Using empowerment to make quality work in health care.

Is TQM dead in health care? If it is alive and well, what role does quality improvement play in managing the changes that come with health care reform? William Byham and Greg Nelson begin this article by presenting results from a recent international study on TQM, outlining factors common to successful and unsuccessful quality initiatives. The key to success? Organizations must improve how people work as much as what they do in their work, and that means empowering people to improve processes. Easier said than done, say Byham and Nelson. Empowerment requires culture change and training. People first need the right environment to work differently, then the skills, knowledge, and techniques to participate in and influence the quality process.