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RD-525 Principles of Quality Management

Dr. Harvey Hoffman

Email Contact: [email protected]

Introduction Quality Gurus

Fairfield University

QualitysFoundation

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 requirements stated orunstated, 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 whichthe product in use will meet the needs and expectations of the customers.

Concept of quality must start with identification of customer quality requirements andmust end only when the finished product is placed into the hands of the customer whoremains 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) thatbears 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

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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 meetneeds of the consumer.

Also known as Customer Oriented Approach

Production Based Approach

An outcome of engineering or operational excellence and is measured in terms ofquality 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

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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


Company wide Quality Control

Measured in all functions connected with production such as

R&D

Design

Engineering

Purchasing,

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Operations etc

Total Quality Management

Measured in all aspects of business,

Top management commitment

Continuous improvement

Involvement & participation of employees


QualityEvolution

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


Quality Assurance vs. Quality Control

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True Value vs. Measured Value

True Value

The known, accepted value of a quantifiable property

Measured Value

The result of an i ndividuals 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 anoutput.

Quality Basics

Variation:

Variation is present in any natural process, no two products or occurrences are exactlyalike.

Specifications:

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Specifications state product or service characteristics in terms of a desired target valueor dimension.

Tolerance Limits:

Tolerance limits show the permissible changes in the dimension of a qualitycharacteristic.

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 operationson a scientific basis in terms of controllable risks.

George Edwards- first president of American Society for Quality Control

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Quality Basics

The Evolution of Modern Quality

Inspection refers to those activities designed to detect or find non-conformancesexisting 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 thequality of a product or service.

Quality Basics


Statistical Quality Control involves collecting statistical data, analyzing it, andinterpreting it to solve problems.

Statistical Process Control prevents defects by applying statistical methods to controlthe processes making products or providing services.

Quality Basics


Total Quality Management is a management approach that places emphasis oncontinuous process and system improvement as a means of achieving customersatisfaction to ensure long-term company success.

Continuous Improvement focuses on improving processes in order to enable companiesto 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 ec onomically, 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)

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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 - TotalQuality Management

Big Q versus Little q

q = the products in manufacturing

Q = ALL processes in all industri es

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, andeducation

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 performanceexcellence. Quality is a race without a finish line.

Contemporary Influences on Quality

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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

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Customer and Stakeholder Focus

Customer is principal judge of quality

Organizations must first understand customers needs and expectations in order to meet andexceed 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) intooutputs (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

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Learning

The foundation for improvement Understanding why changes are successful throughfeedback 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

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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 ofan organization. Thus, quality must begin at a personal level (and that means you!).

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 andEngineers.

Deming taught Japanese engineers and management statistical methods and how to viewproduction 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)

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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 whichmeet customer needs and thereby produce income; in this sense, higher quality usually costsmore

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, qualitycontrol, 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; appointteams; 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 qualityimprovement.

Jurans Quality Planning Process

Identify the customers; anyone who will be impacted is a customer, whether internal orexternal.

Determine the customers needs.

Create product features which can meet the customers needs.

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Create processes which are capable of producing the product features under operatingconditions.

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 meetingcompetition; there are goals for annual quality improvement

Juran & Continuous ImprovementTotal 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; teamworkbetween a company and its suppliers would be based on mutual trust and contracts should begreater duration.

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THIRD, training should be results-oriented rather than tool-oriented; what is desired is related moretoward 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 factit is either conformance or nonconformance to customer/product requirements which is of centralimportance. 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 theirimprovement

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, theneveryone must know what it is

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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. FeigenbaumThree 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 Stepsto 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, andservice 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, notnecessarily luxury. Regardless of organizational niche, q must be closely maintained andimproved.

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

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INTEGRATION: QC requires integration of typically un- coordinated activities into a framework.This framework should assign responsibility for customer-driven quality efforts across allactivities 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 servicecosts, and improved use of resources. Without quality, customers will not return. Withoutrepeat business, no business will survive.

Quality is an expectation, not a desire. In Demings terms, quality begets quality; as onesupplier becomes quality oriented, others must follow suit.

The greatest quality improvements are likely to come from people improving the process, notthrough 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 thecoordinated actions of all resources including people, machines, and information in the bestand 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 anddesign, reduced operating costs and losses, improved employee morale, and reduction ofproduction line bottlenecks.

Quality costs are a means for measuring and optimizing TQC activities. Operating costs aredivided 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 organizationalcomponent has a quality-related responsibility. This must be explicit and visible.

Organizations need quality facilitators who can disseminate information, provide training and soforth not quality police.

TQC is not a temporary quality improvement plan, it is guiding an ongoing practice andphilosophy.

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Statistical methods should be used whenever and wherever they are useful, but they are onlyone 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 streamconcept 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 feltshould be a fundamental management concept. These four elements of Dr. Demings systemare:

Appreciation for a System;

Theory of Variation (Statistical Theory);

Theory of Knowledge;

Knowledge of Psychology.

Fourteen Points for Management:

Dr. Demings System

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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 andlong-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) withinan organization that work together for the aim of the organization.

In almost all systems there is system interdependence between components and the greaterthis interdependence, the greater the need for communication & cooperation between thesecomponents - and this includes people!

The components need not all be clearly defined & documented: people may merely do whatneeds 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 r esponsibility of an organizationsleadership 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 theaim.

If the aim, size or boundary of the organization changes, then the functions of the componentswill 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. Somecomponents 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!

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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 someunderstanding 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 variationtrying 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? Thedistribution of output of a stable system is predictable with a high degree of confidence. Aprocess 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 twostates: stable & unstable. Confusing the two states can lead to calamity.


Knowledge about different sources of uncertainty in the system of measurement: Is themeasurement 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 aspecial or assignable cause -- the ostrich approach.

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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 nullifyefforts.


Understanding the distinction between enumerative studies and analytical problems .

An enumerative study produces information about a frame. The theory of sampling anddesign of experiments are for enumerative studies -- the U.S. Census is an enumerativestudy. Another example is a shipload of iron ore -- both buyer & seller need to knowhow much iron is on board.

The interpretation of results of a test or experiment is something else -- it is predictionthat a specific change in a process or procedure will be a wise choice, or that no changewould 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. Whichquality characteristic has the steepest loss function, and is hence most critical forleadership to work on?


Knowledge about the losses that come from unfortunate successive application of randomforces 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 profoundknowledge.

Enlargement of a committee does not necessarily improve the results of the efforts of thecommittee. 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 . Profoundknowledge 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.

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A statement devoid of prediction or explanation of past events is no help in management of asystem.

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 applicationof the conclusions or recommendations that are drawn from a test or experiment? Thisprediction will depend largely on knowledge of the subject matter. It is only in the state ofstatistical 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 asuccessful 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 theoryrequires modification or even abandonment of a theory.

There is no true value of any characteristic, state, or condition that is defined in terms ofmeasurement or observation. Change of procedure for measurement or observation produces anew number.

There is no such thing as a fact concerning an empirical observation. Any two people may havedifferent 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 usethem to optimize everybodys abilities and inclinatio ns. Management of industry, education andgovernment 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 bylistening, 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 managementthat will bring improvement.

Profound Knowledge:Knowledge of Psychology - Motivation

There is intrinsic motivation, extrinsic motivation, and over-justification.

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People are born with a need for relationships with other people, and with the need to be lovedand esteemed by others. There is an innate need for self-esteem and respect.

Circumstances provide some people with dignity & self-esteem while denying others theseadvantages. 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 ahigher 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 isruled 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 Deming14 Points for Management

Create Constancy of Purpose forProduct & 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 productionin 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 ofmoney will buy.

Reliable service reduces costs. Delays & mistakes raise costs.

Customers dont complain. They merely switch brands.

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In earlier times virtually any system of managementwould have been successful since there was lit tle competition. In a competitive environmentquality 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 tocontinuous improvement.

Defects beget defects.

Good quality begets goodquality.

Price has no meaning without reference to thequality 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 unintelligibleinstruction sets.

All employees will have to have some training in the importanceof variation and must be taught the basics of control charts.

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When new equipment is purchased or new processes are brought on line, there must beappropriate training/retraining.

Teach & Institute Leadership

Leadership is managements job.

Most managers/supervisors do not truly know (how to perform) the duties of the employeesthey supervise.

A deaf ear is often turned to the voice of the employee. Often an employee knows not onlywhat 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 beingtaken, 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 & staffareas.

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.

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Eliminate Numerical Quotas

Quotas are an impediment to quality since they induce the worker to pass on work that issubstandard 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 continuallyacquire new knowledge and skills in order to properly deal with new materials and methods andto 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. EdwardsDeming (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 orincreasing beta-blocker use among patients with an acute myocardial infarction (AMI). The aim shouldbe 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 theteam determine if a change leads to quantitative improvement.

3: Selecting Changes : Ask What changes can we make that will result in improvement? Improvementrequires change, but all change does not lead to improvement. It is the expertise of the team that willdetermine 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-BassPublishers; 1996.

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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 PDSAactivity 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, andselecting 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-basedinterventions 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 improvementis not achieved in one cycle, and so the cycle is repeated. Even if the desired aim is achieved, new aimsand 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 succes sfulPDSA cycles the organization may wish to implement the change on a broader scale. For example, it willmove the new way of doing things from one floor to the entire hospital, or from one clinic to all theclinics.

6: Spreading changes: Ask How can we help others bring about change? Share the changes with otherdepartments 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 somehowacceptable?

Graphs
http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/

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If the team can identify and define an inpatient sub-group at -risk, then improvement efforts couldconceivably focus just on these at -risk patients - this is similar to traditional Quality Assurance. Notethat 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 themean does move toward better care, this is due only to eliminating statistical outliers.


If the team identifies a performance gap applicable to a wider patient population, the team may designchanges in processes with the potential for dramatic effect: improvement and standardization inprocesses reduces variation (narrows the curve) and raises quality of care for all (shifts entire curvetoward 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 mightbe desired? What data are available? Are new observations needed? If yes, plan a change ortest. 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, carryout the change or test decided upon, preferable on a small scale. This is often a ReducedImplementation.

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 planningstage of this repetitive cycle.

Demings Seven Deadly Diseases:

Quality Cancers

Lack of constancy of purpose

Demings Seven Deadly Diseases: Quality Cancers

Demings Obstacles

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Neglect of long-range planning and transformation

Supposition that problem solving, automation, gadgets and new machines will transformindustry

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 ourbusiness.

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

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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


A quality product is a product that causes a minimal loss (expressed in money!) to society duringit's entire life. The relation between this loss and the technical characteristics is expressed bythe 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 whenquality characteristics deviate from the target values. The cost of this deviation increases quadraticallyas 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 andreducing variation and dispelling the traditional view of conformance to specifications:


Kaoru Ishikawa

Simplified statistical techniques for QC

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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, qualityof 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

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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 Juranand 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 andexhortations

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

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Documents