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Abstract
This research explores management viewpoints on quality enhancement methods in tertiary care hospitals located in two key cities of Pakistan: Lahore and Multan. Using a mixed-methods approach that includes surveys and interviews with 120 healthcare managers, this study highlights significant differences in the implementation of quality improvement, challenges faced, and outcomes achieved across these metropolitan healthcare systems. The results indicate notable differences in resource distribution, employee training, patient satisfaction levels, and technology implementation. Hospitals in Lahore exhibited greater adherence to international quality standards (78% compared to 62%), whereas hospitals in Multan displayed more robust community engagement efforts (85% versus 71%). The research offers practical recommendations for healthcare managers aiming to improve quality enhancement strategies in tertiary care facilities across Pakistan