Fairfield University Qualitys Foundation What is Quality FEIGENBAUM (1983) DEFINED QUALITY AS FOLLOWS Quality is a customer determination which is based on the customers actual experience with the product or service, measured against his or her requirementsstated or unstated, conscious or merely sensed, technically operational or entirely subjective always representing a moving target in a competitive market. Quality is total composite product (goods and services) characteristics, through which the product in use will meet the needs and expectations of the customers. Concept of quality must start with identification of customer quality requirements and must end only when the finished product is placed into the hands of the customer who remains satisfied through various stages of relationship with the seller American Society of Quality Control (ASQC) and American National Standard Institute (ANSI) defined Quality is totality of features and characteristics of product (goods and services) that bears on its ability to satisfy given needs Approaches to Define Quality Transcendent Approach Quality is absolute and universally recognisable. It is common notion used by laymen There is no subjective judgement and is estimated by looking at the product Product Based Approach Attributes of a particular product in a specific category These attributes are accepted as bench of quality by the industry Others in the same industry try to produce close to this quality Approaches to Define Quality User Based Approach Defined as Fitness for use Viewed from users perspective and is dependent on how well does the product meet needs of the consumer. Also known as Customer Oriented Approach Production Based Approach An outcome of engineering or operational excellence and is measured in terms of quality of conformance The producer has specifications and produces the product as per the specifications Attributes of Quality Durability Length of time a product can be used before it deteriorates or becomes non functional Serviceability Speed, competence & courtesy of providing ASS Aesthetics Look, feel sound, taste, smell Perceived Quality Resulting from advertisement, image, brand name, earlier use, hearsay Evolution of Total Quality Management Evolution of Quality Management Mass Inspection Inspecting Salvaging Sorting Grading Rectifying Rejecting Quality Control Quality manuals Product testing using SQC Basic quality planning Quality Assurance Emphasis on prevention Proactive approach using SPC Advance quality planning Total Quality Control All aspects of quality of inputs Testing equipments Control on processes Evolution of Quality Management Company wide Quality Control Measured in all functions connected with production such as R&D Design Engineering Purchasing, Operations etc Total Quality Management Measured in all aspects of business, Top management commitment Continuous improvement Involvement & participation of employees Evolution of Quality Management Quality Evolution 1930s Shewart Cycle 1950s Deming in Japan 1980 Productivity / Quality Circles 1985 Deming/Crosby/Juran Late 1980s Total Quality Mgmt 1990s Baldrige Criteria Current Six Sigma Lean Management Evolution of Quality Management Quality Assurance vs. Quality Control True Value vs. Measured Value True Value The known, accepted value of a quantifiable property Measured Value The result of an individuals measurement of a quantifiable property Accuracy vs. Precision Accuracy How well a measurement agrees with an accepted value Precision How well a series of measurements agree with each other Accuracy vs. Precision Systematic vs. Random Errors Systematic Error Avoidable error due to controllable variables in a measurement. Random Errors Unavoidable errors that are always present in any measurement. Impossible to eliminate Quality Basics Processes and Process Improvement A process takes inputs and performs value-added activities on those inputs to create an output. Quality Basics Variation: Variation is present in any natural process, no two products or occurrences are exactly alike. Specifications: Specifications state product or service characteristics in terms of a desired target value or dimension. Tolerance Limits: Tolerance limits show the permissible changes in the dimension of a quality characteristic. Quality Basics History of Quality Pre-history Tarxien and Hagar Qim Temples in Malta 3200 2500 B.C.E. China Decree on standards for materials Romans Road building specifications Greeks Temple design requirements Middle Ages Cathedral design requirements Statistical Approaches to Quality Western Electric 1920s Quality Pioneers Walter Shewhart W. Edwards Deming Joseph M. Juran Harold Dodge - originating acceptance sampling plans for putting inspection operations on a scientific basis in terms of controllable risks. George Edwards- first president of American Society for Quality Control Quality Basics The Evolution of Modern Quality Inspection refers to those activities designed to detect or find non-conformances existing in already completed products or services. Quality Control refers to the use of specifications and inspection of completed parts, subassemblies, and products to design, produce, review, sustain, and improve the quality of a product or service. Quality Basics The Evolution of Modern Quality Statistical Quality Control involves collecting statistical data, analyzing it, and interpreting it to solve problems. Statistical Process Control prevents defects by applying statistical methods to control the processes making products or providing services. Quality Basics The Evolution of Modern Quality Total Quality Management is a management approach that places emphasis on continuous process and system improvement as a means of achieving customer satisfaction to ensure long-term company success. Continuous Improvement focuses on improving processes in order to enable companies to give customers what they want the first time, every time. Modern Importance of Quality The first job we have is to turn out quality merchandise that consumers will buy and keep on buying. If we produce it efficiently and economically, we will earn a profit, in which you will share. - William Cooper Procter Key Idea Quality Assurance ...is any action directed toward providing customers with goods and services of appropriate quality. History of Quality Assurance (1 of 3) Skilled craftsmanship during Middle Ages Industrial Revolution: rise of inspection and separate quality departments Early 20 th Century: statistical methods at Bell System Quality control during World War II Post-war Japan: evolution of quality management History of Quality Assurance (2 of 3) Quality awareness in U.S. manufacturing industry during 1980s: from Little Q to Big Q - Total Quality Management Big Q versus Little q q = the products in manufacturing Q = ALL processes in all industries Malcolm Baldrige National Quality Award (1987) Disappointments and criticism Key Idea History of Quality Assurance (3 of 3) Emergence of quality management in service industries, government, health care, and education Evolution of quality to performance excellence Deming Award Baldrige Award ISO Growth and adoption of Six Sigma Current and future challenge: continue to apply the principles of quality and performance excellence. Quality is a race without a finish line. Contemporary Influences on Quality Globalization Innovation/creativity/change Outsourcing Consumer sophistication Value creation Accreditation Legislations Changes in quality expectations Key Idea Customer-Driven Quality Meeting or exceeding customer expectations Customers can be... Consumers External customers Internal customers Total Quality People-focused management system Focus on increasing customer satisfaction and reducing costs A systems approach that integrates organizational functions and the entire supply chain Stresses learning and adaptation to change Based on the scientific method Principles of Total Quality Customer and stakeholder focus Participation and teamwork Process focus supported by continuous improvement and learning Customer and Stakeholder Focus Customer is principal judge of quality Organizations must first understand customers needs and expectations in order to meet and exceed them Organizations must build relationships with customers Customers include employees and society at large Key Idea Participation and Teamwork Employees know their jobs best and therefore, how to improve them Management must develop the systems and procedures that foster participation and teamwork Empowerment better serves customers, and creates trust and motivation Teamwork and partnerships must exist both horizontally and vertically Key Idea Process Focus and Continuous Improvement A process is how work creates value for customers Processes transform inputs (facilities, materials, capital, equipment, people, and energy) into outputs (goods and services) Most processes are cross-functional Key Idea Continuous Improvement Enhancing value through new products and services Reducing errors, defects, waste, and costs Increasing productivity and effectiveness Improving responsiveness and cycle time performance Key Idea Demings View of a Production System Learning The foundation for improvement Understanding why changes are successful through feedback between practices and results, which leads to new goals and approaches Learning cycle: Planning Execution of plans Assessment of progress Revision of plans based on assessment findings Infrastructure, Practices, and Tools TQ Infrastructure Customer relationship management Leadership and strategic planning Human resources management Process management Information and knowledge management Competitive Advantage Is driven by customer wants and needs Makes significant contribution to business success Matches organizations unique resources with opportunities Is durable and lasting Provides basis for further improvement Provides direction and motivation Quality and Profitability Key Idea Three Levels of Quality Organizational level: meeting external customer requirements Process level: linking external and internal customer requirements Performer/job level: meeting internal customer requirements Quality and Personal Values Personal initiative has a positive impact on business success Quality-focused individuals often exceed customer expectations Quality begins with personal attitudes Attitudes can be changed through awareness and effort (e.g., personal quality checklists) Unless quality is internalized at the personal level, it will never become rooted in the culture of an organization. Thus, quality must begin at a personal level (and that means you!). Gurus/Advocates of Quality Gurus/Advocates of Quality Gurus/Advocates of Quality Shewhart, Deming and Juran The Quality Dream Team Juran and Deming started at Western Electrics Hawthorne plant in Chicago Juran and Deming were Influenced by Walter Shewhart, a pioneer in statistical methods. Both received an invitation to work in Japan from the Union of Japanese Scientists and Engineers. Deming taught Japanese engineers and management statistical methods and how to view production as a system that included suppliers and consumers. Juran delivered lectures in Japan about managing for quality. Quality Advocates Dr. Walter Shewhart (1891-1967) Father of Statistical Process Control Control of Quality of Manufactured Product Van Nostrand Reinhold, 1931 Defined two aspects of quality What the customer wants (subjective) What the physical properties are (objective) Quality Advocates Dr. Shewhart was the first person to encourage the use of easy-to-use statistics to remove variation common cause variation normal process fluctuations special cause variation uncontrolled influence Quality Advocates Dr. Shewhart proposed that controlled and uncontrolled variation exists. A phenomenon will be said to be controlled when, through the use of past experience, we can predict, at least within limits, how the phenomenon may be expected to vary in the future. Here it is understood that prediction within limits means that we can state, at least approximately, the probability that the observed phenomenon will fall within the given limits. Quality Advocates Dr. Walter Shewhart proposed: Common (Chance) Causes Controlled variation that is present in a process due to the very nature of the process. Special (Assignable) Causes Uncontrolled variation caused by something that is not normally part of the process. Quality Advocates Dr. Shewhart: Inventor of Control Charts Statistical Process Control (SPC) charts were originally called Shewhart charts! Regular plotting of data on an SPC chart will tell if the process is out-of-control (subject to special causes) Quality Advocates Dr. Shewhart originated the PLAN, DO, STUDY, ACT cycle for analysis of problems Frequently called Dr. Demings Plan-Do-Study-Act Cycle Deming Joseph M. Juran Defines quality as a composition of two different, though related concepts: One form of quality is income-oriented, and consists of those features of the product which meet customer needs and thereby produce income; in this sense, higher quality usually costs more A second form of quality is cost-oriented and consists of freedom from failures and deficiencies; in this sense, higher quality usually costs less Management of quality, according to Juran, involves the elements of quality planning, quality control, and quality improvement; these form Jurans so-called Trilogy. To support this triad, Juran has formulated a list of nine nondelegatable responsibilities for upper managers: Responsibilities for Upper Managers Create awareness of the need and opportunity for improvement. Mandate quality improvement; make it a part of every job description. Create the infrastructure: establish a quality council; select projects for improvement; appoint teams; provide facilitators. Provide training in how to improve quality. Review progress regularly. Give recognition to the winning teams Propagandize the results. Revise the reward system to enforce the rate of improvement. Maintain the momentum by enlarging the business plan to include goals for quality improvement. Jurans Quality Planning Process Identify the customers; anyone who will be impacted is a customer, whether internal or external. Determine the customers needs. Create product features which can meet the customers needs. Create processes which are capable of producing the product features under operating conditions. Transfer the processes to the operating forces Jurans Feedback Loop Approach to Quality Control Evaluate actual performance levels. Compare actual performance levels to targeted performance levels. Take action to close or eliminate the gap between these two levels. Quality becomes a part of each upper management agenda. Quality goals enter the business plan. Stretch goals are derived from benchmarking; focus is on the customer and on meeting competition; there are goals for annual quality improvement Juran & Continuous Improvement Total Quality Management Goals are deployed to the action levels Training is done at all levels. Measurement is established throughout. Upper managers regularly review progress against goals. Recognition is given for superior performance. The reward system is revised Dr. Jurans Views Dr. Juran believes that self-directed teams will ultimately become a major successor to Taylorism. Some of Dr. Jurans other views include the following: FIRST, the product development cycle should be shortened through use of participative planning, concurrent engineering, and the like. SECOND, supplier relations should be such that a minimal number of suppliers are used; teamwork between a company and its suppliers would be based on mutual trust and contracts should be greater duration. THIRD, training should be results-oriented rather than tool-oriented; what is desired is related more toward behavior change than toward education.
Philip B. Crosby (1926-2001): Zero Defects Effectively this concept implies that poor or high quality has little or no meaning and that in fact it is either conformance or non- conformance to customer/product requirements which is of central importance. Quality management equates to defect prevention. Crosbys 14 Steps to Quality Improvement Make it clear that management is committed to quality Form quality improvement teams with representatives from each department Determine how to measure where current and potential quality problems exist Evaluate the cost of quality and explain its use as a management tool Raise the quality awareness and personal concern of all employees Take formal actions to correct problems identified through previous steps Establish a committee for the zero defects program Train all employees to actively carry out their part of the quality improvement program Hold a zero defects day to let all employees realize there has been a change Encourage individuals to establish improvement goals for themselves and their groups Encourage employees to communicate to management the obstacles they face in attaining their improvement Recognize and appreciate those who participate Establish quality councils to communicate on a regular basis Do it all over again to emphasize that the quality improvement program never ends Crosbys Absolutes Quality means conformance to requirements if you intend to do it right the first time, then everyone must know what it is Quality comes from prevention. Vaccination is the way to prevent organizational disease. Prevention comes from training, discipline, example, leadership, and so forth Quality performance standard is zero defects errors should not be tolerated Quality measurement is the price of nonconformance Armand V. Feigenbaum Three Steps to Quality Quality leadership Modern quality technology Commitment of the organization Armand V. Feigenbaum Four Deadly Sins Hothouse quality Wishful thinking Producing overseas Confining quality to the factory Nineteen Steps to Quality Improvement TQC is defined as: An effective system for integrating the quality maintenance and quality improvement efforts of the various sectors of an organization so as to enable marketing, engineering, production, and service at the most economic levels which will allow for full customer satisfaction. Quality vs. quality. Q refers to luxurious quality, whereas q refers to high quality, not necessarily luxury. Regardless of organizational niche, q must be closely maintained and improved. The C or control in TQC represents a management tool: Setting quality standards Acting when standards are exceeded Planning for improvements in the standards Appraising conformance to those standards INTEGRATION: QC requires integration of typically un- coordinated activities into a framework. This framework should assign responsibility for customer-driven quality efforts across all activities of the organization. Quality increases profits. Properly carried out, TQC programs are highly cost effective since they result in improved levels of customer satisfaction, reduced operating losses and field service costs, and improved use of resources. Without quality, customers will not return. Without repeat business, no business will survive. Quality is an expectation, not a desire. In Demings terms, quality begets quality; as one supplier becomes quality oriented, others must follow suit. The greatest quality improvements are likely to come from people improving the process, not through adding machines. TQC applies to all products and services no person, process, or department is exempt. Quality is a total life-cycle consideration. QC enters into all phases of a production process, starting with customer specifications, through design engineering and assembly, to shipment, installation, and field service. Control the process through control of new designs, incoming material, product, and process. A total quality system is the agreed company-wide and plant-wide operating work structure, documented in effective, integrated technical and managerial procedures, for guiding the coordinated actions of all resources including people, machines, and information in the best and most practical ways to assure customer quality satisfaction and economical costs of quality. The quality system provides integrated and continuous control to all key activities, making it truly organizational in scope. Benefits accruing from TQC programs tend to include improvement in product quality and design, reduced operating costs and losses, improved employee morale, and reduction of production line bottlenecks. Quality costs are a means for measuring and optimizing TQC activities. Operating costs are divided into four different categories: prevention costs, appraisal costs, internal failure costs, and external failure costs. The tenet that quality is everybodys job must be clearly demonstrated. Every organizational component has a quality-related responsibility. This must be explicit and visible. Organizations need quality facilitators who can disseminate information, provide training and so forth not quality police. TQC is not a temporary quality improvement plan, it is guiding an ongoing practice and philosophy. Statistical methods should be used whenever and wherever they are useful, but they are only one part of TQC and are not TQC itself. The best people-oriented activities should be implemented before resorting to automation, which is not a cure-all and can provide the stuff of which implementation nightmares are made. Control quality at its source quality should be an upstream and everywhere in the stream concept and practice, not merely downstream as has too often been the case. Deming Basic philosophy Continual improvement through lifelong learning. System of Profound Knowledge Deming advocated a new approach to management. 1) Appreciation for a system. 2) Knowledge about variation. 3) Theory of knowledge. 4) Psychology. Fourteen Points W. Edwards Deming (1900-1993) Dr. W. Edwards Deming: A System of Profound Knowledge Dr. Deming (1900-1993) Developed a Four-Part System of Profound Knowledge that he felt should be a fundamental management concept. These four elements of Dr. Demings system are: Appreciation for a System; Theory of Variation (Statistical Theory); Theory of Knowledge; Knowledge of Psychology. Fourteen Points for Management: Dr. Demings System of Profound Knowledge Profound Knowledge: Appreciation of a System Managing a system is action based on rational prediction. Rational prediction requires systematic learning and comparing predictions of short-term and long-term results from possible alternative courses of action. What is a System? A system is a series of functions or activities (subprocesses, stages - that is, components) within an organization that work together for the aim of the organization. In almost all systems there is system interdependence between components and the greater this interdependence, the greater the need for communication & cooperation between these components - and this includes people! The components need not all be clearly defined & documented: people may merely do what needs to be done. Managing a system requires knowledge of these interrelationships. The aim of the system must be clear to everyone in the system. Lacking aim - there is no system! The aim is a value judgement. Dr. Deming proposed an aim for every organization -- for everyone to gain -- stockholders, employees, suppliers, customers, community, the environment - over the long-term. System Optimization: Simply stated - this is accomplishment of the aim, so that everyone in the system can benefit. Failure to optimize causes loss to everybody in the system. Optimization requires management of the system so that the responsibility of an organizations leadership is to strive toward optimization of the system, keeping it optimized over time. Additionally, leadership should be ready to push the envelope of the system to better serve the aim. If the aim, size or boundary of the organization changes, then the functions of the components will change for optimization of the new system. Time brings changes that must be managed to achieve optimization. Every system requires guidance. The performance of any component is to be judged in terms of its contribution to the aim of the system, not for its individual production or profit, nor for any other competitive measure. Some components may operate at a loss to themselves, for optimization of the whole system, including the components that take the loss. Any system that results in a win-lose structure is suboptimized! Suboptimization in the Management of People: Causing Losses Unknown & Unknowable The merit system -- a destroyer of intrinsic motivation with emphasis on rank - not on work. Grading in school - from youth through university. MBO (Management by Objective) and MBIR (Management by Imposition of Results). Incentive pay. Business plans - each division with its own business plan, not coordinated toward an aim. Work standards for production & quotas for sales -- quotas for accidents and breakdowns. Competition for market share. Barriers to trade. Profound Knowledge: Statistical Theory of Variation Some understanding of variation, including appreciation of a stable system, and some understanding of special causes and common causes of variation, is essential for managing - including leading people. There will always be variation: between people, output, service, product. What is the variation trying to tell us about a process and about the people that work in it? Understanding the capability of a process: When do data indicate that a process is stable? The distribution of output of a stable system is predictable with a high degree of confidence. A process that is stable (in a state of statistical control) has a definable capability. The leadership of people (manager, leader, supervisor, teacher) is entirely different in two states: stable & unstable. Confusing the two states can lead to calamity. Profound Knowledge: Statistical Theory of Variation Knowledge about different sources of uncertainty in the system of measurement: Is the measurement system stable, in statistical control? There are two costly mistakes in attempts to improve a process: To treat as a special cause any outcome, fault, complaint, mistake, breakdown, accident, shortage, when actually it came from common causes -- this is called tampering. Conversely, to attribute all of these to common causes, when in fact it may be a special or assignable cause -- the ostrich approach. Knowledge of procedures aimed at minimum economic loss from these two mistakes -- Shewhart control charts. Knowledge about interaction of forces. Interaction may reinforce efforts, or it may nullify efforts. Profound Knowledge: Statistical Theory of Variation Understanding the distinction between enumerative studies and analytical problems. An enumerative study produces information about a frame. The theory of sampling and design of experiments are for enumerative studies -- the U.S. Census is an enumerative study. Another example is a shipload of iron ore -- both buyer & seller need to know how much iron is on board. The interpretation of results of a test or experiment is something else -- it is prediction that a specific change in a process or procedure will be a wise choice, or that no change would be better. Either way the choice is a prediction. This is referred to as an analytical problem. Knowledge about loss functions in relation to system performance optimization. Which quality characteristic has the steepest loss function, and is hence most critical for leadership to work on? Profound Knowledge: Statistical Theory of Variation Knowledge about the losses that come from unfortunate successive application of random forces or random changes that may individually be unimportant. Examples include: Working training worker training worker, in succession. Executives working with best efforts on policy, but without guidance of profound knowledge. Enlargement of a committee does not necessarily improve the results of the efforts of the committee. Enlargement of a committee is not a way to acquire profound knowledge. As a good rule, profound knowledge must come from the outside and by invitation. Profound knowledge cannot be forced onto anyone. Profound Knowledge: Theory of Knowledge Any rational plan, however simple, requires prediction concerning conditions, behavior, comparison of performance of each of two procedures or materials. A statement devoid of prediction or explanation of past events is no help in management of a system. Without theory, there is nothing to modify or to learn by comparison with experience. Interpretation of data from a test or experiment is prediction -- what will happen on application of the conclusions or recommendations that are drawn from a test or experiment? This prediction will depend largely on knowledge of the subject matter. It is only in the state of statistical control that statistical theory aids prediction. Profound Knowledge: Theory of Knowledge An example is no help in management unless studied with the aid of theory. Copying a successful example, without understanding it with the aid of theory, may lead to disaster. Communication and negotiation requires operational definitions to achieve optimization. No number of examples establishes a theory, yet a single unexplained failure of a theory requires modification or even abandonment of a theory. There is no true value of any characteristic, state, or condition that is defined in terms of measurement or observation. Change of procedure for measurement or observation produces a new number. There is no such thing as a fact concerning an empirical observation. Any two people may have different ideas about what is important. Profound Knowledge: Knowledge of Psychology Psychology may help us understand people and interactions between people and circumstances. People are different from one another. A leader must be aware of these differences, and use them to optimize everybodys abilities and inclinations. Management of industry, education and government operated today under the supposition that all people are alike. People learn in different ways and at different speeds. Some learn best by reading, some by listening, some by watching pictures - still or moving, some by observation, others by doing. By virtue of her authority, a leader is obligated to make changes in the system of management that will bring improvement. Profound Knowledge: Knowledge of Psychology - Motivation There is intrinsic motivation, extrinsic motivation, and over-justification. People are born with a need for relationships with other people, and with the need to be loved and esteemed by others. There is an innate need for self-esteem and respect. Circumstances provide some people with dignity & self-esteem while denying others these advantages. Management that denies their employees dignity & self-esteem will smother intrinsic motivation. Some extrinsic motivators rob employees of dignity and self-esteem. If for higher pay or for a higher performance evaluation, I do what I know to be wrong, then I am robbed of dignity & self-esteem. Profound Knowledge: Knowledge of Psychology - Motivation Extrinsic motivation is submission to external forces that neutralize intrinsic motivation -- one is ruled by these forces. Extrinsic motivation is a zero-defect mentality. Removal of a demotivator does not create motivation. Overjustification is a result of faulty reward systems -- it is resignation to outside forces. Dr. W. Edwards Deming 14 Points for Management
Create Constancy of Purpose for Product & Service Improvement This implies: Faith in the future. Create Constancy of Purpose for Product and Service Improvement Continuous improvement of product and service: Obligation to the customer never ceases. Status quo will not do. Invest in the maintenance of equipment, furniture, and fixtures, and in new aids to production in the office and in the plant. Learn & Adopt the New Philosophy: Both Executive Leadership & the Workforce The cost of living depends inversely on the cost of goods and services that a given amount of money will buy. Reliable service reduces costs. Delays & mistakes raise costs. Customers dont complain. They merely switch brands. In earlier times virtually any system of management would have been successful since there was little competition. In a competitive environment quality must be pre-eminent. Cease Dependence on Mass Inspection Quality comes not from inspection, but from improvement of the process. The old way: Inspect bad quality out. The new way: Build good quality in. End the Practice of Awarding Business on Price Tag Alone This leads to a proliferation of suppliers and hence an increase in the variability of materials and, ultimately, the variability in the end product. This leads to vendor hopping and reliance on specifications each of which is an obstacle to continuous improvement. Defects beget defects. Good quality begets good quality. Price has no meaning without reference to the quality that is being purchased. Improve Constantly and Forever the System of Production & Service Everyone and every department must devote themselves to constant improvement. Management must lead the way. The focus must be on improvement and not merely fire-fighting. Institute Training & Retraining Workers often learn duties and how to perform them from other employees who didnt know how to perform them in the first place. Similarly, workers often learn these things from unintelligible instruction sets. All employees will have to have some training in the importance of variation and must be taught the basics of control charts. When new equipment is purchased or new processes are brought on line, there must be appropriate training/retraining. Teach & Institute Leadership Leadership is managements job. Most managers/supervisors do not truly know (how to perform) the duties of the employees they supervise. A deaf ear is often turned to the voice of the employee. Often an employee knows not only what the problem is, but also how to solve it. Drive Out Fear - Create Trust: Create a Climate for Innovation Most people on the job do not know how to properly perform their duties (including managers) and are afraid to ask for fear of being viewed as incompetent, or of punitive measures being taken, or of dismissal. People must feel secure in their positions so that they can be effective improvement agents.
Optimize toward the aims and purposes of the company, the efforts of teams, groups & staff areas. Communication is vital to being competitive via company-wide improvement. Break Down Barriers Between Staff Areas
132 sl Eliminate Slogans, Exhortation, and Targets for the Workforce Numerical targets are useless unless methods for achieving them are
in place and the worker is performing within a stable system. Slogans generate frustration and resentment -- implying the worker is intentionally holding back. Eliminate Numerical Quotas Quotas are an impediment to quality since they induce the worker to pass on work that is substandard in an effort to meet the quota. This is a case of haste makes waste. Piecework is demeaning. A proper work standard defines what is and what is not acceptable in terms of quality. Encourage Education & Self-Improvement for Everyone It is not enough to have good people in your organization. They must continually acquire new knowledge and skills in order to properly deal with new materials and methods and to function as an agent for continuous improvement. A company must make it clear that no one will lose their job due to productivity improvement.
In the Spirit of Continuous Improvement What is the Next Turn in the Revolution?
Model for Quality Improvement - PDSA (Plan-Do-Study-Act) PDSA, PDCA, the Deming Cycle, the Shewhart Cycle... it's all the same thing Developed by Walter Shewhart during the 1930's. Promoted from the 1950s on by W. Edwards Deming (Shewharts mentee). Model for Quality Improvement - PDSA (Plan-Do-Study-Act) 1: Setting Aims: Ask What are we trying to accomplish? It may be reducing the clinic wait-time or increasing beta-blocker use among patients with an acute myocardial infarction (AMI). The aim should be time-specific and measurable, and define the population that will be affected. 2: Establish measures: Ask How will we know that a change is an improvement? Measures help the team determine if a change leads to quantitative improvement. 3: Selecting Changes: Ask What changes can we make that will result in improvement? Improvement requires change, but all change does not lead to improvement. It is the expertise of the team that will determine which changes will lead to an improvement. Sources: The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. San Francisco, California, USA: Jossey-Bass Publishers; 1996. Institute for Healthcare Improvement. Available at: Http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/ Model for Improvement using PDSA (Plan-Do-Study-Act) PDSA -Plan, Do, Study, Act - provides a way of testing ideas by starting small and building on the results. With each cycle you gather more knowledge to help make the next improvement. By keeping the PDSA activity small and simple, the organization can measure the effect of change over time. (Plan-Do-Study-Act) 4: Testing Change: Ask How can we make changes in the real world setting? Plan - answering the questions in the first three steps above setting aims, establishing measures, and selecting changes. Do - implementing the changes. It happens when nurses and physicians receive professional development and patients are educated. It happens when the organization use evidence-based interventions that help in providing consistency of care. Study - evaluating the pilot change to see if it produced the desired effect. Act - to adopt, reject or modify the change plan, so that the next cycle can begin. The PDSA cycle offers a route for improvement in a systematic manner. Often the desired improvement is not achieved in one cycle, and so the cycle is repeated. Even if the desired aim is achieved, new aims and goals arise and the process begins with step one. Model for Improvement using PDSA (Plan-Do-Study-Act) 5: Implementing changes: Ask We know this works what do we do now? After several successful PDSA cycles the organization may wish to implement the change on a broader scale. For example, it will move the new way of doing things from one floor to the entire hospital, or from one clinic to all the clinics. 6: Spreading changes: Ask How can we help others bring about change? Share the changes with other departments or organizations and spread best practices. IT Strategy Using PDCA Defining an Approach to Change Will the team target all patients in the inpatient bell curve, or just a sub-group considered at- risk (depicted in the outlying tail)? Is the quality of inpatient care which is not in the tail somehow acceptable? Graphs Defining an Approach to Change If the team can identify and define an inpatient sub-group at-risk, then improvement efforts could conceivably focus just on these at-risk patients - this is similar to traditional Quality Assurance. Note that even if tail events are eliminated, the quality of care for the rest of the inpatient population (depicted by the unchanged position and shape of the bell curve) does not improve at all. While the mean does move toward better care, this is due only to eliminating statistical outliers.
Defining an Approach to Change If the team identifies a performance gap applicable to a wider patient population, the team may design changes in processes with the potential for dramatic effect: improvement and standardization in processes reduces variation (narrows the curve) and raises quality of care for all (shifts entire curve toward better care). This radical change is what defines Quality Improvement.
Take Action to Accomplish the Transformation sPlan: What could be the most important accomplishment of this team? What changes might be desired? What data are available? Are new observations needed? If yes, plan a change or test. Decide how you will use the observations. Do: Search for data on hand that could answer the question put forth in the P stage. Or, carry out the change or test decided upon, preferable on a small scale. This is often a Reduced Implementation. Study the effects of the change or test. Standardize the approach with an eye toward portability of solution. Act: What actions should be taken? Often this implies implementation on a broader scale. Hold the Gain: Prove the gain to be sustainable. This may be concurrent with the next planning stage of this repetitive cycle. Demings Seven Deadly Diseases: Quality Cancers Lack of constancy of purpose Demings Seven Deadly Diseases: Quality Cancers Demings Obstacles Neglect of long-range planning and transformation Supposition that problem solving, automation, gadgets and new machines will transform industry Search for examples that can be copied Obsolete schools of Business The misconceptions that, Anyone who comes to try to help us must understand all about our business. Blaming the workforce for problems False starts Meeting specifications Our problems are different Reliance on QC departments Quality by inspection The unmanned computer Inadequate testing of prototypes. Deming believed: Export anything to a friendly country, except
American Management. Deming Award Establish in 1950 originally for Japanese companies for major advances in quality improvement Deming award is given under jurisdiction of Japanese Union of Scientists & Engineers Today the Deming award is awarded to non Japanese companies and even individuals Other Major Contributors to Quality in the past 35 years Genichi Taguchi Kaoru Ishikawa Masaaki Imai Shigeo Shingo Yoshio Kondo Genichi Taguchi His methodologies held ensure customer satisfaction Taguchis Loss Function Taguchi Method Design of Experiments Taguchis Loss Function A quality product is a product that causes a minimal loss (expressed in money!) to society during it's entire life. The relation between this loss and the technical characteristics is expressed by the loss function Taguchi loss function A way to show how each non-perfect part produced, results in a loss for the company. Deming states that it shows "a minimal loss at the nominal value, and an ever-increasing loss with departure either way from the nominal value." - W. Edwards Deming Out of the Crisis. p.141 A technical definition is: A parabolic representation that estimates the quality loss, expressed monetarily, that results when quality characteristics deviate from the target values. The cost of this deviation increases quadratically as the characteristic moves farther from the target value. - Ducan, William Total Quality Key Terms. p. 171 Genichi Taguchi Pioneered a new perspective on quality based on the economic value of being on target and reducing variation and dispelling the traditional view of conformance to specifications: Taguchis Loss Function Kaoru Ishikawa Simplified statistical techniques for QC Cause and Effect diagrams (Ishikawa Diagrams or Fish Bone Diagrams) Company wide quality control quality does not only mean the quality of product, but also of after sales service, quality of management, the company itself and the human life Kaoru Ishikawa Dr. Ishikawa promoted the use of quality circles Dr. Ishikawa focused on four areas to influence quality: Market-in Quality Worker Involvement Quality Begins and Ends with Education Selfless Personal Commitment Ishikawa Diagram Ishikawa Diagram Diagrams which show the causes of a certain event Three sets of causes 6 Ms Machine Method Maintenance Man Mother Nature Ishikawa Diagram 8 Ps Price Promotion Process Place/Plant Policies Procedures Product (or Service) 4 Ss Surroundings Suppliers Systems Skills Masaaki Imai Introduced the concept of Kaizen or continuous improvement. Expanded work started by Juran and Deming. Shigeo Shingo Fool-Proofing or Poke-Yoke Source Inspection systems No statistical sampling is necessary Zero defects through good engineering and process investigation rather than slogans and exhortations Yoshio Kondo Emphasized inter-relationship between quality and people Creativity joy of thinking Physical activity joy of working Sociality joy of sharing pleasure and pain with colleagues
Fortin, Sebastian - Holik, Federico - Lombardi, Olimpia - López, Cristian - Quantum Worlds - Perspectives On The Ontology of Quantum Mechanics-Cambridge University Press (2019)