Assessing the evidence on CQI: Is the glass half empty or half full?

Review of the literature on CQI/TQM in both health care and non-health care settings reveals some evidence of a positive impact for selected dimensions of CQI/TQM. There is little research, however, that examines CQI/TQM as a holistic integrated approach to quality improvement, nor are there many studies that go beyond single or small sample case studies. Using a conceptual framework involving cultural, technical, strategic, and structural dimensions, a number of barriers to CQI implementation are identified along with suggestions for high-priority areas of research.