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Total Quality Management in the New Century Assoc Prof Ong - arj Viputsiri Chulalongkorn Medical School, 9 August 2004 Bureau of Health Promotion, Dept of Health, MOPH The Evolution of Quality Q Concept 1 : Fitness to Standard Q Concept 2 : Fitness to Use

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Total quality management in the new century l.jpg

Total Quality Management inthe New Century

Assoc Prof Ong-arj Viputsiri

Chulalongkorn Medical School,

9 August 2004

Bureau of Health Promotion,

Dept of Health, MOPH


The evolution of quality l.jpg

The Evolution of Quality

Q Concept 1: Fitness to Standard

Q Concept 2: Fitness to Use

Q Concept 3: Fitness to Cost

Q Concept 4: Fitness to Latent Requirements


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Quality Road Map

Product Issues

Market Issues

Fitness to Standard

Fitness to Use

Fitness to Standard

Fitness to Latent

Requirements


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Future of Fitness or Quality

Q Concept 1: Fitness to Standard

Q Concept 2: Fitness to Use

Q Concept 3: Fitness to Cost

Q Concept 4: Fitness to Latent Requirements

Q Concept 5: Fitness to Corporate Governance

Q Concept 6: Fitness to Societal or Global Environment


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TQM

Total Quality Management

QA

Quality assurance

TQM

QC

QA

QC

Inspection

What is “quality” ?

TQM:

Total Quality Management

QA:

Quality Assurance

QC:

Quality Control

Inspection

What is you measure is what you manage.

“There is a very little agreement on what constitutes quality.”

Masaaki Imai.


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Evolution of Quality Concepts and Methods

standardization

statistical process control

inspection

mass

production

Fitness to standard

1950

market research

cross-functional involement

1960

Fitness to use

QC circle

7 QC steps, 7 QC tools

= Improvement methods

consumer

revolution

1970

Fitness of cost

QFD

7 management tool

Fitness to latent

requirement

competition

1980

Fitness of

corporate culture

1990

Fitness for societal and

global environment

2000

Company Focus

Customer Focus


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Focus on

customers

TQM

activities

Total

participation

Continuous

improvement

Societal networking

Four Revolutions of Management Thinking in TQM


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Four levels of quality management

Level 4:

‘Perfection’

Top performance in quality management

  • End customer

  • orientation &

  • superior service

  • Cultural

  • relignment

Level 3:

‘Prevention’

Level 2:

‘Quality

assurance’

  • Process

  • capability

  • Supplier

  • integration

Level I:

‘Inspection’

  • Improvement of

  • process stability

  • Start of worker

  • involvement

  • Quality through

  • inspection

  • Little quality

  • conciousness

  • and know-how


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  • Product

  • Price

  • Delivery

  • Quality

  • Dissatisfy

Business

Plan

Strategic

Plan

Customer

Quality

Assurance

Strategic

Market

Analysis

Customer

Feedback

System

Product design

& Planning

Time

frame

Competitive

analysis

Us

Competitor

Current

Ongoing

A

P

Process

Owner

C

D


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Identify

Targets &

Goals

  • Act:

  • Adopt

  • Abandon

  • Adjust

Identify

Strategies

to achieve

Goals

Act

Plan

Do

Train in

identified

strategies

Check

Review

Progress:

  • Against the

  • Targets & Goals

Undertake

improvement

Activity

  • Within the

  • strategy


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ISO-9000, Reengineering, and TQM

Identify A Process

Identify

Objectives & Outputs of the Process

Standardize the Process

Flowchart & Document the Process

Create manuals, Procedure & Training

ISO-9000

Redesign All Process

REENGINEERING

TQM

Identify Key Processes

Improve the Process &

Prevention of Recurrence

Analyses the Process

& Cause

No

Satisfy

Yes

Yes

Periodic Review & Report

Monitor the Process


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Fitness to STANDARD

What is standard ?

How is standard set ?

How is standard used ?


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STANDARD

  • Standard is degree of excellence.

  • Standard serves as a basis for comparison.

  • Standard is a minimum requirement.

  • Standard is a model for imitation.

  • Standard is a “ benchmark ” of achievement which is based on a desired level of excellence.

Oxford dictionary


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STANDARD

  • is an agreement established for an object, performance, capability, arrangement, state, action, sequence, method, procedure, responsibility, duty, authority, way of thinking, conception, etc. for the purpose of unification and simplification so that profit or convenience may be obtained with fairness among the people concerned.

Japan Council on Industry


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Level of Standard

  • Level of acceptability or “minimum standard”.

  • Degree of excellence or desirable or “optimal standard”.

Donabedian. 1982


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Type of Standard

  • Structure standard

  • Process standard

  • Outcome standard

Donabedian. 1982


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Focus of Standard

  • Good manufacturing practice

  • Clinical practice guideline

  • Practice standard


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How is a standard set ?

  • Collective judgement; the gold standard

  • Value based

  • Dynamic VS Static


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How is a standard used ?

  • Self-Assessment

  • Inspection by authority bodies

  • Accreditation


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Standard or Accreditation Around the World

  • National accreditation program:

    • US, Canada, Australia, & UK

  • Government legislation:

    • Spain, China, & Latin America

    • France & Malaysia

WHO/SHS/DHS/93.2


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Inspection

  • Salvage

  • Sorting, grading, reblending

  • Corrective actions

  • Identify sources of non-conformance


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Quality Control

  • Develop quality manual

  • Process performance data

  • Self-inspection

  • Product testing

  • Basic quality planning

  • Use of basic statistics

  • Paperwork control


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Quality Assurance

  • Quality system deployment

  • Advanced quality planning

  • Comprehensive quality manuals

  • Use of quality cost

  • Involvement of non-production operation

  • Failure Mode and Effect Analysis

  • Statistical process control


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TQM:Total Quality Management

  • Policy deployment

  • Involve supplier & customers

  • Involve all operation

  • Process management

  • Performance measurement

  • Teamwork

  • Employee involvement


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The Road to Quality: Organizational Analysis Model

Quality guides

Performance measures

Market share

Customer feedback

Customer satisfaction

Direction

Net profit

Return on equity

Continuous improvement

Strategy

Team

Structure

Manager to worker ratio

Motivation

Absenteeism

Turnover

Boredom

Employees

Productivity

Return on assets

Return on people

Tools

Leadership


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The Malcolm Balridge, Health Care Pilot Criteria

System

System

2.0

Information

& Analysis

Goal

Goal

7.0

Patient

3.0

Satisfaction

Driver

Driver

Strategic

Planning

1.0

Leadership

4.0

Progress

Progress

HRD &

Management

6.0

Organaizational

Results

5.0

Process

Management


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Examination Items

1. Customer satisfaction30%

2. Human resource utilization15%

3. Quality assurance of services15%

4. Quality results15%

5. Leadership10%

6. Strategic quality planning9%

7. Information & analysis6%

(Malcolm Baldrige National Quality Award Criteria)


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Stage 4:

Quality is key to customer value management

(Market leader)

Beyond TQM

Stage 3:

Market-perceived quality and value VS competitors

(Market focus)

Increase

effectiveness

  • Customer value learning

  • and innovative organization.

  • Be customer/market-driven

  • Get close to market

  • Use customer value

  • analysis

  • Be market-driven

Stage 2:

Customer satisfaction

(External focus)

  • Get close to customer

  • Understand needs &

  • expectations

  • Be customer-driven

Stage 1:

Conformance quality

(Internal operation)

  • Conformance to requirement

  • Do it right at the first time

  • Reduce reject & rework

Customer value management

TQM


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Strategy

Quality

Satisfy

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