Quality improvement programs, like opinions, everyone has one. Okay, not every company has a quality improvement program. But for the tens of thousands of companies that do, the program is probably monikered as Six Sigma, Lean, Lean Sigma or some variation thereof. Where did these programs come from and why are they under-performing or simply failing?
A Little History
W. Edwards Deming is thought to be the foremost pioneer and number one guru of the quality movement, which started with his work in Japan in the 1950s. Deming’s book, Out of the Crisis along with Joe Juran’s The Quality Handbook appear to be the seminal text’s on quality/systems improvement in the early days. Later, quality/systems ideas morphed into Total Quality Management (TQM) which begot Toyota, Six Sigma, Lean, Lean Sigma and etc. All of these programs are designed to improve systems/processes thereby improving quality while reducing cost.
While the methodologies used in these programs is much the same as the successful ones used in Japan, the results, in general, cannot be more different. These programs are under-performing or failing as "the flavor of the month" in the vast majority of companies implementing them. Even when they are successful, in many cases the programs have proved not to be sustainable. For example, nearly every hospital in the US has one of these programs. Still, with rare exceptions, hospitals have some of the most archaic and inefficient and dangerous systems I’ve experienced in 25 years of doing systems improvement work. If you don’t believe me, don’t ask healthcare “leaders.” Most appear clueless to the conditions/systems where care is actually provided to the patient. Instead, ask the nurses. The front-lines know what is really going on while the further up the management food chain we go the less is known and the more political it becomes.
This example is not to single out healthcare. The same can be said to varying degrees for most industry segments or businesses where some sort of systems-based quality improvement program is being implemented.
Why aren’t these programs working? (more in Part II of this article)