A total quality management (TQM) system to work toward breakthrough improvement. Used by industry for a number of years, Hoshin planning is now being tried by some hospitals as part of their TQM programs. The system was developed in Japan after World War II to plan new processes. It uses seven tools, which are used individually or in combination: affinity diagrams, arrow diagrams, interrelationship digraphs, matrix diagrams, prioritization matrices, process decision program charts, and systematic diagrams. Other terms for the approach include policy deployment, structured breakthrough planning, and management by planning.