Purpose - The purpose of this paper is to examine and discuss the effects of quality management in the health care sector and the general effects of quality management on the health of the employees. Design/methodology/approach - The empirical basis consists of three case studies in one industrial manufacturing company and two hospitals. The empirical data have been gathered with both qualitative and quantitative methods. Findings - The twofold value of quality management, of preventing disease by supporting more rewarding working conditions as well as improving the treatment of disease by increasing the effectiveness of health care organisations is indicated. Leadership commitment was found to be the most crucial common prerequisite for successful quality management implementation and for creating a healthy work environment. In addition, continuous improvements and participation of everybody were found to have importance for well functioning quality management as well as for health. Research limitations/implications - The paper provides additional understanding of the influence of quality management on health and a model is presented. A limitation is that the factors studied are fairly broad and for further research it will be useful to go deeper into the mechanics of them. Practical implications - The three factors, leadership commitment, participation of everybody, and continuous improvements, have been shown to be vital contributors for health and managers should make every effort to implement them. Originality/value - The double effect of quality management on health has not been studied before and knowledge of the factors contributing to it is valuable. © Emerald Group Publishing Limited.