Compact Hospitals ? How


How  is the relationship between audit, accreditation and quality efforts? I am trying to enrich that diagram. I positioned the quality pyramid to middle(you are seeing it from top now-it was the subject of previous post)

It is really a challenging question. Because answers are quite diversified.

Every discipline has own followers and own professionals. Usually people like what they do and become enemy to the others. Accreditation is remedy of all sort of diseases for someone, Lean is the last model for some others. Internal auditing is the only essential task for auditing. … and critics: ISO is outdated, Internal audit is costly and useless, lean doesn’t suit hospitals, innovation is something which can only come from Japan or Harvard.  Read more of this post


Quality pyramid of hospitals



Your hospital must be somewhere in that pyramid. Else you can name it as low quality, high cost hospital

  • You need to have a quality assurance at the bottom.
  • Then you will have to improve your processes continuously
  • If your project includes something new, then you may name this as “innovation”
  • If you have no standard and if you don’t have an accreditation which can serve your assurance, then you should evaluate yourself as “BAD” and you must start to care for QUALITY

Read more of this post

Six sigma and Lean

Six Sigma Lean
Objective Deliver value to customer Deliver value to customer
Theory Reduce variation Remove waste
Focus Problem focused Flow focused
  Assumptions A problem existsFigures and numbers are valuedSystem output improves if variation in all processes inputs is reduced Waste removal will improve business performanceMany small improvements are better than system analysis


MIT OPEN COURSES is my last invention. It’ll be excellent source for me I hope: LINK


From craft to lean: production

Focus Task Product Customer
Operation Single Items Batch and queue Synchronized flow and pull
Overall Aim Mastery of craft Reduce cost and increase efficiency Eliminate waste and add value
Quality Integration(part of the craft) Inspection(a second stage after production) Inclusion(built in by design and methods)


Customization Economics of scale and automation Flexibility and adaptability
Improvement Master-driven continuous imrovement Expert-driven periodic improvement Worker-driven continuous improvement

Red bead game for better understanding Deming

The RED BEAD Experiment is a tool that allows workers and managers and customers to unite using a common language to find ways to treat each other with respect; get beyond the old biases and to work as a team.


The result will be to find the red bead problems that are the causes of their: rework; the wasted effort; and the changes in mind that take away our profit; our worker satisfaction and push good customers away to look for another supplier!

Read more of this post

Deming’s Seven Deadly Diseases of Management

Video from Deming’s voice can be seen: 

While the 14 Points for Management can be said to express Dr. Deming’s philosophy of transformational management, his Seven Deadly Diseases of Management describe the most serious barriers that management faces to improving effectiveness and continual improvement. The video discusses in detail the first Five Deadly Diseases. He did not include in the video number Six and Seven which he said in “Out of the Crisis” were, “Peculiar to industry in the U.S., and beyond the scope of this book.”

1. Lack of constancy of purpose to plan product and service that will have a market and keep the company in business, and provide jobs.

2. Emphasis on short-term profits: short-term thinking (just the opposite from constancy of purpose to stay in business), fed by fear of unfriendly takeover, and by push from bankers and owners for dividends.

3. Evaluation of performance, merit rating, or annual review.

4. Mobility of management; job hopping.

5. Management by use only of visible figures, with little or no consideration of figures that are unknown or unknowable.

6. Excessive medical costs.

7. Excessive costs of liability, swelled by lawyers that work on contingency fees.

*Deming, W. Edwards (2011-11-09). Out of the Crisis (pp. 97-98). MIT Press.

Lean Six Sigma related Dissertations from USA Universities

key words: (six sigma) (hospital) IN ABSTRACTS DISSERTATION

Susan Knapp Susan Knapp Assessment of the Relationship between Organizational Culture and
Six Sigma Implementation
Melissa Shirley Martell-Rojas Melissa Shirley Martell-Rojas USING SIX SIGMA TO IMPROVE PATIENT FLOW
IN A HOSPITAL Read more of this post