Timely and Helpful Article on Mentoring
After six difficult months as a safety auditor, I was asked to mentor a newly hired individual because of the quality of my work and experience within the company. I was told to take this person under my wing, show him or her around and show him or her our company’s way of conducting business.
As I do with many magazines, I turned first to the back page of my September 2004 issue of Quality Progress, and lo and behold, there was an article that clearly outlined exactly how a mentor assists (Evan H. Offstein and Jason M. Morwick, “Back to Basics: Follow My Lead,” p. 104). I enjoyed it so much that I brought the article to my boss, who suggested I write a newsletter article on mentoring so others in the company would help the new employees.
Thank you for the information. Asking and agreeing to be someone’s mentor should not be done lightly.
What Does It Mean To Act Professionally?
Debbie Phillips-Donaldson’s September 2004 editorial (“Why Should You Care?” p. 6) notes that medical errors are increasing or, at least, not lessening. She asks, “What gives?” Many years ago Fred Brooks wrote The Mythical Man-Month and asked how (software) projects get so far off schedule. He replied, “One day at a time.” Similarly, quality deteriorates day after day if constant attention is not paid to it. I’m sure most people don’t start the day intending to give bad service, but do they start the day intending to give excellent service?
Perhaps people really don’t know how to achieve excellence and need quality professionals to help. How-ever, I see people so overwhelmed with their situations that they focus on just doing good enough to get by each day. People have lost the sense that they can provide excellent service/quality. (Even good enough wouldn’t be bad if people knew how to determine what was truly good enough as opposed to just barely enough to get by.)
Healthcare may be more important because life-critical situations are involved, but the overall issue remains for any domain: The sense of excellence has either eroded substantially or was never firmly established. Even in fields with formal standards, being professional may be equated with just doing a job without complaint. Unfortunately, better service/quality often means making waves because real change has to occur.
Most nonmanufacturing, nonengineering based industries/services do not have the cultural background to deal with traditional quality approaches. I’ve noticed this in the software industry. An understanding of and concern for quality are always more evident in companies with existing engineering cultures.
If ASQ wants to urge members to move into fields without such background, some basic ideas have to be introduced, including what acting professionally really means. It has to mean more than just surface politeness toward customers. Wondering what’s wrong in particular industries is important, but the problems are not unique. They all start with how people view their work and their ability to pursue excellence.
Healthcare Not Interested In Quality Professionals
In “Why Should You Care?” Debbie Phillips-Donaldson tells us, “Healthcare is in obvious, crying need for the skills and experience of improvement specialists and systems thinkers.” She asks the equally obvious question of quality professionals: “Could this be a new opportunity for you?” The answer is, “No.”
Unless you’re a registered nurse (RN) with a background in traditional healthcare quality assurance work, the healthcare industry is simply not interested in you. It is locked into an old mind-set of what constitutes quality and how to produce it in an organization. If you want to work in healthcare quality, go back to school and become an RN. Otherwise, don’t waste your time; you won’t get noticed.
R. BARRY CROOK
6 Sigma Mistake In “Up Front” Column?
I think Debbie Phillips-Donaldson made a mistake in her September 2004 column. She says, “ ... nurses and other healthcare workers—probably at least a 6 sigma level of 99.97%—truly want to help people.”
If you look at the statistics involved and do the math, I believe 6 sigma is closer to 0.9 parts per billion. However, many people make the mistake of using the Motorola version in which the mean varies by 1.5 sigma, and they calculate 6 sigma to yield 3.4 parts per million. Phillips-Donaldson’s 99.97% yields 300 parts per million, a mere factor of 100 off.
This should probably be corrected for future articles since many in healthcare are not up to speed on these quality tools, and we don’t want to mislead and confuse them. Safety of the patient may be involved in some studies.
Baton Rouge, LA
Finding Defects Isn’t Prevention; It’s Detection
I found Don M. Nielsen’s comments about Philip Crosby in “Can the Gurus’ Concepts Cure Healthcare?” (September 2004, p. 26) to be a useful application of Crosby’s principles. However, I disagree with this statement: “By emphasizing prevention, Crosby intended for defects to be found before the final product was produced or service provided.” While this is certainly preferable to producing or providing defective products or services, finding defects isn’t prevention of defects; it’s detection.
Dr. Nielsen correctly states that Crosby stood firm on zero defects being the standard. Preventing the physical and philosophical environment that creates defects is the mind-set needed to continually move in that direction.
Downers Grove, IL
Quality Is Not Yet A True Science
Can the Gurus’ Concepts Cure Healthcare?” (September 2004, p. 25) illustrates that quality is not yet a true science. As Thomas S. Kuhn explained in his classic The Structure of Scientific Revolutions (second edition, 1970) normal science occurs when scientists are working from a single paradigm. Progress is incremental, by accumulation of more facts.
Normal science activities include:
- Making ever more precise measurements, perhaps with new tools.
- Matching fact to theory by confirming predictions or hypotheses.
- Resolving ambiguities and persistent problems by defining universal constants and quantitative laws.
Thus, normal science becomes puzzle solving. Experiments are tests of ingenuity and skill, but the theories assure the existence of a solution if you follow the rules, steps and commitments. Scientists are educated almost exclusively from textbooks of current knowledge, with rare exposure to original texts from the past and little awareness of the history of their discipline.
However, a nonscience, or the preparadigm phase of an emerging science, has such characteristics as:
- Competing schools of thought, each of which questions the very foundations of the other schools.
- There is not yet a consensus on the basics of the theory, maybe not even on the definitions.
- Sometimes the schools of thought bear the names of their founders or gurus, and their original works are still studied, even revered.
The four articles about quality in healthcare are examples of the lack of consensus and the differences in basic definitions in the practice of quality. Because statistical process control of variation is only about 80 years old, we should probably not be too impatient for a true science to emerge, though that would be a worthy goal.
TERENCE P. OSBURN
- In “A Class Act” by Dave Nelsen (October 2004, p. 66), the superintendent for the Baldrige winning Palatine school district was incorrectly identified as Robert A. McCanna. His name is Robert A. McKanna.