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Thursday, November 8, 2012

World Quality Month: right boat but a questionable oar.


I was interested to read in Paul Borawski’s blog about accelerating Quality through recognition of a World Quality Month [see: http://asq.org/blog/2012/11/world-quality-month-accelerating-quality/?goback=.gde_3618260_member_183302883 ] about a rule of thumb that suggests that 70 percent of revenue within healthcare is consumed as Cost of Poor Quality.  Said the other way, only 30 percent of money spent on healthcare is spent constructively.  

Well, as Dana Carvey’s Church Lady would say: “isn’t that special!” .  Count me in the suspicious column.

The Institute of Medicine reports point to a lot of problems in health care, and I would be one to agree.  Complications with respect to medication and hospitalization are disturbing common, and some of the perhaps certainly less than 1percent or less result in serious consequence including new or prolonged illness, or even death.  But the vast majority are either on minimal or negligiable consequence.  This is not meant in any way to trivialize the concept that people should not be made unwell by those committed to the very concept, but not of that adds up to anything close to 70 percent.  

We do have problems in healthcare and one of them is it that as it is a huge collective, broadly beyond broadly diverse based on professional, physical, geographic, social, and financial factors.  Trying to develop generalizable information would at best be near impossible, and probably a lot closer to totally impossible.

In my own little area of medical laboratory quality, I have been able to examine the impacts on CPQ in relatively sophisticated laboratories, by which I mean laboratories that can monitor costs and errors.  After looking at about 1000 reported errors in one facility, I was able to calculate that depending at what point of the testing cycle an error was detected an error took from 30 to greater than 1000 minutes to correct.  The average time, when all errors were combined was about 130 minutes per error.  If applied to a small laboratory this could result in as much as 30 percent of human resource time being spend on working on the consequences of previous error,  In a very large laboratory it would be much closer to 11 percent.  Both of these are a terrible waste of time and energy and money, but both are also a lot lower than 70 percent.  

While I am interested in Paul's comment, I am a little suspicious about the accuracy and precision.

But since I am on a roll, let me raise another thought (the word “concern” would be too harsh and to excessive).  For many years the world has celebrated Quality in relative silence.  World Standards Day, which has existed since 1970 has been in relative obscurity until perhaps the last 5 or 6 years.  World Standards Cooperation has been around since 2001, but has become more widely known since it has created is academic day focus.

As much as I like to party and celebrate, I wonder if the creation of a World Quality Month will enhance or compete with these other activities, and I wonder if the Quality community will achieve better of more positive recognition based on this additional month, or just more confusion.  


Now I also understand that Quality is a lot broader than Standards, but there is an important connection between Quality and W. Edwards Deming and World Standards Day, since October 14th is also Deming’s birthday.   

How will we respond when another groups within the Quality arena decide to declare World Accreditation Day, or World Proficiency Testing month, or perhaps the decade for World Quality Educator Programs.   And maybe some will consider it important to create awareness through World Lean Day or World Six Sigma Day, or we will all want to celebrate Walter Shewhart on World Quality Control Week.   And maybe the Committee on Consumer Policy (COPOLC) will move forward on World Customer Appreciation Day.   

Actually I think that some of these are actually interesting ideas.

To be clear, I think that communication is always important to raise awareness, and raised awareness through greater communication results in more and better (?) activity.  And bringing awareness through multiple events can be very enhancing, provided that they don’t end up in competition and as a distraction.

But that is just my opinion.


PS: Paul, maybe you want to re-think that 70 percent number.  And if it is true, I won’t be trilled, but it is better to know than to be oblivious. 

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