Process Quality Improvement

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In order for quality improvement to occur, the processes responsible for creating quality must be improved. Here's a step-by-step guide to improve your business.

Process


A process is nothing more than the steps and decisions involved in the way work gets done. It's the "stringing together" of the individual activities necessary to successfully accomplish an objective.

Everything that we do in our lives involves a process. Here are some work process examples:

  • Completing a timesheet,
  • Preparing a patient dinner,
  • Giving a patient an injection,
  • Repairing an automobile.

As you can see, the level of importance of processes can vary. Some processes, such as giving a patient an injection is very important. If this process is performed poorly, or if it does not do what it is supposed to do, the recipient will have a painful and bad experience.

Other processes such as - completing a timesheet, or preparing a patients dinner are less critical in terms of the overall mission. Although less critical such routine processes are still vital to the smooth functioning of the operation and patient experience.

In addition to differing in importance, processes can be either simple or complicated. Some processes may be comparatively simple.

Replacing the paper in a copy machine, for example. While other processes, such as adding a new wing to a health center, are very complicated. Many people are involved and numerous process steps and contributing processes are required.

Process Ownership


Many people typically have a stake in one or more processes. Groups of individuals share-in and “own” the activities that make up the process. The one individual who is ultimately responsible and accountable for the proper functioning of the process is known as the “process owner.”

The process owner is the immediate supervisor or leader who has
control over the entire process from beginning to end...

A process owner may be a team leader and participate directly in the actions of the process. Or, the process owner may delegate the leadership role to another person who is knowledgeable about the process.

Whatever the case, it is very important for the process owner to stay informed about the day-to-day actions and decisions affecting the performance of the process.

Quality Improvement


“Quality Improvement” means making things permanently better and not just fighting fires and dealing with crises. It means setting aside "blame and train" and taking and allotting the necessary time to really understand problems and looking for and implementing ways to do the work better.

When we don't take a process improvement problem-solving approach to problems, we risk just simply fixing what’s broken, and never truly understanding the root-causes of difficulties.

More often than not the exact problem recurs or manifests itself again in a different way. When you engage in true quality improvement, you seek to understand the process and what within it is causing things to happen.

Process knowledge is used to reduce variation, removing the problems that contribute no value.

Quality Improvement Benefits


Implementing a standardized process improvement methodology in a company is one the healthiest things that a company can do.

Nothing is more frustrating than identifying problems and not having the tools and support to fix them.

Having a quality improvement strategy grounded in process improvement allows us to look at how we perform work and change it when data suggests that a change is necessary. When all of the "stakeholders" are involved in the improvement, they can collectively focus on eliminating waste.

The outcome is that work objectives can be accomplished cheaper, quicker, easier, safer, and with an increased level of quality. Using simple quality tools and methods stakeholder team members’ collective knowledge, experiences, and efforts are a powerful approach to improving both the top and bottom line. Using teamwork, the whole becomes greater than the sum of its parts.

Getting Started


The first step in process quality improvement is for the senior leader to make it a priority. The importance of quality improvement must be communicated from the top.

Leaders must foster an environment in which quality improvement is just as important, if not more important, than making the monthly numbers. They must use, and value that others use, the quality-related tools and techniques on a regular basis.

To achieve this, leaders must ensure that everyone receives training that will enable them to carry out their process improvement efforts effectively.

Instilling a process improvement mentality in an organization can be difficult because it requires different ways of thinking than some are accustomed to.

Quality improvement requires everyone to become a “fire preventer,” rather than a “fire fighter.” The focus must be on quality improvement over the long term, not just applying "band aids" to procedures and work-flows as problems occur.

Getting started with quality improvement involves leaders asking new questions:

  • What processes need to be improved - what's broken?
  • What process is the most important to improve first?
  • What resources are needed for the improvement effort?
  • Who are the right stakeholders to improve the selected process
  • What’s the best way to get data to learn about the process?

Process Improvement


There are two basic parts to process improvement...

Part one involves understanding how work is currently getting done and taking immediate steps to simplify the process and remove the waste such as delays and defects.

Data must be collected, if not readily available, to analyze process stability and process capability.

Depending upon process stability and capability results, part two involves identifying the root-causes of process capability problems and implementing the necessary corrective action to improve performance results.

Improvement itself is a process... 

Using all 14 steps will increase process knowledge, broaden decision-making options, and greatly increase the likelihood of long-term results.

Quality Improvement Process


Step 1: Select the process to be improved and establish a well-defined process improvement objective. The objective can be established by the team or come from management.

Step 2: Organize a team to improve the process. This involves selecting the “right” people to serve on the team; identifying the resources available for the improvement effort, such as people, time, money, and materials; setting reporting requirements; and determining the team’s level of authority. These elements should be formalized in a written charter.

Step 3: Define the current process using a flow chart. This will generate a step-by-step map of the activities, actions, and decisions which occur between the starting and stopping points of the process.

Step 4: Simplify the process by removing redundant or unnecessary activities. It's likely that people may be seeing the process on paper in its entirety for the first time from Step 3. This can be a real "eye-opener" which will prepare them to take the first steps in improving the process.

Step 5: Develop a plan for collecting data and collect baseline data if it's not already being collected. This baseline data will be used as a "yardstick" later in the quality improvement process. This begins the
evaluation of the process against the process improvement objective established in Step 1. The flowchart in Step 3 is used to help determine who should collect data and where in the process data should be collected.

Step 6: Assess whether the process is stable. Create a control chart or run chart out of the data collected in Step 5 to gain a better understanding of what is happening in the process. Future actions of the team are dictated by whether special cause variation is found in the process.

Step 7: Assess whether the process is capable. Create a histogram to
compare the data collected in Step 5 against the process improvement objective established in Step 1. Usually the process simplification actions in Step 4 are not enough to make the process capable of meeting the objective and the team will have to continue on to Step 8 in search of root causes. Even if the data indicate that the process is meeting the objective, the team should consider whether it is feasible to improve the process further before going on to Step 14.

Step 8: Identify the root causes which prevent the process from meeting the objective. Use a cause-and-effect diagram or brainstorming to generate possible reasons why the process fails to meet the desired objective.

Step 9: Develop a plan for implementing a process change based on the possible reasons for the process’s inability to meet the objective set for it. These root causes were identified in Step 8. The planned quality improvement involves revising the steps in the simplified flowchart created after changes were made in Step 4.

Step 10: Modify the data collection plan developed in Step 5, if necessary.

Step 11: Test the changed process and collect data.

Step 12: Assess whether the changed process is stable . Same as Step 6, use a control chart or run chart to determine process stability. If the process is stable, the team can move on to Step 13; if not, you should return the process to its former state and plan another change.

Step 13: Assess whether the change improved the process. Using the data collected in Step 11 and a histogram, the team determines whether the process is closer to meeting the process improvement objective established in Step 1. If the objective is met, the team can progress to Step 14; if not, the team must decide whether to keep or discard the change.

Step 14: Determine whether additional process improvements are feasible. The team is faced with this decision following process simplification in Step 7 and again after initiating an improvement in Steps 8 through 13. In Step 14, the team has the choice of embarking on continuous process improvement by reentering the model at Step 9, or simply monitoring the performance of the process until
further improvement is feasible.


14 Step Quality Improvement Roadmap

Quality Improvement Process Roadmap

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