Innovations in Healthcare Delivery Conference
September 18 and 19
Medical Education and Research Center, Cincinnati Children's Hospital Medical Center
The Innovations in Healthcare Delivery conference series brings together healthcare managers,
physicians, and researchers from a variety of backgrounds and specialties to present and discuss new
insights and creative solutions for the efficient delivery of high-quality care. The conference focus is 'Improving Patient Care by Rethinking Processes, Systems and Organizations'.
See the conference flyer for more details.
For more information on registration, lodging, speakers, and abstracts:
www.cincinnatichildrens.org/ihd-conference
Ohio
Partnership for Excellence - Quest for Success Conference
September 22-23
Columbus Airport Marriott - Columbus, OH
The Ohio Partnership for Excellence administers the Baldrige Assessment
Process for Ohio Organizations. This year's annual Quest for Success
Conference is themed "Celebrate Excellence". The conference will feature 3
of the 5 national Baldrige Award recipients including Ohio's own
PRO-TEC Coating.
Click here for Conference Schedule and Registration
Also, the Ohio Partnership for Excellence is currently accepting
applications for examiners for the 2008-2009 award cycle.
For more information on the Ohio Partnership for Excellence and their
programs, visit
PartnershipOhio.org
ASQ Dayton Section 909 Events
There are many happenings just up the road in Dayton that may be of interest to you. Beyond their monthly Section Meetings, ASQ Dayton is working with the ASQ Customer-Supplier Division to put on a two day Supplier Roadshow Oct 6 and 7. This will feature two seminars
presented by nationally renowned speakers:
- Supplier Auditing taught by Dennis R. Arter
- Supplier Certification taught by Richard A. Gould.
Click here for details on the ASQ Customer-Supplier Division Roadshow.
Check out the
ASQ Dayton September Newsletter or the
ASQ Dayton Website for details on all the happenings in September and October.
ASK MIKE
From Evansville-Owensboro (March08)
The purpose of this column is to help local ASQ members better understand the Society, the local section, the philosophy of total quality management and the tools of quality by allowing section members to send or give questions to Mike. You can contact Mike by calling (812)-853-4893 (W) or (812)-853-9443 (H) or writing to 5311 Woodridge Dr., Newburgh, IN 47630 or Email to pmazu@adelphia.net.
Q. In design of experiments, what are the differences among the various designs?
Design of experiments helps you design an experiment that will provide you with the most information possible with the least amount of work. The basic principle behind design of experiments is that the experimental trials are well spread out from each other. The way the experimental trials are spread out and the model to be fitted create different types of designs. The most common are: factorial designs, fractional factorial designs, and central composite designs.
Factorial designs are probably the best known designs. They are intended to fit interaction models. The experimental trials are spread out geometrically – they are placed at all of the cube or hypercube corners.
Fractional factorial designs are intended to fit interaction models with the higher order interactions ignored. They typically fit all of the 2 factor interactions. The experimental trials are placed at the corners, but not all the corners are used, thus producing a more efficient design.
Central composite designs are intended to fit quadratic models. They place their experimental trials at the corners, the center point and on a sphere enclosing the cube above the centers of the faces.
Q. In design of experiments, what is meant by a constraint?
A constraint is a limitation on an experiment. For example, suppose you want to find the best combination of ingredients for a cooling system. The sum of the ingredients must add to 100%. This limitation, or constraint, makes standard designs useless. Standard designs will ask for 100% of each ingredient, for instance. This constraint requires a special design – a mixture design. Mixture designs have the levels for each experimental trial add to 100%.
QUALITY PROCESS UPDATE
G. Daniel Templeton
Fort Wayne, IN
BIG GOAL
This month QPU looks at an eclectic set of issues
including some emerging technology. China's
quality assurance and control fiascoes have
brought the quality profession back into the
limelight. How can the profession respond? Four
consultants to CEOs provided their short term
fixes in the Financial Times. Longer term fixes
will include improved teamwork between quality
engineers within the supply chain. Emerging
examples of successful world-scale teams are
being reported in the Wall Street Journal.
A consultant from Bain reminded CEOs that they
are accountable personally for the corporate
values radiating from their firm. In the long term
the best relationships, he said, will be built on a
mutually beneficial expectations, not inspections.
Further he notes that all employees should feel
empowered to resolve problems as they arise.
A PR flack declared that Western companies
need to be completely candid about the magnitude
of the problem, hiding nothing. These firms
then need to the uncompromising in their actions
taken with Chinese suppliers. Conversely to the
Bain consultant, the PR guy advocates flooding
China with inspectors to gauge manufacturing
performance. This inspection-heavy process will
need to be built into the cost when comparing to
other sources of the product. So much for
communicating modern thinking to CEOs.
A European MBA professor recommends
managers should carry out a full audit of the
supply chain, identifying vulnerable links. He
scolds that even though outsourced, the supply
chain remains the outsourcing the firm's responsibility.
As Nissan found in the UK, permanent
supplier development teams yield better results than dealing at an arm's length through an agent or a
trading company. However, working with suppliers
on quality assurance programs can be costly in terms
of management time. The benefit is reduced risk of
disrupted supplies. He states that when a process is
left to chance, firms may pay an even higher price.
The president and chairman of a software firm
advocates improving quality using lean technologies.
Giving managers, workers, and suppliers greater
visibility and control over the supply chain reduces the
risks ranging from political to financial to natural
disasters. She forecasts that the next generation of
lean manufacturing will be built on open standards,
collaboration, and automation. In her experience,
added value in efficient production is becoming a core
objective for China’s small and medium-sized producers.
How does one manage a geographically dispersed
and disparate team? Often members in one location
do not know or trust those and other places. For
example, engineers in the US may feel their jobs are
threatened by colleagues in Asia. They may hoard
information. To overcome such organizational and
cultural issues, IBM, Intel, and Tai Ping (a US carpet
maker), have found smoother teamwork occurs the
projects are split into many small pieces. Each chunk
is broken into tasks of about two weeks duration.
These tasks are then subdivided into one or two day
snippets. This appears to be effective because
mistakes and miscommunications are caught quickly.
There is also little time wasted waiting for others to
finish work. From a technology standpoint, communications
tools like interactive bulletin boards, or
wikis, allow real time postings with informal communications.
Some teams have even adopted andon lights
to signify serious problems within a snippet.
In terms of organizational development, experts
continue to suggest that the team have a common
understanding of the tasks and clarify their roles and
responsibilities before starting. It is also important to
set firm ground rules.
Breaking decisions into stages is a recurring theme
in successful business operations. Good managers
have always been able to think on their feet. Two
examples from different arenas include (a) executing
projects during turmoil or when adversity hits
and (b) defining treatment options in highly variable
illnesses.
Instead of making rock-hard plans and irreversible
long-term commitments, researchers are finding
that breaking decisions down into stages provides
increased flexibility to adjust to changes. The
concept of Real Options allows a manager to lay
out a series of decisions over a course of a
project. Once the project is underway, the managers
can account for changes by evaluating each
option as the events unfold.
What does this look like practice? Using an
example discussed later in an upcoming edition of
QPU, the quality assurance manager needs to plan
for the introduction of IP6 in about 2010. Briefly,
this is an expansion of the current IP address
system for the Internet. The quality assurance
manager is getting information from the local
supplier saying, "This will never happen." Intuitively,
and reinforced by websites like
DNSstuff.com, it appears as though this could be
bigger than Y2K. The manager begins by identifying
some options, such as following the Y2K QA
playbook, pointing out some critical events that
shape the roadmap, or allowing suppliers to take
the lead. Each of these options need to have a
small monitoring staff, and break down the tasks in
a time-ordered fashion. Flexibility costs money.
As the picture becomes clearer, at least one of the
option paths will become more dominant and the
tasks and sub-options will be parsed more finely.
The same process looks and functions very
similarly to the Toyota lean product development
process.
One of the major process improvements in the
treatment of cancers in the last 20 years is the
introduction of stages into the diagnostic scheme.
Physicians credit this standardization step in
reducing the variability inherent in assessing and
treating cancers. It has allowed modifications of
treatments as particular cancers move from one stage to another, or even within the stages. Such
parsing is leading further to expert systems.Some
expert systems routinely exceed the accuracy of
decisions by human managers. But, that will be a
topic for QPU November 07.
The Chinese issues may have brought quality to the
top of mind of CEOs, however, government bureaucrats
don't even know quality exists. In a recent
study of Hot Jobs for Indiana through 2014, quality
engineering didn't make the list. It didn't make any
list. The Standard Occupational Codes don't even list
quality engineering as a separate profession. According
to the government, quality engineers are nearly
the same as industrial engineers. Presumably the
standard occupational codes were set in place before
quality engineers became a distinct profession.
Perhaps, a little of the reflected limelight will illuminate
some of the dark recesses of government statistics.
Fashioning the mirrors sounds like a job for ASQ.
TACTICS
New NDT test concept for fatigue cracks.
From the Detroit area, there is a new hybrid ultrasonic/
infrared nondestructive technique for detecting cracks,
called thermosonics. This method uses a brief pulse of low
frequency ultrasound (~500Hz) to cause rubbing of the
crack surfaces. Rubbing induces frictional heating. The
heating is observed through an infrared light video camera.
The image of a surface-breaking crack appears in milliseconds
after the initiation of the ultrasonic pulse. Subsurface
cracks become visible sometime after the pulse. The time is
determined by diffusion of the heat from the crack to the
surface. Investigators have observed fatigue cracks as
short as 20 microns in metal samples.
Energy dispersive X-ray diffraction for semi-quantitative
identification of crystals.
This is a variation on classic x-ray diffraction of crystalline
materials. The sample rotates instead of the detector. The
entire diffraction pattern is measured simultaneously and
converted to the chart form using a Fourier transform. About 10% of the patents issued in the last 10 years have
involved crystalline materials. Examples of quality assurance
applications include detecting counterfeit pharmaceuticals
masquerading as "expired" product, detecting the
ratio of martensite to austenite in heat-treated steel,
recycled plastic identification, lead-based solder or paint
recognition, and products that are susceptible to verification
under California's Proposition 65. EDXRD is suitable
for the determination of lattice orientation of single crystals
that is required for growing and processing single crystal
materials, like semiconductor single crystals Si, SiC, GaAs
and Ge, plus optical lenses as well as industrial diamonds.
LEAN, ISO, AND THE THEORY OF CONSTRAINTS
BY ROBERT JAPIKSE
ASQ Dayton, OH
This article has been presented in three parts starting with the May
newsletter edition. Bob is an external 3rd party ISO 9001:2000 and
BQ-9000 lead auditor and also does consulting with companies in
their total quality system development. He is a member of the Dayton
Section If you have any comments or questions, please contact Bob
at Rjapikse1@aol.com.
PART III - Back to Lean
We have now eliminated excess WIP, but how does this make use
lean? We now know what our true capacity is, and the real rate at
which we can do whatever it is we do, by knowing the rate of our
constraints. Next we need to determine our customers’ rate of need.
This can be tough. A good starting point is the customer’s annual
purchases divided by 52 weeks in a year. Can we produce at this rate?
If the answer is yes, then terrific. If no, we need to figure out what to
do. It is also imperative to know if this rate is seasonal or constant.
We need to open up our constraint so we can match demand. Does it
need to be opened up year round? Or at certain time periods? It does
not matter if it is opened up through capital expenditure, outsourcing/
sub-contracting, or even going back to a previously abondoned
labor-intensive way of doing things to increase the output concurrent
with the new modern approach. It may cost more per item at this
particular stage in the process, but it can be far cheaper in the overall
cost of goods sold/performed.
The benefits of going lean and working to control your constraints
include reduced holding costs, reduced floor space required, faster
product turn around, reduced lead time, and reduced scrap. When
this approach is applied to office and design processes, things like
sales order lead-time, new product to market time, invoice cycle time,
and time spent on any other process that is performed, can be
drastically reduced.
Where quality comes in
You cannot run a lean system without tight quality control. There is
no longer that buffer zone that allows for mistakes. You need to be
proactive. If you wait for the problem to work itself out, then it is too
late and you will miss your shipment of goods or miss the service you
promised to provide. Ok, so how do we make sure we are practive?
It comes back to a good strong quality system to do all this
effectively. A mix and match patchwork of temporary fixes with
everyone doing things just a bit differently will not be albe to meet
the demands of running lean. We will now discuss some parts of the
system, but keep in mind that the parts themselves are still just parts,
and that they need to put togehter into a system.
Everything has to be clearly identified, and there needs to be clear,
concise, and accurate work instructions for everything done to enable
the rapid change from one product/process to another. All information
and instructions need to be at the right revision, at the right place,
and at the right time. These instructions need to identify what the
criteria for acceptance are, and how to let the next step know that the
current step has been completed fully and successfully.
And if it was not completed successfully? Any scrap that is produced
needs to be spotted immediately with mechanisms in place to ensure
it goes no further. Keep in mind that scrap can be a bad service
component as well as a bad product component. Next, it needs to be
carfully analyzed to put controls in place to correct what ever caused
the scrap to be created. Once this “scrap corrective action” is in
place, it certainly needs to be monitored to verify that it did what you wanted it to do and the scrap has not been regenerated from
the same process. This of course would also apply to any defective
product or service that is not included in scrap. Any problem would also
apply to any defective product or service that is not included in scrap.
Any problem (scrap, process error, return, complaint, or other) that
requires action needs the follow through to prevent recurrence. There
also needs to be a good record and analysis of the instances that may
beminor by themselves and not worth addressing, but added together
indicate a trend that can an dneeds to be addressed and corrected.
Working outside your organization
To get a fully functioning lean system you will have to work very hard at
the relationships with your customers and your vendors. It still does
absolutely no good to provide a good or service at improved turnaround
time with cost savings to you if it does not meet the customer’s needs.
Understanding the customer’s perception of how (or if) you have fulfilled
their needs is what will feed right back into the lean process.
Consequently, if you do not have confidence in your suppliers, then it is
hard to keep everything moving. This is why you need to do some sort of
supplier qualification and re-evaluation.
You also can very easily find that your suppliers do not want to supply to
you in “lean fashion”; that is they are still operating on the “economies
of scale” principle. This can be a bit sticky, and many suppliers will not be
ahppy when you say you want to reduce your inventory of their product.
You will have to convince them taht you will still be buying the same over
a period of time; you just want it in smaller batches. Often they will tell
you they cannot produce in smaller batches. This should be music to
your ears. This is where you started out in the process - “we can only
make money if we make big batches”.
Many companies have found that this is a good time to go visit the
supplier and help them look at ways to become lean as well. Not only will
you be working toward getting your raw material in the smaller batches
you want to save your holding costs, but you are also helping your
supplier to reduce costs and building a strong supplier relationship at the
same time. Perhaps reucing your purchase costs?
What does this have to do with ISO?
Let me see, quality system, controls, follow through; sounds like ISO
9001:2000. Is there a part of the Standard we have not discussed? ISO
9001:2000 adds a few things that follow along the same thought
processes. One of the biggest is management by information.
Measurables need to be put in place after you determine your process.
Once you have determined your process flow or plan from the very
beginning to the very end (not just on the “production” processes, but
everything from initial customer contact to final customer accesptance of
finished good or service), then you can set up a measurement plan using
the process plan as your road map. Use this map to setup measurables for
each process that will in turn support the overall measurables for the
whole system. What better way to determine where your constraints are?
Once you have determined which particular processes contain
constraints you can then set objectives based on the baseline data you
collected from your various mesurables. By continuing to measure all
your processes you will then see if you have made your objectives and
improved the system. If so, great job - now you can start tweaking! You
also will probably find that you now see another constraint that was
originally hidden by the first one. If you have not made your objecties
and have not eliminated the constraint, then you need to do some
corrective action to see what can be done.
Final thoughts in the “ISO” section are continued in the Word
document of the complete article at the Dayton website at
www.asqdayton.org
