QUALITY PIONEERS
Ignaz Semmelweis1818 - 1865• Hungarian physician
in Vienna, Austria
Year Births DeathsPhysician
Mortality Rate Births DeathsMidwife
Mortality Rate1841 3,036 237 7.8% 2,442 86 3.5%1842 3,287 518 15.8% 2,659 202 7.6%1843 3,060 274 9.0% 2,739 164 6.0%1844 3,157 260 8.2% 2,956 68 2.3%1845 3,492 241 6.9% 3,241 66 2.0%1846 4,010 459 11.4% 3,754 105 2.8%Total 20,042 1,989 9.9% 17,791 691 3.9%
Physician Clinic Midwife Clinic
Ignaz Semmelweis1818 - 1865• Hungarian physician
in Vienna, Austria
Year Births DeathsPhysician
Mortality Rate Births DeathsMidwife
Mortality Rate1841 3,036 237 7.8% 2,442 86 3.5%1842 3,287 518 15.8% 2,659 202 7.6%1843 3,060 274 9.0% 2,739 164 6.0%1844 3,157 260 8.2% 2,956 68 2.3%1845 3,492 241 6.9% 3,241 66 2.0%1846 4,010 459 11.4% 3,754 105 2.8%Total 20,042 1,989 9.9% 17,791 691 3.9%
Physician Clinic Midwife Clinic
PhysicianMortality
Rate
MidwifeMortality
RateMean 0.0985 0.0404Variance 0.0011 0.0005Observations 6 6Pooled Variance 0.0008Hypothesized Mean Difference 0df 10t Stat 3.5797P(T<=t) one-tail 0.0025t Critical one-tail 1.8125P(T<=t) two-tail 0.0050t Critical two-tail 2.2281
Florence Nightingale1820 - 1910
• “The Lady with the Lamp”
• Nightingale's 'Coxcombs‘
Florence Nightingale1820 - 1910
• Hear her voice:“When I am no longer even a memory, just a name, I hope my voice may perpetuate the great work of my life. God bless my dear old comrades of Balaclava and bring them safe to shore. Florence Nightingale.
• Country Joe McDonald’s Tribute to Florence Nightingale
Abraham Flexner1866 - 1959
• Institute for Advanced Study
• The Flexner Report - Medical Education in the United States and Canada (1910)• Download the Report
Source: Regis, E. (1987). Who Got Einstein’s Office. Reading, MA: Addison-Wesley Publishing.
Ernest Codman1869 - 1940
• 1895 Graduate of Harvard Medical School
• The End Results Hospital
• Halifax Harbor Disaster
• Practice Post-WWI
• Quality Legacy
Quality Pioneers
• Walter Shewhart• W. Edwards Deming • J. M. Juran• Philip B. Crosby• Koaru Ishikawa• Other Quality Gurus
http://www.bizmanualz.com/blog/top-ten/top-ten-quality-gurus.html
Walter Shewhart
• Father of Statistical Quality Controlhttp://www.asq.org/join/about/history/shewhart.html
• PDCA Cyclehttp://www.hci.com.au/hcisite2/toolkit/pdcacycl.htm
W. Edwards Deming
• 14 Key Principles– Constancy of Purpose– Innovation Prized– Emphasis on Statistical Sampling– Top Management Commitment
• 7 Deadly Sins
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
http://www.deming.org/
J. M. Juran
• “Fitness for Use”– Quality as Defined by the Customer
• The Quality Trilogy– Planning– Control– Improvement
• The 10 Step Process
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Philip B. Crosby
• The Art of Hassle Free Management– Management must create the appropriate
environment– What popular social icon
disputes this as the statusquo?
• Dilbert http://www.philipcrosby.com/25years/crosby.html
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Philip B. Crosby
• Quality =– “Conformance to Requirements” in order to
prevent errors
• Ultimate Goal = “Zero Defects”
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Philip B. Crosby
• Best Measure = Cost– Price of Nonconformance– Price of Conformance
• The 14 Step Process– Key Point: Management must be committed to
quality and share this commitment with employees
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Differences Between The Philosophies
• Defining Requirements for Quality– Crosby & Juran: The Provider
– Deming: The Customer
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Differences Between The Philosophies
• Costs– Crosby & Juran: Standardize the Cost Definition,
Then Monitor
– Deming: Emphasize the Process Definition, Examine Variations
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Differences Between The Philosophies
• Role of Authority– Crosby and Deming: Project Improvement Teams
Determine “Bottom-Up” Selection of Areas to Focus on Quality
– Juran: Top Down Selection of Teams and Projects
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Differences Between The Philosophies
• Orientation
– Crosby: Motivation/Culture Change
– Deming and Juran: Use of Statistics
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Top Management Leadership– Must Drive the Process
• Corporate Framework for Quality– Quality Must Be Incorporated Into Mission and
Value Statements– Quality Must Become An Organizational Routine
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Transformation of Current Culture– Why Is This Important?
• Quality Education and Training– Necessary At All Levels– Needed For Employee Orientations And Periodic
Training– Must Incorporate CQI Tools
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Continuous Improvement in Quality
– New Products And Features
– Reduced Costs To Maintain Same Quality
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Role of the Customer– Customer’s Requirements Must Be Identified– Customer’s Satisfaction Must Be Measured And
Monitored– Complaint Management Systems Must Be Developed
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Focus on System Improvement– Study Process Variations– Identify Causes of Error
• Measurement and Experimentation– Employ CQI Tools
• Pareto Chart/Rule• Control Chart• “Fishbone Diagram”
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Common Concepts
• Quality Management Process– Must Be Integral to Day-to-Day Operations
• Recognition and Communication
Source: Sahney et al. “Quality Improvement Process: The Foundation for Excellence in Health Care.” Journal of the Society for Health Systems, Vol. 1, No. 1, 1989.
Kaoru Ishikawa
• Quality Circles
• The Ishikawa (“Fishbone”) Diagram
OTHER QUALITY GURUS
http://www.bizmanualz.com/blog/top-ten/top-ten-quality-gurus.html
QUALITY PIONEERS