In the last decade, the rapid development in the Kingdom of Saudi Arabia (KSA) has forced its government to implement modern management styles such as Total Quality Management (TQM) to ensure continuous improvement in the provision of healthcare. There is a considerable body of literature that shows the benefits of implementing TQM in hospitals, but there are few empirical studies that show TQM implementation efforts in the healthcare sector. Furthermore, the healthcare literature did not explore the implementation of TQM in a context of gender segregated environment such as the case in KSA. This research project is an exploratory investigation assessing the impact of TQM in a gender segregated healthcare environment such as KSA. The research design used triangulation methods to investigate the problem at hand. A combination of quantitative and qualitative methodologies were used through field-work and external comparisons. The approach was based on the following: (1) Assessing the level of perception and understanding of TQM principles in several KSA hospitals, taking into account the differences and similarities between the different gender population, (2) Examining the approach to TQM implementation and its degree of effectiveness in four Saudi hospitals to highlight critical factors for effective implementations using the Baldrige assessment method; (3) Benchmarking the Saudi hospital experiences to UK and USA hospitals to highlight key facilitating and inhibiting factors; (4) Using key findings from the previous steps to identify the critical factors and propose a model for TQM implementations in a segregated healthcare environment such as the case in the KSA. The survey research findings show a weak appreciation, awareness and understanding of TQM in managing healthcare organisations by the respondents in the KSA. It clearly shows that many employees in the organisations do riot understand TQM. The degree of emphasis for each quality activity varied and thus more research needs to be done to investigate the importance of each quality activity to a TQM implementation process, as there are varying degrees of emphasis across the board. The KSA case studies show that in implementing organisations, TQM intentions and TQM policy frameworks are generally acceptable. However, the implementation process is generally weak and lacks coordination in the majority of these organisations. It is clear that the majority of the KSA cases have not succeeded in total commitment towards a total quality culture. When compared to the UK and USA hospitals, the majority of the KSA cases show deficiencies in most of the critical activities that form the foundation of a successful quality process. Furthermore, the study indicates three critical factors in KSA hospitals that either did not exist or were not given full attention. The importance of these factors were further validated in the literature. The factors were continuous top management commitment, continuous education and training, and culture awareness. These factors were then used to develop a model for TQM implementation for a segregated healthcare environment. / King Saud University

In the last decade, the rapid development in the Kingdom of Saudi Arabia (KSA) has forced its government to implement modern management styles such as Total Quality Management (TQM) to ensure continuous improvement in the provision of healthcare. There is a considerable body of literature that shows the benefits of implementing TQM in hospitals, but there are few empirical studies that show TQM implementation efforts in the healthcare sector. Furthermore, the healthcare literature did not explore the implementation of TQM in a context of gender segregated environment such as the case in KSA. This research project is an exploratory investigation assessing the impact of TQM in a gender segregated healthcare environment such as KSA. The research design used triangulation methods to investigate the problem at hand. A combination of quantitative and qualitative methodologies were used through field-work and external comparisons. The approach was based on the following: (1) Assessing the level of perception and understanding of TQM principles in several KSA hospitals, taking into account the differences and similarities between the different gender population, (2) Examining the approach to TQM implementation and its degree of effectiveness in four Saudi hospitals to highlight critical factors for effective implementations using the Baldrige assessment method; (3) Benchmarking the Saudi hospital experiences to UK and USA hospitals to highlight key facilitating and inhibiting factors; (4) Using key findings from the previous steps to identify the critical factors and propose a model for TQM implementations in a segregated healthcare environment such as the case in the KSA. The survey research findings show a weak appreciation, awareness and understanding of TQM in managing healthcare organisations by the respondents in the KSA. It clearly shows that many employees in the organisations do riot understand TQM. The degree of emphasis for each quality activity varied and thus more research needs to be done to investigate the importance of each quality activity to a TQM implementation process, as there are varying degrees of emphasis across the board. The KSA case studies show that in implementing organisations, TQM intentions and TQM policy frameworks are generally acceptable. However, the implementation process is generally weak and lacks coordination in the majority of these organisations. It is clear that the majority of the KSA cases have not succeeded in total commitment towards a total quality culture. When compared to the UK and USA hospitals, the majority of the KSA cases show deficiencies in most of the critical activities that form the foundation of a successful quality process. Furthermore, the study indicates three critical factors in KSA hospitals that either did not exist or were not given full attention. The importance of these factors were further validated in the literature. The factors were continuous top management commitment, continuous education and training, and culture awareness. These factors were then used to develop a model for TQM implementation for a segregated healthcare environment.

The main concern of this thesis is the development of political and economic relations between the PRC and the KSA. The relations that officially developed after the establishment of diplomatic relations are the focus of analysis of the thesis. By examining the historical and statistical data, the thesis assesses the factors that have cultivated and maintained the Sino-Saudi political and economic relations, as well as the implications of these bilateral links. In analysing the relations, a theoretical conception of complex interdependence has been used. The thesis first provides background on China’s policy towards the superpowers and the Middle Eastern countries between 1949 and 1989, and looks at how China and Saudi Arabia related to each other over this period. The thesis then argues that over the first decade (1990-2000) of Sino-Saudi diplomatic relations, the two countries began to lay the basis for complex interdependence between them. It highlights a number of characteristics of complex interdependence which came to exist. The thesis then goes on to examine whether, in the second decade (2001-2010) of bilateral relations, an intensification of complex interdependence ensued. The complex interdependence approach links closely with constructivist theory in terms of how this thesis is conceived. The thesis argues that China and Saudi Arabia between 1949 and 1977 shared an understanding that their ideological positions made official links between them impossible. Over the course of the following twelve years, this understanding gradually changed. The change laid the basis for the development of diplomatic relations in 1990. In the years between 1990 and 2010, the policy responses of China and Saudi Arabia to major regional events exhibited a commonality of perception. This underpinned the development of the relationship. To identify clearly the growth of Sino-Saudi relations, the thesis is divided into three time periods: 1949-89; 1990-2000; and 2001-10. The time period 1949-89 has three distinct phases: 1949-65; 1966-77; and 1978-89. The 1949-65 and 1966-97 periods are characterised by the absence of state-to-state relations between the PRC and the KSA. However, unofficial contact between Muslims on mainland China and Saudi officials and leaders was established and largely maintained. State-to-state contact only existed between the KSA and ROC governments, which shared broadly anti-Communist sentiments. During the 1978-89 phase, hope for the establishment of diplomatic relations between the PRC and the KSA was high. Some intergovernmental contact was initiated, direct communications between the leaders of the two countries were enhanced, and a joint endeavour towards the development of diplomatic ties was pursued. The 1988 missile deal smoothly accelerated the process of developing these ties. In the 1990-2000 phase, four decades after the establishment of the PRC, Sino-Saudi diplomatic relations were established. The establishment of these diplomatic relations was daunting for the ROC, which wanted to preserve the diplomatic recognition that the KSA had granted it for the preceding 45 years. The strenuous efforts of the ROC to prevent a dramatic shift of diplomatic recognition to mainland China were in vain. The 1990-2000 phase was marked by significant growth in the newly established Riyadh-Beijing diplomatic relationship. Economic interests were at the heart of the agendas of the leaders and officials of the two countries. They began to enhance co-operation and to sign agreements related to various aspects of their bilateral relations. A Memorandum of Understanding (MoU) on Oil Co-operation was concluded in 1999. The value of Sino-Saudi total trade rose by 643 percent between 1990 and 2000 and the volume of Saudi oil exports to China increased by 6,721 percent between 1991 and 2000. After nearly ten years official diplomatic relations were established, President Jiang Zemin viewed the development of bilateral relations as impressive, while Crown Prince Abdullah seemed to suggest that there was now “an intimate relationship” between the two countries, saying that he considered the PRC to be the KSA’s closest friend. The period 2001-10 is also sub-divided into two phases: 2001-05 and 2006-10. This period exhibits the three characteristics of complex interdependence that Keohane and Nye (2000) put forward in their scholarly work: multiple channels, the minimal role of military force, and the absence of a hierarchy of issues. Security issues were largely excluded from Sino-Saudi bilateral relations, while economic interests dominated the agendas of the two countries. In the first phase (2001-05), high-level officials continued to play a leading role in bilateral economic relations. They consistently called for the participation of the private sector in expanding Riyadh-Beijing economic ties. The value of Sino-Saudi total trade continued to climb, reaching USD16.1bn in 2005, and the PRC’s oil imports from the KSA reached 22.2 million tonnes in the same year. Some joint investment projects that involved the participation of Chinese and Saudi companies in the hydrocarbons sector were successful. With regard to the construction industry, Chinese companies won four construction projects from the Saudi Arabian cement industry. The second phase (2006-10) was marked by substantial advancement in Sino-Saudi relations. Following the exchange visits of the state leaders in 2006, bilateral contacts expanded rapidly. The visits led to the formulation of more strategies, with the intention of cementing the relationship, increasing contact and concluding more agreements. The Chinese leaders called for “strategic co-operation”, “a friendly and co-operative strategic partnership”, and “strategic friendly relations”, specifically referring to economic co-operation. This second phase saw Sino-Saudi total trade increase to USD 33bn in 2009, and the volume of PRC oil imports from the KSA reached a peak of 41.8million barrels in the same year. With regard to the hydrocarbons joint ventures, in which investments were jointly made by Saudi ARAMCO and Sinopec, the projects in Quanzhou and Rub’ Al-Khali were good examples of the strong co-operation between PRC and KSA companies. The Quanzhou plant launched operation in 2009, and the gas-exploration project in Rub’Al-Khali engaged in drilling for another three years (its operation began in 2004). The achievement of SINOPEC SABIC Tianjin Petrochemical Co., Ltd, as part of the Tianjin petrochemical project, is another example of such co-operation. In non-hydrocarbons joint ventures, mutual investment increased exponentially, particularly in the mining sector.

[ES] El Reino de Arabia Saudí está experimentando un importante crecimiento económico, industrial, comercial y demográfico. Este crecimiento, a su vez, provoca un aumento de la demanda de agua en la región. Además del crecimiento demográfico, también la industrialización y la modernización han ejercido una presión cada vez mayor sobre las infraestructuras hídricas del país. Urge aumentar la disponibilidad de agua para satisfacer la demanda prevista y mantener la seguridad y fiabilidad de los sistemas hídricos. Por lo tanto, es imperativo encontrar soluciones que mejoren la eficiencia del sistema hídrico del país. Un elemento clave en este esfuerzo es comprender y clasificar cómo se consume el agua con sus microcomponentes dentro de varios segmentos. La tesis recopila conocimientos precisos sobre las pautas y tendencias del consumo municipal de agua para comprender mejor los patrones de consumo y los comportamientos de los consumidores, así como desarrollar estimaciones e hipótesis preliminares. De este modo, se impulsará el modelo de demanda de agua municipal en el país para que sea capaz de hacer frente a diferentes escenarios y limitaciones. El desarrollo del modelo municipal de demanda de agua ha mostrado la necesidad de disponer de datos estadísticos y de facturación del agua fiables. Éstos constituyen el punto de partida de la previsión y deben estar disponibles con una resolución suficientemente alta. El modelo aquí presentado proporciona un marco para que nuevos desarrollos futuros. Los resultados del análisis también determinarán los factores y categorías utilizados en el modelo. El modelo se centra en la demanda de agua no residencial. No obstante, se incluyen previsiones separadas para la categoría residencial a fin de permitir la extrapolación de los resultados y el análisis top-down para un enfoque más preciso de las previsiones y, también, para una mejor comprensión general de los comportamientos de consumo de agua de la población. / [CA] El Regne de l'Aràbia Saudita està experimentant un important creixement econòmic, industrial, comercial i demogràfic. Aquest creixement, al seu torn, provoca un augment de la demanda d'aigua a la regió. A més del creixement demogràfic, també la industrialització i la modernització han exercit una pressió cada vegada major sobre les infraestructures hídriques del país. Urgeix augmentar la disponibilitat d'aigua per a satisfer la demanda prevista i mantindre la seguretat i fiabilitat dels sistemes hídrics. Per tant, és imperatiu trobar solucions que milloren l'eficiència del sistema hídric del país. Un element clau en aquest esforç és comprendre i classificar com es consumeix l'aigua amb els seus microcomponents dins de diversos segments. La tesi recopila coneixements precisos sobre les pautes i tendències del consum municipal d'aigua per a comprendre millor els patrons de consum i els comportaments dels consumidors, així com desenvolupar estimacions i hipòtesis preliminars. D'aquesta manera, s'impulsarà el model de demanda d'aigua municipal al país perquè siga capaç de fer front a diferents escenaris i limitacions. El desenvolupament del model municipal de demanda d'aigua ha mostrat la necessitat de disposar de dades estadístiques i de facturació de l'aigua fiables. Aquests constitueixen el punt de partida de la previsió i han d'estar disponibles amb una resolució prou alta. El model ací presentat proporciona un marc perquè nous desenvolupaments futurs. Els resultats de l'anàlisi també determinaran els factors i categories utilitzats en el model. El model se centra en la demanda d'aigua no residencial. No obstant això, s'inclouen previsions separades per a la categoria residencial a fi de permetre l'extrapolació dels resultats i l'anàlisi *top-*down per a un enfocament més precís de les previsions i, també, per a una millor comprensió general dels comportaments de consum d'aigua de la població. / [EN] The Kingdom of Saudi Arabia is undergoing substantial economic, industrial, commercial, and population growth. This growth, in turn, leads to increased water demand in the region. In addition to population growth, industrialization and modernization have placed increasing pressure on KSA's water infrastructure. There is an urgent need to increase the water capacity to meet the projected demand and maintain the water systems' security and reliability. Therefore, it is imperative to find solutions that improve the efficiency of the Kingdom's water system. A key element in this effort is understanding and classifying how water is consumed with its micro-components within various segments. The thesis aims to collect precise knowledge about municipal water consumption patterns and trends to understand water consumption patterns and consumer behaviours better and develop preliminary estimates and assumptions. This will drive the municipal water demand model in KSA to be capable of dealing with different scenarios and constraints. The development of the municipal water demand model highlighted the need for reliable statistical and water billing data. These form the starting point of the forecast and need to be available at a high enough resolution. The model provides a framework for the required data to be built on further. The analysis results will also determine the drivers and categories used in the model. The model focuses on the non-Residential water demand. Still, separate forecasts are included for the residential category to enable the extrapolation of the results and downward analysis for a more accurate and cost-effective bottom-up approach to forecasting and an overall better understanding of the population's water consumption behaviours. / Alhudaithi, M. (2023). A Sectorial Analysis of Municipal Water Consumption and Management in Saudi Arabia [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/201553