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Saturday, December 21, 2013

Reflections on achieving organizational Quality



In a previous post, I commented on a “Notable Quote” printed in the ASQ’s November 2013  Quality Progress magazine.  It was reportedly a quote ascribed to Deming. 

Not entirely by coincidence, I was going through a number of books for our Certificate Course in Laboratory Quality Management and I came across a little book first published in 1996 entitled “Philip Crosby’s Reflections on Quality”.  It is basically a book of 295 quotations written and authored by Crosby.  I suspect by the very design of the book it was intended to be both a compilation of Crosby’s most influential comments on Quality and an homage to the book genre of the 1966 The Little Red Book: Quotations for Chairman Mao Tse-tung.  I mention this second point because while the two are in vastly different spheres, one can see common seeds between the Cultural Revolution and the Quality Revolution.  But that is a topic for a future posting.

What I want to focus on is Crosby’s absolutes, in particular his first “the definition of Quality is conformance to requirements”, his second “the system of Quality is prevention”, his third “the performance standard is zero defects” his fourth “the measurement of Quality is the price of non-conformance”.  

I was in a conversation with a colleague last week and the question came up about, at what point can you say that you truly run a Quality laboratory?  It is a fair question because we all tend to be goal oriented and labels are important.  

If I read Crosby as I think he intended, Crosby had a rather strict view on Quality and was that a Quality organization meets all requirements and has no defects or no nonconformities.  If that is a correct reading, I think that Crosby was of the opinion that the state of Quality is aspirational and a valued ideal, but is not truly or sustainably unachievable.  Quality is the ethereal end to the journey that begins with a single first step (homage to Confucius). 

I know that Crosby and Deming knew each other, but I don’t know if he had met James Reason, the expert on organizational error.  Current risk management is predicated on the concept that bad things happen, most often as the consequence of simple mistakes or distractions.  Many of these will be invisible or benign or seemingly innocuous but some of them will lead to very bad outcomes.  They are for all intents and purposes inevitable.  As long as we have working humans or machines, we will have defects.

But in today’s world recognition and public relations are important to organizations, especially in healthcare.  Top management needs to be able to point to evidence that their efforts to improve the organization are working.  Top management needs to be able to have some markers along the path to which they can honestly refer, and be able to say that the organization is moving well along the path to Quality and success.

So I present some markers that indicate they your organization is moving in the right direction, and at a certain point deserve to call yourself a Quality organization

1: A good start.
Perform your first Gap Analysis against your measureable goal, and develop a process by which you can and will close the gaps.

2: You are Making Progress.
Your first accreditation is always an achievement of which you can be pleased, but it is far more important what you do next.  The first is an achievement, the second is an accomplishment. The third is a demonstrated record.

3: Quality is your middle name.
You still have errors and defects, but now you have a system that detects them quickly and remediates their impact on your customers.  More importantly your system allows you to learn from your errors and put in corrective actions that make it unlikely that you will repeat that error.

4: Your name is Quality.
Your system works.  You know it works, your staff knows it works, your customers know it works, your colleagues know it works, your competition knows it works.  But you are still looking for continuous tweaks for improvement.

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