Effectiveness in Quality Management: Trend Shift or Timeless Strategy?

The ISO 9001:2015 standard and the concept of holistic quality management emphasize entrepreneurial thinking through principles such as structuring and managing an organization, customer focus, and continuous improvement.
In practice, however, the discipline often finds itself trapped in certificates, audits, and internal evidence — leading to excessive bureaucracy. This is reflected in statements from company representatives:

• “We have 36 management manuals.”
• “All documents printed out and stored in folders fill 10 rooms in our company.”
• “We call our colleague ‘Mr. Resubmission’ because he reminds everyone to update documents.”

Experts rightly criticize this phenomenon as a high “theatre quota” with little actual impact. The theatre quota refers to the share of a company’s resources spent maintaining appearances or processes that add no real customer value.
This disconnect between intention and bureaucratic reality is fueling a growing debate about the future of quality management — aptly summarized by Rudolf A. Müller in his LinkedIn post “Where do we go from here?” The core “why” of quality management is increasingly being questioned — and in many companies, clear answers remain elusive.

1. Efficiency vs. Effectiveness

The ongoing debate — whether to abolish quality management or continue as before — reflects a deeper goal dilemma within the field. Yes, QM is needed for certifications and market access. But does managing excessive documentation and theatre really add value internally?

More and more executives are asking: “We need to be more efficient — in both maintaining and managing our documents — and we also need to be more effective.”

However, a push for efficiency alone, aimed at reducing the theatre quota, won’t resolve the problem. Chasing efficiency — doing things right and at low cost — won't achieve greater customer focus or stronger leadership. What’s really needed is a discussion about effectiveness and the broader goals QM should serve.

As Carsten Behrens highlights in his article “How to Become an Effective and Valued Quality Manager”, many companies lack clear goals or incentive systems for quality managers. This lack of direction is reflected in poor perception and acceptance of QM across organizations.

2. Searching for New Goals and Perspectives

While often seen as dry or dull, quality management actually holds tremendous entrepreneurial potential — if its principles are applied properly.
ISO 9001:2015 lays out five foundational principles:

• Customer orientation
• Involvement of people
• Process orientation
• Continuous improvement
• Evidence-based decision-making

These aren’t just buzzwords — they’re the essence of effective business management. Every CEO would recognize these as vital goals. And yet, the true aim of quality management is too often reduced to certificates on the wall and inflated theatre quotas.

Quality Management as a Strategic Differentiator

Let’s look at a practical example that brings these abstract ideas to life. Thomas Müller, a Swiss dentist and managing director, is actively improving the processes in his group dental practice. In a recent conversation, he shared how quality management has become a core business tool for him. Just a few years ago, only Swiss-trained dentists were allowed to practice in Switzerland. But after opening its professional borders, Switzerland saw the number of dentists nearly double — with many coming from Germany, Austria, France, and Italy. The number of patients remained the same, resulting in increased competition and downward price pressure.

So how does a Swiss dentist reposition himself in such a market?

• How can services be delivered more efficiently and with higher quality?
• What competitive advantage keeps patients loyal and attracts new ones?

Thomas turned to quality management for the answer. Together with his team, he focused on three key principles from the standard:

• Mapping processes and creating transparency
• Patient orientation
• Continuous improvement — how can we deliver a better patient experience?

Initially, his organization was bogged down in documents and ineffective systems. The day-to-day reality simply didn’t match the formal processes on paper. But by decentralizing process knowledge and actively involving the team in process design, his team was able to bridge that gap. The result? A highly practical and well-integrated system that delivers real value. Processes are relevant, up to date, and reflect what really happens in the practice.

The impact was clear:

• A personal greeting and escort to the waiting area
• Maximum wait time under 5 minutes
• Open waiting area with visibility into sterilization workflows
• State-of-the-art equipment — including AI diagnostics and 3D-printed implants

Despite fierce competition and price pressure, the practice delivers consistently high quality. Patients return — and recommend the clinic to others. The management system became a tool for market positioning — and a strategic advantage.

A Change in Perspective: Saving Quality Management?

The takeaway from this and similar cases is clear: a new perspective on quality management dramatically boosts effectiveness. Returning to the core principles of the standard may well be the key to rescuing QM from bureaucratic decline.

The current debate demands a critical reexamination of goals — and perhaps a fresh alignment of priorities. A shift in perspective is both necessary and possible. It offers a pathway to making quality management more entrepreneurial and achieving real business impact.