DEMING MEETS BRAVERMAN - TOWARD A PROGRESSIVE ANALYSIS OF THE CONTINUOUS QUALITY IMPROVEMENT PARADIGM

The continuous quality improvement (CQI) model has rapidly become the dominant management paradigm in U.S. industrial and health care leader ship circles. Despite its widespread corporate acceptance and its rele vance to public sector policy issues, there has been a paucity of prog ressive analysis of CQI. The authors begin by noting remarkable simila rities between CQI critiques of Taylorism (so-called scientific manage ment of work) with those made by Braverman, a leading Marxist analyst of the work process. Each of the 14 principles of CQI pioneer W. E. De ming are explained and analyzed for their progressive content. These p luses are then contrasted with 18 problematic issues in an attempt to challenge and go beyond the constraints of CQI as it is currently bein g applied in health care and other sectors. These issues include (1) m ismatch between rhetoric and reality, (2) public sector issues, and (3 ) broader contradictions. The authors emphasize the genuine need for i mproving health care quality and the relevance of CQI for addressing t his need. They challenge progressives to grapple with the profound con tradictions by the CQI paradigm, Inviting a broader dialogue on CQI's meaning for improving the public's health.