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 1. Why did the NUMMI plant succeed? 2. What’s currently enabling your improvement work to succeed? 3. What stopped GM spreading the success from NUMMI throughout the organisation? 4. What will stop your organisation spreading success in improvement? 5. What can you do about it?