What is this “quality” that we’re being asked to sell?
Using the word as a noun implies that it is concrete—a product that you
can package and put on the shelf. “I’ll
have three pounds of quality, please.”
More frequently, it’s used as an adjective, as in “quality service” or “quality
products.” It’s common to see a mission
statement profess to provide “The highest quality healthcare,” whatever that
means.
The term has become a slang expression, having no intrinsic
meaning, and some organizations have dropped it. “Quality” appears only once in
a footnote on the Baldrige Award web site.
The American Society for Quality is now known as ASQ, and you won’t find
a translation of those letters on their web site. It is possible to go thru the ISO 9001
standards and remove the word “quality” entirely, without altering the meaning
of any sentence.
So then, what is it we’re being asked to sell? What does “quality” look like, and why would
anyone spend good money for it? Perhaps
it is an ethereal concept that we can sense or feel but cannot define. More likely, it is an aspect of
organizational culture, relating back to the concept of Total Quality
Management. Every employee has a
compulsion to do whatever they do better than anyone else, anywhere. But that’s not enough. Employees must perform together to provide a
service or product that is best in class.
But even that’s not enough. They
must do this reliably, every day, as a habit.
“This is how we do things here.”
More than once, a Baldrige Award winner has been asked, “You
just won this nice award, but what are you going to do on Monday, when you go
home?” Without exception, the astonished
CEOs have replied, “We’ll do what we always do on Mondays. This is who we are.”
So, back to the original question: What is it that we’re
selling? A concept? Well no, it’s more
like a culture. Can you sell
culture? Can you impose a culture as an
outside consultant? No to both, but you
can help senior management change the culture in their organization, assuming
they see the benefits in doing so. And that’s
something we can sell. AHRQ and others
have demonstrated that you can create or improve a patient safety culture. You can, of course have both—a safety culture
and a quality culture. They are not
incompatible, but they are also not identical.
In either case, you have to work at it.
As Paul’s quote from Deming implies, “Success is not guaranteed.” I like the quote from Paloma Herera (see last
month), “First you must have a passion.
Then you must work very hard.”
That’s a formula for success in almost anything.