Improving Performance? The Adoption and Implementation of Quality Systems in UK Nonprofits Ben Cairns, Margaret Harris, Romayne Hutchison and Mike Tricker Centre for Voluntary Action Research, Aston Business School, Birmingham, England
A paper prepared for presentation to the 33rd Annual ARNOVA Conference, Los Angeles, California, November 2004
Contact person for this paper: Margaret Harris, Ph.D. Professor of Voluntary Sector Organisation Aston Business School, Aston University Birmingham, B4 7ET, England Tel. 44 (0) 121 359 3011 Fax. 44 (0) 121 359 1148 e-mail
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Improving Performance? The Adoption and Implementation of Quality Systems in UK Nonprofits
Ben Cairns, Margaret Harris, Romayne Hutchison and Mike Tricker (1) , Centre for Voluntary Action Research, Aston Business School, Birmingham, England
Introduction – Performance Improvement The puzzle of how to improve organisational ‘performance’ is a recurrent theme in practitioner and academic literature on nonprofits in both the UK and North America. The range of concepts and terms used to reflect and express this managerial puzzle have varied and have included ‘efficiency’, ‘effectiveness’, ‘accountability’, ‘standards’, ‘capacity’, ‘goal achievement’, ‘outcome measurement’ and ‘evaluation’; but the underlying concern has persisted. Nonprofits are expected to deliver ‘value for money’ and also to demonstrate that they are doing so. As Paton (2003) says, the environment of nonprofits is now permeated by ‘expectations of measurement’. The pressures for performance improvement and measurable standards have come from a number of sources. Some have come from within nonprofits themselves as they struggle to provide the best possible service for their clients and beneficiaries and to compete for resources and support. Other pressures have come from donors, governmental funders and business sponsors who seek to ensure that their agents and the recipients of their financial support have the organisational capacity to deliver services effectively (Eisinger, 2002; Home Office, 2004; Wing, 2004). Still further pressures come from clients, potential clients and the general public who seek reassurance that organisations which receive tax privileges can demonstrate that they are working effectively and ethically without wasting resources (CFVS, 1996; Hoefer, 2000). As nonprofits on both sides of the Atlantic move ever more deeply into the role of ‘public services providers’ (HM Treasury, 2002; Salamon, 2003), the pressure to demonstrate ‘performance improvement’ is set to continue (Poole et al., 2001; QSTG, 2004). Nonprofits have responded to the performance improvement imperative with a variety of approaches (Rojas, 2000). The research literature shows that some have focused on evaluating individual programmes or projects and some have implemented selfevaluation or self-monitoring systems (Ball, 1998; Boerner, 2004); and some have taken a broader organisational learning or ‘capacity building’ approach (Blumenthal, 2003; Cairns, Harris and Young, forthcoming). Specific performance-focused approaches taken in recent years in the UK and US nonprofit sectors, many of them derived from business management experience, have included the following. •
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Total Quality Management – a measurement and benchmarking strategy that provides an environment for organisational change through continuous improvement and pursuit of best practice, as well as a customer focus and external perspective. Benchmarking – a process whereby organisations pursue enhanced performance by measuring their processes and practices against those in other organisations.
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Balanced Scorecard – an approach which helps align performance measures with organisational objectives through strategic performance management. Results-based management – a performance management strategy aimed at achieving changes that will lead to improved performance and better results. Key components are performance indicators and the Logical Framework.
As Gaster (1995) points out, all such performance improvement approaches have in common a systematic attention to detail and a strategic framework of policies and values. Although there is, then, a growing descriptive literature on the various approaches to performance improvement taken by nonprofits, we still know little about the internal processes within nonprofits which lead to the adoption of performance improvement approaches. Nor have there been studies of the management implications for individual nonprofits of implementing such approaches. Yet successful implementation of performance improvement approaches requires some understanding of nonprofit experiences in this area, including the organisation and management challenges faced and the organisational benefits that arise. The empirical study at the heart of this paper addresses this gap in the research literature. It is concerned with the adoption and use of one approach to performance improvement - ‘quality’ systems - in the UK nonprofit sector (in the UK usually termed the ‘VCO’ or ‘voluntary and community’ sector). ‘Quality Systems’ and Nonprofits In common with other managerial ideas and approaches, quality management has taken time to move from its original home in industrial manufacturing to the nonprofit sector. While the majority of developments up to the 1980s were focused on the subject of managing quality in manufacturing industry (Morrison, 1990), quality ideas gradually moved out of that domain into the service, health care and public sectors and eventually merged with mainstream organisational management thinking (Bone, 1994; Scott and Cole, 2000). The widespread adoption of quality systems was not only driven by the need for improvement, as in the manufacturing industry, but also by personal sponsorship, ideology and championship. Well known quality ‘gurus’ included Deming, Juran (who developed the ‘quality trilogy’ – quality planning, quality control and quality improvement) and Feigenbaum (the originator of ‘total quality control’) (Dale et al., 1990). Currently, the term ‘quality systems’ is generally used by both practitioners and academics in a broad sense to refer to those performance improvement approaches which are focused on quality of management and services (Ichniowski and Shaw, 2000). It is widely used in the UK as a generic term to cover the range of ways in which organisations implement quality management, whether through established systems or through other internal mechanisms to encourage improvement in meeting stakeholders’ requirements (CES, 2002; QSTG, 2001). Although quality systems have been popular for some time in the business sector, academic commentators have raised questions about the adoption of quality systems in the public and third sectors. Walsh (1995), for example, talks about the difficulty of determining quality in relation to human services rather than to products and Gaster (1995) points out that we do not know whether use of a quality system actually improves the quality of an organisation’s service. Osborne (1996) cites confusion over what is being measured – quality of service or quality of life of its recipients; similarly, Pollitt and Bouckaert (1995) draw attention to the variety of
meanings and approaches encompassed by the term. Paton (2003) shows that different organisational stakeholders often hold different views as to what constitutes ‘quality’; for example, managers may think in terms of resource use and professionals in terms of outcomes. Despite these criticisms, we know from anecdotal evidence that ‘quality’ approaches are now being widely used by nonprofits. However, the approaches vary on a number of dimensions. Some cover all aspects of an organisation’s operations and management (in the UK VCO sector the most commonly employed one is known as ‘PQASSO’ – Practical Quality Assurance System for Small Organisations); whereas other quality systems address just one aspect of an organisation’s operations, such as its human resource management (a widely adopted one in the UK is called ‘Investors in People’). Whereas some nonprofits use generic quality systems employed by all sectors (in the UK these include ‘ISO 9000’, the ‘Excellence Model’ and ‘Quality Mark’), other non-profits have adopted sector-specific quality systems (eg PQASSO as above). Whereas some nonprofits use or adapt ‘off-the-shelf’ systems, others prefer to develop their own ‘in-house’ system. Some quality systems incorporate external assessment or accreditation and others rely on self-assessment. Finally, some nonprofits have opted for ‘sub-sectoral’ systems developed for a particular field of work, often by a national infrastructure body; for example, in the UK there is a quality system known as ‘QuADS’ which is used by some VCOs working in the drug and alcohol-dependency field. Boerner (2004) considers the quality concept in relation to artistic nonprofits such as opera companies. The very limited research literature to date on the adoption of ‘quality systems’ by UK VCOs mostly focuses on the ‘encouraging’ role played by external stakeholders, especially governmental agencies which provide funding. External stakeholders, it is argued, have become increasingly concerned about having evidence that services provided at ‘arm’s length’ from them meet acceptable standards of quality. This concern has led to VCOs feeling pressurised – to varying degrees – to adopt ‘quality systems’ so that they can demonstrate to stakeholders their organisational effectiveness and the standard of their services (Barclay and Abdy, 2001; Johnson et al., 1998). Our own research study was designed to look more deeply into the drivers to adopt quality systems. It also explored the organisational implications for nonprofits of taking a quality approach; it looked at the challenges of implementing quality systems in VCOs as well as the perceived benefits. The UK Quality Study The study reported here constitutes the first research study into the adoption and implementation of quality systems across a range of organisational types and functions in the UK voluntary and community sector. It was commissioned in 2002 by the UK’s Quality Standards Task Group (QSTG); a time-limited body set up in 1997 to assist UK voluntary organisations to improve their effectiveness through the use of quality systems. As researchers, we were given complete independence in conducting all aspects of the research including in matters of method, data collection, data analysis and reporting findings. We began with an online and postal survey addressed to VCOs which had indicated to the QSTG their interest in ‘quality’. Areas covered by the questionnaire included: systems in use, reasons for their introduction, expected benefits, problems encountered, success in meeting objectives and future plans. The second stage of the project, the qualitative phase, which was developed around the findings from the
survey, constituted 38 semi-structured interviews with representatives of VCOs of different sizes, based in different locations, in different fields of work, and using different quality systems. We also conducted four interviews with ‘quality systems guardians’; that is, in organisations which promote and support the use of specific quality systems. In addition to the interviews, we conducted focus groups with staff, volunteers and trustees in 14 VCOs. Later we conducted brief follow-up interviews with 17 staff of 13 VCOs, specifically to ask them for more information about the links between use of a quality system and their services for users. The data collected were analysed thematically using a system of open coding of the interview and focus group transcripts. The following sections of this paper are based primarily on the qualitative phase of the study. We describe our findings and then analyse the drivers to adoption of quality systems in VCOs and the benefits and issues which arise for VCOs in implementing them. We refer to interviewees and focus group participants as ‘study participants’. Unattributed quotations (shown in italics) all come from these study participants. The Drive to Adopt Quality Systems General drivers for quality: The findings suggest that a majority of VCOs were motivated to adopt a quality system by multiple and interrelated internal and external factors. As argued by both Paton (2003) and Scott and Cole (2000), the influence of funders, and the awareness that at some point funders might demand adoption of a recognised quality system, was clearly very important. Some study participants had experienced explicit pressure from funders: ‘on all the application forms, contracts and tenders there is a question which says – which quality assurance system does your organisation follow?’ But for many others, adopting a quality system was a proactive step taken in anticipation of future pressure and to maintain credibility and legitimacy: ‘we knew that at some point smaller organisations would probably be required by funders to use a quality system’; and ‘It became known that there would be some pressure from funders, especially statutory bodies. We therefore thought we needed to do something that demonstrates that we provide a quality service’. Pressure from funders, explicit or anticipated, was not the only driving force on the VCOs we studied. Often the decision to ‘adopt quality’ was part of a more general desire to demonstrate accountability to, and secure legitimacy with, a variety of stakeholders; multiple external stakeholders and also internal stakeholders including paid staff. Study participants described themselves as wanting, for example, to develop a more ‘structured’ approach at a time of organisational growth; to provide the best service to ‘users’; to initiate what they considered to be best practice; or to restore stability after a period of crisis. For many VCOs, an external factor such as the funding environment or the influence of a national infrastructure body reinforced and gave further impetus to adopt an approach that they had already been considering. And for all the VCOs studied the drive to adopt quality systems comprised a complex mix of mandatory and voluntary, and internal and external factors.
Adoption of a particular quality system: The general drivers to adoption of a quality system were not necessarily the same as the drivers to adopt a particular quality system. A range of drivers were described as well as a number of different routes to making the final decision to adopt a particular quality system. Some study participants - of all sizes and in different fields of work – did report being required by a governmental funder to use a particular system, often alongside another system already in use. Some were required to use a particular sub-sectoral system developed for their field of work; others were expected to use one of the generic systems such as PQASSO or the Excellence Model. A few VCS infrastructure bodies required adoption of their own specific quality system as a membership condition. Other VCOs had been ‘steered’ towards a particular system because of the availability of resources and support, often from national or local infrastructure bodies. Well resourced pilot projects in some geographical areas had been a major factor; for example: ‘The opportunity arose to get involved with PQASSO, and to have access to free support, because of the work being done by our CVS [local third sector infrastructure organisation].’ A further group of study participants described their VCO as having taken a much more planned and deliberative approach to the adoption of a particular quality system, with several possibilities being considered before a final decision was reached. In some cases the final decision was based on a view that a particular system most closely met their needs: ‘Quality Mark felt far more appropriate to our work than any other system; staff liked the idea of external assessment, and the fact that the Commission for Legal Services would assist us with the work that needed to be done’. Some organisations were also influenced negatively by a view that some systems were not appropriate for their circumstances, or required too heavy an investment of resources, for example: ‘we felt that PQASSO was the most appropriate; we were not then equipped to use any of the others – Investors in People was still too complex’. Only three VCOs reported that they were exclusively using their own in-house approach to quality, developed out of a desire to reflect their own organisational culture and to improve their services to users: ‘there is strength in developing your own system that is based within the organisation’s culture’. The Implementation of quality systems The Benefits: We asked study participants to tell us about their experiences of the organisational benefits to their VCOs of adopting and implementing one or more quality systems. The main benefits were thought to be in the areas of organisational self-reflection, learning and development: ‘We have had a chance to reflect on performance, highlight areas where improvements were needed and work on them’. Some participants thought that the relationship with their external environment had been improved: ‘[our quality system has] given us a very good reputation in the sector and improved our relationship with partner organisations’. Most study participants also expressed the hope that the use of a quality system would lead to direct benefits in relation to service provision; although in practice, this tended to be confined to improved processes for service planning and arrangements for service delivery.
As regards their service users or clients, study participants generally felt that the benefits in this respect were mostly indirect and also slow to manifest themselves. For example they pointed to improvements in policies and procedures, better planning processes and more confident and motivated staff – all of which were likely to provide indirect benefits to users at some point. Changes such as improving the accessibility of services, or involving users in decision-making had also been put in place as a result of quality processes, but study participants thought that few clients were aware of the changes. Although our study revealed, then, a range of organisational benefits accruing to VCOs as a result of implementing quality systems, it also pointed to numerous challenges of implementation; especially challenges in relation to resources or to do with the quality systems adopted. Difficulties surrounding quality systems: A small number of VCOs had experienced difficulties finding out what quality systems were available. Some might have chosen a different system, or not succumbed to pressure from funders to use a particular system, if they had known earlier the range of what was available: ‘if we had known more about other systems we might have chosen a different one; we may not be so cautious next time’. Several study participants felt their organisation would have benefited from more external help, both with selecting a system and with working through aspects of their chosen system. Infrastructure bodies, ‘system guardians’ (the organisations which develop and promote quality systems) and VCOs themselves– all seemed to be aware of the confusion within the nonprofit sector about the availability and purpose of different quality systems: ‘there is confusion over the multitude of systems, what value each one has and how to decide which one to use’. Another frequently cited difficulty arose from a lack of ‘fit’ between the system adopted and the adopting VCO: ‘the system needs to be as relevant to the organisation as possible, but it can be difficult to find one that relates to the whole of the organisation’s work’. Some VCOs had been required to use a particular system, but did not feel that it related well to their objectives, way of working or size: ‘being forced to keep PQASSO in the background creates problems, and conflicts between the local authority’s culture and our own can cause conflicts between systems’. This kind of problem was exacerbated in cases where the VCO experienced the language and concepts of the system they had been made to adopt as complex or unclear. Problems of ‘fit’ also arose as VCOs tried to decide what aspects of their work would be covered by a particular system: ‘the main problem was establishing whether our work was too narrow to cover the full breadth of Quality Mark requirements’; and ‘we had problems around what should be included, not included; evaluation systems, which ones to use; it was all very time-consuming’. Study participants expressed concerns not only about the appropriateness of the system in use, but also about making it meaningful to, and usable by, different organisational stakeholders; for example, ‘staff do not always understand the need to measure what we do against what we said we would do’. Staff also did not always see the relationship between the quality system adopted and their own work. This was particularly likely to occur where staff had not been involved in the introduction of the system. In such cases the quality system could become a matter of ‘just ticking boxes’. Several of the VCOs studied were found to be using more than one quality system simultaneously; often combinations of ‘off-the-shelf’ and in-house systems. It
seemed that this situation was most likely to arise where funders imposed a particular system on an organisation. Not surprisingly, those VCOs using more than one quality system concurrently found it difficult to establish coherence across systems: ‘it can be difficult remembering the underpinning philosophy of each system’. They were also overloaded by the demands of data collection: ‘it’s a real drawback to have to produce different evidence for each standard’. Resources problems: Most study participants, especially those from smaller organisations, felt that implementation of quality systems had been impeded by lack of staff time and other resources: ‘we would have made more progress if we had more organisational capacity’. Many smaller VCOs reported initial concerns about the amount of time it would take to implement a quality system; time to attend meetings and time to do work such as developing new policies and dealing with necessary ‘paper-work’. Although some had overcome these anticipated problems by means such as employing staff for extra hours, setting realistic deadlines and sharing out the work, several study participants commented that time would always be a problem while staff and trustees treated quality as an ‘add-on’ rather than integral to the organisation’s work: ‘time is a particular problem if people see quality as something separate; this makes them begrudge the time or reluctant to devote resources to it’. Some study participants felt that their VCO’s ability to implement a quality system had been hampered not so much by limitations of time as by staff availability. This was particularly the case in those VCOs which did not have a dedicated staff member with a remit to work on quality issues or which had a dedicated staff member at a fairly junior level. Without a senior dedicated ‘quality’ person in post, somebody to act as a ‘quality champion’, VCO staff gave precedence to work focused on users and clients: ‘even though work on quality systems feels like a positive development it just becomes something else you have to do ...’. Several Study participants suggested that having one person to take the lead on implementing quality systems had helped, or would have helped, their organisation make progress. That person need not necessarily be a senior staff member, but should, it was suggested, be sufficiently senior to command both respect and resources. In some VCOs, however, the problem was perceived less as one of staff availability and more one of staff commitment to the idea of quality systems. Staff were concerned about whether use of a quality system would actually make a difference to the organisation’s users, or whether it would simply be ‘a bit of dry paper that doesn’t mean much’. Some VCOs had lacked commitment to quality from senior staff and so had failed to enthuse more junior staff: ‘leaders need to be seen to be practising what they preach’. In other cases there had been a lack of direction from the board to staff: ‘[if the board had been committed] they would have been saying to senior managers “do this as a priority” rather than “do this on top of other things” ‘. Discussion and Conclusions In this paper we have conceptualised adoption of quality systems as one route amongst several possible routes towards ‘performance improvement’ in the nonprofit sector. In this final section, then, we first look at the implications of our findings for nonprofits considering adopting and implementing quality systems, before looking more broadly at the implications for the performance improvement agenda.
Adopting and Implementing Quality Systems: The suggestion that quality systems are often adopted in the third sector because of pressure from funders and governmental purchasers of services is confirmed by our study. But, our findings also suggest, in line with new institutional theories, that the adoption of quality systems by nonprofits is often part of a rather more complex interaction with their environments than a direct or simple response to resource dependency. Many of the organisations we studied were constantly striving for external legitimacy and credibility with a range of stakeholders and constantly considering organisational adaptations which would bring them into line with this range of environmental pressures. Some actually anticipated environmental pressures before they were manifested. Adoption of a quality system was then, for many of our study participants, just one aspect of a management approach which was constantly alert to environmental pressures, and was seeking to adapt to them pragmatically in order to influence and gain control over a turbulent organisational environment. Thus, we found not only examples of coercive isomorphism (principally driven by key funders who foisted systems on nonprofits as the price of further funding) but also normative isomorphism (where infrastructure bodies provided exemplary standards and systems) and mimetic isomorphism (amongst organisations influenced by the strategies of other actors in their field) (DiMaggio and Powell, 1991). And although many of the nonprofits which adopted quality systems did find ways to use them as instruments of organisational learning and improvement, initial adoption of quality systems was often ‘ceremonial’ rather than a reflection of rational decision-making (Meyer and Rowan, 1991). This was particularly apparent in smaller nonprofits which lacked the knowledge and resources to obtain information about the full range of options which were in principle available to them; or lacked the experience and capacity to make a balanced assessment of the available choices. These latter examples suggest a potential role for third sector infrastructure organisations in supporting smaller and weakly-resourced nonprofits at an early stage of the move to adopt a quality system. The importance of making a rational or informed choice about available quality systems, was reinforced by our findings about implementation of systems. It appears that if ‘quality’ is to useful for nonprofits, if it is to be a means of organisational improvement for example, it needs to be fully integrated into strategic planning processes, work plans and organisational reviews. Those nonprofits in our study where quality remained an ‘extra’, to be discussed and worked on as time allowed, generally struggled with the concept and experienced only limited benefits in terms of improved services and greater sustainability. On the other hand, those organisations which had been able to consider and debate options before adopting a system seemed to be better able to integrate the implementation of quality into the processes and structures of their organisations and thereby achieve organisational benefits. It seems, then, from this study that successful adoption and subsequent implementation of a quality system is positively related to the degree of organisational ‘fit’ between the system and its organisational host. By ‘fit’ we mean how well the system can be integrated with current working practices, how sensitive it is to the culture of the organisation - especially in the language used - and the degree of sophistication in the system. The difficulty of ensuring this kind of organisational fit seems often to be exacerbated by an absence of coordination amongst nonprofits’ external stakeholders. Consequently, nonprofits can find themselves having to operate multiple, externally imposed systems whose operating requirements do not reflect or take account of existing processes and available resources.
Although it was the case that quality systems served only a ceremonial function in some of the nonprofits we studied - quality was just another procedure that had to be added into the daily management routine - implementation of any quality system necessarily consumes organisational resources. Thus if such systems are to be cost effective, they need to be embedded into all aspects of an organisation’s work including planning, staff training, and client satisfaction exercises. In the words of one of the study participants: ‘quality needs to be seen as part of the way the organisation does things’. These findings confirm the suggestion by Poole et al (2001) that nonprofits should involve all their internal groupings in the adoption of quality systems at the earliest possible stage. Board members and service volunteers as well as paid staff at all levels should be given, our study suggests, the opportunity to be involved in debates about adopting systems so that the implementation stage feels less like an imposition and more like an exciting change which will bring organisational benefits for staff and users; and so that implementation can be in accord with the existing organisational culture. Our study findings also suggest that effective implementation is more likely to take place in organisations with leaders that are committed to the selected system, or systems, and can act as ‘quality champions’; explaining purposes and allowing exploration of multiple means of achieving quality ends. Within this, the involvement of board members at early discussion stages and (particularly in smaller organisations) in the process of introduction, appears crucial. Without their commitment ‘quality’ is less likely to be accorded priority and resources or to be integrated into the general work of the organisation. The Performance Improvement Agenda: In addition to expanding knowledge about the adoption and implementation of quality systems in nonprofits, our study suggests some implications and lessons for the broader ‘performance improvement’ agenda. First it raises the question ‘for whose benefit?’ in relation to pressures for performance improvement. It was hoped and expected by our study participants that users would benefit from adoption of quality systems, at least in the long term and at least indirectly; but the immediate drivers to adopt quality systems were clearly funders and other powerful stakeholders, as well as, but less often, the concerns of staff and board members. Although one might assume that the ultimate purpose of improving performance in the nonprofit sector is to provide a better service to service users, the picture that emerges from our study is of quality systems operating in practice as a managerial response to external accountability demands rather than as a product of customer orientation. In the longer term users of services might benefit from organisational improvements in internal systems and processes but none of our study participants could point to evidence of direct or measurable benefits for their end users. Future research might explore ways in which a ‘customer focus’ might be incorporated into quality systems and other performance improvement techniques in the nonprofit and human services sectors, so that they serve as instruments of accountability to both funders and consumers simultaneously. Second our findings reinforce earlier studies (eg. Campbell, 2002; Lozeau et al, 2002) which point to the difficulties of applying performance improvement techniques drawn from the private sector to the circumstances of nonprofit organisations with their distinctive cultures, multiple stakeholders and multiple goals. It seems that performance improvement systems need to be context sensitive (Paton, 2003); and
that this point applies not only to the sector context but also to individual organisations within the nonprofit sector. Systems which are imposed on nonprofits and systems which are not in keeping with the organisational culture are doomed, it seems, to remain no more than managerial fads to which staff pay reluctant ceremonial obeisance. A recent initiative by the UK government is focused specifically on improving the organisational capacity of the voluntary sector and on establishing infrastructure to support such ‘capacity building’ (Home Office, 2004). The adoption of quality systems within the sector could be one area in which sensitive and specialist infrastructure support could improve not only organisational capacity but also the lives of those who are the customers and beneficiaries of nonprofits. However, for this agenda to be taken forward in a way that builds upon the key findings of this study (in particular, the importance of developing an ‘integrated’ approach to quality), serious consideration will need to be given to the preferred model of ‘capacity building’. An ‘empowerment’ model (eg. Letts et al, 1997; Olowu, 2002) might have the potential to help organisations carry out their own purposes and aspirations in a sustainable manner, On the other hand, a ‘deficit’ model (Harrow, 2001) seems more likely to be concerned with equipping organisations with the attributes required to deliver government targets and expectations. How and where infrastructure support is positioned in relation to ‘capacity building’ is likely to have a significant influence on the future of the ‘performance improvement’ agenda in the UK nonprofit sector. References Ball, M. (1998) Evaluation in the Voluntary Sector, Home Office, London Barclay, J. and M. Abdy (2001) Funders and Quality in the Voluntary Sector, QSTG / NCVO, London Blumenthal, B. (2003) Investing in Capacity Building: A Guide to High Impact Approaches Foundation Center, London Boerner, S. (2004) Artistic Quality in an Opera Company: Toward the Development of a Concept Nonprofit Management and Leadership 14, 4 425-436 Bone, C. (1994) Modern Quality Management Manual, Longman, Essex Cairns, B. Harris, M and Young, P.(forthcoming) Building the Capacity of the Voluntary Nonprofit Sector: Challenges of Theory and Practice International Journal of Public Administration Campbell, D. (2002) ‘Outcomes Assessment and the Paradox of Nonprofit Accountability’, Nonprofit Management and Leadership, 12, 3, 243-257 CES (Charities Evaluation Services) (2002) First Steps in Quality, CES, London CFVS (Commission on the Future of the Voluntary Sector – ‘The Deakin Commission) (1996) Meeting the Challenge of Change; voluntary action into the 21st century, CFVS / NCVO, London Dale, B.G.; D.M. Lascelles and J.J. Plunkett (1990) ‘The Process of Total Quality Management’ in B.G. Dale and J.J. Plunkett (eds) Managing Quality, Phillip Allan, Hemel Hempstead
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