“There is no substitute for knowledge.”
W. Edwards Deming was asked how organizations might undertake quality improvement.   He answered: “There is no substitute for knowledge.”

Deming influenced the science of improvement and quality in the US.  He believed that tools or a method, without subject knowledge or without an understanding of the philosophy of improvement would be a flash in the pan.

Deming created a philosophy of improvement.  He called it the System of Profound Knowledge.  Why a phrase like profound knowledge?  It sounds lofty, but Deming felt so strongly about learning and how profound it is to have deep knowledge, that he called it just that.

Deming viewed improvement as a system, made up of 4 parts.  These parts interact with each other:  appreciation of a system, understanding variation (and what we can learn from it), psychology (how people work together, how we differ from each other and what motivates us) and theory of knowledge – or how we learn through small experiments or tests of change.  He called these 4 parts of the system, The System of Profound Knowledge.

One more thing – Ever notice how easy it is to point out a fault or something unique in someone else?  Deming believed that Profound Knowledge comes from the outside, and by invitation only.  This means that often a home health agency cannot understand itself or see itself as clearly as an outsider can, because you are the very system you try to understand.  It is particularly helpful if you invite someone from outside your agency help you get better insight on your total system.

Part of being in a learning community is helping each other learn and learning from what others do. How can you invite patients, providers and hospitals – other parts of the healthcare system to help you improve?  What is driving them nuts? What is going well?  Ask and learn.

Jane Taylor, CHAMP Quality Improvement Advisor