation, bill deductions, successful cardiopulmonary resuscitation, patients' complaints and employees' job satisfaction were collected before the intervention and compared with those of after intervention to determine the efficacy of the quality management model.


Applying a quality management strategy increased surgical patients' number by 14.96%, reduced surgery operations cancellation by 14.6 %, and decreased bill deduction by 44.9%. Besides, successful cardiopulmonary resuscitation increased by 21.17%, patients' complaints reduced by 61.5% and, finally, staff satisfaction increased by 15.6 %. Improved OT productivity resulted in improved financial performance. As a result, the OT revenue has risen by 68.8%.


This study highlights that implementing the right quality management model properly enhances hospitals' productivity. It also offers suggestions on how to implement a quality management model successfully in a hospital setting.



This case study was conducted in the operating theatre of a public hospital in Tehran, Iran. We are grateful to the OT managers and staffs for their full engagement and support in this study. The authors would also like to thank the editor and the anonymous referees for their constructive comments on earlier draft of this paper which helped to improve its quality.


Mosadeghrad, A.M. and Afshari, M. (2021), "Quality management effects on operating theater's productivity: a participatory action research", The TQM Journal, Vol. 33 No. 4, pp. 882-895.



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