PQ Systems, Inc. | Quality Blog

President Barack Obama has picked Donald M. Berwick, MD to head the Centers for Medicare and Medicaid. A champion for hospital quality improvement and safety in medical care, he founded the Institute for Healthcare Improvement (IHI) in 1991 and has been challenging doctors since then to provide better services at lower cost. Heading this important agency is considered by some to be “the second most powerful [healthcare] position in Washington, next to the secretary of health and human services.” The agency has been without a head for four years.  (http://allgov.com/)

Will Berwick be able to change the focus of the programs he leads to one of quality improvement? His background as a dynamic innovator in the healthcare industry promises this—but will he be able to sustain the focus on quality in the highly bureaucratic agency?

Have you had experiences that reflect Berwick’s mark on healthcare through IHI? What thoughts do you have about his potential success in leading this giant agency?

Looking for funding for children’s health improvement projects? One of our Quality eLine readers has generously offered a suggestion for possible grant funding opportunities under the newest healthcare legislation, passed in April.

The Agency for Healthcare Research and Quality (AHRQ) offers information about grant funding through CHIPRA (Children’s Health Insurance Program Reauthorization Act). CHIPRA Pediatric Healthcare Quality Measures Program Centers of Excellence (U18) anticipates making seven to nine awards that total $55 million over a 4-year period. The maximum annual award is $2 million. Awards are contingent upon the availability of funds and the submission of a sufficient number of meritorious applications. Because the proposed research will vary across applications, it is anticipated that awards will vary in size and duration.

Application deadline is June 30, with letters of intent to be submitted by June 1. For more information: http://www.ahrq.gov/chip/chipraact.htm#Grants.

I found this article in the May issue of Continuous Improvement, put together by IHI. What was most enlightening about the following article, by Bob Lloyd, is that your background may affect how you choose to evaluate data and thus how you respond to data.

I have been exposed to control charts for nearly 30 years and I see a use for most process data to be displayed in control chart form. We are all routinely exposed to data in binary form: the stock market went up compared to yesterday, the temperature is cooler today than on this date last year, our company had x% growth over last year, etc. The numbers are interesting, but control charts tell a story.

Helping Leaders “Blink” Correctly

In the first of two articles, IHI’s Bob Lloyd describes two of four core skills health care leaders need to use data appropriately in decision making: understanding the messiness of improving health care, and determining why you are measuring. Without these capacities, Dr. Lloyd argues, we run the risk of going off in the wrong direction in the “blink of an eye.”

Read the article in Healthcare Executive

Like you, I have heard about the myriad of problems Toyota has been having lately. I heard about the sticking accelerator, the brake problem on the Prius, and a vehicle recall that will top 8 million. USA Today listed this as “Toyota’s quality fiasco” http://www.usatoday.com/money/autos/2010-02-05-toyota-recall-friday_N.htm. Toyota’s president Akio Toyoda has stated “Let me assure everyone that we will redouble our commitment to quality as the lifeline of our company” http://news.yahoo.com/s/ap/toyota_recall. As I read this, I wondered, is it really a quality problem?

No doubt Toyota has a problem, but was the accelerator problem caused by poor quality? You might recall that one solution to the accelerator problem was related to the floor mat. The floor mat would be modified so that the potential for it to cause the accelerator to stick would be minimized. So what is the root cause of this problem? Were the fibers used in the floor mat faulty? Were the floor mats sized incorrectly? Did the materials supplier produce defective materials? There are many possibilities.

Toyota is known for their precise specifications. So let’s assume that the floor mats, brake pedals, brake lines, etc. were manufactured to a tight tolerance and functioned as they were designed. If this is the case, isn’t the problem related to the design rather than the quality of the parts produced? If root cause analysis identifies that the problem is with the design, then the media should call it “Toyota’s design fiasco.”

Of course at the end of the day, what really matters is that all automotive manufacturers learn from Toyota’s problems and take steps to prevent an issue such as this from occurring again.

I’d like to hear your thoughts on “Toyota’s quality fiasco.”

I regularly follow Quality Digest articles and videos and have come to really enjoy the material written by Mike Micklewright. His material is not just educational, it is usually presented in an entertaining fashion. Hey, if you can make quality information a little entertaining, then you have some talent! You can see many of his articles directly from the Quality Digest site once you enter Mike’s name in the search engine at http://www.qualitydigest.com/.

For example, in this video, http://www.qualitydigest.com/inside/quality-insider-video/viewpoint-mike-micklewright.html, Mike shares his opinions on the new ISO 9001:2008 standard. If your company is ISO registered or you are interested in more information about the standard, there are many sources of information on the web. Google gave me more than I could have anticipated. Yet in this short video, Mike Micklewright examines the eight quality management principles and what the editors did or more to his point, what they did not do, with the standard.

Mike owns his own company, Quality Quest, and if you are interested in more of his material, Google his name or visit http://www.mikemick.com/. What helpful quality resources do you follow online?

I recently received an e-mail from SPC Press about a new book Donald Wheeler wrote, Twenty Things You Need to Know. Don has written many books on SPC, measurement systems analysis, Six Sigma, and other quality topics.

Although I have not yet read Twenty Things You Need to Know, I can tell you that his other books (such as Understanding Statistical Process Control and Understanding Variation) are worth reading. Okay, they don’t exactly read like a good novel that you can’t put down, but they serve as outstanding quality statistics reference sources.

If you are interested in his new book, you might want to look at an excerpt which is available through this link: http://www.spcpress.com/pdf/three_questions.pdf

In this excerpt, Wheeler states

“…these three questions define the essence of how to get things done.”