The Role of Total Quality Management Systems in Enhancing Patient Safety and Infection Control: A Systematic Review
Keywords:
Total Quality Management, Patient Safety, Safety Culture, Infection Control, Healthcare-Associated InfectionsAbstract
Introduction: The Saudi Vision 2030 has encouraged the healthcare sector in the Kingdom to embrace Total Quality Management (TQM) as a philosophy of transformation in order to be in tandem with the worldwide safety and quality standards of clinical services. This strategy focuses on organization change of culture, leadership dedication and continuous process enhancement to reduce the harm that can be prevented.
Study Objective: This systematic review aims to evaluate the importance of TQM systems for improving patient safety and preventing infection within Saudi Arabian health care organizations. This review will also look at synthesizing the current evidence for the adoption of TQM frameworks within Saudi Arabian hospitals and healthcare facilities.
Methodology: The systematic review consolidated the information about the application of Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI) standards, the Essential Safety Requirements (ESR) and specialized quality strategies such as Lean Six Sigma (DMAIC). The contribution of digital surveillance platforms, including the Health Electronic Surveillance Network (HESN), to the achievement of data-driven safety outcomes.
Conclusion: The evidence suggests that the introduction of TQM is strongly linked to better hospital performance, which has resulted in clinical success (a 48.8% decrease in central line-associated bloodstream infections, or CLABSI) and major decreases in medication errors.6Although national accreditation has standardized safety processes, high staff turnover, resource limitations, and challenges in engaging clinical staff often disrupt sustained excellence.
Downloads
References
1. Ministry of Health, Saudi Arabia. General Directorate of Infection Prevention and Control (GDIPC). The Framework for Infection Prevention and Control Transformation (FIT) [Internet]. Riyadh (KSA): GDIPC; 2024. Available from: https://jed-s3.bluvalt.com/psj1-ifn-s3-ifn01/files/Jan2025/The%20Framework%20for%20Infection%20Prevention%20and%20Control%20Transformation%20%28FIT%29.pdf.
2. Alaraki MS. The impact of critical total quality management practices on hospital performance in the ministry of health hospitals in Saudi Arabia. Qual Manag Health Care. 2014 Jan-Mar;23(1):59-63.
3. World Health Organization. Infection, prevention and control excellence in the Kingdom of Saudi Arabia: reducing central line-associated bloodstream infections [Internet]. Geneva: WHO; 2024. Available from: https://www.who.int/news-room/feature-stories/detail/infection--prevention-and-control-excellence-in-the-kingdom-of-saudi-arabia--reducing-central-line-associated-bloodstream-infections.
4. Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI). The national framework for standards development in Saudi Arabia. Int J Qual Health Care [Internet]. 2024;5(1). Available from: https://academic.oup.com/ijcoms/article/5/1/lyaf005/8119489.
5. Al Kuwaiti A, Subbarayalu A. Application of Six Sigma methodology to reduce medication errors in the outpatient pharmacy unit: A case study from the King Fahd University Hospital, Saudi Arabia. Int J Qual Res. 2016 Mar;10(2):267-278.
6. Al-Malki S, et al. Effectiveness of the Six Sigma methodology in reducing medication errors within the Electronic Drug Administration Record (EDAR) system at the Armed Forces Hospital in Dhahran, Saudi Arabia. Saudi Med J. 2024.
7. Alsughayir A. Barriers to TQM implementation within a private medical services organizations in Saudi Arabia. Int J Bus Adm. 2014 May;5(3):117-121.
8. Ministry of Health, Saudi Arabia. Healthcare Transformation Strategy [Internet]. Riyadh: MoH; 2024. Available from: https://www.moh.gov.sa/en/Ministry/vro/Documents/Healthcare-Transformation-Strategy.pdf.
9. Alomari A, et al. Perceptions of active Health Electronic Surveillance Network (HESN) users regarding its general performance in Saudi Arabia. J Infect Public Health. 2018;11(3).
10. Saudi Central Board for Accreditation of Healthcare Institutions. CBAHI Guidelines: Elevating Healthcare Standards in Saudi Arabia [Internet]. 2024. Available from: https://www.qualityleadersacademy.com/cbahi-guidelines.
11. Albliwi SA, Antony J, Arshed N, Ghadge A. Implementation of lean six sigma in Saudi Arabian organisations: Findings from a survey. Int J Qual Reliab Manag. 2017;34(4):508-529.
12. Al-Tawfiq JA, et al. Total quality management in the healthcare sector: Barriers and effectiveness in Saudi Arabia. Res Gate. 2022 Apr.
13. Alshareef HM, Maajeeny R, Judah MS, Alzaagi EA, Alkhuzaie KH, et al. The relationship between total quality management and patient satisfaction in healthcare sector at Saudi Arabia. J Ecohumanism. 2024;3(8):5040.
14. Ministry of Health, Saudi Arabia. National Guide for Auditors in Infection Control Auditing Strategies for Healthcare Facilities: Version 6. Riyadh: MoH; 2025.
15. Alalawi OO. Quality of care in Saudi academic hospitals: A systematic review. Front Health Serv [Internet]. 2025 Dec 17. Available from: https://www.frontiersin.org/journals/health-services/articles/10.3389/frhs.2025.1701062/full.
16. Ministry of Health, Saudi Arabia. GDIPC Annual Report - 2024 [Internet]. Riyadh: GDIPC; 2025. Available from: https://jed-s3.bluvalt.com/psj1-ifn-s3-ifn01/files/April2025/GDIPC%20Annual%20Report%20-2024-.pdf.
17. Alharthi M, et al. Impact of accreditation on improvement of hospitals' infection control programs quality and safety in Saudi Arabian hospitals. J Res Med Dent Sci. 2022 Sep;10(9):14-19.
18. Alguaedeb MN, et al. The effect of the knowledge and practices of infection control standard among health care workers in the healthcare sector level in Saudi Arabia 2024. Rev Diabet Stud. 2024;48-61.
19. Total quality management in healthcare setting and impact on patient outcomes and healthcare services standard. Insights-Journal of Health and Rehabilitation. 2025 Mar;3(2):208-216.
20. Al Alawi AO. Influence of the Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI) on healthcare performance: a systematic review. Saudi J Health [Internet]. 2024. Available from: https://doi.org/10.1159/000548484.
21. Al-Habsi S, et al. Prevalence of healthcare-associated infections and adherence to preventive care bundles in a major city in Saudi Arabia. Asian J Pharm. 2024;18(1):103-112.
22. Alguaedeb MN, Alquaedeb SN, Alraddadi AM, Alharbi AS, Alraddadi RA, Fallatah AA, et al. The effect of the knowledge and practices of infection control standard among health care workers in the healthcare sector level in Saudi Arabia 2024. Rev Diabet Stud. 2024;48-61.
23. Alzoubi MM, Hayati KS, Rosliza AM, Al-Zoubi KM, AL-Mugheed K, Alsenany SA, et al. Effect of total quality management intervention on medical management efficiency, medical service quality, and safety quality. J Med Qual [Internet]. 2024. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12728011/.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
