Moving from Developing to Accelerating

Healthcare leaders track CMS star ratings, Leapfrog safety grades, and U.S. News rankings. Strong results bring a moment of relief—until the next board meeting asks what you’re doing to get better.

Improvement expectations are rising. Yet many healthcare organizations are still figuring out how to build a true system of improvement. Some are laying the foundation. Others are gaining momentum. A few are refining a mature system. Most aren’t quite sure where they are—or what comes next.

Self-Assessing Progress

In Quality as an Organizational Strategy (QOS), we use a self-assessment to help leadership teams gauge their maturity. But behind the numbers is a deeper question: how developed is your organization’s quality infrastructure, capability, alignment, and ability to achieve results?

We describe three phases in the QOS journey: Developing, Using, and Understanding. Most organizations find themselves between the first two—they’ve built foundations but haven’t yet accelerated progress.

These organizations have committed to improvement, invested in internal and external training, and improvement projects are happening across departments. Leaders celebrate effort and value staff learning. But results are inconsistent, spread is limited, and sustainability remains a challenge.

“Many organizations built the foundations for quality,” reflects Dr. James Moses, Chief Clinical Officer at Corewell Health in Michigan, “what’s needed now are methods to accelerate their progress.”

This is where quality executives recognize the need to lock in the fundamentals, systematize their approach, and move faster. The goal is to shift from isolated success to organization-wide results.

What Does Accelerating Look Like?

Deliver Results: Start with current and planned projects. Do these efforts advance your strategic goals? Focus relentlessly on changes that achieve measurable outcomes and advance your aims. Work to reduce the average cycle time of projects.

Improve Your Form: Adopt a single method (e.g., the Model for Improvement). Use tools like cause-and-effect diagrams, flowcharts, Pareto charts, and time series charts with fidelity. Emphasize testing and experimentation to learn fast. Coach teams on when and how to apply tools, not just what the tools are.

Deepen Sponsorship: Move beyond sign-offs. Sponsors become coaches, resourcing teams, removing friction, and communicating learning across the organization. Leaders recognize that improvement efforts reveal where transformation is needed in their areas of responsibility.

Build Problem-Solving Capability: Analyze the current state, scan the literature, and develop actionable change theories. Structured problem-solving moves teams from brainstorming sessions to implementing meaningful change.

Develop Your Bench: Build high-performing teams through improvement work. Teams develop communication skills, confidence, and cohesion. Staff become local experts with deep knowledge of how their microsystem works and where it doesn’t. They learn how to build and sustain systems that deliver the results their patients expect. Use improvement efforts to develop your future leaders.

Creating Momentum as You Use Your System

Jim Collins describes the flywheel effect: early effort requires force, but each successful rotation builds momentum. When people improve their core work and see measurable impact, they build capability and pride. The more they improve, the more they want to improve. Developing the foundations was hard work. Now comes the real payoff.

“Two important surprises: I didn’t anticipate culture and momentum, but they turned out to be the two most important results of implementing our system,” reflects Joe Penner, a recently retired healthcare executive, on his experience pursuing quality as a strategy.

Accelerating means designing systems that enable this momentum and putting them to use. Give teams agency, connect their work to strategy, and measure what matters. Apply discipline, foster learning, and test changes to make your approach stronger with each cycle. As your organization gets better at getting better, energy builds—and performance follows. This is where strategy meets execution—where improvement becomes how your organization runs.

What Comes Next?

If this sounds like where your organization is now, you’re not alone. Many leaders find themselves here—strong start, strong intention, but unsure how to take the next step.

Start by revisiting your QOS Assessment. Where are you gaining traction? Where are you stalled? Then focus your efforts on accelerating improvement—results, leadership, teamwork, and spread.

You’ve done the hard work of building foundations. Now comes the real payoff: designing systems that create momentum, where each success builds capability for the next. The question isn’t whether to accelerate—it’s how deliberately you’ll design the path forward.

–

David M. Williams, Ph.D. works with leaders and improvement teams to learn and apply Improvement Science to achieve results and adopt quality as a strategy, He is coauthor of Quality as an Organizational Strategy and The QOS Field Guide