title: [Not Available].
abstract: BACKGROUND
  To develop a methodological tool for use in the analysis and management of the health service quality inhibitory factors (HSQIF).
  
  
  METHODS
  A nominal discussion group was used as a research technique. A total of 18 hospital directors from the Mexican State of Jalisco participated in a workshop. Half of them came from the private sector, and the others from public hospitals. The hospital directors came from different counties such as Guadalajara, Zapopan, Tlaquepaque and Tonalá.
  
  
  RESULTS
  Cultural and organizational constraints were major issues found as health services quality inhibitors. Two examples are: the weakness of the quality culture and the lack of management commitment to quality. Lack of strategic planning and the absence of management by process were also found to be linked with the poor hospital management performance. The findings were used to design a test that would detect the main categories of quality inhibitor factors of the organizations. The main categories included, deficient infrastructure, organizational and cultural constraints, poor hospital management, poor human resources management and lack of compliance with the hospital norms were among the main ones included.
  
  
  CONCLUSIONS
  The point of view of directors was used to identify the main health services quality inhibitor factors of private and public hospitals from Jalisco, Mexico. The findings should help to develop a methodological tool for the analysis and decision making to correct them.
authors.affiliation: Departamento de Salud Pública. Centro Universitario de Ciencias de la Salud. Universidad de Guadalajara. México. Electronic address: drmartinezr@hotmail.com.
authors.forename: Armando
authors.initials: A
authors.lastname: Martínez-Ramírez
authors.forename: Salvador
authors.initials: S
authors.lastname: Chávez-Ramírez
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Guadalupe Cambero-González
authors.forename: Erika
authors.initials: E
authors.lastname: Karina Ortega-Larios
authors.forename: Zillyham
authors.initials: Z
authors.lastname: Rojas Jiménez