Five Lessons Learned about Quality Improvement at NC State

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North Central State College Top Five Lessons Learned
1. Accountability /Communication Key for Action Projects
We have found that communication of our action projects and our overall quality initiatives
must cut across departments, be as free as possible of the use of jargon, be consistently
communicated, be reciprocal and iterative and be followed up by specific accountability.
Further this accountability must be fairly and specifically assigned, deduced from valid
measures, and be applied concomitantly with the authority to effect change.
Additionally, we have found that the action projects themselves must be tied to a measurable
need; must have smaller, attainable, and easily communicated goals; and must have stable,
focused, ongoing support and commitment (buy-in) from all departments -- cutting across
“silos.”
We have learned that:
 Accountability without clear vision and communication is unfair.
 Communication and vision without voluntary acceptance of responsibility is impotent.
2. Champions /Teams for Culture Change
We have found, in the pursuit of cultural quality change, that we need both champions and
teams. Linchpin leadership commitment to AQIP is imperative; however, it is not the fully the
responsibility of the leadership to effect quality and cultural change. This is an example of the
both/and balancing act we are learning to achieve. Strong, clear leadership is crucial to
galvanize a team; however, no leader can overwhelm an apathetic majority with brute strength.
At times we have relied upon a few leaders to carry the weight of our quality improvement
project and neglected shared responsibility for moving forward.
We have also experienced the opposite. We have ‘shared’ the responsibility without specific
outcomes, which has led to ‘displaced’ responsibility where no one feels accountable for the
outcome.
3. Measuring /Writing for the systems portfolio
We have found that writing by committee and communicating by jargon does not translate
into effective change. Additionally, we have found that we must be proactive in improving our
critical thinking skills and our understanding of valid outcome measurement. This will help
decision makers identify the obstacles and differentiate between the deeper issues and the
surface symptoms. We have found ourselves at times ‘fixing’ the symptom of a deeper and
intractable problem, while the underlying issue remains untouched.
4. “The product is more important than the process” and other myths dispelled
By broad consensus the reported “best by-product” of the quality initiative project at North
Central State has been the growth throughout the process. We have greatly benefited from the
emphasis on transparency, constructive criticism, and the revelation and acknowledgment of
underlying problems. We are also slowly beginning to understand that AQIP is not just a
replacement for the accreditation review, but a tool for cultural growth.
5. Real Change is slow—not stagnation
Slow change is not necessarily a sign of stagnation or resistance. At 40 years old our
organization is entering a new era of maturity. We are beginning to understand that change
must occur; however, the change must be measured, consensual, focused, concrete,
widespread, and enduring.
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