Advanced Quality Control Course

Quality
Improvement
Prof. Dr. Mohamed Ahmeda Alaalam
‫أ‬.‫د‬/.‫ملاعحا أدحمحأ دمحم‬
Table of contents
Introduction.
What is an improvement?
What is quality improvement?
The history of QI and modern applications
The Model for Improvement
The Toyota Production System
The importance of quality improvement
How to apply quality improvement in your work
 Quality
Quality refers to the degree of excellence of
something.
The definitions of quality can vary across
industries and it’s typically defined from the
perspective of the end user.
 Concepts of
improvement and change
Improvements can be characterised as
changes that make something faster, easier,
more efficient, more effective, less expensive,
safer, or a change that improves end-user
satisfaction.
 Concepts of
improvement and change-Cont.
While there is a strong interplay between the
concepts of improvement and change.
it is important to note that all improvements
require change, but not all changes result in
improvements.
Simply put, just because you change
something, doesn’t mean it is actually
improved.
Quality Improvement (QI)
Now that we have an understanding
of the definitions of both quality and
improvement, let’s bring it together
and look at what quality
improvement is.

What is Quality Improvement?

Quality Improvement can be defined as the:
b “combined and unceasing efforts of everyone.
b Example – healthcare professionals, patients
and their families, researchers, payers,
planners and educators – to make the changes
that will lead to better patient outcomes
(health), better system performance (care) and
better professional development”
Batalden and Davidoff
 (QI) –Cont.
(QI) is the framework used to systematically
improve processes and systems.
Just as it sounds, the goal of QI is to
continuously look for ways to improve the
quality of organization’s outputs, which could
be products, services, or outcomes..
 (QI)- Cont.
b QI is a systematic, formal approach to the
analysis of practice performance and efforts
to improve performance.

bA variety of approaches—or QI models—

exist to help collect and analyze data and
test change.
 (QI)- Cont.
b QI is a structured approach to
evaluating the performance of systems
and processes, then determining needed
improvements in both functional and
operational areas.

b Successful efforts rely on the routine

collection and analysis of data.
Deming’s Profound Knowledge

System
Variation in
where you
the system
work

Theory of Psychology
knowledge - the people

Deming
Theory to method to measurement
Variation Psychology

Theory Method
Theory of
knowledge

Measure
 Plan Do
What changes
can we make Study Act
How will we that will result
know if the in improvement?
What are we change is
trying to improvement?
accomplish?
 Model for Improvement
What change can we make that will result in an improvement ?
The PDSA Cycle

Langley Nolan et al. The Improvement Guide: A Practical Approach to

Enhancing Organizational Performance, 2nd Edition April 2009, Jossey-
Where to start?
Implemen
Test t changes
changes
Establish
measures
Set aims

Define
area for
change
 PDSA Paper Aeroplane Activity

Quality Improvement in Action

Aim: Design a paper plan that will fly the furthest distance

Think of the areas you need to consider:

• Design
• Construction
• Measurement

Run your tests a few times:

• What are you learning?
• How will you factor your learning into the next test?
• Did your change result in improvement ?
 Juran’s ‫ح‬steps for quality improvement

1) Build awareness of need and opportunity for improvement.

2) Set goals for improvement.
3) Organize to reach the goals.
4) Provide training.
5) Carry out projects to solve problems.
Report progress.
6)
Yo u c a n a l s o r e a d
7) Give recognition.
8) Communicate results. more about each step
9) Keep score. in the sheet (see
10) Maintain momentum. classroom).
 1) Know Your Stakeholders

A. . Identify stakeholders and their needs

B. Set goals based on stakeholder needs

C. Monitor performance and satisfaction to target

performance improvement opportunities

D. Improve or redesign how work is done

‫ح‬2 ) Focus on Processes
3) Use Data to Make Decisions

b Use performance assessment data to target improvement.

b Use data analysis tools to develop information.

b Analyze data to identify root cause.

b Use data to monitor performance outcomes.

 4 ) Understand Variation

b Sources of variation include machines, materials, methods,

measurements, people, environment

b Common cause variation occurs if the process is Stable variation in

data points will be random and obey a mathematical lawit is said to be
in statistical control, with a large number of small sources of variation

b Reacting to random variation in a process that is stable/in statistical

control, it is called tampering and leads to further complexity,
increasing variation and mistakes
 5. Use Teamwork

b QI efforts need buy-in from all stakeholders

b Creative ideas are needed

b Division of labor is needed

b Process often crosses functions

b Solution generally affects man

 6. Make QI Continues
b QI is a system-wide approach to assessing and continuously improving
quality of the processes and services over time

b See inter-relationships, not parts

b Understand the flow of work, not the one-time snapshot

b Detail the work processes

b Determine cause and effect relationships

b Identify points of highest leverage Improve and innovate, not just change
for changes sake
Build a QI culture

Connect the organizations strategic plan to performance improvement

Know and use quality principles

Encourage all staff to use quality improvement in daily work

Reward improvements

Assure adequate QI infrastructure for quality assessment and‫ح‬

improvement activities
Steps to Set Up a Rapid Cycle
Improvement
1. Establish a multi-disciplinary RCI team
2. Identify a positive opinion leader
3. Align leadership and administrative support
4. Consolidation of relevant knowledge and experience
(national) for multiple changes
5. Development of an overall aim statement (using the
three questions at a high level)
6. Decide where to start and develop a strategy for a
series of rapid cycles.
Guidance on Following the
Steps
It is important not to try to write the perfect AIM
statement and develop the most thorough rapid cycle
strategy at the start.
It is more important to start small, rapid tests of
change through PDSA cycles as soon as possible.
The AIM statement and strategy evolve continually as
you learn from testing.
The major objective is to build organizational learning
from small tests of change.
 PDCA/PDSA Cycle definition

b The Plan Do Check/Study Act Cycle is a trial-and-learning

method to discover what is an effective and efficient way to
design or change a process.

b The check part of the cycle may require some clarification.

b It compels the team to learn from the data collected, its

effects on other parts of the system, and under different
conditions, such as different communities
Process improvement?

b Business process improvements are methodologies in

which a team evaluates their current processes and
adapts them with the intent to increase productivity,
streamline workflows, adapt to changing business needs,
or increase profitability.
PDCA Cycle- Model for
Continuous Improvement.
 History-
b Shewhart, in the 1920s introduced the
concept of PLAN, DO, STUDY and ACT.

b By 1950s, PDCA cycle was popularized by

Deming, an American engineer,
statistician and management consultant.
He actually developed the model into a
learning and improvement cycle.
Quality Improvement
bQI traces it roots back to the 1920s, and was first

applied to manufacturing by pioneers like

Deming, Shewhart and Juran, widely regarded as
the grandfathers of QI.
P-D-S-A Cycle

Mr. Walter A. Shewhart

P-D-C-A Cycle
P-D-C-A Cycle-cont.

bThe PDCA process ensures

organizations performance
and the supporting activities
can be continually reviewed
and improved to be compliant
with ISO standards.
 Used in Areas –
b The model can be used in all sorts of
business environments, any organization
and irrespective of any industries.
b It is used at the beginning of a new
improvement project, when developing
new process/design/product or
implementing any changes in the process,
etc.
 Advantages-
b Model is simple, yet powerful way to resolve issues and managing

changes at any level of organization.

b Allows team to test solutions and assess results at each step of cycle.

b Improve efficiency and productivity in a controlled standardized ways

b The repetitive approach helps your team find and test solutions and

improve them through a waste-reducing cycle.

b Stimulates continuous improvement of people and processes

b It prevents the work process from recurring mistakes.

 PDCA cycle-
b It is a continuous cycle in the journey of
project improvement.
b It is a four step model for carrying out
change at any level of organization.
b As a circle has no end in same way it is a
continuous cycle of improvement.
b It is never ending process of
improvement.
 Disadvantage-
b Requires commitment to continuous improvement however small
is the project.

b Slow, step by step approach to problems and not a straight

forward implementation

b Time consuming and hence Not for urgent problems or for

handing emergency situation.

b Another version of this PDCA cycle is OPDCA. The added "O"

stands for observation or as some versions say: "Observe the
current condition
PDSA Cycle for Improvement

Act Plan
• What improvement • Objective
will we make next? • Questions and
•Do we need to: predictions (why)
Abandon? Adapt? • Plan to carry out
Adopt? the cycle (who,
•Sustain the gain what, where, when)
Study Do
• Complete the analysis • Carry out the plan
of the data • Document problems
• Compare data to and unexpected
predictions observations
• Summarize • Begin analysis
what was of the data
learned
The 4 sequential categories are:
plan, do, check, and act.

Plan:
b Identify and analyze the problem or opportunity,
develop hypotheses about changes needs to be done.
Depending on the size of the project, planning can take a
major part of your team’s efforts and time too.
b Steps in Plan- identify problem, form a team of relevant
departments, establish objective and goal, critical
thinking – identify potential causes, identify potential
root cause.
b Techniques- brain storming – fishbone diagram/
relationship diagram/ why-why.
 The 4 sequential categories are:
plan, do, check, and act.
Do:
b Ideally test the potential solution and measure the results/ its
effectiveness at small scale. At this stage, be aware that
unpredicted problems which may occur at this phase.
Standardization of procedure will help your team apply the
plan smoothly. Make sure that everybody knows their roles
and responsibilities.

b Steps- execution/implementation of solutions, measure

effectiveness on small scale, set performance indicator.
 The 4 sequential categories are:
plan, do, check, and act.

Check:
b Don’t settle for a less-than-satisfactory solution. Confirm
the results through before-and-after data comparison. If
something went wrong during the process, analyze it and
find the root cause of the problems.
b Steps- collect data, compare actual result against target
result, communicate the changes, staff training and
feedback.
b Technique- audit, checklist, comparison
The 4 sequential categories are:
plan, do, check, and act.

Act:
b If the solution was successful, implement it on
large scale. Continue to look for ways to make
it even better for your organization or
customers.
b Steps- Effective solution set as baseline,
determine new target and start PDCA cycle
again on same project or new project.
b Techniques- Documentation, standardization.
Making Changes
PDSA in Everyday Life
 PDSA in Everyday Life
b it is important to note that all improvements require change, but not all
changes result in improvements. Simply put, just because you change
something, doesn’t mean it is actually improved.
b What is quality improvement?
b As previously mentioned, (QI) is the framework used to systematically
improve processes and systems. Just as it sounds, the goal of QI is to
continuously look for ways to improve the quality of your organization’s
outputs, which could be products, services, or outcomes.
b But as it has been mentioned in the previous section, just because a change is
made doesn’t mean it resulted in an improvement. That’s why QI is built on
a foundation of measurement, goal-setting, and testing. It involves
establishing standard processes to continuously monitor, assess, and improve
processes towards a specific goal or outcome.
b QI can be thought about as a combination of technical and behavioural skills.
Any Question
‫اتءاش نااقياوتلابا‬
Prof. Dr. Mohamed Ahmeda Alaalam
‫أ‬.‫د‬/.‫ملاعحا أدحمحأ دمحم‬