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دبلومة إدارة المستشفياتوالجودة الصحية By DR.Hatem ELBitar
Perception of QualityOnce you get a reputation, it’s hard to lose it
Totality of characteristics of an entity that bear on its ability to satisfy stated and implied needs(ISO 8402 : 1994)
Meeting and exceeding the implied and stated needs of the customer
A successful business meets all its customers’ requirements
A small break in the internal chain can be proportionately greater when they get to the external customer/supplier interface
Quality must be built in from beginning of an organization’s activities, not ‘inspected in’ at the end
Quality Control • Quality Control involves monitoring specific project results to determine if they comply with relevant quality standards, and identifying ways to eliminate causes of unsatisfactory results
Total Quality Management Approach • Methods • Materials • Equipment • Skills & knowledge • Instructions • Processes
Process Inputs Outputs
Q: Are we capable doing the job correctly? Q: Do we continue to do the job correctly?
The customer/supplier chain is the core of the Total Quality Management model
TQM Support Mechanism • Systematic Planning • Tools for measuring delivering and sustaining quality • Organizing for quality & developing teams • Communication between all parts of the organization • Commitment of the organization to a TQM approach • Recognition and perhaps change of the organizations’ culture & environment
Five Pillars of TQM • Product • Processes • Organization • Leadership • Commitment
TQM • A management approach centered on quality, based on company-wide participation and aimed at long term success through customer satisfaction (ISO)
TQM • Based on company-wide participation • TQM involves everyone in an organization -every function and every activity
Evolution of Quality 1200-1799 Guilds of Medieval Europe 1900-1940 Process Orientation 1946-Present Birth of Total Quality 1800-1899 Product Orientation 1941-1945 Quality during World War II
Guilds of Medieval Europe(1200-1799) • Craftsmen across Europe organized into unions called Guilds • Guilds were responsible for developing strict rules for product and service quality • Inspection committees enforced the rules by identifying flawless goods with a special mark • A second quality mark came from the craftsmen themselves • Primary Focus: Product Inspection
Product Orientation(1800-1899) • US quality practices in the 1800s were shaped by several different production methods: • Craftsmanship • The Factory System • The Taylor System
Craftsmanship • Early 19th century- the approach tended to follow the craftsmanship model in the European countries • Masters maintained a form of quality control by inspecting goods before sale
The Factory System • This is a product of the industrial revolution in Europe • The craftsmen became factory workers and the shop owners their production supervisors • Quality in the factory system was ensured through skilled laborers and supplemented by audits and/or inspections • Large production departments employed full-time inspectors who produced quality reports and • Defective products were either reworked or scrapped.
The Taylor System • In the late 19th century US broke from European tradition and adopted a new management approach by Taylor • Taylor’s goal was to increase productivity without increasing the no. of skilled craftsmen • He achieved this by assigning factory planning to specialized engineers and using displaced workers and supervisors to execute the engineers plans • This new approach led to remarkable rises in productivity • BUT …
The Taylor System • Workers once again stripped of their dwindling power and the new emphasis was on productivity which had an adverse effect on quality
Product Orientation(1800-1899) • Primary Focus: Product Inspection
Process Orientation(1900-1940) • Beginning of the 20th century marked the inclusion of processes in quality practices • Shewhart recognized that industrial processes yield data. • He determined that this data can be analyzed using statistical techniques to see if a process is stable or “in control” or if is being affected by special causes that should be fixed. • His concepts are referred to as “Statistical Quality Control” (SQC) • Primary Focus: Product Inspection & SQC
Quality during World War II(1941-1945) • After World War II had started, US enacted legislation to help gear the civilian economy to military production • At that time contracts were awarded to manufacturers who submitted the lowest bid. Products were inspected upon delivery • The armed forces inspected virtually every unit of product to ensure that it was safe for operation • To ease this problem, the armed forces began to utilize sampling inspection to replace unit-by-unit inspection • They adopted sampling tables and published them in a military standard Mil-Std-105 • They also helped their suppliers improve their quality by sponsoring training courses in Shewhart’s SQC techniques • Primary Focus: Sampling Inspection & SQC
Birth of Total Quality(1946-Present) • After World War II, major Japanese manufacturers converted from producing military goods for internal use to civilian goods for trade • Poor response from the world market • Japan started exploring new ways of thinking about quality (Deming and Juran) • Rather than relying purely on product inspection, total quality focused on improving all organizational processes through the people who used them