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Rethinking Quality Management

Posted on October 25, 2013

The question I want to look at in this post is our role as quality managers, not just in our organizations, but in the larger society.  As I mentioned in my last post, I see that the largest amount of error we work to eliminate is not something we cause but error that occurs in society.  These societal errors include trauma, substance abuse, attachment issues, chronic diseases, poverty, homelessness, and the list unfortunately could go on and on.

So if quality management is the focusing of management on eliminating and controlling error; what are we doing?  Here is the slide I included in my last post with one addition: Six Sigma.  For those of you that don’t spend your free time reading quality and statistics books, Six Sigma is one of the most revered benchmarks in the world.  In essence achieving Six Sigma means an error rate of 0.00034% along with processes to achieve this ambitious mark. 


Compare 0.00034% to the rate of trauma, substance abuse, homelessness and chronic diseases and it puts our role in perspective.  Our society has an error rate much higher than what would we accept in nearly any other environment or industry.  In the helping professions we play a critical societal role in managing error.
In thinking about this topic I see the following facets within our quality work:
  • Address societal issues creating the error: Advocacy
  • Stop error from impacting the individual: Prevention
  • Identify societal error that is impacting individuals seeking services: Assessment
  • Match interventions to specific error: Service delivery
  • Ensure error does not reoccur in future: Aftercare

I would like to put forth the concept that we are the quality managers of our society.  The work of helping is an attempt to control and even eliminate error from having negative impact on our communities and the people that live in them.  This conclusion takes quality improvement out of an organizational or system of care context and into the complexities of our world, nation and local communities. 

Our complex communities create and allow for wide spread suffering, but there is little ownership of this fact, much less responsibility for coming up with solution.  Unfortunately too many communities would rather push the homeless to a less visible part of town, incarcerate the mentally ill and label the poor as lazy.  Instead of fixing the error we create system to remove the error from our sight and consciousness.

It has been my experience that we are paid to manage the problem without the needed resources to really address the five aspects of quality management I listed above: advocacy, prevention, assessment, service delivery and aftercare.   Society owns the problem enough to give us some resources but without the realization that society is, in good part, responsible for creating the problem.  There often seems to be little motivation to fix the true causes of these issues.  Without adequate resources, we scramble to fundraise, grant write and innovate ways to keep our doors open, our staff paid, and our clients at least moderately safe.

This rethinking of quality is a call to think beyond our walls and silos created by funding sources and traditional roles and philosophies.  Will we see our society wake up and take responsibility for creating these errors?  I am confident that as helpers we can come together creating communities of care.  No one agency or system can address societal errors in isolation.  We need schools, therapists, firefighters, clergy, medical professionals, parents, public servants and concerned community members to rally together because only in the power we create together can we begin to take on the problems that are hurting our clients and communities. 


My challenge this week is to look at your own organization.  Where is your quality focus pointed?  Is it internal only?  Do you see ways to step out of our silos and REALLY address these critical problems?  I would love to hear your comments and experience as we continue to learn together!

2 responses to “Rethinking Quality Management”

  1. Jon says:

    Holy COW Matt! What a decadent slice of paradigm-shift pie to chew on. I love it when someone ties an elegantly simple bow on a very complex issue. I accept your challenge.

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