Total quality management will provide important benefits for organizations that are involved with the delivery of occupational and environmental health care. These organizations should shift from traditional medical management to the new paradigm. Identification of a set of relevant parameters for this new management system is necessary to implement the quality culture within our professional settings. An exhaustive literature search was undertaken on the topic of total quality management to delineate a framework for consideration by occupational and environmental health managers. Proposed are essential components of a management system for quality excellence which are derived from review of reported approaches among health care organizations and industry, various lists of quality principles and criteria, and classical systems theory.