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DATA SANITY: A Quantum Leap to Unprecedented Results

What they’re saying about Davis…

"I was fortunate to select your presentation at the patient safety academy today and was delighted!  Informative and insightful you were able to put data analysis into a wonderful perspective.
Thank You for probably the smartest, funniest and most useful program on QI that I have ever attended. When you think about special vs common cause it just makes good “common” sense.
Thank you for the program today - it was a refreshing and energizing alternate approach to our current morass of indicators, benchmarking and flashing colored lights to please the board...Your presentation of the Provider level C-Section data gave me a double take."

"Thank you so much for your presentation today.  I really learned a lot and I'm excited to take it back and apply it to my organization."

"Thank you so much for the conference today,  great information that I can put to use right away.  Enjoyed it very much."

"Wonderful presentation today; I feel less intimidated working with stats than I did prior to attending."

Are You Becoming a ‘Qualicrat?’

Beware of letting data and analysis muscle out embedded quality improvement

During my recent travels, I have noticed an increasing tendency toward formalizing organizational quality improvement (QI) efforts into a separate silo. Even more disturbing is an increasing (and excruciating) formality. Expressions such as “saving dark-green dollars” are creeping into justifications for such “programs,” usually referred to as Six Sigma, lean, or lean Six Sigma. As always, Jim Clemmer pinpoints this trend perfectly:

“The quality movement [has given] rise to a new breed of techno-manager—the qualicrat. These support professionals see the world strictly through data and analysis, and their quality improvement tools and techniques. While they work hard to quantify the ‘voice of the customer,’ the face of current customers (and especially potential new customers) is often lost. Having researched, consulted, and written extensively on quality improvement, I am a big convert to, and evangelist for, the cause. But some efforts are getting badly out of balance as customers, partners, and team members are reduced to numbers, charts, and graphs.”

“Doing” QI vs. transforming an organization

Contrast Clemmer’s description with my view of how a quality focus should transform an organization:

QI: “One-shot” skills training via courses
Transformation: Routine, continuous education through daily work

QI: Many teams of key personnel focused on routine, daily operational issues
Transformation: A few top management-led teams focused on key strategic issues

QI: Heavy emphasis on tools
Transformation: Entire work culture educated in QI theory

QI: Focus on obvious, current problems—representing 3–15 percent of opportunity—through:

  • Formal problem identification
  • Problem-solving tools
  • Management guidance teams
  • Formal team reviews
  • Storyboards
  • QI coordinator and formal quality structure

Transformation: Focus on hidden problems—representing 85–97 percent of opportunity—through:

  • Appreciation of systems and interactions
  • Cultural and individual psychology
  • Deep understanding of variation
  • Use of data to test improvement theories
  • Continuous establishment and documentation of routine processes important to customers

QI: Team facilitators with QI tools skills
Transformation: Change agents with formal cultural change skills in addition to problem-solving skills

QI: Arbitrary numerical goals and traffic-light reporting
Transformation: Understanding variation and process capability through targets, runs, and control charts. Establishing an integrated measurement system via a balanced scorecard

QI: Management behavior is:

  • Comfortable with maintaining the status quo
  • Shortsighted, so solves problems only as they crop up
  • Reactive to variation and treats each as unique with special causes
  • Task-oriented, so chooses projects and reviews progress
  • Distancing, so sends people to courses

Transformation: Management behavior is:

  • Engaged and seeks to understand and improve processes
  • Constantly facilitating problem solving and removing cultural barriers
  • Proactively responsive to variation, so asks, “Is this common or special cause?”
  • Able to exhibit QI skills through behavior
  • Interested in teaching QI through routine daily work and meetings

QI: Quality is a “certain percent” of the job and explicit
Transformation: Quality is 100 percent of the job and implicit

Built in, not bolted on

Until quality concepts permeate an organization’s culture to the point where the words “statistical” and “quality” are dropped as qualifiers because they are givens, any “dark-green dollar” savings will be nickels and dimes compared to what is truly possible.

Many organizations are still locked into the mindset of quality as a “bolt-on” program rather than the strategy for developing a strategy. And the “guru vs. guru wars” continue, which means that people still don’t get it.

I once received some feedback from a concerned reader who thought I tended to poke fun at quality programs, especially lean Six Sigma (LSS). I don’t (well, maybe a little), but he said it so well: “I suppose it is valid to poke at those who would market [lean Six Sigma] as a quick fix (and deliver nothing but high-priced training), but I do believe that when viewed as a culture, infrastructure, methodology, and metric, LSS is a disciplined way to organize for quality and make improvements project by project. However, it pains me to have our initiative questioned by folks who, when I referred them to your site (to order your book), come back even more suspicious about LSS.”

In essence, he and I agree. This person does indeed get it, and I apologize for any others I may also be offending.

But the comment got me thinking. There is a message that always bears repeating: Total quality management (TQM), continuous quality improvement (CQI), Six Sigma, LSS, and the Toyota Production System all come out of the same theory, which truly hasn’t changed in the last 22 years.

And, by the way, did you notice that my reader’s comment included the term “project by project?”  I’m not sure that approach (on which Juran’s success was based during the 1970s and 1980s) is going to be effective any more. As I’ve tried to show, this thinking must also infiltrate the everyday management of any organization.

Quality, when integrated into a business strategy, is present in virtually every aspect of every employee’s everyday work. Process-oriented thinking is the anchoring concept of any good improvement framework and creates a common organizational language that will reduce defensiveness. It’s not the problems that march into your office that are important: It’s the ones of which no one is aware.

And then there’s that statistical conundrum: Some lean purists argue that statistics have absolutely no place in the discussion, while the Six Sigma pros contend that it’s all about statistics. It’s become a sort of modern-day “How many angels can dance on the head of a pin?” debate. Don’t you think your time would be better spent considering how you can use your knowledge and experience to help your company move away from quality as a bolt-on program to a built-in culture change?

Have you become a “qualicrat?”

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