Building of profound knowledge

Health systems are complex. Understanding the interrelationship among the four components of W. Edwards Deming's System of Profound Knowledge (theories of systems, theory of knowledge, understanding variation, and psychology of change) allows us to begin the work of quality improvement. Each system is perfectly designed to deliver the results it produces. One must gain knowledge of the system through small tests of change (Plan-Do-Study-Act Cycles). We also need to understand and prevent undesirable variation and encourage desirable variation. Leaders must understand the motivations of people and their behavior and provide the appropriate skills training for people to change and succeed. All four components of Deming's System of Profound Knowledge are necessary for the quality improvement work that will enhance the health care delivery system.