1. Journey to Perfect: Mayo Clinic and the Path to Quality A discussion of new content in the ASQ Knowledge Center asq.org/knowledge-center
This is the first in a new series of local Section meetings offered with assistance from the ASQ Knowledge Center. Find more information and resources here:
The purpose is to involve local Sections in discussions occurring across the Society on key topics in quality.
In case you don’t often check in with the ASQ website, the presentation will also point you to some of the content benefits you have access to with your membership through the Knowledge Center.
The Knowledge Center is designed to be your front door to ASQ publications and other content resources. It contains editors picks that focus on new content, links to topics and types of publications, and a search function that allows you to search all ASQ publications by keyword.
If you have questions or would like assistance before delivering this presentation, contact ASQ Knowledge Center editor Noel Wilson at x7304 or
Thank you for delivering the key messages in this case study to your members!

2. Agenda Key concepts from Mayo Clinic case study
Video clip: Mayo’s value creation system
Discussion
Open networking
The agenda is designed based on a 1- to 2-hour meeting that ends in discussion which should ideally lead to open networking.
If you expect members to read the case study and view the entire video before attending your meeting, you may wish to eliminate some of the slides summarizing the case study.
If you expect most members to be unfamiliar with the case study materials, you may wish to eliminate one or two of the conversation starter slides for discussion.
The recommended video clip that is embedded in this presentation is about 13 minutes long.

3. Access Mayo case study components
asq.org/knowledge-center/
case-studies-mayo-clinic.html
Here is a screenshot of the Mayo case study homepage:
Case study includes PDF article download, video, webcast, and more.
All files are open access, so others in your organization will be able to read and view them.
The case study is part of the Next Generation Quality Leadership series. More case studies like this are in planning and development, with Corning being the next to publish.

4. High-level summary History of Mayo's quality journey
Development of Mayo quality culture: how leaders drove systemwide transformation
Mayo’s approach: a blend of continuous improvement, Toyota total productive maintenance, Baldrige Criteria, Six Sigma, lean
How Mayo prepares the next generation of leaders in healthcare quality
Within the written case study, you will find information on:
- History of Mayo's quality journey
- Development of Mayo quality culture: how leaders drove system-wide transformation
- Mayo’s approach: a blend of continuous improvement, Toyota total productive maintenance, Baldrige Criteria, Six Sigma, lean
- How Mayo prepares the next generation of leaders in healthcare quality, through the Mayo Quality Academy

5. Mayo’s results Safer healthcare
Care that is less expensive than U.S. average
5 to 1 return on investment in quality
Standardized processes that achieve near perfect outcomes (hand hygiene, administration of Warfarin, and Medicare reimbursement for joint replacements)
The case study also details results Mayo has achieved, as listed here.

6. Quality deployment at Mayo
Mayo achieved results through its value creation system, which it calls the Quality Construct.
Mayo developed the Quality Construct to illustrate how the three components of infrastructure—culture, engineering, and execution—align with its vision to provide the best care to every patient, every day, through integrated clinical practice, education, and research.
Culture is key to standardization and transparency and to ensuring that the most accurate data are collected for measurement.
Engineering was already a focus, as the organization had employed systems engineers since the 1940s. The Quality Construct spread engineering principles across all functions and taught staff to identify process flow, eliminate waste, and use duplication and measurement controls. Each improvement team is assigned an engineer to help. This approach diffused knowledge across all disciplines of the organization.
Execution, reliably doing things right every time to achieve the best outcomes, is key to the value of healthcare under the construct.

7. For a closer look at the infrastructure pillar of the construct, show a video clip of James A. Dilling, Mayo’s chief administrative officer for quality.
The clip runs almost 13 minutes and is available at:
Full video is available at
And on YouTube at:
The infrastructure clip runs from 22:13 to 35:04 in the original video.
Dilling discusses four challenges Mayo is still addressing related to infrastructure:
- Decision-making
- Measurement
- Education
- Diffusion
If time permits, or if you would like to run a longer video, you may wish to begin with the segment by Stephen Swenson, MD, chief quality officer at Mayo. The clip featuring Swenson runs from 8:32 to 22:04 and focuses on the culture, engineering, and execution pillars of the construct. Swenson concludes by introducing Dilling.

8. Conversation starter—Mayo Quality Construct
Discuss the significance of the four pillars of the Mayo Quality Construct:
- Culture - Execution
Engineering - Infrastructure
What role do the four pillars play in “making the right thing to do, the easy thing to do?”
For this conversation starter, you may wish to return to slide 6, the figure that demonstrates the Quality Construct. Speaker notes for slide 6 are derived from the online print case study (

9. Conversation starter—infrastructure
Discuss the four infrastructure challenges James Dilling outlines:
- Decision making - Education
- Measurement - Diffusion
What lessons can be found in Mayo’s progress with these challenges?
What best practices can other industries offer Mayo and healthcare? (What advice would you give Mayo engineers?)
This conversation starter depends heavily on viewing the video of James Dilling.
Decision making – Discuss Mayo’s changes in structure to centralize decision-making and roll out decisions to all hospitals in the system.
Measurement – Discussion possibilities include:
- Importance of actionable measures, difficulties when measures are reported infrequently or data are old.
- Mayo’s global quality index (combo of outcome measures, safety measures, patient satisfaction, all rolled together) and overall complexity of measurement (took Mayo 2 years to get at infection data).
- Importance of establishing ultimate goals as well as practical short-term targets.
Education – Discuss use of simulation to train physicians without harming patients, and the role of the Quality Academy in the transfer of engineers’ knowledge to front-line staff.
Diffusion – Mayo has so far identified and fully implemented 6 best practices, tracking success at all sites.

10. Conversation starter—organizational transformation
How can quality be an effective strategic driver for the transformation of an organization?
How might Mayo’s approach affect your definition of quality or the way you talk about quality?
This conversation starter depends less heavily on specific material in the case study. Encourage participants to broaden the discussion to their own organizations and circumstances.

11. Continue the discussion
Complete post-meeting survey or contact
Recommend organizations for case studies
Recommend topics for your Section meetings
Offer feedback on this meeting or the case study
Get help finding more content that meets your needs
Link to post-meeting survey will be provided in time for meeting or can be sent in a follow-up communication.

12. Keep talking about quality content!
asq.org/knowledge-center
Members can always find more case studies by visiting the Knowledge Center. From any page on the ASQ site, use the main menu bar to navigate to the Knowledge Center. Once in the Knowledge Center, the tabbed menu includes an option for case studies.
For assistance finding ASQ content, contact ASQ librarian Katie Kvien at or Knowledge Center editor Noel Wilson at