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Research suggests that there is some confusion among quality improvement managers about the differences between quality management and traditional quality assurance. This lack of understanding would appear to be the same among rural and urban health staff, although there is a higher percentage of staff engaged in multidisciplinary activities in the rural health services. Education of staff and commitment from top management would seem to be the factors inhibiting the health industry from incorporating quality management into their cultures.

Status of total quality management in Australian public health organisations