Quality as an organizational strategy: building a system of improvement

Improvement science offers proven theories and methods that can be applied to specific projects, but they have rarely been applied to the leadership systems of healthcare organizations. This paper presents Quality as an Organizational Strategy (QOS), a method for building a system of improvement that embeds improvement science into leadership and strategy. QOS centers on five activities: defining and communicating purpose, viewing the organization as a system, building a system for obtaining information, planning to improve, and managing improvement efforts. Examples from healthcare settings illustrate how leaders use these activities to align vision, strategy, and culture while fostering continuous learning. QOS is designed to enable organizations to pursue achieving strategic aims and sustaining performance over time. By broadening project-based improvement to improving the organizations as a system, this paper expands the application of improvement science with a practical, generalizable approach for transforming complex health systems.