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?