Why It Matters
The quotation, “Every system is perfectly designed to get the results it gets,” has been popularized in the health care improvement world, yet most don’t know to whom the quote should be attributed.
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Like Magic? (“Every system is perfectly designed…”)

By Kimberly Mitchell | Friday, August 21, 2015

Earl Conway and Paul Batalden, IHI Senior Fellow and Founding Chair of the IHI Board of Directors, clarify the origins of the quotation, “Every system is perfectly designed to get the results it gets.”


The poet William Stafford describes the way that words sometimes seem like magic to come together and live together. In some ways, his simile — “like magic” — remains true about “Every system is perfectly designed to get the results it gets” as noted in the Editor’s Notebook column ["A Quotation with a Life of Its Own" written by Susan Carr] in the July/August 2008 issue of Patient Safety & Quality Healthcare. We write today to offer some additional context.

We worked together as co-chairmen of the US Quality Council of the Conference Board in the 1970s.  While together, we learned that both of us had been tremendously influenced by the thought and practice of Dr. W. Edwards Deming. His invitation to think in terms of results generated by systems within which we all work were deeply important to us then — and now. His teachings build on the Theory of Variation and the need to redesign (i.e., improve) the system to narrow variation as the principal cause of error.

Earl had the benefit of knowing and working with David Hanna at Procter and Gamble. Hanna, a student of organization development and expert who eventually put his thoughts together in a book, Designing Organizations for High Performance, as part of the Addison-Wesley [now Prentice Hall] OD series of volumes. He shared with Earl (and in his book, p. 36) the insight of his P&G colleague from the UK, Arthur Jones: “All organizations are perfectly designed to get the results they get!” Earl brought that insight to the attention of the US Quality Council in one of our meetings.

As Paul thought about the profound truth of that insight and of its use for work with health professionals, some of whom were less interested in “organizations” than in “systems,” Paul created a corollary to the Jones words: “Every system is perfectly designed to get the results it gets” and has shared the words with many others.

We write to share our joy in bringing these additional words of context to others — but in some ways still appreciating the poet’s insight that words come together and live together in what seems — at some level — to be “magic.”

This content originally appeared on the Patient Safety & Quality Healthcare blog on August 3, 2015, and is reposted with permission.

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