Date of Award


Document Type



Edith Cowan University

Degree Name

Doctor of Philosophy


Faculty of Business and Public Management

First Supervisor

Professor Alan Brown

Second Supervisor

Dr Peter Standen

Third Supervisor

Professor Geoffrey Soutar


This study aimed at identifying aspects of health care organisational management and activities that produced the highest level of quality care. A Literature review was conducted to determine the most successful quality activities currently used in a wide variety of industries. Using the findings of this review a questionnaire and interview questions were designed to identify factors associated with successful quality activities I health care organisations. Four Western Australian hospitals that were believed to have effective quality activities were randomly selected as a hospital from each of the following categories. A private hospital accredited by the Australian Council on Health Care Standards. A country hospital that had 100% patient satisfaction and a city hospital with above 96% patient satisfaction assessed by the State wide Government Patient Satisfaction with Care Survey. A hospital that the Health Department of Western Australia considered had best practice in Quality Activities. Each of these hospitals was matched with a control hospital. Data was collected through direct observation of a questionnaire and interviews with people in predetermined health service employment positions and the completion of one randomly selected supplier interview for each of the eight health services studied. The questionnaire was supplied to a range of staff members and interviews were conducted with these employees and hospital goods or service suppliers. Data was analysed using qualitative evaluation, frequency distribution and a factor analysis. Results obtained in this study identified that the most important factors required to produce the most profitable and highest quality of health care were a culture of caring, providing employees with enough time to complete their work and having effective organisation wide communication. A Quality Care Model for use in Health Services was created based on the research findings. When used this model of quality activities should provide customer satisfaction and a high standard of cost effective health care service.