The guy from Wyoming

W. Edward Deming was actually born in Sioux City, Iowa in 1900 but his family moved to Powell, Wyoming when he was seven. They were far from rich, although his father was a lawyer. After getting a degree in engineering at the main campus of the University of Wyoming in Laramie, he went on to receive a PhD in mathematical physics at Yale University in 1927. While working for the USDA, Dr. Deming taught American technicians and engineers statistics for use in improving the quality of war materials during World War II.

It was that work that caught the attention of the Japanese, and after the war the Union of Japanese Scientists and Engineers sought him out because of that expertise. Since 1950 and for the next three decades Dr. Deming devoted time and effort to teaching  the top managers of Japan's companies and helped transform their reputation for manufacturing from laughable to laudable. (Long way from Laramie, huh?)

Dr. Deming's principles relied a lot on the use of statistical measurements to chart how a particular system is working and then to develop ways of improving that system. Since his work with the Japanese companies, the big guy has made himself available to corporate America on a consulting basis. He passed away in 1993 but his work lives on and is widely recognized in American industry. Business courses are taught using his principles as integral parts of the curriculum, and the acronym TQM (total quality management, Dr. Deming's opus) has stuck around for quite a bit, even in the health care industry.

Dr. Deming's basic managerial philosophy is summarized in his widely-quoted Fourteen Points. I am not very sure whether these items fall under public domain, but I post them here anyway, since they are practically everywhere! Alright, you may not have heard of them before because you studied cells and tissues and some pharmacology, but they are very widely adapted and used by the corporate world, including those top managers in the health care industry. Or, if you have not heard of them before, then your institution may not have implemented TQM or its variants....

The Fourteen Points

1. Create constancy of purpose for improvement of product and service.

2. Adopt the new philosophy:mistakes and negativism are unacceptable.

3. Cease dependence on mass inspection.(Switch from evaluating people and measuring their output to the improvement of systems through the use of statistical tools).

4. End the practice of awarding business on price tag alone. (As in, purchasing at lowest prices may not always be the best policy).

5. Improve constantly and forever the system of production and service. (Don't wait for periodic performance reviews. TQM is not a static process. Encourage constant questioning and tinkering with products and services to improve them. This will increase the chance of eliminating problems before they develop. TQM is prevention-based).

6. Institute on-the-job training. (I think if you have been employing people for several years and the knowledge, skills, and attitudes that they have are still almost the same as when they first came in, that speaks something about you too).

7. Institute leadership. (Help people do a better job by setting a good example of commitment to excellence).

8. Drive out fear. (So that everyone may work effectively for the institution...Heck, fear of being laid-off work in the process of downsizing is everywhere! Deming is sure a tough guy).

9. Break down barriers between staff areas. (This might have worked well in Japanese industrial settings. For the American health care institution, I have my doubts).

10. Eliminate empty slogans, exhortations, and targets for the workforce. (Somehow Mr. Costanza raising up his arms and shouting "Serenity now!" comes to mind, but that is not an institutional setting).

11. Eliminate numerical quotas.

12. Remove barriers to pride of workmanship.

13. Institute a vigorous program of education and retraining.Stress teamwork and statistical technique. (Measure whatever you can. Make every worker a partner in the measurement process).

14. Take action to accomplish the transformation. (TQM can't be delegated to a department head or to a QC/QA department.  The head administrator must live and breathe it, for everyone else to embrace the philosophy).

The Seven Deadly Sins/Diseases

1. Lack of constancy of purpose.

2. Emphasizing short-term profits and immediate dividends.

3. Evaluation by performance, merit rating, or annual review of performance.

4. Mobility of top management.

5. Running a company only on visible figures.

6. Excessive medical costs.

7. Excessive costs of warranty fueled by lawyers who work for contingency fees.

The Four Obstacles

1. Neglect of long-range planning.

2. Relying on technology to solve problems.

3. Seeking examples to follow, rather than developing solutions.

4. Excuses. the belief that "Our problems are different..."

There. I believe that you have seen the principles above at work, some more than the others, in your unique environment. Later on we will examine what other gurus have to say, too...

Continuous quality improvement

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