AMERICAN SOCIETY FOR QUALITY QUALITY 101 Michael Hagan, D.O., MHSA, CMQ

AMERICAN SOCIETY FOR QUALITY

QUALITY 101

Michael Hagan, D.O.,

MHSA, CMQ

• Why study quality?

© 2001 ASQAll rights reserved. ASQ IL1-3

Module 1: Quality Benefits

Tangible– Increase in earnings

– Decrease in waste

– Increase in productivity

Intangible– Customer goodwill

– Alignment between business activities

© 2001 ASQAll rights reserved. ASQ IL1-4

W. Edwards Deming on Quality Meeting customer needs + wants = quality. Quality improves products/services and processes. Improved products/services and processes =

profitability.

© 2001 ASQAll rights reserved. ASQ IL1-5

A Quality Approach Benefits . . .

Employees Organizations

Suppliers Society

Customers

© 2001 ASQAll rights reserved. ASQ IL1-6

Benefits to Employees

Product quality

Greater job security/benefits

Process quality

Profit

Customer satisfaction

Pride in products andservices

Job satisfaction

Improved communicationsStreamlined work processes

Happier customersStrong customer

relationships

© 2001 ASQAll rights reserved. ASQ IL1-7

Benefits to Organizations

Q u a lity

O rg a n iza tio n s

C o st

M a rk etS h a re

P ro fit

© 2001 ASQAll rights reserved. ASQ IL1-8

Quality Studies and Standards

Released the Profit Impact of Market Strategy (PIMS) study.

Partnered with the Baldrige recognition program.

Both organizations support the link betweenquality and profitability.

Strategic PlanningInstitute

National Institute ofStandards and

Technology

N I S T

• National Institute Standards & Tech

• Baldrige Quality Award

• Baldrige index• Outperforms the S & P 500 index

IT WORKS

• Companies that look at themselves and constantly ask the question

• “how can we improve”

• Are more successful as a company

© 2001 ASQAll rights reserved. ASQ IL1-11

External and Internal Customers

PublicationDepartment

SalesDepartment

Customer

BENEFITS TO CUSTOMERS

• External CustomerPerson or organization that (buys)receives the product or service

• Transplant center• Other OPO• Donor hospital• Tissue Bank

BENEFITS TO CUSTOMERS

• Internal Customer

Employee or department that receives the output

• OPO Coordinators• OPO HD• OPO Finance department

© 2001 ASQAll rights reserved. ASQ IL1-14

Benefits to Customers

Quality results in: Increased choices. Improved goods and

services. Expectations met or

exceeded.

© 2001 ASQAll rights reserved. ASQ IL1-15

Benefits to Suppliers

Achievement of performance requirements

Streamlined processes

Efficient communication

Increased customer satisfaction

© 2001 ASQAll rights reserved. ASQ IL1-16

Benefits to Society

Economic growth and stability

Increased employment opportunities

Product safety

OPO’s BENEFIT TO SOCIETY

• Disease free organs and tissues

• Better functioning organs

• More transplants

• More lives saved

© 2001 ASQAll rights reserved. ASQ IL1-18

Module 2: The Evolution of Quality

Provides a framework for understanding the history of the quality movement.

Expands the definition of quality.

QUALITY DEFINED

• Many definitions

• No perfect definition

• Usually it is very clear

when quality is missing

MISSING QUALITY

• Missing a pt on the match run• Incorrect lab, HLA, etc.• Mislabeled blood type• Surgical damage• Liver in a heart box

JURAN FITNESS FOR USE

• Degree to which the product or service conforms to design

• The degree to which the transplant centers are called on each of their patients

JURAN FITNESS FOR USE

• Product or service availability, reliability, and maintainability

• Reliability of the software systems to produce accurate match runs

JURAN FITNESS FOR USE

• Available customer service

• Ability of transplant centers to request customer service from the OPO

© 2001 ASQAll rights reserved. ASQ IL1-24

ISO Definition of Quality

Degree to which a set of characteristics fulfills requirements

Requirements:Convenience and speed

Product:Telephone

Characteristic:Speed dial

© 2001 ASQAll rights reserved. ASQ IL1-25

Crosby’s Definition of Quality

Quality is conformance to requirements. Requirements are answers to key organizational

questions:– How quickly will orders ship?

– What is our return policy?

– What forms of payment are acceptable?

© 2001 ASQAll rights reserved. ASQ IL1-26

Quality Evolution: Medieval Guilds

Guilds: Developed strict rules for products

and services. Used stamps to identify flawless

goods.

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© 2001 ASQAll rights reserved. ASQ IL1-27

Quality Evolution: Product Orientation

Master craftsmen trained apprentices. Industrial Revolution divided trades into

specialized tasks; inspectors guaranteed quality.

Taylor system increased productivity; inspection departments found defects.

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© 2001 ASQAll rights reserved. ASQ IL1-28

Quality Evolution: Process Orientation

Processes became critical. Shewhart identified statistical quality

control. Developed strict rules for products

and services. Quality became relevant for process,

not just product.

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PROCESS ORIENTATION

• Shewart: in 1920s, Bell Labs• Process yields data• Data can be analyzed• Statistical analysis and control• Control charts for the process

© 2001 ASQAll rights reserved. ASQ IL1-30

Quality Evolution: Wartime

Quality became a safety issue. The military developed a

sampling inspection system and trained suppliers.

Y ea r a n d P er io d1 2 0 0 -1 7 9 9 1 9 0 0 -1 9 4 0 1 9 4 6 -P re se n t1 8 0 0 -1 8 9 9 1941-1945G u ild s o f

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© 2001 ASQAll rights reserved. ASQ IL1-31

Quality Evolution:Total Quality Movement

Developed in response to Japanese quality movement.

Focused on improving all processes through people who used them.

Y ea r a n d P er io d1 2 0 0 -1 7 9 9 1 9 0 0 -1 9 4 0 1946-P resen t1 8 0 0 -1 8 9 9 1 9 4 1 -1 9 4 5G u ild s o f

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© 2001 ASQAll rights reserved. ASQ IL1-32

Use of Standards

Definition: A standard is a “statement, specification, or quantity of material against which outputs may be judged as acceptable or nonacceptable.”

Result: Interchangeable products. Examples: Military and ISO 9000 standards.

© 2001 ASQAll rights reserved. ASQ IL1-33

ISO Registration

Independent third party audits the quality management system.

Certificate of registration awarded when audit is passed.

Registration is maintained via surveillance audits.

Step 1

Step 2

Step 3

© 2001 ASQAll rights reserved. ASQ IL1-34

Baldrige Program

Improves organizational performance. Facilitates the sharing of best practices. Provides a tool for

managing performance and guiding planning and opportunities for learning.

BALDRIGE 7 CATEGORIES

• Leadership• Strategic planning• Customer & market focus• Information and analysis• Human resource• Process management• Business results

BALDRIGE CORE VALUES

• Visionary leadership• Customer driven excellence• Organizational & personal learning• Valuing employees and partners• Agility• Focus on the future

BALDRIGE CORE VALUES

• Managing for innovation• Management by fact, data• Public responsibility & citizenship• Focus on results, creating value• Systems perspective

QUALITY QUESTIONS

• What does AOPO consider a good quality OPO?

• One that has met accreditation requirements

QUALITY QUESTIONS

• What does CMS consider as a good quality OPO?

• One that has met the CMS contractual requirements

QUALITY QUESTIONS

• What does UNOS consider as a POOR quality OPO or program?

• St. Vincent, skipped candidates,

program now closed

NOT QUALITY

• There is a very real cost of poor quality or lack of quality.

• Cost of time, resources, people

• Poor outcomes, fewer transplants

QUALITY IMPROVEMENT

• HRSA Collaboratives and

AOPO Quality Council

• Strive to improve quality

• More transplants, save more lives

QUALITY GOAL

• All 58 OPOs

• High quality OPOs

• High quality organs and allocation