RESUMEN
BACKGROUND: The implementation of Total Quality Management (TQM) principles in the sanitary field, in order to be effective, requires a radical change in management practice as well as the organizational culture and its philosophy. The need to monitor such a transformation emerges too. OBJECTIVES: This study surveys how well TQM principles are known and understood by health care professionals from the employees' point of view and the factors affecting it. RESEARCH DESIGN AND SUBJECTS: The Health Care System in Trieste was surveyed. MEASURES: The Total Quality Test was used, a novel and quick instrument aimed at routine assessment of the penetration and interiorization of TQM principles within the health care structure. RESULTS: Direct exposure to public, job role and time spent working within the same structure have been proved related to the penetration of TQM principles, whereas previous formative intervention did not prove to be associated with the penetration of TQM principles. CONCLUSIONS: The implementation of a quick and simple instrument to monitor the TQM implementation highlighted several critical areas for intervention.