MODULE 1 Introduction and foundation to Total Quality Management

TIME ALLOTMENT 1 Week

INSTRUCTOR Mr. Jaime A. Berbano, LPT, MBA

FACEBOOK james berbano

EMAIL [email protected]
CELL NUMBER 09193919946

I. OVERVIEW

This module will walk you through the: Introduction and foundation to Total Quality Management: a.
Defining Quality, b. History of Quality Management, c. Quality in Manufacturing, d. Quality in
Service Organizations, e. Quality in Business Support Functions, f. Quality and Personal Functions,
Quality and Competitive Advantage, g. Quality and Personal Values, h. Quality in Practice.
II. TARGETED COURSE LEARNING OUTCOME

This part will enable you to:

CO1. Have full understanding of the basic foundations an-in-

timed concepts of Total Quality Management in a business
organization
CO1. Have full understanding of the basic foundations an-in-timed
concepts of Total Quality Management in a business
organization
III. TARGETED TOPIC LEARNING OUTCOME

At the end of the module you should have:

TLO1. Discuss the concepts of Total Quality Management in Organizations.
TLO2. Discuss the overview and definition of Total Quality Management;
TLO3. Philosophies and Framework 
IV. LESSON PROPER
Introduction to Quality Management

Defining Quality

What Is Quality in a Business?

A business is a system of moving parts that all work together to earn a profit. The main part of a business
is the quality product or service that business sells to its customers. Quality can have many meanings in a
business, and it is important to the function and success of the business. In this article, we will explain
why quality is important, types of quality and how to improve quality.

Why is quality important?

Quality is vital to the success of a business. If a business can create and distribute high-quality goods and
services, then it is more likely to be a successful enterprise. Here are some benefits of consistent quality:

 Increase customer loyalty

 Build a reputation
 Lead the industry
 Manage costs

Increase customer loyalty

Quality is the foundation of a business and is the key to keeping customers satisfied. If a business’s
product meets and exceeds the customer’s expectations, then it is highly likely that the customer will
continue to purchase that product. Engaging the customer, asking for feedback and improving functions
can help maintain a quality product and increase loyalty.

Build a reputation

Good quality products will achieve positive reviews from customers. In today’s technologically advanced
world, social media reviews can help boost a business’s traffic and orders. A business that has a strong
reputation for high-quality goods and services may generate more revenue and customer traffic than a
business with a negative reputation.
 Lead the industry

Businesses with the best quality items become industry leaders and set the standard for other businesses
in the market to follow. If a business can continue to create high-quality products and upgrade and adapt
the products to meet customer demand, then that business can lead the way for others in the industry.

Manage costs

Companies track all profits and costs related to producing a product. Good quality products and services
should be able to lower production costs and increase profit margins. As repeat sales and customer
loyalty increases because of quality, a business’s profit should rise. 

Types of quality

Types of quality vary by point of view, so one business or industry may have a different outlook on quality
than another. For example, a manufacturer’s interpretation of quality may differ from a marketing team’s
definition of quality.

Some ways to define quality in a business include:

 Usefulness
 Requirements
 Value
 Cost

Usefulness

This quality states that the product or service is beneficial and practical for the customer. Therefore, a
quality product is one that proves useful consistently. Products of good quality that are reliable and
efficient are appealing, as customers can feel comfortable using the product or service repeatedly. 

Requirements 

Quality means that the products meet and exceed all requirements, standards and specifications. For
example, certain industry products may need to meet specific standards and specifications for legal or
medical reasons. Many companies also develop their own set of quality requirements that each product or
service must meet before releasing it to the public.

Price

With this definition, quality is determined by how much customers will pay for the product. The higher the
amount customers will pay, the higher the quality of the product.

Value

Quality products have a high value to the customer for their price. Companies may sell a product at a
higher price if they have a product that’s better than their competitors’ offerings. For example, people may
be more likely to purchase a cellphone that has a long battery life, even if it’s more expensive than a
competing company’s cellphone with a shorter battery life.

Cost

This interpretation states that quality products cost more to make and distribute. Many products that last
longer or excel in serving their function consist of high-quality material. Extensive planning and
developing by experts ensures a better product, typically at a higher cost. 

Quality Management Definition

Quality management overlooks all activities of the organization "that determine quality policies, objectives
and responsibilities so that the project would satisfy needs for which it was undertaken" (Project
Management Institute). Quality management generally incorporates four processes: quality planning,
quality assurance, quality control and quality improvement.

A core definition of total quality management (TQM) describes a management approach to long-term
success through customer satisfaction. In a TQM effort, all members of an organization participate in
improving processes, products, services, and the culture in which they work.
History of Total Quality Management

The history of total quality management (TQM) began initially as a term coined by the Naval Air Systems
Command to describe its Japanese-style management approach to quality improvement. An umbrella
methodology for continually improving the quality of all processes, it draws on a knowledge of the
principles and practices of:
  The behavioral sciences
 The analysis of quantitative and non-quantitative data
 Economics theories
 Process analysis

History of Total Quality Management (TQM)

 Some of the first seeds of quality management were planted as the principles of
scientific management swept through U.S. industry.
 Businesses clearly separated the processes of planning and carrying out the plan,
and union opposition arose as workers were deprived of a voice in the conditions and
1920s functions of their work.
 The Hawthorne experiments in the late 1920s showed how worker productivity could
be impacted by participation.

 Walter Shewhart developed the methods for statistical analysis and control of quality.
1930s

 W. Edwards Deming taught methods for statistical analysis and control of quality to
Japanese engineers and executives. This can be considered the origin of TQM.
 Joseph M. Juran taught the concepts of controlling quality and managerial
breakthrough.
1950s  Armand V. Feigenbaum’s book Total Quality Control, a forerunner for the present
understanding of TQM, was published.
 Philip B. Crosby’s promotion of zero defects paved the way for quality improvement
in many companies.

 The Japanese named their approach to total quality "companywide quality control." It
is around this time that the term quality management systems arises.
1968  Kaoru Ishikawa’s synthesis of the philosophy contributed to Japan’s ascendancy as a
quality leader.

 TQM is the name for the philosophy of a broad and systemic approach to managing
organizational quality.
 Quality standards such as the ISO 9000 series and quality award programs such as
the Deming Prize and the Malcolm Baldrige National Quality Award specify principles
and processes that comprise TQM.
Today  TQM as a term to describe an organization's quality policy and procedure has fallen
out of favor as international standards for quality management have been developed.
Please see our series of pages on quality management systems for more
information.

An Introduction to Quality Control in Manufacturing

“Quality is Everyone’s Responsibility”

Edward Deming, considered to be a “God” in the eyes of the Japanese business community for his
influence on their manufacturing sector after WWII is attributed as the source of the now somewhat
obvious quote above. His philosophy was one that wanted us to see manufacturing as a “system,” not a
series of bits and pieces of additive work.

The idea was that by applying appropriate principles of management consistently, quality could be
increased AND costs reduced by reducing waste, improving customer satisfaction, less staff churn, and
less litigation. His philosophy remained relatively unknown in the US until the 1980’s, when it became
clear that Japanese manufacturers - who took this approach to heart in the 1950’s – were going to be
succeeding at bumping the US off its perch in many key industries due their superior quality and cost
management techniques, including the “just-in-time” manufacturing that the Japanese auto industry made
into a household term.

How They Do It

Deming's philosophy was summarized by some of his Japanese followers in the 1970’s with the following
"a"-versus-"b" comparison:
 (a) When people and organizations focus primarily
on quality, defined by the following ratio, quality tends to increase, and costs fall over time.

(b) However, when people and organizations focus primarily on costs, costs tend to rise, and quality
declines over time.

One might even say this is a modern version of the Ben Franklin wisdom of being “penny-wise, pound
foolish” applied to manufacturing. The key takeaway here is that a focus on quality is NOT a path to
higher cost, but rather that the path to lower costs is a healthy obsession with quality.

Quality Has Many Names

In the last 20-30 years, there have been many “systems” created and rolled out that were supposed to be
the final word in quality. Undoubtedly, there will be more coming our way in the following decades as well.
For today, we’ll take a brief look at the four major success stories in the evolution of quality.

Total Quality Management (TQM). TQM is an entire management system focused on people their focus
on increasing customer satisfaction while continually reducing costs. It uses scientific methods for
assessing quality, its associated costs and constraints to implementing improvement. TQM also requires
a total systems approach where all functions, processes, and departments, and all employees at all
levels, are integral to ensuring success – be it in manufacturing or delivery of services. Learning and
adaptation to continual change are essential for achieving success.

Six Sigma. Coined by Motorola as its methodology for improving business processes by minimizing
defects, Six Sigma refers to a statistical measurement of “only 3.4 defects per 1 million opportunities.” To
produce a defect (or virtually zero). As an organizational approach, it means that companies make
decisions based on data, seek roots of problems, define defects based on customer requirements, and
track leading indicators of problems to prevent them from happening.

Lean Production. Lean production, which can be

credited to the Japanese adoption of Deming’s teachings, refers to the continuous flow of products or
services to the customer at the moment it is needed and to the customer’s specifications. It focuses on
increasing productivity and quality while reducing inventory and shortening lead time from floor to
customer. Its principles include workplace safety, order, and cleanliness; just-in-time production; built-in
Six Sigma quality; empowered teams; visual management to track performance and provide immediate
feedback on a daily or even hourly basis; and continual pursuit of perfection.

International Standards Organization Quality Management Standards. The International Standards

Organization (ISO) has developed a series of quality management standards that support the quality
philosophy. Specifically, it has developed a set of five such standards, ISO 9000–9004. The
American National Standards Institute (ANSI) and the American Society for Quality Control (ASQC)
developed the ANSI/ASQC Q9000–Q9004. Also, specific standards also exist for automotive, aerospace,
and telecommunications industries and environment management. These standards have been
revised over the years, and organizations must continually address these revisions. Organizations
competing in the global market must achieve the quality levels dictated by these standards.
 TQM Approach

The importance of quality both as a means of

ensuring customer satisfaction and reducing cost has become increasingly recognized over the past
thirty years. The philosophy has shifted from Quality Control to Quality Assurance to Zero Defects and
beyond, while standards such as ISO 9000 have sought to level on the practice.  Total Quality, in fact,
means that quality is all pervasive through a company’s products, processes, procedures and
systems and thinking - and is  practiced  by all.

The question 'What is quality?' may be debated at length, and there are many definitions. For now, let's
assume it primarily means 'Giving the customer what he/she wants,' and 'consistency.'

Consider a manufacturing process. There are some ways it may endeavor to ensure the customer gets
what he/she wants. 

1. The process can make a good product but is unreliable, and defects escape into the market. If
customers complain, their complaints are resolved. This is costly and may harm reputation.

2. Inspectors detect bad product at the end of the process and repair/reject it to protect the customers.
This is costly and frustrating; deliveries will be delayed or costly buffers of finished goods required.

3. Defects are returned to source for rectification or rework. Costs remain, as in (2). There are delays in
identifying problems so causes may not be apparent.
4. Defects are detected at the source; causes will be more obvious. Delivery remains erratic, downstream
customers are kept waiting, but at least they're not adding value to the defective product.

5. Defects are prevented. Through improving products and processes, we can assure delivery without
incurring rectification costs.

There are a number of things which we have to accept if we wish to achieve the scenario depicted
in (5):

 The customer knows what they want. We have to ask the right questions to define the
specification. Market research may involve anticipating consumer needs; we need feedback from
customers. We need data.
 We need materials and equipment capable of achieving what is expected, and products designed
not only for the market but for manufacture. We rely on those responsible for Design,
Engineering, and Sourcing to provide what is required.
 We have to accept responsibility for our own actions. People need to be trained, directed and
motivated. We look to Personnel and Training for their support.
 We are all part of a team which is the Business; a team which is our particular Division or
Department; and a team which consists of those with whom we work on a day-to-day basis. We
can take pride in what we collectively achieve for our customers and shareholders, and
satisfaction in playing our part as individuals. 

TQM primarily addresses the business as a whole, developing a state of mind consistent with the above.
Three major divisions of a manufacturing company may be considered as illustrated left.

While GK is consistent with this, and the same disciplines prevail in all three divisions, the prime focus for
GK is Manufacturing and its immediate support areas: 
Six Sigma is a similar approach which uses the same tools and techniques, ' re-labeling' some and
according to the title 'Black Belts', etc. to the facilitators. It's simple (but not easy!) goal is to achieve six
sigma capabilities of all business processes - a 3.4 ppb defect rate.

Quality Control in a Service Business

Since this article is about people, I shall begin with a story about a person I know. The purpose of this
story is to provide a reference point for the discussion and analysis that follow, for in every case the
programs to be described must be evaluated in terms of how well they meet the needs of particular
individuals who, like the subject of my story, possess conflicting motives and desires.

Ten years ago an employee whom I’ll call Tom Simpson went to his boss, one of our vice presidents, and
announced that, although not disappointed with the progress he was making, he would soon be leaving
Marriott to join a competitor.

Simpson was then assistant manager of a large restaurant in one of our major hotel properties. He was in
his late twenties and had made steady progress with us. His file was clean of those pesky, lukewarm
evaluations that can cool the enthusiasm of superiors as they leaf through personnel records seeking
indications of exceptional management talent. There were no “Good, but needs improvement in handling
people” comments or “Promising, but not achieving full potential.” Simpson had consistently been rated
“Excellent,” “Superior,” or “Promotable.”

No company likes to lose good, young talent, certainly not service companies, which typically are labor
intensive. For a service organization, quality control of employee attitude and performance is pretty much
the equivalent of product quality control for a manufacturer. Computer manufacturers, for example, point
to a roomful of hardware that has been quality controlled down to the last core and spool. The service
company has nothing so tangible. It counts instead on favorable impressions made on customers as a
result of services properly rendered. Everything depends on “quality control” of personnel. As J. Willard
Marriott, the founder of our company, has said many times, in the service business you can’t make happy
guests with unhappy employees.

After good people have been recruited and trained, it is essential to keep them. Accordingly, Simpson
was interviewed several times by senior executives when he announced his resignation. He was asked to
reconsider, told that he was thought to have exceptional talent and promise, and assured that he could
look forward to a well-paid career with increasing responsibilities. However, he held to his decision and
joined a new company that was just entering the restaurant business.

Six months later we wrote Simpson asking that he send us a constructive critique of our company. We
asked him to tell us about complaints that he, or others he knew, had about us, and also to tell us what he
felt to be good about Marriott. He sent us a fine letter of criticism, and we acted on some of his
suggestions.

Within two years, Simpson had cooled on the new employer. He contacted us to see if we might be
interested in his return, and although many companies seem opposed to rehiring anyone, we snapped up
Simpson without hestitation. Now that he’s back, we think he may be a better man for his experience with
another company. Today he is general manager of a Marriott division.
Simpson’s case is not an isolated one; as many as 10% of the managers who leave us voluntarily return
as he did. We try not to feel insulted when they leave, and we always feel complimented when they
return.

One reason for the departure of our managers is the unusual amount of entrepreneurial ambition among
people in the food and lodging business. Sometimes it seems as if, deep down, everyone in the industry
wants to open his own restaurant. This speaks well of the level of individual ambition, but it’s a
troublesome thing for the company, and it’s a problem not fully shared by any other industry I can think of.

Another reason for good people leaving us—and thereby hurting our quality control program—is dislike
for the physical requirements of our business—the long hours of physically demanding work, the weekend
and holiday duty, and so on. After all, how many management careers can you think of where the
heaviest work load comes on family holidays like Thanksgiving and Easter? Still another reason for losing
good people like Simpson is the seeming attractiveness of a higher position with a competitor. This is a
reflection of the intense competition for good personnel in our industry; the problem is most acute for
industry leaders.

Because of pressures like these we pursue an elaborate “rescue” operation for our good management
people. But, needless to say, maintenance of a high level of performance cannot be accomplished just by
retrieving good people who have left. When able employees are hired, the objective must be to retain
them by keeping them challenged and satisfied and growing in their jobs.

Overview of Eight Programs

It would be convenient if this objective could be achieved by one extremely effective program. To the best
of my knowledge, however, no such program exists. It takes a number of personnel programs to keep
good people, partly because employee needs vary so widely and partly because a variety of subjects,
settings, and instructors often serves to “reinforce” a person’s knowledge and understanding.

Let us turn now to eight of the most effective programs that Marriott has developed over the years.

1. Individual Development

This program (which we refer to as “ID”) is designed to teach new management employees necessary
skills and technical knowledge during their two- or three-month formal training period so they can assume
responsible management roles quickly. (See Exhibit I for a list of programs offered by Marriott.) ID leans
heavily on programmed instruction manuals written specifically for the assistant manager positions that
the trainees are preparing for. It involves numerous, highly detailed task sheets that break required job
knowledge down into dozens of major and minor components, and it establishes performance times for
the degree of mastery required in each instance. Also, this program allows the individual to set his or her
own pace in acquiring the skills, mixing a series of structured on-the-job experiences with classroom
seminars where the learning process is shared with other trainees.

A program like ID helps a geographically dispersed company ensure that requisite job skills are being
taught to new managers in a consistent manner and at the accelerated pace desired by most trainees.

2. Management Training

Our company policy calls for every member of management up through the middle levels to attend one
management development session each year.

Sessions are conducted by the corporate training department and include a variety of two- and three-day
seminars, for groups of 10 to 20, on a wide variety of professional management topics. Courses are
aimed at the first three levels of management, and an individual usually attends with members of his peer
group from various operating divisions. This program is first cousin to ID.

As a company with a progressive profit sharing plan that allows managers to retire at any age after 20
years of service, Marriott’s management organization tends to be youthful, starting with president Bill
Marriott, Jr., who is 43. Restaurant managers average between 24 and 29 years of age, and district
managers are in the 28- to 35-year range, very close in age and outlook to the managers they supervise.
As a result of this youthfulness, there is little in the way of a generation gap between top management
and the “firing line.” Yet the company still emphasizes communication skills, offering such seminars as
“Managing the ‘Now’ Generation” in which 30-and 35-year-old middle managers learn to deal with their
even more youthful subordinates.

3. Manpower Planning

How many and what kinds of people will be needed in three or four years to fill key company positions?
Properly managed, the manpower planning process can create an inventory of good prospects who are
trained and ready to be shifted upward to fill newly created managerial opportunities.
The employee who knows how he or she is performing on the job, and what his or her chances are for
more pay and responsibility, is more likely to be a happy employee. Thus a key element of good
manpower planning is the periodic performance review of all management personnel. Our people know
that these reviews of their work, attitudes, and potential are prerequisites to promotion, and it follows
naturally that our better people look forward to them.

Our policy is to schedule these reviews annually (or more frequently), for if spaced too far apart they lose
effectiveness. They should be formalized. We try to use them to focus on strengths rather than
weaknesses. While they are time-consuming and, for some managers, difficult, they are the only
consistently effective way we know of to identify good back-up personnel long before the actual need for
them arises.

Manpower planning is carried out by successive layers of management, with the process starting from the
bottom and moving upward. Each manager personally reviews two layers of employees below his own
rank. This allows an overlap in the evaluation procedure, because everyone is evaluated by his
immediate superior as well as by the person two ranks ahead.

Each line division or staff department plots three-to five-year expansion curves and the management
talent needed to accomplish the growth. For example, if in two years we will be needing five additional
district managers in a given division, we should be able to identify five to ten people now who can
reasonably be expected to grow to fill those positions. If such individuals need further training and
experience, top management should know who they are and should insure that they get the needed
attention.

Keeping it personal

Managers tend to be unwilling to admit that some subordinates are truly non-promotable; rather they will
say that a particular individual “isn’t ready yet” or “just needs more experience.” In manpower planning,
therefore, we try to focus most of our attention on those individuals who are identified as promotable
“immediately” or, at most, “within one year.”

We have found it extremely important to keep the process personal, and not let it become statistical.
Therefore, an executive doesn’t try to evaluate employees who are more than two levels below him.
Beyond that point he (or she) cannot be directly knowledgeable about the performance of the people
involved.

When I participate in manpower planning, I ask such questions as these of my team:

 How many new units are you going to open in each of the next two years?

 What will your organization structure look like two years from now?

 How long will it take you to develop the talent you will need for each position?

 Do you have enough identified reserve talent now to meet your needs two years out and, if not,
can you recruit the talent you need from other divisions within the company?

 As a last resort, when must you recruit the necessary “fast track” candidates from outside to fill
the vacancies that remain?

Manpower planning often makes it necessary for a manager to “bite the bullet” in order to cope with a
shortcoming. For example:

Some time ago we had a man in a middle management position who was considered a prime future
candidate for two or three different higher-level jobs. But most of them would require considerable travel
—and he was deathly afraid of flying. We told him where he stood and asked him to grapple with the
problem, with our help if he wished, before it could affect his career. As a result of this candid approach,
he decided to seek medical assistance. He brought his fear under control and was subsequently
promoted into a position that he could not have filled successfully before.

Such high store is set by manpower planning appraisals that our corporate president examines reports on
management down through several ranks and often compares them with reports from previous years. He
also reports personally to our board of directors on manpower planning and appraisal for the two layers of
management below him.

4. Standards of Performance

We find it helpful to have written, highly detailed statements of expected productivity for each member of
management. They are negotiated personally between subordinate and superior every year. They enable
a person to answer the all-important question, “Exactly what is expected of me in my job in order for me to
be rated at least a satisfactory performer?” They allow managers the much needed freedom to determine
for themselves how a task is to be performed, while being held strictly accountable for the end result.

Standards of performance are also applied to improving the performance of lower-ranked employees.
They help the holders of even unskilled jobs understand the importance of their function to the
organization and the company’s expectations of them. For example:

 A series of booklets tells employees in our hotels what their attitudes toward guests should be,
how they should conduct themselves when dealing with customers, what courtesies to show, and,
in many cases, how to speak.

 “The Marriott Bellman” booklet is designed to convince our uniformed doormen that they
represent an all-important first and last impression for many of our guests, that they must stand
with dignity and good posture, and that they must not lean against the wall or put their feet up
when sitting. Important standards of personal hygiene are outlined in the booklet as well.

Bellmen are often looked at subconsciously by guests as being “Mr. Marriott himself,” because many
times a guest will speak to and deal with the bellmen more often during a visit than with any other
employees of the hotel. The bellman is the person the guest talks with on the way up to his room. It is the
bellman who points out the air conditioning dial and where the extra towels are. And while making the
guest comfortable, the bellman is expected to explain about the restaurants on the property, what great
food they serve, and which ones the guest might enjoy most during his stay.

Our bellmen, bell-ladies (we call them “doorbelles”), and the young people who drive our airport
limousines are some of our best sales persons. They are coached to smile often and do all they can to
make the guest feel welcome and special. It’s a regular practice for a bellman to check the guest’s
luggage tag and find out where he comes from. This is a fine basis for conversation as the guest is
escorted to his room; there is power in suggesting to, let us say, an Atlanta-based guest that “you really
should visit our great hotel in Atlanta—it’s got some terrific restaurants and meeting facilities!”

I have even known bellmen to strike up a conversation about Marriott stock on the way to the room, one
reason for this being that a large number of our employees own company stock. Ask a Marriott bellman
what the current price of his stock is, and you’re very likely to get a right answer! We encourage employee
interest in our stock through our profit sharing plan, stock purchase plan, and various management equity
programs. We believe that stock ownership helps build pride, identification, and a sense of profit
responsibility at all levels.

Another booklet, “The Switchboard Operator,” tells in detail how to speak with the guest, and it offers
guidelines in handling a variety of specific situations that might face a hotel switchboard operator. Still
another booklet, “The Housekeeper,” tells precisely how a room is to be tidied and is accompanied by a
12-minute audiovisual film to help insure that the job is done right. Standards are established for every
part of the job—even such details as requiring wrapped bars of soap to be placed on the same side of
each wash basin, with labels upright so they can be read by the guest.

The ‘flying squad’

By themselves, standards are not enough. To see that they are followed, a “flying squad” of inspectors
goes periodically from one hotel property to another to observe operations. Typically, the squad consists
of a representative of each of the key job skills in a hotel—experts on food and beverage, sales and
marketing, accounting and finance, personnel, front desk operation, banquets, restaurants,
housekeeping, and so on.

Soon after its arrival, the squad assembles all the employees, gives a pep talk on the purpose of its visit,
and often counsels individual employees on their work, attitudes, and opinions about how the property is
being operated. Each employee is rated as to technical proficiency, attitude, cleanliness, and how well he
or she communicates with guests and other employees. A lengthy evaluation is prepared on each facet of
the hotel’s operation, comparisons are made with prior reports, and objectives are negotiated for
improved future performance. Arrangements are made with the resident managers to follow up on the
appraisal after the squad departs.

Flying squad reports are often used by those who assign employees to the next new hotel “opening
team.” These teams consist of one or more outstanding performers in every area of operation—
dishwashing, cooking, housekeeping, waitressing, and so on. The employees are selected from Marriott
hotels all over the country. Recently, for example, our new 1,000-room Marriott in Los Angeles opened
with very few hitches, thanks to the opening team that moved into the hotel a few weeks before
operations began and spent from one to three months training the new Los Angeles employees.

5. Career Progression

This is a job advancement program designed to provide hourly employees with a ladder of advancement
up through positions of increasing skill, responsibility, and pay—even up into management—if they have
the ability and the industry to go with their ambition. It was designed originally for the underprivileged,
minority-group employee. In many hundreds of instances it has enabled employees to pull themselves
and their families out of the poverty cycle.

Employees must request consideration for career progression, and only those with positive attitudes,
aptitudes, and a Marriott work history are accepted. (See Exhibit II.) The employee must say, in effect, “I
want to grow with the company. I want to get ahead. I’m ready and willing to work harder, do more, study,
and prepare myself for promotion.” Adult education courses at local schools are sometimes used to
improve reading skills, sharpen writing abilities, and learn mathematics. Individual step-by-step programs
are devised by our personnel people for employees in the program. Times are allotted for the completion
of each progression step; and if an employee lags too far behind for lack of effort, he is dropped from the
program.

An average of 800 employees are usually enrolled in career progression at any one time. It has enabled
many people to get two or three extra promotions beyond what they might otherwise have earned. As an
example:

I recall one restaurant employee who was ambitious and appeared to have real growth potential. She
talked with her boss, the manager in one of our good service operations, and, after being accepted in the
program, started learning various new job skills. She spent 40 hours in training for promotion at the rate of
one hour per day beyond her regular employment time. When a vacancy in a higher-paid job turned up,
she was promoted for a trial period to prove her proficiency. She obtained progressively higher-rated jobs
this way and today is manager of one of our food service operations in a retirement home near
Washington. Without the career progression program, it is hard to imagine that she would have been able
to advance as she did from kitchen worker to unit manager.

Employees understandably feel good about the career progression program. Whether or not an employee
has the desire to seek enrollment, the knowledge that the opportunity exists is a strong ingredient in
maintaining a positive attitude toward the company.

6. Opinion Surveys

We conduct annual surveys of rank-and-file opinion. These surveys are our first line of defense against
the buildup of unfavorable attitudes—our “early warning system.” Also, like the fair treatment policy to be
discussed, they are one of our most important quality control devices.

Specially trained personnel representatives go to each one of our units and conduct a meeting of all
employees. They explain about the opinion survey and urge frank, open participation by everyone. (See
Exhibit III for a sample of Marriott’s employee survey questionnaire.)

Employees do not have to sign the questionnaires; in addition, they may add anonymous comments
about each statement in subsequent interviews with the personnel representatives. The survey responses
are analyzed by computer, and two weeks later an employee meeting is held to discuss the results of the
survey and to solicit additional comments. Four weeks after that, another meeting is held to announce the
action that will be taken in response to the survey. Results of surveys made in previous years are often
brought out for comparison with new surveys.

Many times the surveys bring to light small but potentially serious situations that can get out of hand if
ignored. One recent survey, for example, revealed that employees resented not being provided with a
safe place to store their valuables while they worked; they were troubled by occasional petty theft from
their lockers. When this sentiment was brought to light, a safe storage place was made available for
employee use, and a cause of ill will was eliminated.

7. Fair Treatment

Our fair treatment program predates and goes beyond the Federal Government’s Equal Opportunity
legislation of the 1960s. We give new employees a handbook that outlines the kind of conduct the
company expects and what, in turn, the company considers its obligations to the employee. The
handbook outlines, among other things, job security, promotion possibilities, disciplinary measures,
safety, and a step-by-step procedure for bringing any personal grievance to a just conclusion.

The grievance procedure, part of our fair treatment policy, is a bulwark of our quality control program. It
tries to guarantee that no one supervisor has the last word about an employee’s job in the event of a
dispute. If an employee doesn’t think he or she has been treated fairly, he or she can appeal without fear
of retribution by the supervisor. An ombudsman is provided for many of our employees. He is John
Randolph, a 61-year old man who has been with the company since its early days. He is the honored
friend of all, from dishwashers to senior executives, and he holds the absolute right to take any
disagreement, any charge of unfair treatment, all the way up the chain of command—to the president’s
office if necessary. A recent example of his work is illustrated by the following story:

A restaurant employee who was transferred from one unit to another resented the move. Although she
complained, her supervisor decided that the transfer stood as ordered; his superior, when brought into the
case at her request, also agreed with the decision. She then called John Randolph. He listened to her
story and then traveled the 100 miles from Washington to her unit, interviewed her supervisor, and finally
agreed with her that she had been unfairly treated in being forced to transfer to another department.

Failing in his attempts to have the decision reversed at the unit level, Randolph took the case through
channels to the division vice president and conducted a meeting attended by the employee, the district
manager, and the unit manager in question. After reviewing the facts, the vice president upheld lower
management. But Randolph still disagreed.

He took the case to the next higher level, a group vice president, where a complete review of the case
brought out additional information that favored the employee’s point of view. The group vice president
reviewed the case in its new light with the managers involved and then, with their concurrence, put the
woman back to work at her old job, with no loss in pay.

This case, like many others pursued by John Randolph, consumed several weeks and many hours of
executive time—all in the interest of justice for a single employee. We think our known willingness to go
“all the way” in this manner, when necessary, is an important ingredient in our employee quality control
program.

In all parts of our operation we maintain personnel representatives who can function as ombudsmen
when the need arises. Sometimes, in divisions where large numbers of high school or college youths are
employed, the role is assumed by a “house mother” who is expected to guide the youngsters and alert
management to troublesome situations that may develop.

8. Profit Sharing

This program originated in the belief of Mr. and Mrs. J. Willard Marriott, who started our company with a
root beer stand in Washington nearly 50 years ago, that their employees were responsible for much of
their company’s success and deserved more than a paycheck and a few fringe benefits in return for their
efforts. Their son, Bill Marriott, Jr., agreed wholeheartedly with this approach, and our profit sharing plan
has been improved upon several times since he became president.

All employees and managers are eligible to join our plan after three years of service, and 80% of those
who are eligible do join. They contribute at least 5% of their earnings to the plan, and the company makes
a distribution from profits that has, in the past, more than equaled the amount of employee contributions.
These proceeds are invested by a board of trustees that includes both company management and
outside advisers. Since the plan is only 15 years old, none of our retirees has yet actually received the
maximum benefit from it, but a projection of the return for one of our recent new hires will serve to indicate
the magnitude of the program:

Last year Bill Jones brought his wife and child to the Philadelphia area to start a management career in
our Roy Rogers Family Restaurant division. Bill, who was 25 years old, had completed two years of junior
college and his military service and had had a year of unpromising job experience behind him. We started
him at a trainee salary of $9,000 per year.

If Bill stays with us until age 55 and makes reasonable progress in his 30 years of service, advancing
three or four positions to the level of district manager, his profit-sharing fund expectations are impressive.
Even at age 45, his retirement fund will be worth almost $150,000; after 30 years, his fund should exceed
$600,000. (These projections assume average annual salary increases of 8% and fund performance
equivalent to that achieved during the past 15 years.) His total salary deduction in the 30 years, on the
other hand, will be less than $50,000.

Continuing Evolution

The programs and efforts described here are far from being the last word in quality control. They have
taken much time and brought many good results, but they must be regarded only as steps along the way.
The programs that kept our employees happy yesterday are not necessarily the ones that will work
tomorrow. Consider just two examples of the need for continued change:

1. Our profit sharing and career progression plans were developed to meet the needs of an era when
most of our employees were adult, career-service, full-time, mostly black, relatively uneducated, and only
marginally skilled workers. But today much of our work force is made up of part-time workers, youthful
employees who are completing their education, and educated workers for whom there are an ample
number of alternative jobs. Also, the federal government now takes considerably more interest in the
subject than it did when our plans were started. In short, we cannot take for granted that the programs are
up to date.

2. Our approach to management training and development evolved before the post-World War II baby
crop, the “Now Generation,” began to enter the management work force. It was a time when “traditional”
values were accepted without question. It was generally believed that the advancement of a man’s career
was his most important life goal, that the gratification of wants should be deferred until earned, and that a
woman’s primary interest should be her family and her husband’s career. Of course, we now have a
generation of management trainees who are often indifferent to these values. Therefore our approach to
career development programs must keep evolving, and we must look at these programs with open minds.
In one important respect, however, we feel that our quality control approach is as sound as it ever was.
Half a century ago, J. Willard Marriott reasoned that it takes happy employees to make happy customers.
We find that this simple conviction continues to make good sense.

Quality Management, Organization, Responsibilities and Information Systems

The content of this page reflects a large part of our standard processing, however there may be
exceptions. Please contact us if further clarification is needed.

Quality Management

Your satisfaction is our top priority. To ensure we meet your quality standards we have created these
management programs and processes:

 Regular Quality Reviews

o Chairman: CEO
o Facilitator: VP of Quality
o Attendees: CEO’s direct staff
o Topics: key quality results, customer feedback and trends, status of quality improvement
initiatives
o CEO can adjust corporate strategy and resources to stay on target with your needs and
expectations
 The NXP Way, a guiding philosophy for quality strategy, goals and new quality programs

The NXP Way

Our company-wide continuous improvement effort focuses on problem solving and providing the highest
level of quality.

Instead of lessening problems, The NXP Way focuses on getting rid of them altogether. By understanding
our top problems, our corrective actions can be targeted and efficient. We teach our team members to be
good problem solvers and our managers to be good mentors and coaches. With the NXP Way, everyone
has the power to make changes and we expect 100% participation as we seek to find ways to improve
the quality of our work and workplace.

Quality Roles and Responsibilities

Our quality team is a worldwide organization that leads customer-critical functions within NXP. Their
responsibilities include:

 Finding the root cause of quality issues

 Working on product quality improvements through preventive and
Customer Quality
corrective actions

 Working with final manufacturing subcontractors and foundries on

quality-related tasks, audits and incidents
External Quality
 Being the main quality point of contact for outsourced products

 Electrical and physical product analysis for new product development,

customer issue resolution and manufacturing effectiveness
Failure Analysis Lab improvements
 Providing an expert voice in new product development teams

 Working with customers for quality-related tasks, audits and incidents

 Collecting and reporting customer quality data to drive improvement
Field Quality
within NXP

 Acting as customer advocate for internal manufacturing sites regarding

change management, discrepant material and product qualifications
 Overseeing and performing quality audit activities
Manufacturing Quality
 Giving expert knowledge, with the help of quality tools and methods, to
help ensure quality of manufactured products

 Driving quality into product development activities

New Product
 Helping ensure that new product releases meet customer and standards
Introduction (NPI)
requirements
Quality
  Voicing Our position and interests within industry standard bodies such
as AEC, IEC and JEDEC
Quality Standards and
 Communicating internally, industry standard trends and changes
Bodies
(planned or actual)

 Managing our quality rules, process structure and documents

 Coordinating internal and certification audits
 Leading continuous improvement activities
Quality Systems
 Making sure that customer-specific requirements are available and
understood

 Operating life and environmental stress labs to validate long-term

Reliability Lab reliability of our products

 Driving quality into software development activities

 Making sure new software releases meet customer and standards
Software Quality
requirements

 Working with suppliers on quality related tasks, audits and incidents

 Driving supplier quality improvements
Supplier Quality  Handling supplier audits, data collection and analysis and quality related
items, including issues and changes

 Environmental Health and Safety

o Conduct business activities in a responsible manner
o Provide a safe work environment for our employees
o Reduce our environmental impact
o Work to meet the EHS expectations of our customers, suppliers,
partners and the community
 Business Continuity Management
o Identify critical processes that may interrupt business operations
and implement strategies to minimize the impact
Sustainability Office
 Social Responsibility
o Ensuring a workplace that is safe, secure, and in which every
employee is treated humanely, with respect and dignity
 Eco-Products
o Drive NXP products toward environmental compliance with
reduced environmental impact from hazardous substances and
conflict minerals
 Additional information can be found at: Corporate Responsibility

The importance of quality in creating competitive advantage

Most businesses operate in competitive markets: they have to 'take on' and 'see off' rivals. Each
organisation must decide for itself how best to try to do this. Not all firms come up with the same answer
and for good reason. Firstly, there are several different ways of gaining competitive advantage. Secondly,
businesses need to play to their strengths and not all businesses have the same strengths. Thirdly, many
markets are segmented and what is important to one set of customers may be less important to another
set. So businesses need to decide which segments of the market they are targeting. Ways of seeking to
gain competitive advantage include:

 offering lower prices

 offering clearly superior products at above average prices
 delivering products more quickly
 offering superior customer service, including after sales service.

This Case Study focuses on how Portakabin has set about gaining a competitive advantage in the hire
and sale of interim (temporary) or permanent accommodation by concentrating on quality.

The Portakabin Group is a private company, owned by the Shepherd family. Clients want modular
buildings for a variety of reasons. For example:
Portakabin operates in a highly competitive market and competes with tough competitors. Despite this,
Portakabin has 17% of the overall UK market (its nearest competitor has 14%). In competing for
business, the company decided early on to establish a reputation for quality.

It has attracted key customers who recognise that their own reputations depend, at least in part, on the
quality of accommodation and facilities they offer their own customers. The chart shows the broad nature
of Portakabin's high profile customer base.

Portakabin has positioned its products at the top end of the market: it looks to provide high levels of
quality at premium prices.

Quality is associated with consistency. A customer who is happy with the first buying experience needs
and wants to be equally happy on each further occasion.

Portakabin's motto is: Quality - this time - next time - every time.

The company believes that clients who really care about quality are willing to pay that bit more to obtain it
and see 'the extras' as worth the additional expense. Today the company operates in a range of
European countries as well as the UK. Portakabin's brand vision is:

'To provide peace of mind for our customers across Europe through quality buildings and services.'

What is quality?

Most businesses operate in competitive markets: they have to 'take on' and 'see off' rivals. Each
organisation must decide for itself how best to try and do this. Not all firms come up with the same answer
and for good reason. Firstly, there are several different ways of gaining competitive advantage. Secondly,
businesses need to play to their strengths and not all businesses have the same strengths. Thirdly, many
markets are segmented and what is important to one set of customers may be less important to another
set. So businesses need to decide which segments of the market they are targeting. Ways of seeking to
gain competitive advantage include:

  offering lower prices

 offering clearly superior products at above average prices
 delivering products more quickly
 offering superior customer service, including after sales service.
This case study focuses on how Portakabin has set about gaining a competitive advantage in the hire and
sale of temporary or permanent accommodation by concentrating on quality.

Portakabin has positioned its products at the top end of the market: it looks to provide high levels of
quality at premium prices.

Quality is associated with consistency. A customer who is happy with the first buying experience needs
and wants to be equally happy on each further occasion. Portakabin has the motto 'Quality - this time -
next time - every time'.

The company believes that clients who really care about quality are willing to pay that bit more to obtain it
and see 'the extras' as worth the additional expense. Today the company operates in a range of
European countries as well as the UK.

What is quality?

Quality relates to 'appropriate use': how well a product does what it is intended to do.

Portakabin's 'Ultima' building illustrates quality well. The Ultima specification includes:

 modern design
 high quality materials
 layout and fitting of the building to clients' requirements allied to :

 rapid construction to provide:

 a smart modern working environment

 an image that reflects the status of the client.

The 'appropriate use' quality comes from two sources. One is internal to the company. Portakabin has
developed its range of buildings around its own market research, which discovers customers' precise
needs. The company knows how important it is to offer optional extras, such as high quality carpeting,
fitted furnishings and climate control systems to provide a quality working environment. Simultaneously
being able to offer not only the building but also the aforementioned accessories, gives the customer a
quality 'one-stop-shop' service.

The other source of quality control is external e.g. national building requirements and standards.
Portakabin's products, whether interim or permanent, comply fully with all appropriate building
regulations. They also meet the demands of ISO 9001: Quality Management Systems. This is an
internationally recognised standard which acts as a form of guarantee that everything the company does
is managed to the highest quality standards.

The group's Quality Systems Manager (QSM) is responsible for ensuring that Portakabin has in place
systems that guarantee quality throughout the Group. To manage quality, the QSM has created an
electronic system that all PCs throughout the whole company can access. One of the system's key
features is the 1-page Quality Manual that defines the requirements of the Quality Management System.
This is easy to communicate both within the organisation and also to customers.

Quality products

The term 'product' covers not only goods but the services that support them. Portakabin offers a range of
tangible products e.g. Lilliput (a modular nursery building) and Titan (a modular building for office
applications). The company also offers key services e.g. Total Solutions, a planning and project
management service for customers wanting to hire modular buildings. Portakabin also offers a wide range
of support services to clients for whom a modular building is part of a larger plan. If requested, Portakabin
will take on the customer's project from start to finish. This includes managing planning applications,
project management and providing health and safety advice, as well as providing access for the disabled.

Product quality also relates to how well a product meets changing demands. In modular buildings,
technologies are increasing the range of what is possible. At the same time, customers are becoming
more particular about their own requirements. For example, they want building solutions that are safe and
clean, which minimise disruption, save time and guarantee quality. Quality involves keeping pace with
these demands.

Modular construction involves manufacturing a building off-site in a controlled factory environment. For
example, the steel modules used to construct Ultima buildings are fully fitted out with all electrics,
plumbing, heating, doors, windows and internal finishes before they leave a Portakabin production centre.
This enhances their quality and also reduces programme times.

Being registered as meeting the requirements of ISO 9001 is very important to Portakabin. This is
because many customers will deal only with organisations that can demonstrate they meet this rigorous
standard. All of Portakabin's products meet with modern standards and requirements, and this enhances
consumer confidence. To reinforce this quality system, Portakabin has a 'zero tolerance' quality checking
system (see section 4) in place, so that no building may leave the production site until it has been
checked against, and complies with, demanding customer standards. Furthermore, because of their high
quality standards, Portakabin are the only modular building company to offer quality guarantees in the
form of 5 and 20 year warranties.

The standards required are wide ranging. For example, the recently ratified Kyoto Protocol requires
industrialised nations to limit their production of gases that are harmful to the environment. Portakabin
takes this requirement very seriously. As a result, all of its buildings are thermally efficient to minimise
energy use. Following Kyoto there are a range of new building requirements and these are particularly
important for Portakabin's public sector customers such as hospitals and schools.

Quality processes

Any form of production activity involves sets of interlinking processes.

Portakabin's factory-based production process combines standardisation with customisation. The

modules to be assembled come in standardised sizes and shapes. However, the way they are put
together and their interior design depends on clients' individual specifications. For example, modules that
are assembled for Sainsbury's to train new checkout staff are different from those designed for an
easyJet office.

To ensure that all customers get what they want, Portakabin deploys the Quality Systems approach
referred to earlier. A Corporate Quality Team (comprising senior managers) is responsible for ensuring
that individual teams understand quality processes.

Communication takes place by means of process charts. These are clear illustrations that set out the
processes involved e.g. in creating a new set of school classrooms or laboratories.

The essentials of the Quality System are:

1. Say what you do

By studying the Quality Manual, teams working on a particular process know what the job requires. If in
doubt, they can ask team leaders. This process enables everyone involved to understand and state the
process and their role within it.

2. Do what you say

Once they understand the process, team members are able to implement it e.g. by constructing a new
building for a specific client.

3. Record what you have done

Construction teams record all actions taken, so that all those involved know the current position, what has
gone on before and what still needs to be done.

4. Review what you have done

Records are regularly reviewed both to ensure delivery targets can be met and to identify any problem
areas.

5. Take remedial action where necessary

If problems or potential problem areas are identified, steps are taken to eliminate or reduce these.

6. Then start the process again

This procedure is followed for each stage in each process to ensure that everyone benefits from solutions
to problems, which have already been devised.

These essential steps can be illustrated in the form of a hierarchy of quality processes:
An essential part of improving quality is to identify problems as and when they occur. These can then be
addressed and resolved immediately. This is what Portakabin mean by 'zero tolerance'. To address any
issues, Portakabin deploys a 'commando team' as part of its Quality Team. This team scrutinises
products and processes from the customer's viewpoint. On one occasion the team found blistering on the
walls of a particular building, a quick 'alert' to the manufacturing team led to the fault being eliminated
before it became a problem for the customer. Teams complete quality reports with the purpose of:

 fixing the immediate problem

 identifying its cause
 making changes to prevent the problem reoccurring.


Quality Service

Providing customer service is another vital part of Quality Management. See steps 6 and 7 in the chart
below.

The company believes that providing exceptional levels of customer service is as important as the quality
of the products it makes. To support this commitment, it has developed a number of initiatives aimed at
continuously improving service. Portakabin:

 guarantees to complete projects on time and on budget

 operates a Customer Charter that sets out minimum standards that customers of its Hire Division
can expect to receive. This charter includes the pledge where Portakabin will recompence the
customer if it fails to deliver a building on time
  offers a complete plan, design and build service, whereby a client can choose simply to accept
the keys and open the doors on completion
 runs a comprehensive customer satisfaction survey every month.

Conclusion

In a competitive market, businesses stay ahead by offering products that are different and/or superior in
ways that matter to customers. Portakabin has positioned itself at the top end of the modular buildings
market in terms of quality, whilst at the same time providing value-for-money products that fully meet key
standards set out in IS0 9001. The most recent external audit of Portakabin's practices showed that the
company is meeting the required standards in all aspects of quality. This outcome is the result of a great
deal of thought, careful planning and ongoing education and training of a skilled and dedicated workforce.

Core Values: Overview and Examples

Core values are personal values that guide you when making important decisions and doing work.
Determining the values that are meaningful in your life can help you to develop personal and professional
goals. It can also help you find jobs and companies that align with your ideals.

Let’s take a look at what core values are, how to identify them and how you can use them to advance
your career.

What are core values?

Core values are a set of fundamental beliefs, ideals or practices that inform how you conduct your life,
both personally and professionally. Businesses can also have and maintain core values. These can help
an organization determine how to allocate resources, make important decisions and grow.

People and companies follow a small number of core values, typically prioritizing under 10 specific ideals.
These values can inform how people interact (humility, respect, honesty), the focus of a person or
business’s work (ingenuity, creativity, data-driven) or the individual responsibilities one will hold
(consistency, quality and reliability).

Identifying core values for yourself or within a company can provide structure and instruction, especially
when dealing with a certain decision or dispute. If one of your core values is honesty, for example, you
would refer back to it when deciding whether or not a certain piece of information should be kept secret.

How do I identify my personal core values?

If you’re unsure about what your core values are, it might be helpful to take time to reflect on what’s
important to you. It might take many moments of reflection over time to clearly identify your core values,
so be patient and attentive to what motivates and drives your thoughts and decisions.

To get an idea of what your core values might be, consider your answers to the following questions:

 What kind of culture do you want to work in?

 What things, settings or resources are necessary for you to do your best work?
 What qualities do you feel make strong, healthy relationships?
 What qualities do you admire most in your role models?
 What motivates you?
 What qualities do you wish to develop in yourself professionally and personally?
 What are your future goals? What qualities will it take to achieve them?

Consider these and other questions that might inform what key values you want to prioritize in your job
search, on the job and in your life. You can use them as a guideline to work toward your goals and
advance your career.

Related: Core Values of a Great Leader

Using your core values

Once you have defined a few values to prioritize, you can use them in a few different ways:

1. Include core values in your resume

If you are updating or creating a resume, it might be helpful to list your core values as relevant to the
position you’re applying for. Especially if you are new to the job market or have little professional
experience, identifying how you like to conduct work might be helpful for employers. If you do have
experience, you might weave core values into examples of specific accomplishments in your previously
held jobs.

2. Align your core values with companies when searching for jobs

Search for jobs at companies that align with the type of work you want to do, the culture you want to be in
and the mission you want to work toward. Carefully review the job description for ways your core values
would be relevant and helpful in the role. You should also do company research to ensure the company’s
mission and core values align with your own.

3. Discuss your core values during interviews

Many employers will ask questions specifically about what qualities are most important to you during
interviews. These might be questions like, “What motivates you?”, “What type of employee are you?” or
“Why did you choose to apply here?” You can use your core values to answer these questions and to
provide context to your most important accomplishments. For example, if you helped your previous
company increase productivity by 15%, you can explain how you highly value responsibility with time and
resources.

4. Use core values in the workplace

If you’ve gotten a job or have been in a career for several years, you can use your core values to continue
advancing in your role. Clearly defining your goals can help you make important decisions about your
career like which industry you want to be in or what short-term and long-term goals you should set.

Example list of core values

Here is a list of example core values that could work in personal or corporate situations. You can use this
list as inspiration when deciding on your own core values, planning answers to interview questions or
understanding what others might select as their core values.

 Acceptance
 Achievement
 Adventure
 Bravery
 Community
 Creativity
 Curiosity
 Family
 Friendships
 Growth
 Happiness
 Hard work
 Honesty
 Humility
 Ingenuity
 Innovation
 Integrity
 Kindness
 Knowledge
 Open communication
 Optimism
 Patience
 Peace
 Popularity
 Power
 Quality
 Respect
 Responsibility
 Spirituality
 Stability
 Success
 Tenacity
 Time management
 Wealth
 Wisdom
 Work/life balance
 History of the Current Quality Improvement Paradigm

In the United States there has been an evolution from quality assurance, where the emphasis was on
inspection and punishment for medical errors (the “bad apple” theory) to QI, where we ask, “How did the
system fail to support the worker involved in an error?” Table 4.1 contrasts these two frameworks.

Table 4.1. Quality Assurance vs. Quality Improvement

Quality Assurance Quality Improvement

Individual focused Systems focused
Perfection myth Fallibility recognized
Solo practitioners Teamwork
Peer review ignored Peer review valued
Errors seen as opportunities for
Errors punished
learning

This evolution began in earnest with the publication of two landmark Institute of Medicine (IOM) studies:

 To Err Is Human: Building a Safer Health System (1999) focused on patient safety and brought to
the public’s attention the fact that 44,000 to 98,000 deaths occur each year due to medical errors.
 Crossing the Quality Chasm: A New Health System for the 21 st Century (2001) built on To Err is
Human. It called for a fundamental change in the health care delivery system through a complete
redesign of patient/provider relationships and revised patient care processes, leading to improved
health care outcomes.

Before these studies, some pioneering individuals had been advocating for the use of measurement and
data to judge how effective processes were at achieving desired outcomes. Notably, W. Edwards Deming
talked about the science of improvement in his System of Profound Knowledge in the early 20 th century.

Dr. Deming was a statistician who used statistical process control tools to determine sources of variation
that led to waste in manufacturing. His approach to improvement shifted focus from individuals to
underlying processes as the primary source of error and variation. This concept of process improvement
helped pave the way for today’s view of QI. In his 1982 book Out of the Crisis, Deming laid out his
philosophy for transformation of organizations, emphasizing the concept of total quality management and
the importance of understanding the type of variation in a process. The more variation, the more waste
and inability to consistently produce the outcomes desired. His 14 points, shown in still resonate today.
Although written for manufacturing, they have become part of health care thinking and are inherent in all
QI methodologies.

Deming’s 14 points

1. “Create constancy of purpose towards improvement.” Think long-term planning, not

short-term reaction.
2. “Adopt the new philosophy.” Management as well as the workforce should actually
adopt this philosophy.
3. “Cease dependence on inspection.” If variation is reduced, there is no need for
inspection since defects (errors) will be reduced or eliminated.
4. “Move towards a single supplier for any one item.” Multiple suppliers mean variation.
5. “Improve constantly and forever.” Focus on continuous quality improvement.
6. “Institute training on the job.” Lack of training leads to variation among workers.
7. “Institute leadership.” This draws the distinction between leadership, which focuses
on vision and models, and supervision, which focuses on meeting specific
deliverables.
8. “Drive out fear.” Management through fear is counterproductive and prevents
workers from acting in the organization’s best interests.
9. “Break down barriers between departments.” Eliminate silos. All departments are
interdependent and become each other’s customers in producing outputs.
10. “Eliminate slogans.” It is not people who make most mistakes—it is the process in
which they are working.
11. “Eliminate management by objectives.” Production targets encourage shortcuts and
the delivery of poor-quality goods.
12. “Remove barriers to pride of workmanship.” This leads to increased worker
satisfaction.
13. “Institute education and self-improvement.”
14. “The transformation is everyone’s job.”

Source: W. Edwards Deming Institute, 14 Points for Management, Available at www.deming.org .

 The Model for Improvement

The Model for Improvement (MFI) is the most commonly used QI approach in health care and one you
will want to teach your practices. The MFI was developed by the Institute for Healthcare Improvement
(IHI) in 1996 and published in The Improvement Guide: A Practical Approach to Enhancing
Organizational Performance (1996).

The MFI uses a rapid cycle process called Plan Do Study Act (PDSA) cycles to test the effects of small
changes, make them, and ultimately spread the effective changes through the practice or organization.

 What are we trying to accomplish?

 How will we know that a change is an improvement?
 What changes can we make that will result in improvement?

Quality improvement teams then introduce and test changes designed to achieve the improvement aims
using successive PDSA cycles until they arrive on a change they believe will produce the desired results
and is ready for implementation and spread. This process is depicted in.

* The Plan-Do-Study-Act cycle was developed by W. Edwards Deming. [Deming WE. The new economics
for industry, government, education. Cambridge: Massachusetts Institute of Technology; 1994.]

You will need to be prepared to teach your practices how to use the MFI, and specifically, how to carry
out repetitive and systematic processes for testing and then implementing improvements, the PDSA
improvement cycles. Your goal will be to instill these as “habits” in your practices. Every improvement
activity they decide to undertake should be an opportunity to encourage them to take a systematic and
data-driven approach to implementing, testing, and then sustaining the change.

An essential part of introducing a culture of quality in a practice is assisting the practice to shift its focus
from individuals to processes. Organizations can often get mired in finding individuals to blame for less
than optimal outcomes, an approach that can produce a punitive and problem-focused work environment.
You can use the MFI and the basic tool of PDSA cycles to assist practices in making a shift to thinking
about their processes and systems and how they can be modified to produce better outcomes.

Too often organizations go “charging off in all directions” in an enthusiastic effort to improve. But without
discipline and the ability to assess the real effects of the improvements, these enthusiastic efforts can
yield little in terms of real outcomes. One of your roles will be to help practices develop the discipline of
using a systematic process to develop and test improvements.

The MFI and PDSA cycles are a simple yet effective “discipline” that you can help practices develop. One
of the best ways to do to this is to encourage the practice to go through the discipline of completing an
improvement form based on the MFI. The mere act of completing the form helps reinforce the idea and
build the internal discipline and skill of using a defined process for testing and adopting changes to the
usual course of business.

You will also need to know how to introduce the MFI to your practices. This can be difficult in a practice
that is enthusiastic about making improvements. It can also be difficult in a practice where buy-in to
improvement efforts is low. The enthusiastic practice may lack patience for systematic improvement work
and may have difficulty instituting the discipline needed to use the PDSA process. Practices where buy-in
is low may lack the commitment and associated energy needed to engage in a systematic approach to
change.

Use of the Model for Improvement

To use the MFI, first you will need to help your practices identify their “aims” or goals for improvement.
Often this will require you to listen “between the lines” and simplify the discussion for the practice. Large
and lofty goals are excellent for inspiration and rallying troops, but the actual work of improvement can be
mundane and tedious and involve small changes, tested, and then spread, in sequence until the goal is
attained.

Because the MFI and PDSA processes have been the primary approach to practice improvement over
the past 10 years, you may also encounter practices that have been “overexposed” to the approach. They
will need to be skilled in navigating their reactions to processes they may have used with limited success
in the past. While there can be barriers to getting a practice to use the MFI and PDSA cycles in their
improvement work, it is a “habit” that is very helpful for practices to develop. Without some type of
systematic approach, improvement work can become chaotic, ineffective, and unlikely to produce the
outcomes desired.

In addition to the MFI and PDSA cycles, there are a wide variety of QI tools that you will find helpful in
your work with practices. Some of these are covered in subsequent modules and include workflow
mapping, audit and feedback, benchmarking, academic detailing, and best practices research.
 Assessment/Quizz:

Explain each statement comprehensively and cite specific example to support your claim.

1. Briefly describe Quality Management history.

2. Define quality based on Deming’s 14 points in summary.
3. Explain the importance of quality in both a manufacturing and service businesses.
4. Describe the relationship between quality and personal functions and values.
5. Consequences of a business missing out quality in business support functions either for
manufacturing and servicing.
6. The importance of quality in practice, competitive advantage in both local and global
organizations.

ESSAY RUBRIC