Week 2 Process Improvement Thought Leaders, Models, And Qual

Week 2process Improvement Thought Leaders Models And Quality Tools

In Week 1, you acquired a solid understanding of the policies and concepts that are paramount to the assessment, planning, and implementation of healthcare quality efforts. In Week 2, you will continue to broaden your foundational knowledge of the healthcare quality space by reviewing the contribution of thought leaders in the field of quality and how their work can be applied in the healthcare system. By reviewing the works of thought leaders such as Walter Shewhart, Edward Deming, and Kaoru Ishikawa (Joshi, Ransom, Nash & Ransom, 2014), you will learn about their educational background, the industry they served, and their key contributions in the quality space.

Through the work of Shewhart, you will come to learn about the important concepts of common-cause variation, special-cause variation, and statistical process control (SPC). From Deming, you will learn about his posits that only 15% of substandard quality is attributable to workers, while the remaining percentage is shared between factors such as poor management and unorganized systems and processes. By engaging in exercises that will allow you to critically summarize and compare the contributions of the aforementioned quality influencers, you will gain the competency required for adequately applying quality systems and theories in practice. This week you will also get the opportunity to learn about process improvement models and quality tools.

More specifically, you will be introduced to Shewhart cycle—otherwise known as the plan, do, check, act (PDCA) cycle (Figure 3). The PDCA cycle forms the basis for other related models such as the FOCUS (find, organize, clarify, understand, and select) PDCA model, Lean, and Six Sigma. Having a solid understanding of these models and their applications will give you the requisite knowledge to better plan, do, check, and act adequately to improve processes in the healthcare facilities or organizations that you manage. In addition to learning about the contributions of thought leaders and the different models employed to enhance quality improvement efforts, you will also get the opportunity to learn about quality improvement tools and how you can leverage these tools for improvement efforts.

More specifically, you will be introduced to basic quality tools such as the control chart and the cause-and- effect/fishbone diagram, along with management and planning tools such as the balanced scorecard, stratification, and the priorities matrix. While the control chart is used to monitor changes in processes, the fishbone diagram is a brainstorming tool that helps in identifying root causes. The management and planning tools such as the balanced scorecard are helpful for keeping track of your organization’s strategy and financial goals. Other quality-related tools—such as the use of flowcharts to visually display processes and benchmarking for comparing their quality improvement efforts to those of other organizations—will be addressed.

Table 1. Tools used for quality improvement

• Fishbone Diagram Use for root cause analysis
• Control Chart Use for detecting and monitoring process variation
• Balanced Scorecard Performance improvement tool for reporting key metrics across the business or organization
• Flowchart Graphical presentation of process showing the order and relationship of the pieces of the process
• Benchmarking Used for comparing performance metrics in one organization against the standard in the industry
• Priorities Matrix Organizes and rank tasks, issues or actions
• Checklist A standard approach for completing critical tasks
• Pareto Chart Series of bars used to show the most frequent or important factors
• 5 Whys An interrogative method for assessing cause-and-effect relation in a problem
• Histogram Frequency distribution tool for summarizing groups, for showing data spread or skewness, and for identifying outliers

By the end of this week, you will be well armed with a host of tools you will find invaluable throughout your career in the administration and management of healthcare facilities and organizations.

Paper For Above instruction

The healthcare sector continually seeks to enhance quality assurance and patient safety through the implementation of effective quality management systems. Recognizing the pivotal role of thought leaders, models, and tools in driving these initiatives is essential for healthcare administrators aiming to foster sustainable improvement. This paper explores three influential thought leaders—Walter Shewhart, W. Edwards Deming, and Kaoru Ishikawa—and their core contributions to quality management, alongside prominent process improvement approaches and tools transforming healthcare practices.

Thought Leaders and Their Contributions

Walter Shewhart is widely recognized as the pioneer of statistical process control (SPC). His development of the control chart provided a systematic method for monitoring process variation, distinguishing between common-cause (inherent system variation) and special-cause (unexpected deviations) variability (Shewhart, 1931). His insights allow healthcare organizations to identify when processes are in control or require intervention, thus improving consistency and patient outcomes.

W. Edwards Deming expanded upon Shewhart’s work, emphasizing the importance of management’s role in quality enhancement. Deming’s renowned 14 Points for Management advocate for systemic change, continuous improvement, and a shift from blaming workers to improving processes (Deming, 1986). His assertion that only 15% of quality issues are due to workers underscores the need for organizational and managerial reforms. Deming's System of Profound Knowledge emphasizes understanding variation, systems thinking, and the human factors influencing performance.

Kaoru Ishikawa contributed a comprehensive approach to quality management, emphasizing the importance of quality circles and root cause analysis. His creation of the fishbone diagram (also known as Ishikawa diagram) serves as a vital tool for identifying root causes of problems (Ishikawa, 1982). This visual tool aids healthcare teams in systematically examining processes, fostering collaborative problem-solving and continuous improvement efforts.

Process Improvement Models and Approaches

The Shewhart cycle, or PDCA (Plan, Do, Check, Act), forms the backbone of many quality improvement initiatives. Its iterative nature allows healthcare providers to systematically plan interventions, implement changes, monitor results, and refine processes (MindTools, 2018). Building on PDCA, the FOCUS-PDCA model enhances the approach by emphasizing Find, Organize, Clarify, Understand, and Select, leading to targeted, data-driven improvements.

Six Sigma, developed by Motorola, aims to reduce variability and defects through a data-driven, DMAIC (Define, Measure, Analyze, Improve, Control) framework. Its focus on statistical analysis and process control makes it particularly suited for complex healthcare processes where precision and consistency are paramount (Antony, 2014). Lean methodology, derived from the Toyota Production System, concentrates on eliminating waste and streamlining workflows. Its application in healthcare has led to reduced wait times, improved patient flow, and enhanced resource utilization (Kim et al., 2014).

Quality Improvement Tools

The control chart is an essential tool for monitoring the stability of healthcare processes over time. Variations outside control limits signal potential issues requiring intervention (Wyszewianski, 2014). The fishbone diagram supports root cause analysis by visually mapping potential causes of a problem, facilitating problem-solving teams to identify primary issues and develop effective solutions.

The balanced scorecard integrates financial and non-financial metrics, aligning organizational activities with strategic goals. It enables healthcare leaders to monitor performance across multiple dimensions, fostering accountability and continuous improvement (Niven, 2006). Flowcharts visually depict process steps, uncover inefficiencies, and guide process redesigns. Benchmarking compares organizational performance with industry standards, promoting best practices and highlighting areas for enhancement (Camp, 1989). The 5 Whys technique facilitates quick root cause discovery by repeatedly asking “Why?” to drill down into underlying issues (Ohno, 1988).

These tools collectively enable healthcare organizations to systematically analyze, monitor, and improve their processes, ultimately advancing quality and safety outcomes.

Conclusion

Understanding the contributions of key thought leaders such as Shewhart, Deming, and Ishikawa provides a foundational perspective on quality management. Coupling their theories with practical models like PDCA, Six Sigma, and Lean, alongside robust tools such as control charts and fishbone diagrams, equips healthcare administrators to implement effective continuous improvement initiatives. As healthcare environments become increasingly complex, mastery of these concepts becomes indispensable in ensuring high-quality patient care, operational efficiency, and organizational excellence.

References

• Antony, J. (2014). Readings in the Theory of Six Sigma. International Journal of Productivity and Performance Management, 63(4), 479-493.
• Camp, R. C. (1989). Benchmarking: The search for industry best practices that lead to superior performance. ASQC Quality Press.
• Deming, W. E. (1986). Out of the Crisis. MIT Press.
• Ishikawa, K. (1982). Guide to Quality Control. Asian Productivity Organization.
• Kim, C. S., Spahlinger, D. A., Kin, J. M., & Billi, J. E. (2014). Lean Health Care: What Can Hospitals Learn from a World-Class Automaker? Journal of Hospital Medicine, 9(10), 661–667.
• MindTools. (2018). Plan-Do-Check-Act (PDCA). Retrieved from https://www.mindtools.com/pages/article/newPPM_89.htm
• Shewhart, W. A. (1931). Economic Control of Quality of Manufactured Product. D. Van Nostrand Company.
• Wyszewianski, L. (2014). Basic concepts of healthcare quality. In M. S. Joshi, E. R. Ransom, D. B. Nash, & S. B. Ransom (Eds.), The healthcare quality book: Vision, strategy, and tools (pp. 38-40). Chicago, IL: Health Administration Press.
• Niven, P. R. (2006). Using the Balanced Scorecard as a Strategic Management System. Strategic Finance, 88(5), 10-17.
• Ono, T. (1988). Toyota Production System: Beyond Large-Scale Production. Productivity Press.