Quality and a Just Culture

It is fascinating that for all the discussion around quality culture, which borrows from Safety II and other safety movements/submovements, we’ve largely avoided using the term justice, which is so prevalent in certain areas of the safety world. One can replace quality with justice and talk about many of the same things.

Both attempt to realize Deming’s Point 8—to drive out fear—which I consider Deming’s most radical proposition.

We really should see them as building blocks. A just culture enables the open reporting and analysis of errors necessary for a quality culture to identify areas for improvement. The two cultures are complementary—a robust quality program requires psychological safety fostered by a just culture. However, a quality culture has broader aims beyond responding to errors or safety lapses. We cannot have a Quality Culture without a Just Culture.

Psychological safety creates an environment where staff can speak up, enabling a just culture. A just culture defines the balanced accountability approach for responding to errors and safety events. A quality culture is a broader concept that drives improvement across the organization, relying on the foundation of a just culture.

But I really wish we used the term justice more. Promoting justice is an activity I wish we took more seriously as a profession.

Utilizing the Nadler-Tushman Model for Culture of Quality Initiatives

The Nadler-Tushman Congruence model is a diagnostic tool developed by organizational theorists David A. Nadler and Michael L. Tushman in the early 1980s. It analyzes and identifies the root causes of performance issues within an organization and can be a helpful model for diagnosing and improving a culture of quality.

Nadler-Tushman Congruence Framework

The Nadler-Tushman Congruence model is based on several assumptions that are common to modern organizational diagnostic models:

  • Organizations are open social systems within a larger environment.
  • Organizations are dynamic entities (i.e., change is possible and occurs).
  • Organizational behavior occurs at the individual, group, and systems level.
  • Interactions occur between the individual, group, and systems levels of organizational behavior

The model is based on the premise that an organization can achieve high performance when four key elements – work, people, structure, and culture – are aligned or congruent with each other. These elements are defined as:

Work

This refers to the core tasks and activities that the organization performs to achieve its goals. It includes the processes, workflows, and the skills/knowledge required to carry out the work effectively.

People

This element focuses on the individuals within the organization, their skills, knowledge, personalities, work styles, and how well they fit with the work requirements.

Structure

This encompasses the formal aspects of the organization, such as its hierarchy, reporting lines, policies, procedures, and systems that govern how work gets done.

Culture

This includes the shared values, beliefs, behaviors, and norms that shape how people interact and work together within the organization. The basic premise is that when these four elements are well-aligned and congruent, the organization operates smoothly and performs at a high level. However, a misalignment or incongruence among these elements can lead to friction, inefficiencies, and poor organizational performance.

Use

The Nadler-Tushman Congruence model can be effectively used for root cause analysis of organizational performance issues by following these steps:

  1. Identify the symptoms or performance gaps within the organization, such as low productivity, high employee turnover, quality issues, etc.
  2. Analyze the four key elements of the model – work, people, structure, and culture – to understand their current state within the organization.
  3. Assess the level of congruence or alignment among these four elements by examining their interactions in pairs:
  • Work and people: Do employees have the right skills/knowledge for the work? Is the work meaningful to them?
  • Work and structure: Does the organizational structure support efficient work processes?
  • Structure and people: Does the structure enable or hinder employee engagement/motivation?
  • People and culture: Are employee values/behaviors aligned with the organizational culture?
  • Culture and work: Does the culture facilitate or impede effective work practices?
  • Structure and culture: Is there harmony or conflict between the structure and cultural norms?
  1. Identify areas of incongruence or misalignment among these elements that could be the root causes of the performance issues. For example, a misalignment between people’s skills and work requirements or between an innovative culture and a rigid hierarchical structure.
  2. Conduct a root cause analysis by further investigating the specific reasons behind the identified incongruences using techniques like fishbone diagrams or Why-Why analysis.
  3. Develop an action plan to address the root causes by realigning the incongruent elements. This may involve changes to work processes, training programs, organizational policies, cultural initiatives, etc.

The key strength of the Nadler-Tushman model is its ability to provide a comprehensive framework for diagnosing performance problems by examining the interactions among the critical organizational elements. This systemic approach helps uncover root causes that may be overlooked in a siloed analysis of individual elements.

The Means Justify the Ends

A central premise of the Quality mindset is that the means justify the ends and that how we work produces a better result.

At its core, a Quality mindset values the journey as much as the destination. It’s an understanding that the path taken to achieve results is integral to the quality of those results. This mindset shifts the focus from merely meeting targets to how those targets are met, emphasizing continuous improvement, attention to detail, and a commitment to excellence at every step of the process.

The Means Define the Culture

One of the most profound impacts of adopting a Quality mindset is on organizational culture. When a company prioritizes the means as much as the ends, it fosters a culture of integrity, responsibility, and continuous learning. Employees are encouraged to take ownership of their work, innovate, and find better ways to achieve objectives. This enhances the quality of work and boosts morale and engagement among team members.

Process Improvement as a Habit

Incorporating a Quality mindset means viewing process improvement as not a one-time initiative but an ongoing habit. It’s about making small, continuous adjustments that cumulatively lead to significant improvements.

Building Resilience through Quality

Another critical aspect of the Quality mindset is its role in building organizational resilience. Companies can create flexible and robust processes that withstand external pressures and disruptions by concentrating on the means. This resilience is crucial in today’s fast-paced and ever-changing business environment, where adaptability and agility are key to survival and success.

The Role of Leadership

Leadership plays a pivotal role in cultivating a Quality mindset within an organization. Leaders must set the tone by demonstrating a commitment to quality in their actions and decisions. They should encourage open communication, foster a culture of feedback and learning, and recognize and reward quality improvements. By leading by example, leaders can inspire their teams to adopt a Quality mindset and contribute to a culture of excellence.

Conclusion

Adopting a Quality mindset is a strategic choice that can lead to superior outcomes for organizations. By focusing on the means—how work is done—companies can improve processes, foster a positive culture, build resilience, and ultimately achieve higher-quality results. Embedding this mindset into the fabric of the company’s operations requires a commitment from all levels of the organization, especially leadership. In the end, a Quality mindset is not just about achieving better results; it’s about building a better organization.

ISO 9000 and 10000 Series and Quality Culture

At the SQA’s Quality College, I presented a workshop on Quality Culture. In interests of time, I glossed over the ISOs and wanted to come back and treat them in more detail.

ISO 9000 is a set of international standards on quality management and quality assurance developed to help companies effectively document the quality system elements needed to maintain an efficient quality system. Designed to be general in approach, they are not specific to any one industry and can be applied to organizations of any size.

There are some 25 series 9000 standards, with the core for this topic being:

  • ISO 9000 Quality management systems -Fundamentals and vocabulary
  • ISO 9001 Quality management systems – Requirements
  • ISO 9004 Managing for the sustained success of an organization – A quality management approach

The ISO 10000 series supports standards in the ISO 9000 series with more specific guidelines, there are several here relevant to the question of Quality Culture:

  • ISO 10010 Quality management — Guidance to understand, evaluate and improve organizational quality culture
  • ISO 10015 Quality Management – Guidelines for competence management and people development Training
  • ISO 10018 Quality Management – Guidelines on People Involvement and Competence

Where I am at

I recently joined Just Evotec Biologics as the Senior Director of Global Quality Engineering and Validation. For a variety of reasons (just look at my past company on my LinkedIn bio and search the news to find one) it was a good time to move. I had decided that I wanted a position that was tied to an innovative manufacturing company and was deep in domain expertise. The combination of Just Evotec Biologics innovative technology aims and the ability to deep dive into one of my favorite topics was just too much to resist. Add to it the opportunity to work with a leader I deeply respected again and well, here I am. And feeling very good about it.

When I first started I met with the team and laid out my 30-60-90 day goals.

As well as talking a little about how I operate.

A big chunk of my time has been getting the lay-of-the-land institutionally. Setting some standards, doing gap assessments, figuring out what-is-what, and getting to know all my partners and stakeholders. For reasons of confidentiality, this post won’t be going deep on that.

What I do want to talk about is our team values and ways of working. I’ve been focused heavily on three areas with the team:

  1. Team Values
  2. Team Decision Making
  3. Team Competencies

Team Values

We did a few workshops where we identified a set of values:

  1. Leader to Team: How I expect the team to perform
  2. Team to Leader: How the Team expects me to perform
  3. Team to Team: How we expect each other to perform

This exercise really helped me understand what was going on within the team and through it I really started to understand some priorities.

For each of these, we created a Value Statement. Here are some examples.

Value: United Front

Definition: Decisions are made and recorded honestly and transparently. Employees understand decisions and how to execute them. The entire team represents the decisions made, and the decision-making process with one voice. 

Desired Behaviors:

  1. I hold myself accountable for representing the decisions made by the team.
  2. I work to anticipate and fend off the possibility of failures occurring.
  3. I engage with decision making and respect the decisions that result.

Value: Open to Change

Definition: Willingness to listen to the team.  Actively looking for feedback and input from the team before making decisions that impact the team.  Open to changing established ways and revisiting previously made decisions.  

Desired Behaviors:

  1. I will be transparent with decision-making.
  2. I will create an environment where new ideas are welcome and challenging ideas are encouraged.
  3. I will include the team in decision-making where applicable.
  4. I will actively seek out individual and group feedback to enable continuous improvements.

Value: Learning Culture

Definition: Share lessons learned from projects so team can grow together and remain aligned.  Engage in knowledge-sharing sessions.

Desired Behaviors:

  1. I will share lessons learned from each project with the wider QEV team via teams channel &/or weekly team meetings.
  2. I will encourage team members to openly share their experiences, successes, and challenges without fear of judgement.
  3. I will update RAID log with decisions made by the team.
  4. I will identify possible process improvements and update the process improvement tracker 

Team Decision Making

Currently working with the team to define decision-making, introducing the RAPID model and working on a matrix of decisions.

Team Competencies

Starting with technical skills we are defining our core competencies. Next, we will tackle, with the larger quality organization, the soft skill side of the equation. This is definitely a work in progress.

Skill Area

Key Aspects

Proficiency Levels

 

Beginner

Intermediate

Advanced

Expert

General CQV Principles

       Modern process validation and guidance 

       Validation design and how to reduce variability

       Able to review a basic protocol

       Able to review/approve Validation document deliverables.

       Understands the importance of a well-defined URS.

       Able to be QEV lead in a small project

       Able to answer questions and guide others in QEV

       Participates in process improvement

       Able to review and approve RTM/SRs

       Able to be QEV lead in a large project project

       Trains and mentors others in QEV

       Leads process improvement initiatives

       Able to provide Quality oversight on the creation of Validation Plans for complex systems and/or projects

       Sets overall CQV strategy

       Recognized as an expert outside of JEB

Facilities and Utilities

       Oversee Facilities, HVAC and Controlled Environments

       Pharma Water and WFI

       Pure Steam, Compressed Air, Medical Gases

       Understands the principles and GMP requirements

       Applies the principles, activities, and deliverables that constitute an efficient and acceptable approach to demonstrating facility fitness-for-use/qualification

       Guide the Design to Qualification Process for new facilities/utilities or the expansion of existing facilities/utilities

       Able to establish best practices

Systems and Equipment

       Equipment, including Lab equipment

       Understands the principles and GMP requirements

       Principles, activities, and deliverables that constitute an efficient and acceptable approach to demonstrating equipment fitness-for-use/qualification

       Able to provide overall strategy for large projects

       Able to be QEV lead on complex systems and equipment.

       Able to establish best practices

Computer Systems and Data Integrity

       Computer lifecycle, including validation

       Understands the principles and GMP requirements

       Able to review CSV documents

       Apply GAMP5 risk based approach

       Day-to-day quality oversight

       Able to provide overall strategy for a risk based GAMP5 approach to computer system quality

       Able to establish best practices

Asset Lifecycle

       Quality oversight and decision making in the lifecycle asset lifecycle: Plan, acquire, use, maintain, and dispose of assets 

       Can use CMMS to look up Calibrations, Cal schedules and PM schedules

       Quality oversight of asset lifecycle decisions

       Able to provide oversight on Cal/PM frequency

       Able to assess impact to validated state for corrective WO’s.

       Able to establish asset lifecycle for new equipment classes

       Establish risk-based PM for new asset classes

       Establish asset lifecycle approach

Quality Systems

       SOP/WI and other GxP Documents

       Deviation

       Change Control

       Able to use the eQMS

       Deviation reviewer (minor/major)

       Change Control approver

       Document author/approver

       Deviation reviewer (critical)

       Manage umbrella/Parent changes

       Able to set strategic direction

Cleaning, Sanitization and Sterilization Validation

       Evaluate and execute cleaning practices, limit calculations, scientific rationales, and validation documents 

       Manage the challenges of multi-product facilities in the establishment of limits, determination of validation strategies, and maintaining the validated state

       Differentiate the requirements for cleaning and sterilization validation when using manual, semi-automatic, and automatic cleaning technologies

       Review protocols

       Identify and characterize potential residues including product, processing aids, cleaning agents, and adventitious agents

       Understand Sterilization principles and requirements 

       Create, review and approve scientifically sound rationales, validation protocols, and reports

       Manage and remediate the pitfalls inherent in cleaning after the production of biopharmaceutical and pharmaceutical products

       Define cleaning/sterilization validation strategy to meet GMP requirements

Quality Risk Management

       Apply QRM principles according to Q9

       Participate in a risk assessment

       Determine appropriate tools

       Establish risk-based decision-making tools

       Set risk-based approaches

       Define risk management program for CQV activities

 

I’d love feedback on this.

My Overall Philosophy

I’ve been focusing on five key tasks as a leader in this organization:

  1. How I build and gain agreement
  2. Grow the Team
  3. Results and Learning
  4. Deliberate Presence
  5. Prioritizing the Right Relationship

Still a lot to do but I am having a blast.