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The decision in 2015 by the stewards of ISO 9001 to create Quality Management Principles that include engagement is supported by both researchers and workplace observers who have observed ISO standard compliance in action. A study of ISO compliance by professors at the Western Michigan University School of Engineering and a report in the publication Medical Laboratory Observer both found engagement to be a critical determinant of success.
“Based on the literature on employee engagement, survey and anecdotal data, there will likely be a low level of participation by the lowest level employees in nominally mandated quality system improvement,” wrote Bryan Booker and Walter Tucker of the School of Engineering Technology at Eastern Michigan University in a paper entitled, “Lowest Level Employee in Employee Engagement in Quality System Compliance: Audits, and Improvement.” They found that “Quality systems audits can significantly affect employee engagement by improving the meaningfulness of the work and communicating the importance of the audit-related roles and responsibilities. The engagement factor coding summary suggested that the level of employee engagement, related to quality system compliance, may be more strongly associated with the factors of meaningfulness of the work and communication.” This would suggest that compliance efforts should involve an ongoing employee engagement process requiring sound leadership, communications, training, innovation, rewards and recognition, analytics and feedback.
The authors also found, perhaps ironically, that top management engagement is equally necessary. In other words, the C-suite should demonstrate its commitment to the process on an ongoing basis. “Based on the literature, anecdotal and survey results, this study suggests some remedies. Strategies to increase participation in mandated continuous improvement include: Publicly obvious and continuous support from executive managers and the modeling of continuous improvement behaviors by all decision makers; policies extolling the cost-benefits of continuous improvement beyond mere compliance to external quality standards; deliberately funded and appropriately staffed units to elicit and respond to suggestions for improvement; some form of …ways to develop and communicate a few focused annual priorities for improvement; development of appropriate incentive systems including extrinsic and intrinsic rewards at all levels; and the application of lean principles and practices that both require and rely on employee involvement.”
The authors concluded, “When the 1980s-quality movement began, there were many claims about the benefits of employee involvement. Quality standards such as ISO 9000 include requirements for team-based problem-solving, knowledge and awareness of quality systems among all employees, and continuous improvement as part of the audit requirements. However, there is little current evidence that the expected improvement potential has been realized.”
This study suggests organizations can do a lot more to tap the power of engagement at the front lines, and that starts at the top. The authors call for a more systematic approach to the application of engagement to achieve maximum achievable results.
Engagement applies to other ISO standards as well. Writing about ISO 15189:2007 standards on medical laboratory management, author Lisa M. Walters, PhD, MBA, wrote in the publication Medical Laboratory Observer, “Quality is everyone’s responsibility, but organizations with quality-management systems (QMS) still tend to surrender all quality issues to one department, even while QMS is expected to engage all staff members within the day-to-day work of the organization toward that higher quality goal.”
ISO 15189:2007 governs requirements for quality and competence in the medical laboratory. According to Walters’ article, the standards are sustained by the creation and continual improvement of policies, procedures and protocols. “To be robust, this framework must be consistently implemented by the lab’s most critical resource: humans. And therein lies the problem. People, by nature, exhibit a great deal of variation. As a result, a whole bunch of folks are difficult to control. Thus, it is easier to put the process into the reins of a limited number of hands – like one department or one person.”
Unfortunately, she writes, “limited control usually means limited knowledge, as information that may be vital to the process might be lost or disregarded by those that are not part of the ‘Q club.’ You want staff members to fully implement ISO 15189 on their own, without the signage reading, ‘Not my job; take it to the quality department.’ How can you get everyone on board with ISO 15189? QMS structure requires implementation, and that implementation requires engagement.”
Walters goes on to write: “Engagement is more than work satisfaction or loyalty. Engagement is passion and commitment, a willingness to go beyond the day-to-day by investing oneself and one's discretionary effort to help the employer succeed. This sounds a bit like an engagement of the heart, does it not? It helps to think that you do not marry someone just because you are satisfied with him or her; you marry when you are willing to invest your time, energy and self into another’s goals. When you think of it that way, engagement is even more than commitment, because engagement is more action-oriented, resultant from passion. By understanding the role of engagement in organizational initiatives, not only will ISO 15189 elevate the lab to a new level of quality, but everyone just may want to be a part of it.”
The author believes that engagement can be thought of in terms of trait engagement, state engagement and behavioral engagement.
Trait engagement is part of you like a proactive personality. Trait engagement is an antecedent of state engagement, which represents the psychological state of engagement, manifested as energy or absorption in work. The result of state engagement is behavioral engagement, and that is really where the rubber meets the road. Behavioral engagement is the discretionary work performed; it is the work we would like to see staff undertake as part of QMS implementation.
According to Walters, “critical to these dimensions of engagement are work attributes, leadership and trust. Work attributes include challenging and important work, and work autonomy. Transformational leadership is visionary, challenging people to achieve the exceptional. It inspires, and it provides clear expectations, fairness, recognition of exceptional behavior and realization of existing staff competencies.”
She also asserts that “Trust is a fragile but necessary component. Lack of trust equals no engagement, and no sustainable ISO 15189.The primary responsibility of building trust is on management. Trust means openness, honesty, two-way communication, willingness, to be influenced and willingness to change if necessary. Trust encourages self-control, as opposed to control through direct supervision.”
Prior to beginning accreditation processes, she urges people to “explore how engaged you really are. Consultants may advise you to gap the lab to ISO 15189 to begin the accreditation process. Instead, try to first analyze the engagement gap. By identifying gaps and then improving those engagement conditions, there is a better chance of successfully deploying and sustaining not only ISO 15189 but other initiatives as well. By understanding the role of engagement in organizational initiatives, not only will ISO 15189 elevate the lab to a new level of quality, but also everyone just may want to be a part of it.”
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