Describes the process used by the Mater Infirmorum Hospital in Belfast in 1992-1994 to achieve high quality care (Seamless Service), motivate staff to deliver and measure performance. Aims of the project include focusing the organization on the customer, improving teamwork and motivation at all levels. After comprehensive data collection from GPs, patients and staff management forums developed a full TQM strategy to gain support and maintain momentum including innovative staff events (every staff member was given the opportunity to attend) where multilevel, multidisciplinary workshops enabled staff to design customer care standards, develop teams and lead customer-driven change.