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Quality Improvement Overview. Edward Crooks MD, CMQ, CLSSBB,. Quality Improvement. Total Quality Management
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Quality ImprovementOverview Edward Crooks MD, CMQ, CLSSBB,
Quality Improvement Total Quality Management • Total Quality Management, is any quality management system, that addresses all areas of an organization, emphasizes customer satisfaction, and uses continuous improvement methods and tools. • This approach emphasizes far more than statistics. • Embraces the entire organization not just the production area. • Involves a change in management style, not just the use of statistical tools.
Quality Improvement TQM includes • Management Philosophy • An Improvement Process or Model • A set of tools that may include the seven quality control tools. Practitioners of TQM might follow a program based on: • Deming’s fourteen management points • Juran’s Trilogy (Quality planning, quality control and quality improvement. • Phillips Cosby’s Four Absolutes of Quality Management
Quality Improvement Leaders of organization adopting TQM usually make fundamental changes in their management philosophy and methods. TQM Programs include: • Senior management leadership of quality • Employee involvement and empowerment. • Customer defined quality and a focus on customer satisfaction • A view of work as process. • Continuous improvement.
Quality Improvement Seven QC Tools • Most fundamental tools and first ones developed. • First emphasized by Kaoru Ishikawa, professor of engineering at Tokyo University. • Original 7 tools were: • Cause and effect diagram • Check sheet • Shewart’s control chart • Histogram • Pareto chart • Scatter diagram • Stratification
Quality Improvement Seven Management and Planning Tools • 1976 JUSE (Union of Japanese Scientist and Engineers) saw the need for tools to promote innovation, communicate information and successfully plan major projects. • A team researched and developed the seven new QC tools. • Affinity diagram • Relationship diagram • Tree diagram • Matrix diagram • Matrix data analysis (prioritization matrix) • Arrow diagram • Process decision program chart (PDPC)
Quality Improvement Seven MP Tools • Introduced in US in mid 1980’s, with Hoshin planning, a breakthrough strategic planning process that links visionary goals to work plans.
Quality Improvement Other Developments • Genichi Taguchi – new methods of applying experimental design to QC. • Masaaki Imai – popularized the term and concept Kaizen (which means small, continuous improvement often using the PDSA cycle).
Quality Improvement New Developments/Repackaging • Lean Manufacturing (Toyota) • Six Sigma (Motorola • Malcolm Baldrige National Quality Award (MBNQA) • Benchmarking (Xerox) • ISO 9000 (International Organization for Standardization) • Quality Function Deployment (QFD)
Quality Improvement Tools • A tool is any implement, instrument or utensil held in hand and used to change something. • Tools are small, often part of a larger unit • They do something – each is designed for a specific purpose. • Concepts are not tools ( they don’t do anything) • Methodologies and systems are not tools because they are large and do too many things.
Quality Improvement Quality Tools Quality tools are diagrams, charts, techniques and methods that, step by step, accomplish the work of quality improvement.
Quality Improvement To choose the right tool one have to answer three questions. • What do we want to do with this tool? • Where are we in our quality improvement process? • Do we need to expand or focus our thinking?
Quality Improvement What do we want to do with this tool. Quality improvement tools can be group according to how they are used. • Project planning and implementing tools • Idea creation tools • Process analysis tools • Data collection and analysis tools • Cause analysis tools • Evaluation and decision-making tools
Quality Improvement Project planning and Implementing tools • Balance score card • Flow chart • Force field • Gantt chart • Plan-do-study-act • Project charter • Stakeholder analysis
Quality Improvement Idea creation tools • Affinity diagram • Benchmarking • Brainstorming’ • Relationship diagram • Storyboard
Quality Improvement Process analysis tools • Benchmarking • Critical to quality analysis • Failure modes and effects analysis • Flow chart • Matrix diagram • Mistake proofing • SIPOC diagram • Story Board • Value-added analysis • Work flow diagram
Quality Improvement Data collection and analysis tools • Balance scorecard • Benchmarking • Box plot • Control chart • Correlation analysis • Cycle time chart • Design of experiments • Histogram • Hypothesis testing • Pareto chart
Quality Improvement Cause analysis tools • Failure modes and effects analysis • Fishbone diagram • Forced field analysis • Matrix diagram (generic) • Pareto chart • Scatter plot • Stratification • Why-why diagram
Quality Improvement Evaluation and decision-making tools • Decision matrix • Matrix diagram (generic) • Paired comparisons • Prioritization matrix
Quality Improvement Ingredients for a successful QM Program • Great deal of learning • Intense analysis • Hard work • Focused attention over an extended period of time.
Quality Improvement Where are we in our quality improvement process?
Quality Improvement Do We Need to Expand or Focus Our Thinking ? • The process of QI goes through alternating periods of expanding our thinking to many different ideas and focusing our ideas to specifics. • The expanding period • Creative • Can generate new and innovative ideas • The focusing period • Analytical • Action oriented To obtain results, you eventually have to stop considering options, decide what to do, and do it.
Quality Improvement E-X-P-A-N-D Focus Your thinking Expand Problem well-defined Focus Analyze causes Expand Focus Root Cause Identified Generate Solutions Focus Solution chosen
LEAN MANUFACTURING • Refers to a system of methods, that emphasize, identifying and eliminating all non-value-adding activities (waste) from a manufacturing or manufacturing support organization. • Process becomes faster and less expensive • Characterized by fast cycle times, just in time methods, pull systems, little or no inventory, continuous flow or small lot sizes production levels, and reliable quality. Lean organizations are efficient, flexible and highly responsive to customer needs.
LEAN MANUFACTURING • Principles, concepts, and tools of lean manufacturing are often credited to Taiichi Ohno an engineer at Toyota. • Ohno himself declared, that many of his ideas was learned from Henry Ford and Ford Motor Company. • The concept of lean requires changes in support functions, such as product and process design, purchasing, shipping and indeed throughout the entire supply chain. • A company implementing lean concepts in all these ways is called a lean enterprise. • Lean manufacturing effort addresses waste reduction and thus solve the problems of cycle time reduction, standardization, flexibility and quick response to customer needs.
LEAN MANUFACTURING Constraint Management (TOC) and synchronous flow manufacturing (SFM) developed by Dr. Eliyahu Goldratt fit beautifully with lean concepts. Methods and Tools • Value added analysis and value stream mapping are used along with the seven QC tools and an improvement process such as kaizen. • Mistake proofing is widely used. • QFD is used to accomplish linking customer needs to process activities.
LEAN MANUFACTURING An important tool that is unique to Lean is 5S: • Seiri - sort • Seiton - set • Seiso - shine • Seiketsu - standardize • Shitsuke - sustain
Six Sigma Six Sigma • Organization wide approach, use to achieve breakthrough improvements that are tied to significant bottom-line results. • Uses key data and statistical analysis. • Uses highly trained project leaders (black belt, green belt). • Project selection is based on estimated bottom-line results. • The goal is to reduce errors to 3 per million opportunities.
Six Sigma Motorola Story • SPC called for improving defect levels measured in percentages (part per hundred). • 1980 Motorola realized that this was inadequate to meet their competition. • Motorola developed and implemented Six Sigma Quality – a unique approach to dramatically improve quality. • In 1988 Motorola became one of the first winner of the new MBNQA.
Six Sigma • Six Sigma have reported huge savings when applied to complex, even organization wide problems that need breakthrough solution. • It is best focused on reducing variation in any major process. • The kind of issues that Six Sigma addresses include customer requirements, defect prevention, waste and cycle time reduction.
Quality Toolbox Six Sigma • Sigma, written with the Greek letter - is a measure of a process’s variation or spread. • Under traditional quality standard the spread is reduced until the specification limit is 3 away from the process mean. • 6.7 % of output still would be outside the specification • This unacceptable output generates cost of poor quality
Six Sigma • With Six Sigma Quality, process variation is squeezed even more reducing until the specification limit is 6 away from the mean. • Unacceptable output is 0.00034 % • Common measurements of performance in Six Sigma programs are the sigma levels and defect per million opportunities.
Six Sigma Six Sigma prescribes an improvement process known as DMAIC
Six Sigma For developing a new product or process or for processes that need total overhaul, there is a modified version called Design for Six Sigma DFSS. The process used in DFSS is DMADV
Six Sigma • After each phase of DMAIC or DMADV, a tollgate review is held. Standardized checklist and questions ensure that all the necessary work of that phase has been done. • Most of the tools of Six Sigma are from TQM, SPC and other improvement methodologies. • All of the seven basic QC tools are used. • Sample, measurement system analysis, hypothesis testing, correlation and regression analysis are important because of an emphasis on using data to make decision. • Some tools have been modified from more general tools and are applied in a specific way with Six sigma, such as project charter, SIPOC diagram, CTQ trees, and cause and effect matrix.
Six Sigma • Other mega tools are often used: • VOC in the Define phase (from QFD) • DOE in the Analyze phase • Benchmarking • SPC • ISO 9000
Six Sigma • In Six Sigma improvement is driven by projects carefully selected by the organization’s leaders to ensure impact on key stakeholders (customer, shareholders and employees), integrated with the organization’s goal and bottom-line results. • Senior managers are champions or sponsor of improvement projects, • Six Sigma uses highly trained project leaders know as Green Belts and Black belts. • Six Sigma uses the most powerful methods and tools or previous quality improvement efforts and adds to them a blueprint for how the organization’s leaders should lead the effort.
Malcolm Baldrige National Quality Award • Annual national award given to high-performing organizations (or divisions) • It was created to help US businesses focus on the systems and processes that would lead to excellent performance and improve their global competitiveness. • Provide a guide for developing management systems that can achieve high levels of quality, productivity, customer satisfaction, and market success.
Malcolm Baldrige National Quality Award Malcolm Baldrige National Quality Award • It was established by an act of Congress (Ronald Regan 1987) and was named after the recently deceased Secretary of Commerce who believed in the importance of quality management to America’s prosperity and strength. • This award is administered by the NIST (National Institute of Standard and Technology and the American Society for Quality. • Awards was given in three categories initially: manufacturing, service and small business. • Since 1999, healthcare and education were added.
Malcolm Baldrige National Quality Award Award criteria • Not fixed • Continuously reviews and modified based on proven practices of the best-performing companies in the world. • How widespread and broadly applicable a practice is. • Evidence of links to performance results. • Criteria build around seven major categories based on key organizational processes. • Leaders drive the organization through leadership, strategic planning, and customer and market focus. • The work of the organization is accomplished through human resource focus and process management. • All these processes are supported by measurement, analysis and knowledge management.
Malcolm Baldrige National Quality Award The Seven categories • Leadership • Strategic planning • Customer and Market Focus • Measurement, Analysis and Knowledge Management • Human Resource Focus • Process Management • Business Results
Malcolm Baldrige National Quality Award The Seven categories Leadership Strategic planning Customer and Market Focus Measurement, Analysis and Knowledge Management Human Resource Focus Process Management Business Results Driver Triad Work Core Outcome