Effectiveness in quality management: A turnaround or a tried and tested recipe for success?

The ISO 9001:2015 standard and the idea of holistic quality management emphasize entrepreneurial thinking through keywords such as structuring and managing a company, customer orientation and continuous optimization. In practice, however, the discipline is often trapped in certificates, audits, and internal evidence, which leads to excessive bureaucracy in many companies, which is reflected in statements from company representatives:

• “We have 36 management manuals. ”
• “All documents printed out and stapled into folders fill the 10 rooms in our company. ”
• “We call the colleague Mr. Resubmission because he reminds colleagues to update the documents. ”

A phenomenon that is rightly criticized by various experts as too high a “theatre rate” without direct effectiveness. The “theatre ratio” describes the proportion of a company's resources and activities that are spent on maintaining a specific image or maintaining processes that do not directly create value for customers. This discrepancy between the actual goal and excessive bureaucracy is fueling the current debate about the future of quality management, which Rudolf A. Müller sums up very well in his LinkedIn publication: Where, please move forward. The basic “why” of quality management is increasingly being questioned and the answers to this question often remain unclear in many companies.

1. Efficiency vs. effectiveness

The current discussion (abolish quality management or continue as before) reflects a goal dilemma in the sector. Yes, quality management is required in companies for certifications and associated market access — but does managing the excessive documentation load and excessive theatre rate provide further benefits within companies? More and more managing directors are asking themselves this question and often argue: “We must become more efficient in this area, both in managing and maintaining documents, and we must become more effective. ”

The demand for efficiency to reduce the often criticized “theatre quota” will not lead to a better goal, but will continue to pursue an entrepreneurially inefficient goal. It is therefore necessary to ask the question of effectiveness, which entails other quality management objectives. Just becoming more efficient, i.e. doing things correctly and cost-effectively, does not help the topic achieve more customer orientation or better leadership.

There is often a lack of target systems and incentive systems for the responsible quality managers in companies, as Carsten Behrens explained in his article “How do I become effective and valued as a quality manager” represents. This vague vision makes it clear that many companies have not yet answered the question of the effectiveness of quality management for themselves. The consequences are reflected in the perception and acceptance of the division among other colleagues: The high level of bureaucratic effort and the “theatre quota” perceived as annoying have led to many colleagues finding working on processes “unsexy”, as do their own management system managers such as Anja Hirschler: Processes are unsexy — omg, did she just say that write it yourself.

2. Search for new goals and perspectives

Quality management, often perceived as dry and boring, has enormous entrepreneurial potential in its principles that is often overlooked. The ISO 9001:2015 standard enshrines clear objectives in its principles, such as:

• customer focus,
• involving people,
• process orientation,
• continuous improvement and
• evidence-based decision making.

These principles are not just buzzwords, but rather the essence of an effective company, which every managing director underlines as desirable goals. The actual goal of quality management goes beyond simply putting certificates on the wall and a high theatre rate.

Quality management as the key to positioning on the market

Here is a practical example that shows how quality management is used as an entrepreneurial tool and brings these standard buzzwords to life. Thomas Müller, A Swiss dentist and managing director, is working intensively on the development of processes within his community dental practice. In a joint discussion, Thomas explained his view of quality management and the corporate target value of this discipline.
A few years ago, only dentists with Swiss university degrees could practice in Switzerland. With the opening of professional borders in Switzerland, the number of dentists has almost doubled in a short period of time due to dentists from Germany, Austria, France and Italy. The number of patients remained the same, with the result of increasing competition and corresponding price pressure. How can a Swiss dentist reposition himself in the market with the unanswered questions? :

• How can the service be offered in a better quality/more efficient way?
• What competitive advantage can be achieved so that patients stay and new ones join?

The focus on the discipline of quality management supported him as managing director in answering these questions. In his management system and his employees, he focuses on the three principles of the standard:

• mapping processes and creating transparency,
• patient orientation,
• Continuous improvement: How can we offer patients better performance?

His organization initially struggles with a lot of bureaucracy, many documents and little effectiveness. Everyday practice cannot be integrated into processes and documents. As in many other companies, the internal benefits do not exist. The decentralized distribution of processes and information to employees and the involvement of all employees in process design with a high level of knowledge transfer makes it possible to integrate everyday life into the processes. The effectiveness and acceptance of quality management in the everyday life of employees is ensured by the high level of practical relevance and the timeliness of the information. The effect on the company is primarily characterized by a high level of patient orientation in processes and continuous improvement of processes. This is reflected in a very modern and progressive practice:

• personal welcome through personal greetings and accompaniment in the waiting area,
• maximum patient waiting time of less than 5 minutes,
• open waiting area with insight into the practice's sterilization processes,
• State-of-the-art equipment — AI integration in diagnostics, 3D printing of implants.

Despite price war and competitive pressure, the practice is able to guarantee high quality in all processes, which means that patients return and the practice is regularly recommended to new patients. A management system as a tool for market positioning and as a competitive advantage!

A change of perspective for effectiveness: Saving quality management?

The conclusion from this example and similar experiences is clear: A different perspective on quality management can significantly increase effectiveness. This return to the underlying principles of the standard could even save the discipline of quality management. The current debate on quality management requires a critical review of the goals and a possible realignment. A change of perspective appears necessary and possible in order to make the discipline more entrepreneurial and achieve better entrepreneurial effectiveness in quality management.