Abstract
There is increasing recognition that many quality management initiatives in health care are undertaken without the appropriate development of a responsive and supportive organizational environment. In the present study, a multidisciplinary team was empowered to make appropriate changes in order to improve a variety of problem areas that affected the total pathology service of the hospital. Major changes were initially undertaken to develop a quality management environment. The four elements found to be important to the creation of the Total Quality Management (TQM) environment were change in management culture, development of teamwork, focus on customers, and continuous feedback to staff. The accomplishment of the TQM was assessed and confirmed using criteria developed by the Pathology Project TQM Team. As the TQM approach is process driven, it should be adaptable to other clinical situations and not just to pathology services. Potential barriers to achieving the required organizational environment are also explored.

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