TQM as a managerial innovation: research issues and implications.

TQM is a managerial innovation that is likely to have profound consequences on the delivery of health services. As an innovation, it is important that attention be given to the fundamental research issues associated with implementation and impact. Using a variance and process perspective, selected research issues are identified within organizations and among work units within these organizations. The variance perspective at both the organizational and work unit level considers the explanation of impact and adoption at a particular point in time. The process perspective considers the particular steps or events in the overall adoption process. The managerial implications for each perspective are discussed.