The study researches the applied principles to achieve Total Quality Management (TQM) at healthcare institutions. Main elements elaborated in accordance with field specialists and international standards. These principles, elements, and the associated processes were reflected on the healthcare industry and the specific requirements of its operations, management, and customers. In order to apply the literature study into the field, a case study of the healthcare industry in Libya is adopted. The research method was to survey hospital staff from all levels and in several institutions about the basic principles of TQM at their workplace. The participants were also asked about the work methods, their awareness about the importance of TQM, the usage of modern technology by their institutions, utilization of resources, and the problems that may hinder the implementation of TQM the hospitals. The analysis of the survey indicated that the implementation of quality at Libyan hospitals is estimated at 33.6% with a significant lack of awareness about quality. A set of recommendation is then provided for hospital leadership for study and implementation.