The methods and tools you learned from the text are very useful in developing and implementing a strategic plan. Almost all organizations using this methodology should achieve some success. However, I believe to achieve full or a higher level of success, leadership must first build a strong internal environment within the organization. The goal is to create a positive environment that is adaptable to change. Leadership has to build trust with the employees, focus the employees on caring for the patient ( if in a direct care environment) or the customer. I believe you must have an organization that will provide an environment for every employee to be successful and feel proud in their job duties and accomplishments. I also believe that leadership must institute an environment of continuous quality improvement in both clinical processes and administrative processes. The Deming methodology is proven and works. There are many spinoffs from Deming. 6 sigma, the toyota way, etc. but they all really use the Deming PDCA model. You have to have a constant focus for CQI to become ingrained in the organization. But even with CQI the creation of a positive work environment is the foundation for greater success