DEFINITIONS AGAIN
In his 7 Jun posting, Paul Borawski asks whether “quality”
is more related to the product/service or to the organization as a whole. In his speculation, he references a report
written by an ASQ Board member for The Conference Board. The Quality Council of The Conference Board
opines that Quality is not merely a set of tools, but they’re a little unsure
about what the alternative is.
The subject of the paper is ostensibly what CEOs are
thinking about, but most of the discussion centers on how to achieve excellence
in the areas under discussion. How do
you “create a culture of innovation?”
How do you achieve “Global expansion” without over extending. Human Capital is a perennial problem—how do
you get the best employees and then get the best out of the employees you
have?
Is any of this
relevant to healthcare? Does anyone on
the sharp end of healthcare care about innovation? Global expansion? Human capital? Without any real competition—particularly price
competition, there is little serious interest, and we even seem to be getting
less competitive, as major players stake out spheres of influence.
Whither “quality” in healthcare? If it’s not a set of tools or techniques, what
does quality look like in healthcare?
Part of the answer comes in one of the strategies from the Conference
Board under Innovation: “Create a culture of innovation . . . .” In a comment on Paul Borawski’s
original blog, Mike
Alumbaugh refers to an “excellence centric culture.” So what’s a culture anyway? And how does it relate to quality (whatever that is!). Think of culture as “a collection of beliefs
shared by a defined population.” Think
for a moment, if everyone in your organization worked every day to do whatever
they do better than anyone anywhere. Congratulations. Assuming you define “quality” as doing
something really well, you have just created a quality culture. Everyone in the organization shares the
belief that quality is important. They
know the CEO believes it is important, so quality is now a culture, and
employees will work to further that goal.
Some years ago, I was standing on the deck of the Queen Mary
2. Three senior officers came thru a
door onto the deck near me, and as they did so, one of them bent over to scoop up a scrap of paper from the deck. Why
did she do that? Cleaning the deck was
not her job! But, yes, it really was her
job. Keeping a neat ship was part of
their culture, so of course she would pick up a stray scrap of paper, as would
any other employee.
A patient’s family wrote me a thank you note after one of
our employees changed a flat tire so the departing patient wouldn’t have to wait
for the repair truck. I knew nothing
about this but I wasn’t surprised. It
was consistent with our culture of providing exemplary service—of course he
would change the flat tire and not regard that as anything special. That’s what culture does for you—shared beliefs. Of course the nurse would make her intake
visit in the parking lot, so mom wouldn’t have to awaken her sleeping
child. That's what we do here.
You can define “quality” any way you want. It can mean excellence in customer
service. It can mean cost effective
care. It can mean all of the above or
other things. The only trick is getting
employees to share that definition. That’s
leadership. The end result is a culture of quality in the organization. Tools may be useful and used, but it is the
pervasive culture that defines quality in the organization. A
collection of beliefs in a defined population.