The top three reasons for failure in quality improvement efforts are:

• Lack of executive leadership and sponsorship for quality
• The "middle management black hole"
• The failure to manage the "people side of improvement"

The TEN principles of successful improvement efforts:

1. Obtain executive leadership and sponsorship
2. Organizations must reward process improvement
3. Manage the people side of improvement (e.g., resistance to change)
4. Own your improvement effort
5. Organize for improvement
6. Invest in yourself
7. Achieve measurable results
8. Process quality governs product quality
9. Use a proven approach
10. Achieve revolutionary improvement (rapid, successful, measurable improvement)