Quality Improvement through Problem Solving

QUALITY PROBLEMS

A quality problem is defined as any instance where the desired quality characteristic is not present or not up to the intended level. In other words, it is an instance of failure to conform to standards or specifications. It can also be considered as the “Quality Gap”.

THE ATTITUDE TOWARDS PROBLEMS

It is disappointing to encounter problems despite putting in a good design and scrupulous control. However, problems should be seen as a challenge to put out a better product or service. Problems should not be brushed off or ignored but efforts need to be made to know what problems exist and how serious. Each problem should be subjected to further inquiry regarding why they happen and what can be done to avoid them.

THE PROBLEM SOLVING CYCLE

The first step is to identify, clarify and verify the existence of a quality problem. Then, an approach must be found to solve these problems. The problem solving process is based on the scientific approach.
The approach is depicted below as a cycle of recurring activities.
Outline of The Problem Solving StepsProblem Solving Cycle 2

PROBLEM IDENTIFICATION

a. Problem Identification via Statistical Quality Control
The main way to identify problems is by detecting non-conformance through quality control. According J.M Juran, in ‘Quality by Design’, Quality control is “the regulatory process through which we measure the actual performance, compare it with standards and act on the difference”. In the last part of this definition, Juran has incorporated quality improvement as part of control.
A defective product / unsatisfactory result can occur by chance. Knowing the frequency of occurrence is therefore important. Statistical Quality control is the detection of the rate of non-conformance in a sizable quantity of products produced or delivered. In clinical practice, statistical quality control takes the form of Clinical or Medical audit.

b. Customer Complaints
Through stringent quality control non-conformant items are rejected. If however substantial numbers of customers are still unhappy, there is a problem in the quality control or the design. Customer opinion regarding quality should be actively sought for through Customer Satisfaction Surveys or Complaint Boxes
c. Employee Complaints
Any complaint from employees about the process, the equipment or the work environment, should be considered as a problem. To encourage reporting, complaints can be disguised as Employee suggestion (see later).
d. Incident Reporting
Incidents occurring during production, delivery and use of products should be identified as problems and studied closely. The occurrence of incidents should be reported by employees and sought from customer complaints.

THE PROBLEM SOLVING CYCLE

To be effective, the problem solving process need to be orderly and scientific in approach. The first step is to identify, clarify and verify the existence of a quality problem. The causes must then be found. Consequently, methods must be found to solve these problems.
The approach is depicted below as a cycle of activities. Often not all aspects of a problem can be corrected at any one time. Also, new problems keep on being detected. Therefore quality improvement efforts is continuous. It is appropriate perhaps to name it as “The Problem Solving Cycle”.

The problem solving exercise needs to be approached from two distinct perspectives:

  • theoretical
  • empirical

The context within which the problem occurs need to be known. The possible causes are postulated from a knowledge of the the input, processes and environment. Data is then collected to clarify what factors are in operation when the defective product was made or unsatisfactory service was delivered. The corrective action or remedy involves a level of experimentation outside of the operations domain. Only after the suggested remedial action is proven to be effective is it adopted.

Therefore, even though the changes are meant to be gradual, the problem solving approach need to be taken as a project. There is a need for proper planning, organization, scheduling, and control.

“The Problem Solving Cycle”

Improvement Cycle

Elaboration of the Steps of the Problem Solving Activity/Project

The steps of the Problem Solving exercise, is elaborated below:

Step 1. Assess Quality of Service
Collect data to measure current performance. This step is actually.the activity of Quality control. In clinical medical practice medical audit is used for this purpose.
Step 2. Identify Problem
A Quality problem is said to occur if there is a quality gap or deficit (shortfall in quality) based on the outcome results compared to the standard set.
Step 3. Analyze Problem
At this step a theoretical analysis of the factors that may contribute to the occurrence is performed. Factors may include input, processes, the environment and organisation of the system as a whole. The production process / service delivery process need to be clarified by studying existing work flow charts or redrawing them.
Step 4. Postulate Causes
Tools such as relations diagram (Bubble chart) and Ishikawa Herring Bone chart may be used to demonstrate and clarify cause and effect.
Step 5. Identify data required and how to obtain them
Theoretical postulates put forward at the previous step need to be proven by a study of actual happenings. This would require the collection of relevant data. To do this, questions of what data, where to obtain them and how must be answered.
Step 6. Plan Data Collection
At this stage it is necessary to know whether data required already exists or new data need to be collected (e.g. via observation). Decision must be made on data collection techniques, responsibility for data collection and data storage. Performing all these is equivalent to designing a research study.
Step 7. Collect Data
This step is the actual activity of data gathering and collation (put together).
Step 8. Analyze Data
Data that have been collected are tabulated, analysed and presented using simple statistical tools.
Step 9. Derive Causes of Problems
The results of data analysis are interpreted to prove or disprove postulates made previously. Collected data may also reveal or suggest other possible causes.
Step 10. Plan Corrective/Remedial Measures
Strategies for Improvement need to be formulated and planned with care. Based on the causes identified above, various factors requiring correction are identified. Alternative solutions to solving the problem may be identified and shortlisted through Employee suggestion, Literature Review and Benchmarking. In the long term, research and innovation may provide better solutions.
Step 11. Carry out Remedial Measures
The most effective strategy to use in implementation of remedial measures is the use of the Shewhart PDCA cycle as described below:

Application of thePDCA Cycle to Carrying out Remedial Actions

PDCA 3In this approach, the remedy being suggested is first planned properly and put to the test (the Do step). This test is done as simulation, trial or pilot project and data is collected to confirm it’s effectiveness or otherwise (the “Check” stage). When it is a complete success it can be adopted and institutionalized. If it is not entirely acceptable it can be amended or adapted and tried again.
A complete failure warrants re-planning (back to the drawing board) and a repeat of the whole cycle.
Step 12. Re-evaluate the problem
Collect data to determine the frequency and seriousness of the problem. This step means the continuation of the Quality control activities. If the problem has not been solved the problem may require re-analysis or study. It may also mean that the remedial measures chosen were not carried out fully or they wee not effective.
Step 13. Prevent the problem from recurring
If corrective actions / measures have been successful, all changes made need to be adopted and institutionalized. This usually means that the changes are incorporated into policies, the work procedures and work culture. Continuous vigilance through quality control will ensure that the problems do not recur.

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