Saturday, May 24, 2014

How to improve Education?



This post is a deviation from my usual.  It is written in response to Julia McIntosh who put forward a June question for ASQ Influential Voices.  Enjoy.

One of the advantages of participating in ASQ is that it crosses all the industry and professional borders.  In ASQ we have the opportunity to think about and apply our common interest of Quality in the broadest variety of subjects and situations.  I think we call that being engaged in the world around us.

My personal interest in Education is much more at the adult end of the scale and in particular continuing education in the arena of healthcare.  To be honest, my kids are well beyond school age, and when they were involved in school, my wife was much more engaged than me.  It would be far to say that I am not an expert or an authority in the area of Quality and primary and secondary Education.  But that does not mean that I am without opinion.

Being from Canada, I am pleased with our record of OECD performance, but also recognize that we too have a ways-to-go to improve our schools.  In comparison to the United States, I note that on the aggregate Canadian schools and students do better, but as an observer of successes of the American side of my family (my mother was from Kentucky) I think that it is probably still true that our education performance falls within a fairly narrow band, above the OECD average, while the US performance is much broader with more higher peaks and and unfortunately more lower valleys. 

OECD indicates some strong correlates with educational performance.  The ones that jump out in the most recent The OECD Programme For International Student Assessment (Pisa) 2009 [see: http://ourtimes.wordpress.com/2008/04/10/oecd-education-rankings/] at me are:


1.    Socioeconomic background of students and schools does appear to have a powerful influence on performance.
2.    Regardless of their own socio-economic background, students attending schools with a socio-economically advantaged intake tend to perform better than those attending schools with more disadvantaged peers.
3.    Across OECD countries, first-generation students – those who were born outside the country of assessment and who also have foreign-born parents – score, on average, 52 score points below students without an immigrant background
4.    Successful school systems – those that perform above average and show below-average socio-economic inequalities – provide all students, regardless of their socio-economic backgrounds, with similar opportunities to learn.
5.    Schools with better disciplinary climates, more positive behaviour among teachers and better teacher-student relations tend to achieve higher scores in reading.
And in my mind, most importantly…
6.    In all countries, students who enjoy reading the most perform significantly better than students who enjoy reading the least.

My first comment here is that from the OECD perspective, there is a lot of room for finger pointing at those who design and administer education, those who work within it and students and their families.  Put in the terms of ISO and Crosby, Education does not appear to be "meeting requirements" for many, or perhaps, hardly anyone.  

And maybe within that group there are some apathetic students and teachers and administrators who think that “good enough” is indeed good enough, but on first glance the issues seem to be a lot bigger and maybe a little less petty. 

The message to me is that large and powerful structural issues abound with socioeconomic statues, single parents, ESL, teacher engagement, and the student desire to read. 

And that is what concerns me.    The aforementioned are “big ticket items” that require and demand a lot of thought on how to address and focus on better schools, better teachers, more societal wealth stable families and more engaged students who love to read. 

These are not issues that Qualitologists are going to solve. 

These are big issues that must be addressed in the arena of engaged and honest brokers; debate devoid of party politics, and unions, and media bias.  These are not the sort of issues that go away tomorrow, or next month.  OECD measures time in decades and multiple decades, and that makes sense to me.  This is about LONG TERM commitment and resources and vision. This requires acknowledgement that “Baby Steps” are part of an important path forward, but certainly not  the goal. 

So upon reflection, maybe Michelle Rhee is part of the solution.  Maybe the first step has to be the understanding that “success” will ONLY be found when we understand acknowledge demand and accept that “Good Enough” will never be good enough.  

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Sunday, May 18, 2014

Standards Development in the crosshairs.



Standards Development in the crosshairs.

There is a revolution afloat in international standards development.  Without knowing all the details yet, the  International Organization for Standardization (ISO) is creating new requirements that include new format rules and perhaps more importantly new justification rules.  I suspect the organization is feeling some concerns about some sector and subject specific documents that each introduce some subtle variation from the parent document.  Whether or not my assumption is correct, from my perspective, this is a dangerous road for the organization to travel.  It could well end up with some unintended consequences.  

So far I am aware of two examples where the process has resulted in a rejection of approval to update an existing standard. One example is the standard for what the medical laboratory community calls Point of Care Testing.  This is the performance of a laboratory test, sometimes by a laboratory trained person, often not, outside of the traditional laboratory environment.  This is possible, primarily as a result of innovation and inspiration by researchers and reagent producers.  These kits in many respects have been created to be almost idiot proof, the key and operative word being ALMOST.  The results of POCT tests are still vulnerable if the sample is collected improperly or insufficiently, or if the kit is out of date or stored or used improperly.   Folks need to know and understand this because clinicians, and especially patients, expect to get accurate and reliable  information regardless of who did the test and where it is performed.  And the standard that was developed was used as a foundation document to help people learn and introduce the necessary precautions.  

Without going too far into the details, when the technical committee set out to update the document, ISO, applying the new rules first halted the process and then caused it to cease, as is their right,

But if the document is not updated, the existing document now obsolete and incomplete may continue to be used.  That serves nobody’s purpose, and that includes ISO.

In the past I have talked about the intricate dance between Quality Partners [see: http://www.medicallaboratoryquality.com/2011/06/more-musings-on-quality-partners.html] which are the organizations that work together to enhance and ensure Quality improvement.

First off, to be clear, just because a company puts the word “standard” in their name, does not mean that their documents are recognized and used as standards.  Authoritative and informative documents can equally be written by national or provincial or regional organizations.  In many jurisdictions, an accreditation body has the right and authority to consider a number of documents and decide which one makes the most sense in their domain.   In jurisdictions where there is no accreditation body, local groups can convene and make their own local decisions.  More importantly, in situations of litigation, the courts can deem any public document as a standard of practice, including information written as a “Letter to the Editor” in what the court considers a journal of record.  

The bottom line is that organizations including bodies like ISO have competition, and more importantly can be subject to the good will of their document writers, all of whom are volunteers, many of whom are putting their own time and money on the table.  The reality is that while ISO personnel are managers of their document structure and format and style, they are totally dependent on those volunteers for the true essence of the documents, the subject content.

When organizations change the rules, countries can choose to no longer send delegates, and volunteers can choose to no longer expend their effort and expertise and slowly and quietly the documents starts to diminish and their appeal starts to decline.  

The truth is that many folks are already feeling a certain degree of ISO fatigue.  Meetings are expensive to attend and cost a bomb to put on.  ISO puts nothing in to process other than their name and expects that participants to put up with their whims and vagaries.  This is not a formula that leads engenders a lot of lasting support.

Dangerous game they are playing.

Tuesday, May 6, 2014

Modern Quality’s Greatest Enemy



Modern Quality’s Greatest Enemy

Once upon a time there was a young prince born in 1971.  A gangly child, army brat who hung out on university campuses, until his early twenties when he suddenly became known worldwide.  He was swift of foot, indeed so fast that he rapidly developed the reputation of being the microsecond man… flash.  Nobody faster.  He was the darling in all the land and everyone wanted to know him.  

As the years and decades passed the prince went from young shiny and handsome to something larger.  With an appetite ravenous he bulged and bulged; what started as a flash and media darling slowly (or rapidly depending on your time frame) started to bog down and seemed to choke on his own gargantuan mass, until one day people looked around and realized the young svelte flash had transformed into one ginormous frog.
 
This parable is of course my story of the transformation of email from the miracle of modern magic to the bane of human existence.  A few years ago, Martin Bryant wrote that by 2001, there were around 31 billion emails were sent daily, and by a decade later that number grew to staggering 294 billion.  Some days I have the terrible feeling that everyone on planet has decided to include me as a CC and I receive all 294, ever day, seven days a week.  

To Qualitologists this has become a major problem.  For all intents and purposes, communication has ceased to function.  Every step of get on top of this mountain of electrons fails.  Keeping separate email addresses for work and pleasure fails in a matter of days.  Using an index system buries critical messages.  Trying to sort out what needs to be addressed now becomes near impossible and makes things infinitely worse because the pressure to push out a response cause all sorts of errors, not limited to tragic spelling or unchecked grammar or misconstrued text.  Spam pollutes and phishing savages.  There is no relief.  

I am starting to think that Quality professionals need to get a grip on all the misdirected emails, the lost messages, and the generated confusion.  Start with the premise that even if the sender believes that the message of value, the risk of a non-value outcome or a jeopardous outcome is too high.  

Over the last 2 working days I have received 201 emails.  Twenty-six were relevant and material, and 24 more were valid but unnecessary copies sent to me, just because.  Sixty-two were spam or phishing files sent directly to my spam file, unfortunately along with 1 file that I was actually supposed to receive.  Twenty-three were social media related to LinkedIn or Twitter.  The remainder were emails that were not spam but were clearly in the promotion or updates category of which I really was not too interested, except for 2 that should have been in my primary index.  And annoyingly there was one of my usual misdirected homonymous misdirects, an email sent to me but really intended for someone else.

Taken at its best this represented a defect rate of 4 per 201 (Sigma value 3.6).  On the other hand if we take into consideration the unwanted and dangerous stuff the error rate is more like 100 (Sigma 1.6).  The point is that neither value is one of which a Quality program would be proud.  And this was only two random days,

My point is that I know that my email experience is all too typical, but is fraught with error and confusion to a level that no one interested in Quality should tolerate.  Email has become time consuming, error prone, loaded with opportunity for miscommunication or lost communication.  What started with so much promise has become a choke point, a quality failure and a true pain in the butt.

Business and society will tolerate this for only so long, and then technology will thankfully move on.  As far as I am concerned, enough has clearly and definitely become enough.

Time for a new plan.