When you drive your car you can avoid being given a ticket for speeding by checking your speedometer and taking your foot off the gas pedal if needed, maybe even touching the brake. You can also be distracted and not look at the speedometer. The mere presence of the speedometer will not guarantee that you do not get a ticket for speeding.
You could even have someone in the back seat (or passenger seat) watching the speedometer and nagging you that you are going too fast and still choose to ignore them.
You can have Required Organizations Practices (or ROPs), Accreditation or Certification Surveys, Quality Committees and regulatory reports, and an annually revised Quality Improvement Plan, but none of these will guarantee regulatory compliance any more than a speedometer because, ultimately, it’s up to the driver.
Who is the driver in your organization? That’s a trick question, isn’t it, because it is not usually one person but a team of key decision makers and influencers, some from the Board of Directors, others from the Board of Management, and probably others as well, like staff who have the respect of their peers when they speak. This group of people, if they are working together as a team, are the influencers with the power to create and nurture a culture of quality in an organization, but only PROVIDED they keep an eye on the dashboard and, as a team, respond appropriately with the pedals.
The question is, are the process owners and managers sufficiently mandated and empowered, trained and resourced, and held accountable to take the actions necessary to enhance the quality management system and foster a culture of quality to prevent the bad stuff happening?