An approach to Quality Management …

Introduction

The reasons for needing to understand and define ‘quality’ are varied. The nature, needs and demands of organisations, suppliers, manufacturers and consumers is equally varied and their subjective perspectives on quality make a single definition, that will be appropriate in all circumstances, challenging, if not impossible, to affirm. It is important, however, that any organisation is able to express its own definition of quality so that it is able to shape its approach to quality management within the context of its own values, goals and activities.

Many organisations and individuals have published widely recognised, but generic, definitions of quality that attempt to describe it in the context of any given circumstance. By taking elements of these definitions, they can be merged, trimmed and fine-tuned to produce a definition that may be considered appropriate for an Estates or Project Management scenario. It could read as follows:

‘Quality - the essence of service delivery that consistently satisfies needs or expectations to a level that is at or above the required and specified standard.’

So what this is saying, is that quality management is about defining a standard (be it regarding regulatory requirements, budgetary constraints, safety, response times, technical specifications or the intended use or application), measuring performance against that standard and ensuring that any controls put in place are able to be operationalised. The closest recognised and published definition to the one suggested above is possibly that of ISO Quality Management Principle 1 (ISO, 2015) which states that the ‘primary focus of quality management is to meet customer requirements and to strive to exceed customer expectations’.

The Theories of the Gurus

The earliest quality management principles originated in the United States and were initially focussed upon an ability to pre-empt failure with the intention of eliminating defects. The academic and industrial-led development of the management of quality gained momentum throughout the 20th century with each generation drawing on their own experience and research to build upon the work of their predecessors.

Until Japanese and European industry began to intensify in the 1950s (Garvin, 1987), focus upon quality within the US had only been made with the intention of minimising defects but this new overseas influence led to quality being seen to give a more commercial competitive advantage. This brought about change in the way quality was perceived globally.

Each of the main ‘Quality Gurus’ brought their own unique and individual approach to their work but many, if not all, shared consistent views on the many aspects of quality. The ‘big 3’, Crosby, Deming and Juran, for example, have shared views on at least four elements of quality management that they maintain should be consistently present.

Whilst they do agree on some aspects of quality, it is where the Gurus disagree that debate is stimulated. One example of how opinions are divided is where Deming advocates the control of materials and components through the use of a single supplier whist Juran rejects this view pointing out the commercial benefits that may be lost if Deming’s route is followed.

Another example relates to how they view performance standards. Crosby’s ‘zero defects’ concept (1979) and Juran’s avoidance of ‘campaigns to do perfect work’ (1981) are polar opposites in the context of the subject. Juran’s view on the matter is consistent with his suggestions that the cost of quality should have a limit that is offset by the benefits to be gained. As Juran argues, the size and extent of any Quality Management System (QMS) must be proportionate. The implementation of the system and the resources required to maintain it must not become greater than the benefits to be achieved. In simple terms, the cost of failure deducted from the cost of ‘quality’ will provide the justification (or not) of the very existence of the QMS. When the unavoidable costs of successful quality control (those of inspection, sampling, auditing, etc.) remain lower than avoidable costs associated with defects, failures, waste, complaint processing, etc., then the commercial benefits to be gained, referred to as ‘gold in the mine’ by Juran, can be significant. 

Crosby, on the other hand is clear that it is cheaper to get things right at the first attempt and that, by its nature, a push towards ‘zero defects’ will, in itself, drive quality improvements. The Martin Company implemented a ‘Zero Defects’ approach to their Pershing missile production in 1961. The initiative was a success and the post-project review concluded that it was an improved staff attitude that had brought about this success and that the change in attitude had been motivated, amongst other factors, through robust training and the recognition of achievement. ‘Zero defects’ will be difficult to achieve within the uncontrolled environments of healthcare premises but the lessons learned about staff attitude and motivation should be acknowledged and acted upon.

As well as being cost effective, the QMS must be robust. Like the links in a chain, a quality system is only as strong and effective as it’s weakest part or parts. There is little to be gained if a manufacturer, for example, operates within a rigorous quality system if the work of the designer is flawed in the first place. This was the basis of ‘Total Quality Control’ (TQC) that required all departments to take responsibility for all aspects of the design and manufacture (Feigenbaum, 1956). This approach lends itself well to certain activities undertaken by NHS Estates teams, for example, where a TQC system would be effective if implemented across the Estates Helpdesk, the maintenance teams, buyers and those responsible for obtaining customer feedback and user satisfaction data. 

In this example, it will be ‘user based’ and ‘value based’ approaches to defining quality that will be most appropriate (Garvin, 1987). Of Garvin’s eight dimensions of quality, those of performance, conformance to standards and, to some extent, aesthetics and perceived quality (reputation) will be most prominent. An Estates service, for example, delivered to a high quality and with adequate controls and measures in place will not only contribute towards keeping the users from harm and protecting them from annoyances, but it will also have the additional benefit of pleasing or satisfying them.

At an executive and planning level, Strategic Quality Management provides an opportunity for senior managers and leaders to use quality as an effective strategic weapon. The inspection of superconductors from the US and Japan in 1980 as an example of this (Garvin, 1987). The effective creation, analysis and presentation of meaningful Key Performance Indicators (KPIs) that demonstrate high levels of achievement act as effective additions that will support bids for further work and commercial growth. 

Conclusion

There are many published views, opinions and theories on the subject of quality. There are also a number of core concepts that are common across all theories. It is important that students of the subject familiarise themselves with these concepts developing skills that will enable the implementation of quality mechanisms within their field of work, whatever that may be.

Any organisation seeking to implement a QMS will be restricting its opportunities to maximise the potential benefits if it strives to follow just one theory from one Guru. Instead, it is important to acknowledge the 20th century evolution of quality philosophies and principles, to note the lessons learned and to apply the key messages appropriately so that they are able to have a profound and lasting impact.

References

• Crosby, Philip, W (1979). Quality Is Free: The Art of Making Quality Certain, McGraw-Hill, New York.

• Deming, W. Edwards (1986). Out of the Crisis. MIT Center for Advanced Engineering Study.

• Feigenbaum, A. (1956) Total Quality Control, McGraw-Hill, New York.

• Garvin, David, A. (Nov-Dec 1987), Competing on the Eight Dimensions of Quality, Harvard Business Review.

• International Organisation for Standardisation (2015), ISO Quality Management Principles.

• Juran, Joseph, M. (1951), Quality Control Handbook, McGraw-Hill, New York.

• Juran, Joseph, M. (1981), Product Quality – A Prescription for the West, Juran Institute.