This research investigates the mediating role of the perceived value of audit services on the relationship between external audit characteristics and Total Quality Management (TQM) effectiveness in Egyptian hospitals. Recognizing the essential function of audit services in ensuring financial accuracy, corporate governance, and accountability, this research assesses how audit perceptions influence TQM practices in a healthcare setting where both financial and human considerations are at stake. A quantitative methodology was employed, distributing questionnaires to 100 healthcare customers across Egypt to capture data on the interplay between audit traits and TQM outcomes. The results highlight the substantial mediating effect of the perceived value of audit services, suggesting that perceptions of audit service value significantly influence the relationship between audit characteristics and TQM efficacy. Specifically, the findings underscore the importance of audit service characteristics—namely independence, thoroughness, and competence—and their perceived value in reinforcing TQM implementation. While revealing the intricate dynamics between external audit attributes and quality management in healthcare, the research acknowledges its limitations due to geographical focus and self-reported measures. This research contributes to the literature on audit services in healthcare by elucidating the mediating influence of perceived value and offering insights for enhancing audit and quality management systems in hospital settings. Future research directions include expanding the scope of the research to incorporate diverse geographical locations and integrating qualitative methods to deepen the understanding of audit service impacts on healthcare quality management.