QRM Process / QRM Tools

Closing the ‘Inspiration Gap’

Motivating and sustaining quality improvements at scale

By Paul Rutten and Kayvan Kian, McKinsey & Company; and Wolf-Christian Gerstner

Most employees don’t associate “inspiration” with the quality function, but it’s time that they make this connection and perceive quality as an inspiring job. By seeking out inspirational ideas and applying them to develop an attractive vision for quality, leaders can in turn galvanize the rest of the organization to advance to higher levels of performance. A compelling change story can motivate employees to get started, and ongoing inspiration from leaders can help to fuel continuous improvement and a sustained transformation. 

“Inspiration exists, but it has to find you working.”
—Pablo Picasso

Picasso’s advice to artists may seem far removed from the work of the quality organization. Indeed, most employees in the quality function and other areas consider today’s pharma quality environment to be anything but inspiring. Quality employees are frequently perceived as “police officers” who check and control adherence to standards and enforce bureaucratic requirements, or “firefighters” who arrive on the scene to prevent issues from growing into catastrophic events. Quality procedures are seen as overly bureaucratic and too complex, perhaps better suited to meet regulators’ increasing expectations but not to achieve the ultimate goal of improving patients’ lives. These perceptions are a source of frustration for the entire industry because they place quality in a no-win situation.

Most executives are aware of quality’s “inspiration gap” and acknowledge that closing it will require significant effort — but yield great benefits. As a first step to closing the gap, they will need to convince their organizations that inspiration and quality transformation are inextricably linked.

INSPIRATION MOTIVATES AND SUSTAINS TRANSFORMATION
Artists do not have a monopoly on inspiration. In fact, inspiration is the starting point for each change a business organization seeks to make, whether to catch up to the industry average or to improve from “good” to “great.” At companies that are lagging behind their industry peers, inspiring stories of success can open employees’ eyes to the gap between their current performance and best practice and motivate them to start the journey toward greatness. For companies that are on par with their industry peers, inspiration is particularly important for dispelling employees’ complacent beliefs that “everything is good” or “we are doing fine.” Examples of what superior performance looks like can provide a case for action that motivates employees to overcome their complacency and pursue new avenues to success.

Inspiration is the engine that keeps a transformation moving forward by fueling continuous improvement through new energy and ideas. Consider the cautionary example of one pharmaceutical company’s quality transformation that suffered from an “inspiration gap.” The transformation generated great momentum during the initial phase, and executives understood the need to sustain the momentum and improvements. But almost as soon as the program began, they became concerned that the organization would revert to the “old normal” after 9 to 12 months. Employees seemed uninspired about the need for change and doubtful of their own abilities to sustain improvements. Their comments reflected their lack of inspiration: “This quality initiative will go away after one year at most, just like every other major project” or “This quality transformation is just another swing of the pendulum —t he organization will soon swing back from strong quality to business as usual.” To successfully address this “inspiration gap,” the executive team spent significant time and effort to engage and inspire a broad group of executives far beyond the core group working on the transformation or affected by it.

Most pharmacos face similar challenges. How can they overcome them and inspire their entire organization to achieve and sustain higher levels of quality performance?

TURNING INSPIRATION INTO TRANSFORMATION
An organization’s journey from good to great can start with just one executive being inspired and then using that spark as the basis for developing a new vision for quality’s future state and a change story. By spreading ideas to other executives and employees, an executive can mobilize a critical mass to support change. But inspiring others starts with finding your own inspiration. What is the best approach for making this happen?

FINDING INSPIRATION 
Finding improvement ideas that inspire change is actually the easiest step of the process. But we often find that the mindset of leaders is the greatest barrier to finding inspiration. Leaders need to believe that they will find inspiring and helpful examples — they need only to look. And sources for inspiration are not hard to find. Every good manager should continually keep up with internal and external best practices and be on the lookout for fundamentally new ideas.

Internally, managers should seek to understand and build upon the ideas of their peers, management teams, experts and visionary people throughout the organization. In particular, executives should ask the type of positive questions that are often not asked: What is quality’s “golden batch” (with no deviations and meeting all requirements)? How do we achieve quality’s “best day” or “best week” (with our fewest quality issues ever)?

Externally, managers can first look to competitors within the pharma industry for inspiration. Understanding how these competitors advance quality can be best experienced through site visits. Engaging in real discussions with colleagues, consultants and academics can help. Participation in industry benchmarking exercises is another good way to understand what best-in-class means. A benchmarking study will provide relevant insights into a company or site’s quality performance relative to its competitors and highlight the corresponding best practices.

External inspiration can also be found beyond pharma, from other industries that have faced similar challenges or are strong in certain functional or technical areas. For example, some automotive plants have used innovative approaches to foster quality awareness. Executives at one injection-molding plant, for instance, put defective parts on display in the plant’s cafeteria. The “parade of ugly parts” raised awareness of the issues and motivated employees to discuss how to improve quality. Another automotive company sent all employees a package bearing the message, “See who’s responsible for quality.” Employees found a mirror when they opened the package. Other companies post this message next to the restroom mirrors. As another example, nuclear power companies have a mindset of reporting and addressing every near miss — not only incidents that actually occur. They are also very adept at detecting low-likelihood but high-impact events.

USING INSPIRATION TO FORMULATE A FUTURE-STATE VISION 
Managers then face the more difficult task of translating these ideas into an inspiring and bold, yet attainable, vision of what world-class quality could mean for the organization. Although leaders may need to dream to create the vision, they also must structure, articulate and refine their ideas to describe a cohesive future state. The future-state vision should set out specific aspirations for simultaneously raising the quality system’s performance, productivity/cost and speed. Several “champion sites” in McKinsey’s POBOS Quality benchmarking have demonstrated that high aspirations are actually achievable. Beyond these quantitative performance aspirations, the vision should also include qualitative aspirations. Most importantly, the organization could aspire to have both quality and operations personnel perceive quality work as an inspiring and meaningful role in pharma operations.

For example, one site had the vision of “improving quality through participation, empowerment and transparency.” The site involved all relevant stakeholders in daily cross-functional meetings on the shop floor, with quality as a standard agenda item, and strongly embedded quality activities into operators’ roles and responsibilities. The site also implemented an innovative online system through which operators could alert managers to potential quality issues before harm occurred. By allowing operators to link themselves with the potential issues they raised, this system helped to reverse the site’s culture. Operators previously had tried to distance themselves from any issues that occurred to prevent being blamed.

Another site, dedicated to sterile production, developed an inspiring future-state vision to “drive quality and productivity by becoming the leader in plant automation.” To make this vision a reality, the site has made extensive use of automation for several years — including using robots in packaging and quality control (QC) testing, electronic batch records in production and QC labs, and radio-frequency identification (RFID) chips to improve operator compliance. Visitors to the site can see that all employees are inspired by the vision and participate in some type of automation project.

Both of these examples represent unique and deliberate choices to improve a site’s performance and culture so that it could better fulfill its role within the company’s network. In each case, managers were inspired by internal and external ideas and built upon these through extensive discussions with the site leadership to develop their future-state vision.

INSPIRING OTHERS
After managers define an inspiring future state, they must undertake the most challenging task of all — making the future-state vision a reality. This challenge can be even greater if employees believe their organization is “good” and has already been operating at the pharma industry’s average level of performance for several years. In such cases, it can be hard to inspire a critical mass of employees to achieve a more advanced level of performance. A truly bold vision will require mobilizing the organization to address many difficult topics.

In our experience, a sustained set of interventions is essential for gaining an organization’s support for the vision and mobilizing it to take action. Leaders need to develop a road map that will guide the organization’s journey through several phases over one to two years. The road map should be based on a concrete action plan for making the future-state vision a reality.

An action plan by itself does not explain to employees why change is needed or inspire them to actively support the new direction, however. That is why engaging all employees requires accompanying the road map with a compelling change story that draws upon the original inspiration and highlights gaps that the organization seeks to close. This change story should be cascaded throughout the organization, from top to middle management and down to the shop floor. Every leader should apply the “art” of good storytelling by personalizing the message to his or her experience. This not only serves to make the story authentic and tailored to the goals of the leader but also shows a level of personal commitment that does not come across if each leader communicates the identical message. Maintaining consistency between what leaders say and what they actually do is essential, because nothing kills inspiration faster for employees than seeing a disconnect between their leaders’ messages and actions.

Leaders should also apply the “science” of good storytelling by stressing positive outcomes rather than negative consequences. Researchers have found that the prospect of positive outcomes is more effective for motivating behavioral change than threatening negative consequences. For example, well-known research has found that messages emphasizing significant negative consequences are not effective for changing smoking habits. Only 10 percent of smokers “kicked the habit” when they participated in a smoking-cessation program that emphasized the threat of heart attacks. However, among those participating in a program that emphasized the positive effects of smoking cessation (such as the joys of a longer and more pleasurable life) and offered continual reinforcement, up to 70 percent stopped smoking.

BECOMING AN INSPIRING LEADER TO TRANSFORM QUALITY
Beyond a road map and a change story, leadership capabilities are required to master the transformation’s day-to-day, people-related challenges. Even good managers may need to build these leadership capabilities. Managers are skilled at setting challenging goals and giving presentations, but it takes a leader to communicate a compelling change story. Managers conduct business planning, but leaders handle uncertainties. And while managers are skilled at measuring and rewarding performance with financial incentives, leaders master the ability to motivate by creating meaning in people’s jobs. 

Multiyear research has identified five mutually reinforcing capabilities that distinguish inspirational leaders from good managers. These capabilities are meaning, framing, connecting, engaging and energizing (see above exhibit):

1) Meaning. This leadership capability entails finding and communicating personal meaning at work and, in turn, enabling others to tap into their own sources of motivation and purpose. It is important for leaders to think about how to create meaning in an environment such as pharma quality, which is often described as bureaucratic and frequently struggles to attract the best talent. Leaders need to create a vision for a future state in which quality employees and operators perceive their jobs as more meaningful. To do this, they have to change how they communicate quality’s contribution. To understand what this means, consider the story of a man who came upon a construction site where three people were working. He asked each worker, “What are you doing?” The first answered, “I’m laying bricks.” The second answered, “I’m building a wall.” The third worker, who was humming a tune as he worked, stood up and smiled. He said, “I’m building a cathedral.”

Many quality employees believe they are enforcing bureaucratic requirements: the equivalent of “laying bricks.” Imagine how the whole organization, its energy, and its ability to improve would be enhanced if quality employees were to regard their daily work as “building cathedrals”: curing diseases, preventing deaths, avoiding reputation damage and more. Pharmacos can achieve this mindset shift by demonstrating to quality employees that there is a clear link between their work and this higher purpose. They can also highlight the tangible impact of quality on a daily basis, such as by quantifying the impact in terms of lives saved and benefits to families and society.

2) Framing. Leaders must be able to surface and challenge assumptions and approach even the most difficult issues in a way that leads to constructive, creative solutions. The ability to challenge the existing ways of working and create new ones is essential in pharma quality, which is burdened by many “sacred cows” that impede making real improvements to proactively address risks. For example, employees may not challenge whether documentation requirements are effective or may give priority to checks and controls to catch issues rather than embedding quality by designing better systems. Leaders have an opportunity to transform quality by changing the organization’s perspective toward it.

3) Connecting. Leaders proactively build a rich web of internal and external relationships and use it both to support their personal development and to achieve organizational goals. They have the ability to identify the right people to connect with at the right time and can build a coalition to drive change.

4) Engaging. Leaders have confidence to step up and take action in the face of risk and uncertainty. This goes beyond exhorting employees with phrases like “Yes, you can!” or “Just do it.” Truly engaging with employees in a transformation takes a combination of finding the right solutions, making decisions and coaching on personal challenges.

5) Energizing. Transformation leaders need to create the norms and practices required for sustaining momentum and creating resilience within the organization. Systematically investing to build and maintain energy levels is essential for keeping a transformation alive beyond one year.

Although managers can learn how to apply these five capabilities, they need to make a personal investment of time and energy to become a truly inspirational leader — having bright ideas is not enough. McKinsey’s experience supporting more than 600 leadership development programs has revealed a set of changes that typically occur on the leadership journey. These include shifting from being a “victim” of circumstance to a “master” of one’s own experience, from believing that some people never change to recognizing that people have the ability to grow, and from regarding the organization as unreceptive to change to seeing it as a system that can be influenced.

Inspired organizations will find it easier to overcome the burdens that inevitably accompany a fully compliant, regimented quality system. However, the ability to inspire the organization is an underdeveloped skill among quality leaders today. Before they can inspire others, quality and operations executives need to find their own sources of inspiration. They should begin the quest for inspiration today and continually pursue it as a core responsibility of their roles. Leaders who rise to the challenge may find that they have the organization’s most satisfying job description: “Inspiring people to bring quality to their work every day.”