Hi, Would anyone be able to help in answering Chapter 2 problem 18 from the book

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Hi,

Would anyone be able to help in answering Chapter 2 problem 18 from the book Quality 5th Edition by Donna C.S Summers? I’ve checked the solution manual and noticed that these questions haven’t been answered yet.

Here is the question:

Hospitals are very concerned about the spread of germs in a hospital environment. For patient and guest safety. Infection rates in any hospitals are carefully monitored. Continuous are made to reduce the chance of spreading infections among or between patients or guests. Unfortunately, studies reveal that every year in U.S. hospitals, nearly 2 million people are infected with a death rate approaching 80.000. Transmission of these infectious pathogens occurs most often through the contaminated hands of health-care workers. This means that good hand hygiene is the most important infection control measure available.

JQOS is a 100-bed hospital that offers a full range of services including emergency services, maternity, child care, orthopedic, cardiac, and general welfare. Management at JQOS has long believed that prevention is the best approach to any issue. They have decided to tackle the hand-washing issue head-on. Their goal is to improve hand-washing compliance among health-care workers (doctors, nurses, care-givers, orderlies, etc.) throughout hospital.

d. You are the senior team leader in charge of making improvements to the process of hand-washing compliance. You have recently attended a seminar focused on Dr. Shewhart’s teaching. Clearly state one of Dr. Deming’s 14 points that you will keep in mind as you focused on this situation. How will this point guide your actions and behavior as you tackle making improvements?

e. Describe 2 clues that suggest that the hospital is practicing Juran’s little q versus big Q. If they were to practice big Q. Describe one way in which their focus would need to change.

f. During a meeting, someone has cornered you concerning the improvements and changes your time would like to make at the hospital. They accuse you of wanting to create a luxurious at environment at the hospital. They said that a patient’s judgment of quality of the hospitals is intangible and not measurable. They also said that there is an economic s of quality. You recognize these statements as three of Mr. Crosby’s five erroneous assumptions about quality. Using what you know about Mr. Crosby’s approach to quality, pick one and argue against what this person has said.

Here are some resources from the book:

Really looking forward to hearing your reply,

Thank you so much for your time

Quality Advocates person can improve upon this time is to change the process by finding new route. Uncontrolled variation, also known QUALITY ADVOCATES s have proclaimed the importance of qual. as special or assignable causes, ity. The seven discussed in this chapter are among the most prominent advocates. You'll see that basic similarities exist among their ideas. Following a brief introduction to the to the process. This type of variation is not normally part of the process. It can be identified and isolated as the cause of a change in the behavior of the process. For instance, a com- agement and explain some of the similarities found in the philosophies of these leading professionals. nearly impossible. Uncontrolled variation prevents the process from performing to the best of its ability Dr. Walter Shewhart It was Dr. Shewhart who put forth the fundamental prin- Like most of us, Dr. Walter Shewhart (1891-1967) believed ciple that once a process is under control, exhibiting only con- that we could make great decisions if we had perfect knowl trolled variation, future process performance can be predicted, edge of the situation. However, life rarely provides perfect within limits, on the basis of past performance. He wrote: knowledge and who has time to wait for it anyway? Since work needs to be done and decisions need to be made Dr. Shewhart (Figure 1) developed statistical methods that can be used to improve the quality of the processes that pro- A phenomenon will be said to be controlled when, through the use of past experience, we can predict, at least within limits, how the phenomenon may be ex- pected to vary in the future. Here it is understood that prediction within limits means that we can state, at least approximately, the probability that the observed phenomenon will fall within the given limits." vide goods and services. While working at Bell Laboratories in the 1920s and o encourage the use of sta- tistics to identify, monitor, and eventually remove the sources of variation found in repetitive processes. His work combined 1930s, Dr. Shewhart was the first t Though he was a physicist, Dr. Shewhart studied f quality: the subjective aspect, what the cus- Based on his understanding of variation a process control through the use of charting techniques. two aspects tomer wants; and the objective side, the physical properties of the goods or services, including the value received for the assignable causes of variation could be found and elimi- price paid. He recognized that when translating customer nated, Dr. Shewhart developed the formulas and table of requirements to actual products and services, statistical mea- constants used to create the most widely used statistical sures of key characteristics are important to ensure quality. control charts in quality: the X and R charts (Appendix). Dr. Shewhart identified two sources of variation in a These charts (Figure 2) first appeared in a May 16, 1924, in- process. Controlled variation, also termed common causes,ternal Bell Telephone Laboratories report. Later in his 1931 is variation present in a process due to the very nature of the text, Economic Control of Quality of Manufactured Product, process. This type of variation can be removed from the Dr. Shewhart presented the foundation principles upon process only by changing the process. For example, consider which modern quality control is based. a person who has driven the same route to work dozens of times and determined that it takes about 20 minutes to get from home to work, regardless of minor changes in weather or traffic conditions. If this is the case, then the only way the To develop the charts, Dr. Shewhart first set about de termining the relationship between the standard deviation of the mean and the standard deviation of the individual observations. He demonstrated the relationship by using numbered, metal-lined, disk-shaped tags. From a bowl borrowed from his wife's kitchen, he drew these tags at ran dom to confirm the standard deviation of subgroup sample means is the standard deviation of individual samples divided by the square root of the subgroup size. Vn where This asset is intentionally omitted from this text. = standard deviation of the mean (standard error) s = standard deviation of individual observations n number of observations in each subgroup mean The control charts, as designed by Dr. Shewhart, have three purposes: to define standards for the process, to aid in Walter Shewhart, Economic Control of Quality of Manufactured Product New York: Van Nostrand Reinhold, 1931, p. 6.

Explanation / Answer

D. Being the senior team leader of the assignment at the hospital, i will follow the 14th point of Dr. Deming while dealing with the problem, which says, 'Put everyone in the organization to work to accomplish the transformation'. The issue raised in the hospital was not due to an individual or a certain department but instead it was regarding the hygeine habbits of all the employees of the hospital. So if a particular group of people feel responsible to work on it the results will not be achieved and the excercise of bringing the change will be a waste. So it will be important that all the employees are involved in participating in this step towards transformation. The importance and effectiveness of the plan towards making the environment at the hospital more hygienic by hand washing compliance will be explained clearly to every employee at the hospital regardless of his position and role at his work. Being a leader I wont focus on doing the job but instead on getting the job done. So to make the hand washing compliance successful at the hospital at achieve desirable results, I will involve every one to participate in the process of transformation.

E. The two aspects where it can be seen that the hospital is using little q and not the big are the processes and customers. In the processes terms, it focuses on working only for the services of the patients in the hospital and not diversified to working in all areas like internal organizational structure, cleanliness and hygiene and support from the employees to attain this goal. In the terms of customers, it aims only at servicing the customers that buy the product which here means that patients who take the aid from the hospital and not the other people connected to the hospital internally and externally. This includes the employees working at the hospital from the management to doctors, nurses, cleaning staff etc.and the visitors who are with the patients. A big cause of the unhygienic environment could be these two but the hospital neglects their development. They should change their focus from the patients only to all the other sources of maintaining hygeine in the hospital. Keeping a check on the hygeine habbits of the staff and the visitors is an effective way to do this.

F. Using the approach of Dr. Crosby, i would like to argue on the point that the patients judgement on the quality of hospital is intangible and not measurable. Though measuring quality is a complex task and in a large organizational structure it is not always easy to bring the correct results but this concept is still not impossible in terms of quality check. Quality of the services can be calculated in terms of cost of doing the activities incorrectly. The cost incurred in failures or rework or wastage due to unsatisfied results determine the quality of the services provided. More the cost less the quality. Hence check can be kept on how to avoid such cost and give fully effective results by taking quality measures.

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