Attempts at developing a unifying set of concepts and practices for im
proving quality has been largely ineffective. Because of the wide vari
ety of organizational differences, broadly endorsed applications of qu
ality improvement may be unwise. However, the effect of a clear and bo
ld organization vision, enthusiastically supported by executive manage
ment, is positive and constructive when combined with a good understan
ding of interactive relationships, over time - or systems thinking. Th
is combination of vision and systems thinking may be most promising wh
en it is tied to total quality management applications.