معوقات تطبيق منهج إدارة الجودة الشاملة في المؤسسات الصحية الجزائرية - دراسة ميدانية مقارنة لمجموعة من المؤسسات الصحية العمومية

Résumé: The aim of this study is to know the level of the application of the Total Quality Management (TQM) approach in the Algerian health institutions, where only public institutions have been addressed with out private institutions. This is because the contribution and end eavor to improve the public institutions is more important than the private institutions. Afield study was performed by distributing a questionnaire forms on sample of workers in a group of health institutions consisting of five hospitals from the east of Algeria. This study concluded in the theoretical part that the health institution is considered as a total system consisting of subsystems, which includes inputs consisting of a set of financial, material and human resources that combine in a certain way, leading to the achievement of a set of outputs that are considered as the result of the activities of the health institution,which Leads to the achievement of the goal of maintaining the health of various groups of society.that system is considered the most open and related to society. The concept of Total Quality Management in the field of healthis close to its concept in general. It is considered bothas an organizational culture and as an administrative method .this latter isbased on a total change of different activities of the health institution (inputs, processes and outputs), and itisbased on set of principles, especially, the Collective participation of employees In the health institution ,the focus on the patient care and the continuous improvement of quality.From these principles,it can be deduced the extent of the presence of constraints in implementing Total Quality Management, because the Total Quality Management method is considered as a new organizational culture and As long as the old organizational culture bears close and similar principles to the principles of TQM,it will facilitate the application of this method in an official manner, which will reflect on the satisfaction of customers and the achievement of the goals of the health institution and excellence in its performance. In the applied part, it was found that there is a low level of the presence of obstacles to the application of Total Quality Management (lack of commitment of senior management, lack of continuous improvement, lack of customer orientation, lack of participation, lack of encouragement and motivation, absence of education and training, absence of communication and information) Taken individually and collectively.There were statistically signifi cant differences (α≤0,05) for the opinions of the respondents Towards the total constraints of the application of Total Quality Management due to personal and functional variables (Name of V health institution, social gender, educational level, job nature, years of experience),how ever There were no statistically signifi cant differences (α≤0,05) for the opinions of the respondents Towards the total constraints of the application of Total Quality Management due to the personal variable (age). A number of recommendations and suggestions were addressed to the Algerian health institutions in general, which aim to facilitate and over come the obstacles to applying the Total Quality Management approach in the future, Especially with regard to emphasizing the interest in Change the prevailing organizational culture making it encouraging to apply the Total Quality Management method and the modern administrative methods in general. Thus improving the performance of the health system in Algeria

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