Spot the difference: QI and OD

Image by Dmitry Abramov from Pixabay

Last summer, I asked Twitter users, what their views were on the difference between Quality improvement (QI) and Organisational development (OD) is and I followed it up in a blog. I promised I would write another blog about it… so here it is. This blog tries to summarise the responses I got, and incorporates some reflection from me.

Many responses to the question argued there is little tangible difference between OD and QI. For example, some argued that in practice it is hard to see a difference: action research cycles that inform many action learning sets and much reflective practice, also informed Deming when he developed PDCA, and later, PDSA; and that many variants of ‘change’ approaches have the same or connected roots. Other arguments included that both are about change and both are about working with staff to resolve issues, conflicts and problems to improve effectiveness; both seek to change culture and behaviours (eg see Toyota principle respect for people, and use of behavioural routines e.g. Leadership Kata); both have specific tools and practices… eg 5S, mapping, psychometric tests, and both most definitely use measures and measurement instruments; and both are capability development approaches.

Yet, many responses also pointed out differences, such as: differences in ‘who’ can practice OD and QI, and who ‘leads’ it; differences in emphasis on measurement, relationships and action; differences in views of culture and if it is something that can be intentionally changed, or if culture is something that mediates QI or an outcome of QI, or a combination. Some said OD is about change readiness and is strategic and argued that QI is about the tactical application of tool whereas others argued that QI is a strategic approach where is OD is for individual development at the micro level. Some also indicated there were differences in the view of, if a so called ‘good’ culture has to be in place before QI is used for it to be sustained and successful, or if culture is created as part of QI work; and there were differences in views about if ‘QI’ can be learnt through ‘training’ or if practice is ‘the only way’. Some pointed out that perhaps there is a different audience – staff for OD and ‘the customer’ (service user, patient, citizen etc.) for QI; and that different groups tend to prefer particular approaches, perhaps contraversially, arguing that there are the strong links between the nursing profession and OD and there are growing links between the medical profession and QI. Some responses indicated a view that OD is for people and relationships whereas QI is tools, measures and processes, revisiting longstanding tensions between perceived ‘hard’ (systems) approaches and ‘soft’ (people/culture) (Wilkinson, 1992). Finally, a number of responses said that QI is for efficiency whereas OD for effectiveness. (NB: I personally don’t agree with some of these arguments… especially the last two points).

For me though, a more interesting question might be: why do so many perceive a difference between OD and QI? Some of the responses I received through my twitter question included: professional protectionism; identity and power dynamics; a lack of measurable results from OD; and poorly practiced QI that focuses only on the application of tools with little fidelity to QI approaches, sometimes leading to OD practitioners having to ‘pick up the pieces’. A strong theme was a view that there is a narrow or limited understanding and conceptualisation of QI particularly by observers, (and from my engineering colleagues, a view that when observing lean / six sigma / theory of constraints etc. being used in manufacturing in practice, many have stereotyped engineers and just assumed only mechanical tools were being ‘practiced’, failing to notice the socio-technical approaches being applied ‘in full’). Finally, I wonder if to some extent the long term ‘split’ between so called ‘soft’ and ‘hard’ approaches to change underpins many of these views; and for some a continued lingering (and imho false) perception that many QI approaches are Taylorism reinvented, taking little account of more humanistic approaches.

A friend of mine, an OD practitioner, wondered if the difference was that QI was more specific than OD. That is, she wondered if QI is OD with a purpose… with language generated through different professional paradigms and there is strength from a combination of approaches that benefits patient care. At least, that was the only main difference she could spot, from her lens anyway.

What do you think? Can you spot the difference?

Please also note, I am most certainly not an expert here, and I haven’t read very much research in this area, particularly for OD. This is just a blog, I’m thinking this through, using the blog as a way of doing that.

Refs: Wilkinson, A. (1992) The other side of quality: soft issues and the human resource dimensions, Total Quality Management, 3: 323-9.



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