1. AMERICAN SOCIETY FOR QUALITY QUALITY 101 Michael Hagan, D.O., MHSA, CMQ

2. Why study quality?

3. © 2001 ASQ All rights reserved. ASQ IL1-3 Module 1: Quality Benefits u Tangible –Increase in earnings –Decrease in waste –Increase in productivity u Intangible –Customer goodwill –Alignment between business activities

4. © 2001 ASQ All rights reserved. ASQ IL1-4 W. Edwards Deming on Quality u Meeting customer needs + wants = quality. u Quality improves products/services and processes. u Improved products/services and processes = profitability.

5. © 2001 ASQ All rights reserved. ASQ IL1-5 A Quality Approach Benefits... Employees Organizations Suppliers Society Customers

6. © 2001 ASQ All rights reserved. ASQ IL1-6 Benefits to Employees  Product quality Greater job security/benefits  Process quality  Profit  Customer satisfaction Pride in products and services Job satisfaction Improved communications Streamlined work processes Happier customers Strong customer relationships

7. © 2001 ASQ All rights reserved. ASQ IL1-7 Benefits to Organizations

8. © 2001 ASQ All rights reserved. ASQ IL1-8 Quality Studies and Standards Released the Profit Impact of Market Strategy (PIMS) study. Partnered with the Baldrige recognition program. Both organizations support the link between quality and profitability. Strategic Planning Institute National Institute of Standards and Technology

9. N I S T National Institute Standards & Tech Baldrige Quality Award Baldrige index Outperforms the S & P 500 index

10. IT WORKS Companies that look at themselves and constantly ask the question “how can we improve” Are more successful as a company

11. © 2001 ASQ All rights reserved. ASQ IL1-11 External and Internal Customers Publication Department Sales Department Customer

12. BENEFITS TO CUSTOMERS External Customer Person or organization that (buys) receives the product or service Transplant center Other OPO Donor hospital Tissue Bank

13. BENEFITS TO CUSTOMERS Internal Customer Employee or department that receives the output OPO Coordinators OPO HD OPO Finance department

14. © 2001 ASQ All rights reserved. ASQ IL1-14 Benefits to Customers Quality results in: u Increased choices. u Improved goods and services. u Expectations met or exceeded.

15. © 2001 ASQ All rights reserved. ASQ IL1-15 Benefits to Suppliers u Achievement of performance requirements u Streamlined processes u Efficient communication u Increased customer satisfaction

16. © 2001 ASQ All rights reserved. ASQ IL1-16 Benefits to Society Economic growth and stability Increased employment opportunities Product safety

17. OPO’s BENEFIT TO SOCIETY Disease free organs and tissues Better functioning organs More transplants More lives saved

18. © 2001 ASQ All rights reserved. ASQ IL1-18 Module 2: The Evolution of Quality u Provides a framework for understanding the history of the quality movement. u Expands the definition of quality.

19. QUALITY DEFINED Many definitions No perfect definition Usually it is very clear when quality is missing

20. MISSING QUALITY Missing a pt on the match run Incorrect lab, HLA, etc. Mislabeled blood type Surgical damage Liver in a heart box

21. JURAN FITNESS FOR USE Degree to which the product or service conforms to design The degree to which the transplant centers are called on each of their patients

22. JURAN FITNESS FOR USE Product or service availability, reliability, and maintainability Reliability of the software systems to produce accurate match runs

23. JURAN FITNESS FOR USE Available customer service Ability of transplant centers to request customer service from the OPO

24. © 2001 ASQ All rights reserved. ASQ IL1-24 ISO Definition of Quality u Degree to which a set of characteristics fulfills requirements Requirements: Convenience and speed Product: Telephone Characteristic: Speed dial

25. © 2001 ASQ All rights reserved. ASQ IL1-25 Crosby’s Definition of Quality u Quality is conformance to requirements. u Requirements are answers to key organizational questions: –How quickly will orders ship? –What is our return policy? –What forms of payment are acceptable?

26. © 2001 ASQ All rights reserved. ASQ IL1-26 Quality Evolution: Medieval Guilds Guilds:  Developed strict rules for products and services.  Used stamps to identify flawless goods.

27. © 2001 ASQ All rights reserved. ASQ IL1-27 Quality Evolution: Product Orientation  Master craftsmen trained apprentices.  Industrial Revolution divided trades into specialized tasks; inspectors guaranteed quality.  Taylor system increased productivity; inspection departments found defects.

28. © 2001 ASQ All rights reserved. ASQ IL1-28 Quality Evolution: Process Orientation  Processes became critical.  Shewhart identified statistical quality control.  Developed strict rules for products and services.  Quality became relevant for process, not just product.

29. PROCESS ORIENTATION Shewart: in 1920s, Bell Labs Process yields data Data can be analyzed Statistical analysis and control Control charts for the process

30. © 2001 ASQ All rights reserved. ASQ IL1-30 Quality Evolution: Wartime  Quality became a safety issue.  The military developed a sampling inspection system and trained suppliers.

31. © 2001 ASQ All rights reserved. ASQ IL1-31 Quality Evolution: Total Quality Movement  Developed in response to Japanese quality movement.  Focused on improving all processes through people who used them.

32. © 2001 ASQ All rights reserved. ASQ IL1-32 Use of Standards u Definition: A standard is a “statement, specification, or quantity of material against which outputs may be judged as acceptable or nonacceptable.” u Result: Interchangeable products. u Examples: Military and ISO 9000 standards.

33. © 2001 ASQ All rights reserved. ASQ IL1-33 ISO Registration Independent third party audits the quality management system. Certificate of registration awarded when audit is passed. Registration is maintained via surveillance audits. Step 1 Step 2 Step 3

34. © 2001 ASQ All rights reserved. ASQ IL1-34 Baldrige Program u Improves organizational performance. u Facilitates the sharing of best practices. u Provides a tool for managing performance and guiding planning and opportunities for learning.

35. BALDRIGE 7 CATEGORIES Leadership Strategic planning Customer & market focus Information and analysis Human resource Process management Business results

36. BALDRIGE CORE VALUES Visionary leadership Customer driven excellence Organizational & personal learning Valuing employees and partners Agility Focus on the future

37. BALDRIGE CORE VALUES Managing for innovation Management by fact, data Public responsibility & citizenship Focus on results, creating value Systems perspective

38. QUALITY QUESTIONS What does AOPO consider a good quality OPO? One that has met accreditation requirements

39. QUALITY QUESTIONS What does CMS consider as a good quality OPO? One that has met the CMS contractual requirements

40. QUALITY QUESTIONS What does UNOS consider as a POOR quality OPO or program? St. Vincent, skipped candidates, program now closed

41. NOT QUALITY There is a very real cost of poor quality or lack of quality. Cost of time, resources, people Poor outcomes, fewer transplants

42. QUALITY IMPROVEMENT HRSA Collaboratives and AOPO Quality Council Strive to improve quality More transplants, save more lives

43. QUALITY GOAL All 58 OPOs High quality OPOs High quality organs and allocation