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Organising for Quality – The Story of Toyota and General Motors. From test and initial success To spread and sustainability. Healthcare Context Organising for Quality. Research into what it takes to successfully organise to deliver high quality care
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Organising for Quality – The Story of Toyota and General Motors From test and initial success To spread and sustainability
Healthcare Context Organising for Quality • Research into what it takes to successfully organise to deliver high quality care • Eight organisations studied: macro and micro systems • Organising for quality, Bate et al, 2008
Achieving and Sustaining Improved Quality • Successfully recognised and addressed all six challenges on an ongoing basis • In ways that have been appropriate to the local contexts in which they have found themselves
Common Challenges, Diverse Solutions • Structural • organising, planning and co-ordinating quality efforts • Political • addressing and dealing with the politics of change surrounding any QI effort • Cultural • giving quality a shared, collective meaning, value and significance within the organisation
Common Challenges, Diverse Solutions • Educational • creating a learning process that supports improvement • Emotional • engaging and mobilising people by linking QI efforts to inner sentiment and deeper commitments and beliefs • Physical and technological • designing physical systems and technological infrastructure that supports and sustains quality efforts
The flip side • Structural • fragmentation, lack of joined-upness between different part of organisation doing QI • Political • Disillusionment, blocking and resisting change • Cultural • Evaporation, not rooted in habitual thinking and behavioural routines; reminiscent of programme or project based QI
The flip side • Educational • amnesia or frustration, knowledge is forgotten or fails to accumulate, QI skills don’t keep pace with aspirations • Emotional • disinterest or fade out, run out of energy and forward movement • Physical • exhaustion as people try and do it all by hand, no way of taking the weight of necessary activities
Learning from NUMMI • Why did the NUMMI plant succeed? • What’s currently enabling your improvement work to succeed? • What stopped GM spreading the success from NUMMI throughout the organisation? • What will stop your organisation spreading success in improvement? • What can you do about it?