When I think of philosophical elements and structural elements of a continuous quality improvement, I imagine that the philosophical elements are what a continuous quality improvement consists of, and structural elements are how we get there. Philosophical elements include things like goals, focus, values, data, solutions, and learning. Structural elements include things like teams, tools, management, analysis, and adjustments. These elements are important in new initiatives because they drive motivation, they maintain structure, and they give organization. The Deming cycle is a process used in continuous quality improvement. It has four parts: plan, do, check/study, and act. The plan step is where the elemental structures of a goal, mission, and theory are formed. The do step is where the structural elements are used. This step is where action takes place; teams are formed, products are made, services are provided, and so forth. The check/study step is where results are monitored, and errors or mistakes are identified. The act step is used for adjustments. When all four steps are completed, the cycle starts again. To put it simply, the Deming cycle is used in healthcare because it can be repeated over and over to continuously grow, improve, and learn (The Deming Institute, 2025).

The Deming Institute. (2025). PDSA cycle.

https://deming.org/explore/pdsa/