Chapter 8
Objectives
• After going through this chapter, you will be able to
understand:
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Get acquainted with Quality Control Tools and Techniques
Understand detail use of Quality Tools,
Gain knowledge Of quality Improvement,
Understand use of Six sigma in Health Care industry.
Flow Charting
• A Flow chart is schematic diagram of the sequence of
steps involved in an operation or process. It
• presents a visual tool that is easy to use and understand.
By seeing the steps involved in operation or
• process, everyone develops a clear picture of how the
operation works and were problem could arise.
• A graphical representation of the sequence of steps
needed to produce any output.
Flow Charting
• The output may be a physical product, a service,
information or combination of all three. Basic symbols
of flow diagram are specific to function these symbols
are explained below and in the next slide –
Flow Charting
Brain Storming
• Techniques for generating constructive and creative
ideas from all participants. Use of this tool should
provide new ideas or new applications and novel use of
existing ideas. Brain storming technique is given below:
– Step 1: Good ideas are not are parsed or endorsed. All
suspended initially in preference generating ideas.
– Step 2: Thinking must be unconventional, imaginative, or
even outrageous, self-criticism and judgment are
suspended.
Brain Storming
• Techniques for generating constructive and creative
ideas from all participants. Use of this tool should
provide new ideas or new applications and novel use of
existing ideas. Brain storming technique is given below:
– Step 3: To discover analytical or critical thinking, team
members are instructed to aim for a large number of ideas
in shortest possible time.
– Step 4: Team members should hitchhike on other ideas , by
expanding them, modifying them or producing new ones by
association
Pareto Analysis
• A Pareto analysis is a technique used to identify quality
problems on their degree of importance. The logic
behind Pareto analysis is that only a few quality
problems are important where as many other are not
critical.
• The technique was named after Vilfredo Pareto a
nineteenth century Italian economist who determined
that only a small percentage of people controlled most
of the wealth.
Pareto Analysis
• This concept has often been called the 80:20 rule and
has extended to many areas. In quality management the
logic behind Pareto’s principle is that most quality
problems are a result of only a few causes. The trick is to
identify this cause.
• This is a tool used to establish priorities dividing
contributing efforts into the “vital few” and “useful
many”.
Pareto Analysis
• A Pareto diagram includes three basic elements as
mentioned below.
– (a) The contributors to the total effort, ranked by the
magnitude of contribution,
– (b) The magnitude of the contribution of each expressed
numerically,
– (c) ‘The cumulative percentage of total percentage of total
effect of the ranked contributors.
Cause and Effect Diagram
• Cause and Effect is developed by Kaoru Ishikawa. This
analysis tool is frequently called as the Ishikawa
diagram. Its purpose is to organize and display
interrelationship of various theories of root cause of
problem
• By focusing on the problem causes of a specific problem
in constructed, systematic way, the diagram enables a
quality control team to clarify its thinking about those
potential causes and enables the team to work more
productively towards discovering the true root cause or
causes.
The Generic Fish Born Diagram
• Cause and effect analysis is done by use of tool called
Ishikawa Diagram as explained above. Ishikawa diagram
is also called fish bone diagram because they looks like
the bones of a fish.
• A general cause and effect diagram is shown in the next
slide. The head of fish is quality problem. The diagram is
drawn such a way that the spine of the fish connects
“head” to the possible causes of the problem.
The Generic Fish Born Diagram
• These causes could be related to machines, workers,
measurement, suppliers, materials and many other
aspects of the process.
• Each of these possible causes can then have smaller
“bones that address specific issues that related to each
cause.
The Generic Fish Born Diagram
The Generic Fish Born Diagram
• Scattered Diagrams are that show how two variables
related to one another.
• They are particularly useful to detecting the amount of
correlation or degree of linear relationship between two
variables.
• For example increased production speed and number of
defects could correlate positively, as production speed
increases, so does the number of effects.
The Generic Fish Born Diagram
• The greater the degree of correction; more linear are
the observations in the scatter diagram. On the other
hand, more scattered the observations in the diagram,
less correlation exist between the variables.
• Other types of correlation ships are also be observed on
a scatter diagram for example inverted U. This may be
the case when one is observing the relationship
between two variables such as oven temperature and
number of defects, since temperature below and above
the ideal could lead to defect.
Business Analysis
• As the scope of business analysis is very wide, there has
been a tendency for business analysts to specialize in
one its strategic direction, and identifying initiatives that
will allow a business to meet those strategic goals like
Creating and maintaining the business architecture,
Conducting feasibility studies
• Identifying new opportunities of the three sets of
activities which constitute the scope of business
analysis, the primary role of business analysis is to
identify business needs and provide solutions to
business problems.
Process of Re-engineering
• Process Re-engineering (PR) is basically rethinking and
drastically redesigning an organization’s existing
resources.
• PR, however, is more than just business improvising; it is
an approach for redesigning the way work is done to
better support the organization’s mission and reduce
costs. Re-engineering starts with a high-level
assessment of the organization’s mission, strategic
goals, and customer needs.
Process of Re-engineering
• As a structured ordering of work steps across time and
place, a business process be decomposed into specific
activities, measured, modeled, and improved
• It can also be completely designed or eliminated
altogether. Re-engineering identifies, analyzes, and redesigns an organization’s business processes with the
aim of achieving striking improvements in critical
performance such as cost, quality, service, and speed.
Bench Marking and Its Types
• Companies implement Continuous improvements by
studying business practices of companies considered
best in class.
• This is called Bench Marking things is an important part
of continuous improvement. The ability to learn and
study how other do things is an important part of
Continuous improvement.
• The Bench Marked Company does not need to be in the
same business, as long as it excels at something that the
company doing the study wishes to emulate.
Kaizen Concept
• Good change means kaizen, meaning of either
“continuous” or “philosophy” in Japanese dictionaries in
everyday use.
• The kaizen refers to any improvement, one-time or
continuous, large or small, in the same sense as the
English word “improvement”. However, given the
common practice in Japan of labeling industrial or
business improvement techniques with the word
“kaizen”
Kaizen Concept
• The format for kaizen can be individual, suggestion
system, small group, or large group.
• Kaizen on a broad, cross-departmental scale in
companies, generates TQ, and frees human efforts
through improving productivity using machines and
computing power.
• While kaizen usually delivers small improvements, the
culture of continual associated small improvements and
standardization yields large results in terms of overall
improvement in productivity.
Deming Wheel — PDCA Cycle
• Plan — Do — Check — Act (Pl)CA) cycle describes the
activities a organization need to perform in to
incorporate continuous improvement in its operation.
• This action is shown in figure below is also called as
Fleming wheel or Shewhart cycle.
• Circular nature of this cycle shows that a continuous
improvement is a never ending process. Following are
the steps involved in the cycle.
Deming Wheel — PDCA Cycle
Deming Wheel — PDCA Cycle
• Step 1: Plan: Managers must evaluate the current
process and make plan based on any problems they
find.
• Step 2: Do (Implementation): In this step it needs to
implement the plan prepared in planning.
• Step 3: Check: The third step is to check the data
collected during the implementation (Do) phase.
• Step 4: Act: The last phase of the cycle is to act on the
basis of the results of first three phases.
Six-Sigma Concept in Health Care Industry
• Six- Sigma is a group of techniques and tools for process
improvement. Six-Sigma seeks to improve the quality of
process Outputs by identifying and removing the causes
of defects (errors) and minimizing inconsistency ¡n
production and business activities.
• It uses quality management methods, including
statistical methods, and creates a special infrastructure
of people within the organization (“Champions”, “Black
Belts”, “Green Belts, “Yellow Belts”, etc.) who are
experts in these methods.
Six-Sigma Concept in Health Care Industry
• The term Six Sigma start from terminology associated
with manufacturing. The maturity of a manufacturing
process can be described by a sigma rating indicating its
perfection ¡n manufacturing.
• A six sigma process is one in which 99.99966% of the
products manufactured are statistically expected to be
free of defects (3.4 defective parts/million). The term
“six sigma” comes from statistics and is used in
Statistical Quality Control, which evaluates process
capability.
Six-Sigma Concept in Health Care Industry
• Health care industry’s traditional reliance on external
and internal inspection to maintain quality has its
expected effects on performance. The extensive
inspections are very costly, but are agreed to, by
provides and outsiders alike, as the best they can do.
• Reviews do tend to call attention to serious problems,
some of which are remedied correctly, and others which
invite overreactions that have probably added to the
cost complexity of care without much gain in quality or
efficiency.
Six-Sigma Concept in Health Care Industry
• Features that set Six Sigma apart from previous quality
improvement initiatives include
– (a) A clear focus on achieving measurable and quantifiable
financial returns from any Six Sigma project.
– (b) An increased emphasis on strong and passionate
management leadership and support.
– (e) A clear commitment to making decisions on the basis of
verifiable data and statistical methods, rather than
assumptions and guesswork.
Chapter 8