This document discusses three influential quality management experts: W. Edwards Deming, Joseph M. Juran, and Philip B. Crosby. It outlines their key contributions which helped revolutionize quality practices. Deming emphasized continuous quality improvement and introduced the PDCA cycle. Juran developed the quality trilogy of quality planning, control, and improvement. Crosby defined quality as conformance to requirements and advocated preventing errors rather than inspection. Together, these experts transformed approaches to quality management.

1. Authors of quality
By /Mahmoud Shaqria
‫شقريه‬ ‫محمد‬ ‫محمود‬

2. Out lines:
• Definitions of quality
• Factors that determine quality of patient care
• Authors of quality
–W. Edwards Deming
–Joseph Moses Juran
–Philip B. Cosby (Phil Crosby)

3. • How to measure quality:-
–Developing standards
–Criteria
–Clinical indicator
–Auditing.
–Peer review.

4. Definitions
- Quality: is to satisfy customers.
- The American National Standards Institute (ANSI) and
American Society for Quality (ASQ) define quality as “the
totality of features and characteristics of a product or service
that bears on its ability to satisfy given needs”.
- Quality is the degree to which patient care services increase
the probability of desired patient outcomes and reduce the
probability of undesired outcomes given the current state of
knowledge.

5. Factors that determine quality of
patient care:
• Accessibility to care: the ease with which a patient can obtain the
care he/she needs.
• Timeless of care: the degree to which care is made available to a
patient when it is needed.
• Effectiveness of care: the degree to which the care rendered is
provided in the correct manner, given the current state of the art.
• Efficacy of care: the degree to which a service has the potential to
meet the need for which it is used.
• Appropriateness of care: the degree to which the care received
matches the needs of the patient.
• Efficiency of care: the degree to which the care received has the
desired effect with a minimum of possible effort, expense, or
waste.

6. • Continuity of care: the degree to which the care needed by the patient is
coordinated effectively among practitioners and across organizations and time.
• Privacy of care: the rights of a patient to control the distribution and release of
data concerning hisher illness, including information provided to health care
professionals and any additional information contained in the medical record
andor other source documents.
• Confidentiality of care: information the health care team obtains from or about a
patient that is considered to be privileged and thus, expect in specified
circumstances that may vary by illness and jurisdiction cannot be disclosed to a
third party without the patient's consent.
• Participation of patient and patient family in care: patient (or patient family)
involvement in the decision-making process in matters pertaining to hisher
health.
• Safety of care environment: the degree to which necessary spaces, equipment,
and medications are available to the patient when needed.

7. Authors of quality
–W. Edwards Deming
–Joseph Moses Juran
–Philip B. Cosby (Phil Crosby)

9. Quality Authors:-
• W. Edwards Deming, Joseph M. Juran, and Philip B.
Crosby are regarded as true "management gurus
‫"معلنون‬ in the quality revolution.
• Their insights ‫رؤيتهم‬ on measuring, managing, and
improving quality have greatly influenced the
practices that organization use today.

10. W. Edwards Deming (October 14, 1900 -
December 20, 1993)

11. Life and career

12. • Deming was trained as a statistician and worked for
Western Electric during its pioneering era of statistical
quality control development in the 1920s and 1930s
during World War ІІ he taught quality control courses as
part of the national defense effort.
• After the World War he invited to Japan to teach
statistical quality control concepts. By the mid-1970s, the
quality of Japanese products exceeded that of western
manufacturers, and Japanese companies had made
significant penetration into western markets.

13. • Deming received Japan's highest honor, the Royal
Order of the scared treasure.
• Deming was unknown in the United States until 1980
when NBC aired a white paper entitled "If Japan can
…why cannot we?" this program made Deming a
house hold name among corporate executives, and
competencies such as Ford invited him to assist them
in revolutionizing their quality approaches.

14. • Deming worked with passion until his death in
December 1993 at the age of 93.
• W. Edwards Deming is considered by many to be the
pioneer in quality management. An advocate for the
principle of management for quality, he found that 80%
- 85% of problems are with the system; only 15% - 20%
are with workers.

15. ‫ملخص‬Deming philosophy synopsis
• Unlike other management gurus and consultants,
Deming never defined or described quality
precisely.
• Deming stressed that higher quality leads to
higher productivity, which in turn leads to long-
term competitive strength.

16. The Deming chain reaction :
• Improve quality.
• Decrease costs with fewer mistakes, less rework,
fewer delays, and better use of time and
materials.
• Improved productivity.
• Capture the market with better quality at lower
prices.
• Stay in business.
• Provide jobs.

17. • Dr. Deming's philosophy was summarized by
some of his Japanese proponents ‫المؤيدين‬ with
the following 'a'-versus-'b' comparison:

18. (a) When people and organizations focus primarily on quality,
quality defined by the following ratio:
Then quality tends to increase and costs fall over time.
( b) However, when people and organizations focus primarily on
cost, (often dominant ‫/المستيرر‬typical human behavior) then costs
(due to not minimizing waste, ignoring amount of rework
occurring, taking staff for granted, not rapidly resolving
disputes ‫الخالفتت‬ and failing to notice lack of product improvement
plus, over time, loss of customer loyalty) tend to rise and quality
declines over time.

19. The Deming System of Profound ‫العميقه‬
Knowledge
• "The prevailing ‫العت‬ style of management must undergo
‫يخضع‬ transformation . A system cannot understand
itself. The transformation requires a view from outside.
• It provides a map of theory by which to understand the
organizations that we work in.

20. • "The first step is transformation of the individual. This
transformation is discontinuous. It comes from
understanding of the system of profound knowledge.
• The individual, transformed, will perceive new meaning
to his life, to events, to numbers, to interactions
between people. "Once the individual understands the
system of profound knowledge, he will apply its
principles in every kind of relationship with other
people.
• He will have a basis for judgment of his own decisions
and for transformation of the organizations that he
belongs to.

21. The individual, once transformed, will:
• Set an example.
• Be a good listener, but will not compromise
‫.خضوع‬
• Continually teach other people.
• Help people to pull away from their current
practice and beliefs and move into the new
philosophy without a feeling of guilt about the
past.

22. Deming advocated that all managers need to
have what he called a System of Profound
Knowledge, consisting of four parts:

23. • Appreciation of a system: understanding the overall
processes involving suppliers, producers, and customers (or
recipients) of goods and services.
• Knowledge of variation: the range and causes of variation
in quality, and use of statistical sampling in measurements.
• Theory of knowledge: the concepts explaining knowledge
and the limits of what can be known
• Knowledge of psychology: concepts of human nature.
Parts of System of Profound Knowledge

24. Deming's 14 points :
Deming offered fourteen key principles for
management for transforming business
effectiveness

25. • Create constancy of purpose toward improvement of product and
service, with the aim of becoming competitive, staying in
business and providing jobs.
• Adopt the new philosophy. Western management must awaken
to the challenge, must learn their responsibilities and take on
leadership for change.
• Cease dependence on mass inspection ‫متع‬ ‫الم‬ ‫تل‬ ‫الث‬ ‫نتن‬ ‫.الكت‬ Build
quality into the product from the start.
• End the practice of awarding business on the basis of price tag
alone. Instead, minimize total cost. Move towards a single
supplier for any item, based on a long-term relationship of loyalty
and trust.

26. • Improve constantly and forever the system of production and
service to improve quality and reduce waste.
• Institute training and retraining.
• Institute leadership. The aim of supervision should be to lead
and help people to do a better job.
• Drive out fear so that everyone may work effectively for the
company.
• Break down barriers between departments. People in research,
design, sales and production must work as a team, to foresee
and solve problems of production.
• Eliminate slogans ‫تعترا‬‫ت‬‫,الش‬ exhortations and targets for the
workforce as they do not necessarily achieve their aims.

27. • Eliminate numerical quotas ‫ي‬ ‫توا‬‫ت‬‫العش‬ ‫تتثت‬‫ت‬‫س‬ ‫ال‬ in order to
take account of quality and methods, rather than just
numbers.
• Remove barriers to pride of workmanship.
• Institute a vigorous program of education and re-training
for both the management and the workforce.
• Take action to accomplish the transformation.
Management and workforce must work together.

28. Deming's seven deadly diseases of
management

29. • Lack of constancy of purpose to plan products and services
that will have a market and keep the company afloat.
• An emphasis on short term profits and short term thinking
(just the opposite from constancy of purpose to stay in
business), fed by fear of unfriendly takeover ‫,االستهيال‬ and by
demand from bankers and owners for dividends ‫صص‬ ‫.ال‬
• Evaluation of performance and annual reviews.
• Mobility of managers and job hopping.
• Management by use only of available data.
• High medical costs.
• High costs of liability.

30. PDCA Cycle (The Deming Wheel)

31. • Walter Shewhart originated the concept of the PDCA cycle
and introduced it to Deming.
• Deming promoted the idea widely in the 1950s and it
became known as the Deming Wheel or the Deming cycle.
• The PDCA (Plan-Do-Check-Act) cycle consists of four steps or
stages which must be gone through to get from `problem-
faced' to `problem solved.’ Repetition of these steps forms a
cycle of continual improvement:
• Plan for changes to bring about improvement.
Do changes on a small scale first to trial them.
Check to see if changes are working and to investigate
selected processes.
Act to get the greatest benefit from change.

32. • According to Juran this concept was based on
five quality characteristics:-
– Technological (e.g. strength)
– psychological (e.g. beauty)
– Time-oriented (e.g. reliability)
– Contractual (e.g. guarantees)
– Ethical (e.g. sales staff courtesy)

33. Joseph M. Juran

34. Life and career
• He is considered the leader of the quality
management of the last 70 years. The influence
of the scripts ‫تتت‬‫ت‬‫المخرور‬ he has written is
considered the core of quality management.

35. • Juran like Deming was involved with Japanese in the 1950.
In 1951 he wrote, edited, and published one of the most
comprehensive books on quality, (the quality control
handbook).
• To Juran , qualities means fitness to serve, correct service
the first time to meet customers' needs, and freedom from
deficiencies.
• Quality requires identification of customers and their needs
in a product-by-product and step-by-step process.
• He attributed with addressing the costs of poor quality,
which include wasted efforts, extra expenses, and defects.

36. • Juran's philosophy of quality is based on three major
premises: quality planning, quality control, and
quality improvement.
• According to Juran, this quality trilogy can be grafted
onto the strategic planning processes.

37. • Juran's definition of quality
• Is Fitness for use. He uses this in the context if
a user-based view signifies ‫هثتين‬ that quality lies
with the actual use of a product or service

38. Juran's Quality Trilogy
• Quality planning: creates a process for meeting
goals under operating conditions.
– Identify customers, both internal and external.
– Determine customer needs.
– Develop product features that respond to customer
needs.
– Set goals that meet needs of customers and suppliers.
– Develop process to produce the product features.
– Prove process meets quality goals during operations.

39. • Quality control : Is performed by operations
personnel who put the plan into effect by identifying
deficiencies, correcting them, and monitoring the
processes. Quality control includes the following:
– Choose what to control.
– Choose units of measurement.
– Establish measurement.
– Establish standard of performance.
– Measure actual performance.
– Interpret the difference.
– Take action on the difference.

40. • Quality improvement: includes the following:
– Prove the need for improvement.
– Identify projects for improvement.
– Organize to guide the projects.
– Diagnosis to find the causes.
– Provide remedies.
– Proveremedies are effective under operating
conditions.
– Provide for control to hold the gains.

41. Philip B. Crosby(1926-2001):

42. Life and career
• Crosby was born in West Virginia in 1926. A graduate of Western
Reserve University, he saw service in the navy ‫ترو‬‫ت‬‫االس‬ during
World War II and again during the Korean War, in-between he
completed a degree at Ohio College of Podiatric Medicine.
• He started his working life on the assembly ‫لت‬ ‫م‬line in 1952 at
Crosley Corporation, later moving on to Bendix Corporation in
1955. After two years he left to become a senior quality engineer
for The Martins Company in Florida; it was there where he
developed and first implemented the Zero Defects concept.
• After working his way up, in 1965 Crosby became Corporate Vice-
President ‫ي‬ ‫التر‬ ‫ت‬ ‫نت‬ and Director of Quality at ITT Corporation for
14 years.

43. • As a result of the interest shown in Quality is free, he left ITT
Corporation to set up his consultancy company, Philip Crosby
Associates Incorporated ‫تت‬‫ت‬‫نهتث‬ ‫تتق‬‫ت‬‫,أنش‬ and started to teach
organizations quality principles and practice as laid down in
his book.
• In 1985 his company was floated for $30 million. In 1991 he
retired from Philip Crosby Associates to launch Career IV Inc, a
consultancy advising on the development of senior
executives.

44. Crosby defines quality as conformance‫الهوافق‬ to
requirement. He believes that the system for
creating quality is prevention of errors instead
of appraisal.

45. Crosby has identified 14 steps to quality
improvement:
• Commitment for management.
• Use of quality management teams composed
of people with process knowledge and
commitment to action.
• Quality measurement to identify areas that
need improvement and change.
• Measuring the cost of quality and non-quality.
• Quality awareness by all personnel.

46. • Corrective actions through opportunities for
improvement.
• Zero defects planning-do it right the first time.
• Employee education for quality improvement.
• Zero defect days as demonstration ‫وص‬ of
commitment to quality.
• Goal sitting toward zero defects.
• Error-causal removal by removing barriers.

47. • Recognition for meeting goals.
• Quality councils to assist people in quality
improvement.
• Do it all over again.

48. Crosby defines quality by four
absolutes ‫أساسيات‬
• Quality is "conformance to requirements". If the
process is done right the first time, there is no need
to redo it. Management sets the requirements and
supplies the wherewithal to employees to do the job
by encouraging and help.
• The system of quality is prevention rather than
appraisal.

49. • A performance standard of zero defects. A policy
should be to deliver defect-free products on time.
• The measurement of quality is the cost of
nonconformance ‫مهوافتتتتق‬ ‫,الغيتتتتر‬ because service
companies spend half of their operating expenses on
the cost of doing things wrong.

50. Thank you….