Quality as an Organizational Strategy: Building a System of Improvement

From the authors of The Improvement Guide, The Health Care Data Guide, Quality Improvement Through Planned Experimentation, and Transforming Health Care Leadership.

Quality as an Organizational Strategy describes an approach to leading organizations based on W. Edwards Deming's charge that leaders need a new theory of management and a strategy built on quality. The book defines quality as a strategy and describes a framework of five activities for leaders that can generate both immediate results and long-term performance. The framework aligns the functions of measurement, marketing, planning, and execution of improvement projects to optimize the performance of any organization.

Five activities for leaders to focus the organization on improvement:

• Purpose activity - Establish and communicate the purpose of the organization
• System activity - View the organization as a system (System Map and Vector of Measures)
• Obtaining information activity (customer focus) - Establish a system to obtain information relevant to the Need the organization is fulfilling
• Planning activity - Planning to improve
• Managing improvement activity – Managing improvement efforts

Reflections from Leaders with Quality as an Organizational Strategy

“This is a brilliant book! It is stunning in its comprehensiveness and references, and it uses
Dr. Deming’s systems view so well as a backbone. I think this will become the defining
text in the field.” DONALD M. BERWICK, MD, President Emeritus and Senior Fellow Institute for Healthcare Improvement, Former Administrator of the Centers for Medicare & Medicaid Services

“Before QOS, my experience was that the ‘beautiful strategy’ was finalized, communicated, and put on the shelf until the next year. QOS is the way to bring the strategy to life. The five activities bring Dr. Deming’s philosophy to life.” ROGER B. QUAYLE, Senior Quality Manager at Brown & Root, Inc., and Executive Vice President of Quality and Technology at Operations Management International, Inc. (OMI)

“Jönköping County continues to use QOS twenty-plus years later. We use the parts of QOS to onboard and develop new leaders: our purpose, appreciating the system of processes and our work within it, and using the Science of Improvement to get better. We also expanded beyond healthcare into other areas of the county and municipalities. This is now who we are, and you can see examples anywhere you go.” DR. MATS BOJESTIG, Director of Health and Medical Services, The County Council, Jönköping County, Sweden and GÖRAN HENRIKS, Chief Executive of Learning and Innovation at Qulturum in Region, Jönköping County, Sweden

“The holistic approach of QOS is most beneficial to any organization, especially those who are faced with change and must adapt quickly. These tools and methods have been critical to our business. My learning will never be complete, and [QOS] provides the framework for this learning.” DAVE HEARN, President, Metalforms, Ltd.

“Quality as an Organizational Strategy (QOS) provided a framework that enabled me to build on what I had learned about quality improvement and apply it to the complex work of leading and managing an entire organization as a system. It was extremely useful as a means to think about building a new organizational form called a Learning Health Network. I have found using it immensely helpful over a twenty-year experience.” PETER MARGOLIS, MD, PhD Co-Director, James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Research Foundation Chair in Improvement Science, Professor of Pediatrics, Cincinnati Children’s Hospital Medical Center