Quality Improvement Processes and Tools

Week 2 A: Quality Improvement Processes and Tools

Quality Improvement Definition:
“a process of measuring quality, analyzing the deficiencies discovered, and taking action to improve performance followed by measuring quality again to determine whether improvement has been achieved. It is a systematic, cyclic activity using standards of measurement.”

Improving Quality
Systematic approach for improving the gaps between current practices and desired standards

Quality Improvement Processes
1. PDCA/PDSA cycle
2. FOCUS PDCA model
3. Lean/Toyota Production System
4. Six Sigma
5. Lean 6 Sigma

1- Plan-Do-Check-Act (PDCA) cycle
u Walter Shewhart, who developed the concepts and techniques of statistical process control, was one of the first quality experts to discuss a systematic model for continuous improvement.
u Deming modified Shewhart’s original model and renamed it the Plan-Do-Study-Act (PDSA) cycle. PDSA is the most widely recognized quality improvement process today.

1- PDCA or PDSA Cycle
Plan
u Objective: What are you trying to accomplish?
u Questions and predictions: What do you think will happen?
u Plan to carry out the cycle: Who, what, where, and when?
Do
u Educate and train staff.
u Carry out the plan (e.g., try out the change on a small scale).
u Document the problems and unexpected observations.
u Begin analysis of the data.

Check/Study
u Assess the effect of the change
u determine the level of success as compared to the goal/objective
u compare results to predictions
u summarize lessons learned
u determine what changes need to be made.
Act
u Act on what you have learned
u perform necessary changes
u identify remaining gaps in process or performance
u carry out additional cycles.

FOCUS PDCA
F.O.C.U.S
u Find a Process Improvement Opportunity
u Organize a Team Who Understands the Process
u Clarify the Current Knowledge of the Process
u Uncover the Root Cause of Variation/Poor Outcome
u Start the “Plan-Do-Check-Act” Cycle

P.D.C.A

u Plan the Process Improvement
u Do the Improvement, Data Collection & Analysis
u Check the Results and Lessons Learned
u Act by Adopting, Adjusting, or Abandoning the Change

2- FOCUS PDCA Model – 1990s

F = FIND a process to improve/ an opportunity to improve care
O = ORGANIZE a team that knows the process.
C = CLARIFY current knowledge of the existing or redesigned process.
U = UNDERSTAND the variables and causes of process variation
S = SELECT the process improvement and identify the potential action to achieve it.
u PDCA phase
 Plan the change by studying the process, identifying areas needing improvement, and determining ways to measure success.
 Do the change on small scale, and gather data to measure success.
 Check the data to determine whether the change produced desired improvements. Modify the change if necessary.
 Act to maintain the gains. Implement the change if it is working well. Abandon the change if it is ineffective, and repeat the PDCA phase.
u FIND OPPORTUNITY
• Is there a clear simple description of the process?
• What is the process?
• What are the major process problems?
• What are the perceived boundaries?
• What are the resource boundaries?
• What are the key issues?
o FIND …………….TOOLS
u Brainstorming
u Data Collection

u Organize a Team
u Are there people who work in this process including?
• Internal customers
• External customers
u A Team That Knows the PROCESS
u Is Technical Guidance and Support Available?

o ORGANIZE…………….TOOLS
u Brainstorming

u Clarify current process & desired outcome
Current Knowledge of the PROCESS
• Who are the customers?
• What are their needs?
• Should boundaries be defined?
• What is the actual flow of the process?
• Is there needless complexity/redundancy?
• What are the outcomes/best way for the process to work?
o CLARIFY…………….TOOLS
u Data Collection
u Flow Charting

u Understanding the Problem
Causes of PROCESS Variation or poor quality
• What are the major causes of variation or poor quality?
• Which key characteristics are measurable?
• What.. Who.. Where.. When.. How will data be collected?
• Does the data reflect common or Special cause?
• Which causes of variation can we change to improve the process?
o UNDERSTAND…………….TOOLS
u Brainstorming
u Cause and Effect Diagram
u Inverse Tree Diagram
u Multi-Voting
u Scatter Diagrams
u Run and Control Charts
u Histograms

u Select
• Select a portion of the process to improve
• What is the proposed process improvement?
• Write the Mission Statement
• What changes to the process are most feasible?
u Plan Improvement
• What.. Is the process improvement to be piloted?
• Who..will do the pilot?
• How..will it be piloted?
• Where..will it be tested?
• When..will it be tested?
• What data must be collected to measure the improvement?
o PLAN…………….TOOLS
u Brainstorming
u Process Decision Program Charts
u Do
• Do the improvement
 Collect data
 Analysis
• Are there significant in the pilot change or data collection efforts?
u Check
The Results and Lessons Learned
• Did the process improve as expected?
• Did the process improve for the customer’s point of view?
• Does the data support the improvement?
• How could the team efforts be improved?
o CHECK…………….TOOLS
u Data Collection
u Scatter Diagrams
u Run and Control Charts
u Histograms
u Customer Surveys
u Act to hold the gain
• What parts of the improved process needs to be standardized?
• Policies or procedures to be revised?
• Who needs to be made aware of the change?
• What can be measured to ensure gain is held?
• What are the next steps in CONTINUOUSLY improving this process?

Quality Tools
u During an improvement project, various analytic tools are used to discover the causes of undesirable performance and plan solutions.
u There are over 50 quality tools,
u Six categories of quality tools:
1. Cause analysis/Fish bone analysis
2. Evaluation and decision making
3. Process analysis
4. Data collection and analysis
5. Idea creation
6. Project planning and implementation
Six Categories of Quality Tools
Quality tool Six categories of quality tools
Root cause analysis/ Fish bone
5 Why Cause analysis
Flow chart
value stream mapping Process analysis
Pareto chart
run chart -control chart Evaluation and decision making
Checklist/check sheet-survey Data collection and analysis
Brain storming Idea creation
Priorities matrix Project planning and implementation

1- Cause-and-Effect/Fishbone Diagram
Ishikawa diagrams(1960s)
u Kaoru Ishikawa is well known for his “fish bone” model for deep-root analysis.
u Fish bone used to identify all possible causes /major factors that influence the effect (problem)
u The four Ms—methods, manpower, materials, and machinery—or
u The four Ps—policies, procedures, people, and plant.
u More than four factors may be identified for complex topics.

Five Whys

§ Used to find the underlying causes of performance problems.
§ The Five Whys tool helps an improvement team dig deeper into the causes of problems by successively asking what and why until all aspects of the situation are reviewed and the underlying contributing factors are considered.

Pareto Chart
What Is a Pareto Chart?
u Bar chart arranged in descending order of height from left to right
u Bars on left relatively more important than those on right
u Separates the “vital few” from the “trivial many” (Pareto Principle)
u In this way the chart visually depicts which situations are more significant. This cause analysis tool is considered one of the seven basic quality tools.

Pareto Principle
u The principle was developed by Vilfredo Pareto, an Italian economist and sociologist who conducted a study in Europe in the early 1900s on wealth and poverty.
u He found that wealth was concentrated in the hands of the few and poverty in the hands of the many.
u The Pareto principle is based on the unequal distribution of things in the universe
u The 80 / 20 rule: 80% of wealth in the hand of 20% of people, 80% of the total problems incurred are caused by 20% of the problem causes .

When to Use a Pareto Chart
1. When analyzing data about the frequency of problems or causes in a process
2. When data be arranged into categories
3. When there are many problems or causes and you want to focus on the most significant.
4. When analyzing broad causes by looking at their specific components.
Pareto Chart Procedure
1. Decide what categories you will use to group items.
2. Decide what measurement is appropriate. Common measurements are frequency,
3. Decide what period of time the Pareto chart will cover: One work cycle? One full day? A week?
4. Collect the data, recording the category each time, or assemble data that already exist.
5. Subtotal the measurements for each category.
6. Construct and label bars for each category. Place the tallest at left, then the next tallest to its right, and so on.
7. If there are many categories with small measurements, they can be grouped as “other

u Figure 2 takes the largest category, “documents,” from Figure 1, breaks it down into six categories of document-related complaints, and shows cumulative values.
u If all complaints cause equal distress to the customer, working on eliminating document-related complaints would have the most impact, and of those, working on quality certificates should be most fruitful.

5S
u A systematic program that helps workers take control of their workspace.
u Seiri (Sort) means to keep only necessary items.
u Seiton (Straighten) means to arrange and identify items so they can be easily retrieved when needed.
u Seiso (Shine) means to keep items and workspaces clean and in working order.
u Seiketsu (Standardize) means to use best practices consistently.
u Shitsuke (Sustain) means to maintain the gains and make a commitment to continue the first four Ss.