This paper has outlined some of the factors which have given rise to the interest in TQM which is evidenced by changing accreditation requirements and widespread implementation in health care facilities. Implementation of TQM in the clinical laboratory is dependent upon: 1. A clear focus on the most important aspects of the service we provide, where if quality fails patient care would be most seriously effected (high volume procedures, high risk and/or problem prone). 2. A focus on the customers of our services: ensuring that process improvements address their requirements. 3. A new leadership philosophy: tapping into the expertise of each member of the team to achieve service improvements. 4. Recognition of the importance of interdisciplinary and/or multidisciplinary collaboration: closing the gaps in our existing QA programs and ensuring that quality is defined in terms of the broad experience of patients receiving health care. 5. Taking advantage of staff development in the use of team tools to provide teams the opportunities to be successful in collaborative projects. 6. Demonstrating perseverance and commitment to quality improvement. Giving the process time to demonstrate success. The methods and tools used to accomplish the transformation from quality assurance to TQM are various. The important point for laboratory professionals is to ensure that our plans are consistent with the total quality picture for patient care. To do this will require collaboration, coordination and communication between the various care givers with whom we interact. It will also require recognition that no one health care process stands alone: quality patient care requires an intersection of processes that ensures our ultimate customer, the patient, of service that will meet expectations and will produce a successful outcome.