As director of quality for Illinois CancerCare, I am often asked, “Is quality something that an organization just has, or is it created?”

Good question. The answer, while there are varying factors, is that it is unlikely to just happen. Quality is created, nurtured and cultivated within an organization in order for it to be sustainable.

A Culture of Quality
Organizations that choose to embed a culture of quality must first understand that to change a culture, employees must:

• Have a standard definition of quality that fits their industry and the products or services provided
• Be included in all training that teaches how quality impacts the lives of those they serve—and themselves, and
• Be an active participant in making that change happen.

When moving toward a culture that “breathes” quality, the first critical step is to determine what “quality” means for your organization. Can you intertwine what quality means with your mission statement or with your core values? Or does your definition of quality seem to contradict the reason your organization exists?
The next step is to look at the mission statement and core values. What an organization cares about most should be there. The questions to ask when reviewing both are:

• “Is this really what we believe?
• Do our employees know our mission statement and core values? 
• Do they believe our organization exemplifies both? 
• Is this what we show the people who receive our services?”

If the answer is “no” to any of those questions, you must begin by discussing these with your employees to get them on the right page with the purpose of the organization. If the mission statement is too long, your employees will not be able to recite it or begin to instill it into their thinking.

Employees must also understand what the people who run the organization find to be most important via the core values, and they need to believe that those are the values they see funneling from the top down.

The third step is to provide adequate training for all employees. You cannot create a culture of quality without first giving all of your staff the same information. Do not allow them to receive it for the first time second-hand. One of my favorite statements is, If you fail to give it to them and they hear it somewhere else, by the time they think they understand it, it will be the complete opposite of what you said!

Provide an inviting atmosphere that will help employees understand the importance of quality, the implementation of quality tools and the importance of sustainability for quality processes.

If you are going to implement 6 Sigma, for example, create an awareness program and make it mandatory for all employees. The program should provide an overview of the methodology and allow time for employees to ask questions to help them get a better grasp on the forthcoming change. At first, it may not be received well by all, but with enough training and evidenced outcomes, your employees will eventually adapt.

The final step in creating a quality culture is to task your employees with the responsibility of showing behavior that falls in alignment with the quality program. There are many ways employees can show engagement with your new quality program. As a department or organization leader, ask them to participate on a process improvement team or focus group, or give them the opportunity to make comments regarding a current project or problem.

In healthcare, your best employees generally have a compassionate spirit that drives them to achieve great performance. These are the types of employees that you want in your organization.
You want your employees to show quality behavior by:

• Understanding that change towards quality is fundamental to survival
• Identifying errors and reporting them to the Quality Department (when they cannot be immediately fixed)
• Working in cross-functional teams to identify solutions that impact various areas
• Working to understand and fully implement solutions to make sure processes are controlled 
• Exhibiting an attitude that shows the mission and values of the organization. iBi

At Illinois CancerCare, our values are:

• Putting patients first
• Treating others with respect and compassion
• Providing timely and open communication
• Being committed to research
• Taking ownership in our practice
• Showing a positive attitude at all times. 

•  All processes that lead to our patients are error-free.
• Everyone we are in contact with is treated with respect and compassion.
• Communication to patients, their family members and our employees is timely and comprehensive.
• Research is available for qualified patients.
• Every employee knows they have a responsibility to identify and report errors, and work to help sustain improvements.
• Every employee understands the importance of showing a positive attitude with everyone they encounter.