Date of Award


Degree Name

Doctor of Education


Educational Leadership

First Advisor

Dr. Uldis Smidchens

Second Advisor

Dr. Robert Brashear

Third Advisor

Dr. David Cowden

Fourth Advisor

Dr. Thelma Urbick


The use of quality circles in nursing has been widely espoused in nursing literature as a concept that enhances participatory leadership, promotes job satisfaction, improves the quality of patient care and contributes to cost containment. This study was conducted to examine the relationship between the use of quality circles in nursing units and leadership, job satisfaction, the quality of patient care and cost containment.

Quality circle and non-quality circle units in two midwest hospitals were used for data collection. Staff nurses only were asked to complete the survey. A total of 126 of the possible 295 staff nurses in the two hospitals made up the 43% return rate.

Conclusions in this study were: (1) Nurses in quality circle units perceive their leaders to be more of a participatory nature than do those in non quality circle units, (2) Staff nurses perceive job satisfaction being greater in units using quality circles than in those not using them, (3) The quality of patient care is higher in units using quality circles than in those not using them, (4) The correlation between willingness to be a patient in one's own hospital and five quality care items was relatively low (r ranged from.18 to.40), and (5) Participants in quality circles felt more involved in cost containment measures than those in non-quality circle groups.

Even though the literature review and the data analysis provided a strong argument for the use of quality circles in nursing, many hospitals previously using quality circles have discontinued them. Telephone interviews with nursing leaders in hospitals who discontinued their use suggested three major reasons: (1) staffing problems, (2) cost containment, and (3) administrative changes. This prompted a recommendation for continued study of problems nursing leaders encounter in today's health care industry.

Access Setting

Dissertation-Open Access

Included in

Nursing Commons