Thursday, October 24, 2013

Bitter pill: Quality Improvement is most needed in the Quality Profession itself


Earlier this month Paul Borwaski, CEO at ASQ, wrote an interesting and usual post on ASQ having a Doors Open event recently. During this event many at ASQ realized that most people still consider Quality a very ‘Manufacturing’ subject. He ended his post with a question - What new fields or disciplines could most reap the benefits of quality tools and techniques?

So where can quality principles are applied?  We could argue that we can apply them anywhere we like, but I would prefer to apply some criteria. Applying such criteria will help us prioritize and as you know nothing really gets done unless we prioritize.

Quality principles, tools, and methods can be best applied wherever a process exists and it can be broken into steps and is repetitive. Process. Steps. Repetitive.

Of course there will be exceptions to this principle. Quality is very useful in Research but one could argue that the research process is not repeatable. 

Here is my list of some industries which can benefit from applying quality principles. Some of them are probably applying these principles, but clearly can do better.  

While Quality in Healthcare is undoubtedly a priority in the developing world, I believe there is a disturbing trend which indicates that some ‘wastes’ may need to be cut from healthcare in the developed world.  Healthcare in the developed world is becoming so expensive that we now see people travel to lower cost countries to get treated. India is benefiting from such medical tourism already. Studies have shown that same quality treatment could cost a patient upto 1/3rd to 1/5th lower in India compared to the USA.

Is treatment in lower cost countries of a lower quality? Unlikely. Most physicians and surgeons in these lower cost countries have trained in the USA. Agencies like the Joint Commission International (JCI) accredit many such facilities. USA has already seen a major issue recently where government and congress could not agree on the spending bill for next year. At the core of this issue was the spending on healthcare. Quality can help USA reduce healthcare costs. If it does not do so, it is ripe for some disruptive trend such as medical tourism to low cost countries.

Quality in Education is slowly becoming a huge issue. This is at all levels. Last year as part of the World Quality Month celebrations, I delivered a lecture at two High Schools. My talk at these schools was titles the Right to Quality. Apart from sharing some basic tools with students I spoke about their right to quality services.  This right to quality is only available if they invest by doing their part of the deal well. This is applicable to all of us. We deserve good quality and this can be true only when we do our parts well. ASQ India team is now trying to take this program to schools across India.

Legal profession: Now, I can be sued here but I feel strongly about the inefficiency in the legal system. At least in India, cases take years in courts and there are thousands of cases where culprits leave this world before being officially convicted. Courts in india are probably the only institutions which are closed for a summer break! I am told such is the case in other countries as well. There is little focus on outcome and justice delayed becomes justice denied.

Not for Profit organizations: Again this is more a developing world need. A lot of money goes into these organizations and very little accountability. Most of their processes are ad-hoc and consume more resources/energy than they should. Of course, there are some exceptions who manage well. There are several cases of development officers allocating money to non-existent Not-for-Profit organizations. This is pure corruption, but I believe better monitoring and control could help.

Finally, I think Quality needs to be applied to the Quality Profession itself. In the last few years I have noticed (and others confirm this) that the quality of quality professionals is going down. I don’t find enough young and hardworking talent taking to quality. Many people who move to quality mid-careers think of this as a career-break. Now, of course I am not generalizing. All is not lost. I would love to see using quality improvement methods to improve the quality of quality professionals themselves.


In summary, for the larger good of the developing world quality principles should be applied to Healthcare, Education, Legal Justice, Not for Profit organizations, and the Quality Profession itself. Quality has to now move to make the world a better place. We all have a responsibility that is beyond earning a living. Very few other professions have this advantage and responsibility.