The Pyzdek Institute has been notified that Thomas Pyzdek has received the Lean & Six Sigma Leadership Award from the American Quality institute. The award was for:

“Your willingness to inform, share and inspire others in the Lean & Six Sigma Community.”

The Pyzdek Institute was informed of the award by Sermin Vanderbilt, President, The International Lean & Six Sigma Conference on August 8, 2010.

Thomas Pyzdek has written over 50 copyrighted works, including such classics as The Six Sigma Handbook, The Quality Engineering Handbook, and The Handbook for Quality Management. Pyzdek’s work is widely acclaimed for its ability to make the seemingly complex subject of process excellence understandable. Pyzdek is the author of all of the training courses offered by The Pyzdek Institute.

At least 211 people are in unmarked or unrecorded graves in Arlington National Cemetery, according to Stars and Stripes. Army officials announced the findings of an investigation into Arlington that found remains buried in graves listed as empty, unmarked graves and improperly handled cremated remains. The inspection found that 117 grave sites marked as occupied on maps did not have headstones. An additional 94 grave sites were supposedly unoccupied, but each had a headstone. And some grave sites were not on maps at all. The report also said at least four urns were discovered in a pile of dirt used to fill graves. One was re-buried as an “unknown” because it had no markings on it.

The problems uncovered by the probe could be the tip of the iceberg. “There could in fact be more [problems],” said Lt. Gen. R. Steven Whitcomb, Army Inspector General.

The findings caused outrage and grief among veterans and their loved ones. House Armed Services Committee chairman Rep. Ike Skelton, D-Mo. said “Arlington National Cemetery is a sacred shrine and it breaks my heart to learn about mismarked grave sites, mishandling of remains, missing documentation and failures to notify next-of-kin,” Skelton said in a news release. “This conduct is disgraceful and cannot be tolerated.”

The problems are, of course, avoidable.  Army Secretary John McHugh has vowed to fix the problems. Retiring Arlington Superintendent John Metzler “acknowledged that map inaccuracies were a systemic problem, but evidence indicated he failed to adequately inquire into these discrepancies to ensure they were properly resolved,” the report said. The Associated Press reports that Mr. Metzler has decided to retire early.

Quality problems have been aggressively addressed for over a century in the manufacturing sector and numerous scientific breakthroughs have reduced manufacturing problems to the parts-per-million range. However, other sectors have lagged seriously behind in adopting modern quality and process excellence techniques. The Washington Post reports that Arlington National Cemetery, with over 300,000 graves, may have hundreds or even thousands more missing or misidentified graves. If this turns out to be true, it is certainly a horrific black mark on American Quality.

New iPhone Customers Got Another AT&T Surprise

As an AT&T and iPhone user I am often surprised at the poor level of service the former “Phone Company” monopoly provides to its customers. For example, although I can see the AT&T cell tower from my Tucson home, I frequently experience failed calls, dropped calls, choppy reception and other poor quality phone service. At my vacation home in Pinetop, Arizona there is no 3G service and I am charged the same data rates as I’d incur if I were traveling overseas. I recently “solved” these problems by purchasing an AT&T MicroCell tower, an expensive device that AT&T sells to its hapless customers to improve call quality. At least I get decent call quality at home (of course, I still burn my plan minutes even though there is no usage of AT&T’s cell network.)

Today, June 7, AT&T went to new lengths to annoy existing and potential customers. A few hours ago Apple announced its new iPhone 4.0. My grown son has been wanting an iPhone for quite some time and I had the thought that I could add him to my plan and save a few bucks. I also wanted to know if I could grandfather him in on my unlimited data plan. AT&T announced a few days ago that they were discontinuing the unlimited data plan and charging new customers for data usage. Of course, I learned that I couldn’t grandfather my son in. However, I thought there might be some option that could save us a few dollars. After listening to the agent on the phone for a while I became confused by all of the options and decided to do some research online. Alas, all I could see at the AT&T site was the message “Due to a system upgrade the site is temporarily unavailable…” In other words, on the day that Apple upgrades the iPhone, which is used by more AT&T customers than any other phone, AT&T decides to upgrade their wireless site in the middle of the day.

Apparently “The Phone Company” has yet to understand that they now have competition. Hopefully Apple will seriously consider allowing some of that competition to carry their phone. Until then I’ll be looking at the silver lining: my AT&T customer experience will certainly continue to provide fodder for this blog!

ASQ’s Six Sigma Forum is sponsoring a combination expert panel/roundtable discussion (based on the café model that ASQ has been using for discussions) on Wednesday morning, May 26, at WCQI from 8 am – 10 am.  Attendance has been capped for the session at 64 attendees, who will be arranged in tables of eight.  There will be six sigma related topics assigned to each table.  There will be a subject matter expert at each table. If you’re planning to be at the WCQI conference in St. Louis, sign up and join Tom at a table!

Donald Berwick

Donald Berwick, a Harvard University professor and leading advocate for improving health-care quality and efficiency, has been named by President Obama as his choice to head the Centers for Medicare and Medicaid Services (CMS.) Berwick is well-known in Quality circles for aggressively advocating quality improvement in healthcare. Berwick, who specializes in health-care policy and pediatrics, has never led such a large organization. As head of the Boston-based Institute for Healthcare Improvement, however, he is known for persuading doctors and hospitals to adopt innovative methods for reducing medical errors. Dr. Berwick is author of numerous articles and books, including the classic work demonstrating the application of quality technology to health care issues, Curing Health Care. He is one of the nation’s leading authorities on health care quality and improvement. He is also Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, and Professor in the Department of Health Policy and Management at the Harvard School of Public Health.

If confirmed by the Senate, Berwick will face a number of daunting challenges. One is the sheer size of the CMS, which is about to become even larger. The agency, which is part of the Department of Health and Human Services, must oversee a massive expansion of Medicaid, the federal-state insurance program for the poor, with an estimated 16 million people expected to join its rolls by 2020. At the same time, Medicare, the insurance program for the elderly, will need to reduce payments to health-care providers by about $400 billion over 10 years without impacting the quality of coverage. Lean Six Sigma and Quality technologies provide an approach for doing this while minimizing the impact on value-added health care processes, operations and activities. Berwick’s familiarity with these areas provides reason for optimism or, at least, hope. This blog has frequently posted examples of poor quality in health care. Let’s hope that Dr. Berwick will have a positive impact at CMS.

The Associated Press reports that firms which use the Just-in-Time system are experiencing problems due to the Iceland volcanic eruption. The strategy of keeping inventories lean paid off for U.S. manufacturers during the recession. Just-in-time delivery of parts makes even more sense when budgets are tight.Now that a giant ash cloud from a volcano in Iceland is disrupting global air freight, some manufacturers are finding that this strategy is backfiring. Nissan suspended production at two Japanese auto assembly plants Tuesday and BMW was forced to idle three plants in Germany because of shortages of critical parts. Computer maker Dell is experiencing delays in getting notebook computers to European customers.

These kinds of production delays could lead to higher prices for a number of everyday items — from cell phones to seat covers, experts say. And some say the disruption from the volcanic ash cloud will lead companies to make changes in the way they do business.

That would be a mistake. JIT is an integral part of Lean Production, you can’t have Lean without it. Lean pays off every day, 24/7/365. Well, perhaps 24/7/365-days lost due to volcanic activity. The difference in total cost over any reasonable period of time between carrying “just in case of a volcano-type event” inventory and JIT will be hugely in favor of JIT. Let’s hope industry can avoid swallowing the silly pill and stick with what has proven itself to be a success over a period of decades, rather than overreacting to a once in several decades event.

Forbes.com reports that six of the seven worst cars on the road are produced by either GM or Chrysler Corporation, the two auto companies which received billions of dollars in government bailout funds. Sadly, the seventh car on the list is also American made, a Ford product.

GM has experienced a surge in sales in recent months. Unfortunately just because GM’s cars are selling well now doesn’t mean they’re the best bet for durability or value — yet. If quality isn’t improved, it is not likely that the improved sales can be sustained. The public may be attracted to low price for a while, especially during a prolonged recession. But history shows that premium quality creates customer loyalty in the long run. For example, despite the headlines regarding Toyota’s recent quality problems, their sales continue to be impressive, both among existing as well as new customers. The message is that, in the long run, quality pays.

The North Carolina Medical Board recently reviewed a case where doctors and interns tried to induce labor on a patient, and then performed a Caesarean section, but found there was no baby inside the woman’s womb, Foxnews.com reports. Apparently an intern did an ultrasound before the surgery and could not find a heartbeat. It was at this time that the patient convinced doctors to induce her. The medical board said the intern did not have enough experience to make the “appropriate diagnosis.”

No kidding.

It was determined that the patient suffered from pseudocyesis, which is the medical term for “false pregnancy.” A person suffering from pseudocyesis may often have all the same signs and symptoms as a person who is actually pregnant, but there is no fetus.

While I accept the likelihood that pseudocyesis was the patient’s root problem, I am curious about the failed ultrasound. As father of three and grandfather of two I’ve seen a few fetal ultrasounds. Although I’m not expert enough to use them for diagnoses, I think even I could determine if a full-term fetus was there or not.

The desperate need for process improvement in healthcare continues to blare forth in the headlines. I may need to start a regular feature on the subject!

Fox News reports that e-mail messages obtained by a Freedom of Information Act request reveal that NASA concluded that its own climate findings were inferior to those maintained by both the University of East Anglia’s Climatic Research Unit (CRU) — the scandalized source of the leaked Climate-gate e-mails — and the National Oceanic and Atmospheric Administration’s National Climatic Data Center.

Earlier this month a report by Christopher Horner revealed that 3 of the 4 data sets used to evaluate climate change were tainted. Not only that, all four data sets have a great deal of overlap. Since the data sets are not independent, analysis based on them cannot be viewed as providing independent verification, as has been claimed by climate change advocates.

In Lean Six Sigma projects we spend a great deal of time in the Measure phase. My training courses have more modules in the Measure phase than in any other. I do this for a reason: garbage-in-garbage-out. No amount of analysis can fix bad data, so if the measurements aren’t trustworthy there’s no point moving into the Analyze and Improve phases. When data are being used for something as important as public policy, the need for data excellence is even more urgent. The politics of climate-change and the money involved may make it tempting to cut corners on assuring measurement quality. It’s certainly less glamorous than sensational predictions and it’s unlikely to grab many headlines (other than this one.) But it must be done if science is to be done right. And science that guides public policy and the expenditure of billions in tax dollars and trillions in economic impact must be done right.

Ready-Fire-Aim. Once again the healthcare profession finally gets around to looking at data, only to discover that it is actually harming patients by treating them. The Los Angeles Times reports that a major nationwide trial called ACCORD released Sunday show that lowering either blood pressure or cholesterol levels below current guidelines do not provide additional benefit and, in fact, increase the risk of side effects. A third arm of the study, released two years ago, shows that lowering blood sugar levels excessively actually increases the risk of heart disease.

The Lean Six Sigma and Quality professions learned long ago that there is no substitute for facts and data. In pursuing Lean Six Sigma so many myths are exploded that we soon come to question any so-called fact that can’t be supported with evidence, with the important exception of creative ideas and innovation. As time goes by the value of this position becomes obvious. As change agents trained in the approach move into positions of leadership the organization’s DNA begins to change.

In most industries mistakes result in an economic loss. Although serious, it is usually possible to learn from mistakes and improve. In contrast healthcare mistakes create health consequences, sometimes as serious as death. Yet the healthcare profession remains incredibly resistant to using facts and data to guide their recommendations and treatment. The ACCORD study is but the latest example. A few years ago the ENHANCE study produced similar lessons regarding the treatment to prevent heart disease. Other studies show that low cost diuretics are as effective as the high priced prescription medications normally prescribed. Another study showed that the standard treatment for sudden deafness is no better than a placebo. Still another showed that the standard of care for certain breast cancers was based on fraudulent research and killed patients.

All of these studies have a number of things in common. All were conducted to verify treatments that had been in use for many years. All showed that the treatments were either worthless, or worse than worthless. And most have been largely ignored by the healthcare profession.

It’s anyone’s guess when the healthcare profession will join the business community in embracing process improvement. Let’s hope it happens soon, before change is forced upon them.