Hospitals are facing with customer dissatisfaction with services almost on a daily basis, with escalating costs, intense competition, and as a result, many hospitals have incorporated total quality management (TQM) to improve quality care and decrease costs. Costs might be contained with a better quality service. Although quality has a cost, the failure to provide quality can provoke higher rates of costs because, if a product or service does not satisfy a customer, the cost of putting the situation right after failure may be greater than actually preventing the failure from the outset (Jarlier, A., Charvet-Protat, S. 2000, p. 125). Preventing the failure should be regarded as one of the most important strategies for reducing costs.This approach is known as total quality management (TQM), or continuous quality improvement (CQI), and there is a hope that widespread implementation of the underlying philosophy, approaches, and tools of CQI/TQM will result in an ability of an organization to both maintain and improve quality while controlling increases in costs. The key elements, the key factors in a combined definition of CQI/TQM include continuous, long-lasting improvement, customer focus, structured processes, and organization-wide participation. This approach, the CQI/TQM approach differs from the traditional quality assurance in many ways. Among the most important difference comes from CQI/TQM’s focus on understanding and improving underlying work processes the traditional quality assurance emphasis.