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Welcome
"Take a method and try it.
If it fails, admit it frankly, and try another.
But by all means, try something.“
-Franklin D. Roosevelt
1 - 2
IS 628 Total Quality Management
Welcome
Hey Prof,
I completed a major graduate internship at Montefiore Medical
Center 3
weeks ago and just received a full time offer as a supervisor at
the CMO
division at Montefiore. During my internship I did a lot of
performance
improvement work as well as Excel analysis. I must say your

class really
helped out because I was able to apply methodologies as well as
systematic tools/flow maps to help my department be more
efficient to
improve patient experience.
… 2011-2012 MBA IS628 Student
1 - 3
Grades
A
“Calculation”
(for a society that insists on the chaotic measurement of the
unknowable)
Class Participation 40%
Midterm 15%
Final 15%
Homework 15%
Project 15%
100%
1 - 4
What do I want from you?

Get it… and Live it
Knowing about something vs Knowing it
Move from education to application
Information to Transformation
Who are you…
Newbies… Introduce yourself
• Name
• Where are you coming from before class?
• Work Experience
• Hobby or Interest
• What do you want from your education?
• Expectations that the MBA will provide to you
• What specifically do you want from me?
1 - 6

DRAFT
Schedule
12
Classes
You only have me
for 36 hours.
Use me to get what
you need.
Iona IS628 TQM Winter Trimester 2015-2016
Date Class Location Subject / Guest Speaker / Comments
11/18/15 1 Iona
Getting to Know Each Other
Chapter 1. Differing Perspectives on Quality
11/25/15 No Class
12/2/15 2 Iona
Chapter 2. Quality Theory
Chapter 3. Global Quality & Int'l Quality Standards
Chapter 4. Strategic Quality Planning

12/9/15 3 Iona
Chapter 5. The Voice of the Customer
Chapter 6. The Voice of the Market
Chapter 7. Quality & Innovation in Process Design
12/16/15 4 Iona Joel Seligman, CEO of Northern Westchester
Hospital
12/23/15 No Class
12/30/15 No Class
1/6/16 5 NWH Maria Hale, VP Patient & Family Advocacy
1/13/16 6 NWH Kate O’keefe, VP Quality Management
1/20/16 7 Iona
Chapter 8. Designing Quality Services
Chapter 10. The Tools of Quality
1/27/16 8 Iona
Chapter 12. Statistically Quality Improvement for Attributes
Chapter 13. Six-Sigma Management and Lean Tools
2/3/16 9 Iona
Chapter 14. Managing Teams and Projects
Chapter 15. Implementing and Validating
2/10/16 10 Iona Presentations (2 groups)

2/17/16 11 Iona Presentations (2 groups)
2/24/16 12 Iona Wrap-up & Final
Project
Board of Trustees
Presentations During the
Last 2 Classes
1 - 8
The Board’s
Overall Strategic Initiatives
r in patient centered care
quality indicators
1 - 9

The Board has Strategic Priorities
ses starting on time
Redesign
Workflow Redesign
– Leveraging
information systems to provide vital data
What is Quality?
Chapter 1 Review
• There are different perspectives on quality.
• Quality is defined differently for products vs services
• We must define quality before talking about it.
• Quality control, quality assurance and quality management
focus on different aspects of quality
• Quality improvement requires a complex mix of factors

`
What is Quality for Products?
Product Quality Dimensions – Discuss from our perspectives
• Performance
• Features
• Reliability
• Conformance
• Durability
• Serviceability
• Aesthetics
• Perceived Quality
©
(© 2007 Pearson Education

Copyright © 2010 Pearson Education, Inc. Publishing as
Prentice Hall.
What is Quality for Services
Service Quality Dimensions – Discuss from our perspectives
• Tangibles
• Service Reliability
• Responsiveness
• Assurance
• Empathy
Lets Get This Party Started…
…The Party Don’t Start to You Walk In!
Chapter 2
Quality Theory

Quality Theory
Leading Contributors to Theory
W. Edward Deming
Deming, an American scholar whose management and
motivation theories were more popular outside the
United States, went on to help lay the foundation of
Japanese organizational development during their
expansion in the world economy in the 1980s. Deming's
theories are summarized in his two books, Out of the
Crisis and The New Economics, in which he spells out
his "System of Profound Knowledge".
Quality Theory
Deming’s 14 Points for Management
1. Create a consistency of purpose toward
improvement of product and service with the
aim to become competitive, stay in business
and provide jobs

As a leader, you need to state the same
consistent purpose over & over & over & over.
Quality Theory
2. Adopt a new philosophy:
We are in a new economic age
The customer is in charge
Zero defects
Feature rich
Inexpensive
3. Cease dependence on mass inspections to

improve quality
Engineer quality into product/service design.
“Quality at the Source” – each worker is responsible.
If you have to inspect masses, then your process is not
well designed or implemented.
Quality Theory
4. End the practice of awarding business on
the basis of price tag alone.
Build relationships with vendors for the long term
Align incentives
Quality Theory
5. Improve constantly and forever the system
of production and service, to improve quality and
productivity, and thus constantly decrease cost

Create a culture where everyone is always looking
for ways to improve the product or service.
Provide resources to the workers
Quality Theory
6. Institute training on the job.
Effective training, reinforce, monitor, retrain…
continuous.
Quality Theory
7. Improve leadership
Make quality THE priority

Provide resources necessary
Help people and machines do a better job.
Quality Theory
8. Drive out fear so that everyone
may work effectively for the
company
Fear of…
Change
Being labeled as a BMW
Losing your job due to increased productivity
Quality Theory
Deming’s 14 Points for Mgmt

9. Break down barriers between departments
Process focus vs departmental focus
Customers hate departments
Quality Theory
Food Hskpg
Floor
RN’s
MD’s Labs Consult X-Ray
Transport
HIS
Patient Care Spans All Departments
Process Redesign Crosses Functions & Departments

10. Eliminate slogans, exhortations and targets
for the workforce that ask for zero defects and
new levels of productivity
Cut the BS
Implement the fundamentals so workers can do
their job
Quality Theory
11. Eliminate work standards on the factory floor
Work Standards may result in unintended consequences.
Production quotas
Goals set without the systems to achieve them
Quality Theory

12. Remove barriers that rob workers of their
right to pride in the quality of their work
Remove the “hourly employee” phenomenon
Just putting in my time
Quality Theory
13. Institute a vigorous program of education and
self improvement
Point 6 – on the job training – is specific
Point 13 – generalized education… learning. Puts
things in context (like this course).
Quality Theory

14. Put everybody in the company to work to
accomplish the transformation
Acknowledge that quality is everybody’s priority
Quality Theory
Quality Theory
The Juran Trilogy
• Quality Planning
• Provide the operating forces with the means
of producing products that meet the
customers needs
• Quality Control
• Control vs. Breakthrough
• Reengineering vs CQI – Both are required
• Quality Improvement
• Project by project improvement

Quality Theory
Juran
Pareto’s Law (80/20 rule)
The majority of quality problems are the result of
relatively few causes.
Quality Theory
Ishikawa
• Training

• Continuous Improvement
• Statistical quality control
Quality Theory
The Rest of the Pack that Shape Current Quality Theory
• Feigenbaum - Managers are quality facilitators, not cops
• Crosby – Zero Defects
• Camp
• Peters
• Hammer & Champy
• Covey
• Nehemiah – Has Human Behavior ever evolved?

Quality Theory
Quality Theory from a Contingency Perspective
There is a mass of potentially “contradictory”
information…
…it is best to focus on fundamentals:
• What are our strengths?
• What are our competencies?
• In what areas do we need to improve?
• What are our competitors doing to improve?
• What is our organizational structure?
2 - 38
Quality Theory
Quality Theory from a Contingency Perspective
Core Fundamental Variables

• Leadership
• Information Analysis
• Strategic Planning
• Employee Improvement
• Quality Assurance
• Customer role in Quality
• Quality Department
• Environment / Infrastructure
• Philosophy Driven
• Quality Breakthrough
• Project/team-based
improvement
Theme…
Mediocre or poor performance of a
system is most often the result of…
…poor management.

Hmmmmmmmm
What is your role as umbra-manager?
What will you do differently tomorrow?
Homework
• Deming believed poor quality was not the fault of the
workers, but resulted from management. Do you agree?
Explain why or why not. (~1-2 pages)
• Select 2 of Deming’s 14 points, describe how the points
could have improved quality in a business or volunteer
organization you have been involved with. (~1 page each)
• Discuss some of the ways leaders resolve conflict in
organizations. Which of these ways have you found to be
most effective? Why?
• Why do companies that focus on their customers often
develop a set of ethics that includes valuing employees?
Please make your answer as substantive as possible.
Chapter 3
Global Supply Chain
Quality and

International Quality
Standards
• Managing Quality for the Multinational Firm
• Quality Improvement: The American Way
• Quality Improvement: The Japanese Way
• Quality Improvement: The European Way
• Quality Improvement: The Chinese Way
• ISO 9000:2000
Global Supply Chain Quality and
International Quality Standards
Chapter 3
Globalization

Managing Quality for the Multinational Firm
The Malcolm Baldridge National Quality Award
Seven Categories
1. Leadership
2. Strategic Planning
3. Customer and Market Focus
4. Measurement, Analysis and Knowledge
Management
5. Human Resource Focus
6. Process Management
7. Business Results
Quality Improvement: The American Way

Malcolm Baldridge National Quality Award
Deming Categories
Global Supply Chain Quality and International Quality
Standards
The Japanese Way -- The Deming Prize
• Policy
• Organization and operations
• Collecting useful Information
• Analysis
• Planning for the Future
• Education and training
• Quality assurance
• Quality effects
• Standardization
• Control
Anything that does not add value

for the customer should be eliminated.
The Japanese Way -- Shingo’s seven wastes
1. Waste of overproduction
2. Waste of waiting
3. Waste of transportation
4. Waste of processing itself
5. Waste of stocks
6. Waste of motion
7. Waste of making defective products
Application:
The boss says, we need to cut costs.
Here is your answer of how.

The Japanese Way -- The Five S’s
1. Seiri: Organizing by getting rid of the unnecessary
2. Seiton: Neatness that is achieved by straightening offices
and work areas
3. Seiso: Cleaning Plant and Equipment
4. Seiketsu: Standardized locations for tools and equipment
5. Shetsuke: Discipline in maintaining the four prior S’s
The Worldwide Way ISO 9000:2008
Five Clauses:
1. Quality Management Systems
2. Management System
3. Resource Management
4. Product Realization
5. Measurement Analysis and Improvement

The Worldwide Way IS0 9000:2008
Eight Principles:
1. Customer focus
2. Leadership
3. Involvement of people
4. The Process approach
5. A systems approach to management
6. Continual Improvement
7. Factual Approach to Decision Making
8. Mutually beneficial supplier relationship

The Worldwide Way IS0 9000:2008
Chapter Summary
Quality Models
Get it?
Create a culture of…
Increasing Value added

Eliminating Non-Value added (waste)
Ongoing at every moment, not just as a project
What do you think about awards?
When you are the CEO…
Will you organize your organization to get an award?
or
Will you organize your organization to be a quality (safe)
organization, and apply for an award?
What values do the awards offer us (managers)?
Chapter 4
Strategic Quality Planning
1 - 57
Vision
Desired Future
Today

Cu rre n t
Re a li t y
We (YOU) need to create a
compelling vision to
change people’s behavior
Adapted from “The Systems Thinker”
Chapter 4
• Strategy and quality
improvement
• Content
• The importance of time in
Leadership for quality
• Quality and ethics
• Quality as a strategy
• Quality strategy process
• Deploying quality

• Does quality lead to
better business results?
• Supply chain strategy
Strategy Content
Quality improvement involves identifying
potential areas for improvement and planning
the implementation of projects and
improvements
The importance of time in quality improvement
When goals are set, one of three things will occur:
1. People will achieve the goals and incur positive results

2. People will distort the data
3. People will distort the system
Problems with measuring Educational Performance
- Change answers
- Coaching during exams
- Handing out tests in advance
- Not counting weaker/ prevent from taking test
Leadership is the process by which a leader
influences a group to move towards the
attainment of superordinate goals (goals that
get people from opposing sides to come
together and work toward a common end
result).

For followers to have power, leadership
must share power.
As a result leadership is about the sharing of
power.
This power takes many forms:
• The power of expertise
• Reward power
• Coercive power
• Referent power
• Legitimate power

Quality and Ethics
Quality appears to be good business
Quality is also good ethics
“We build good ships. At a profit if we can, at
a loss if we must. But, we build good ships”
Quality as a strategy
Cost of Quality
PAF Paradigm
• Prevention Costs (training, planning)
• Appraisal Costs (testing equipment & time)
• Failure Costs (internal & external)
Prevention Costs

Failure Costs (Internal & External)
Quality as a strategy
Product/Service Differentiation through
• Cost – Low cost provider
• Focus – Market segment
• Quality – Quality as a core competency
Mature Strategic
Planning Process
Hoshin Kanri
Policy Deployment
Catchball
(Policy Deployment)
Interactive nature of teams
reporting up and feedback from

management.
Company develops a
3 - 5 year plan
Senior Executives develop the
current year’s objectives.
Does Quality Lead to Better Business Results?
Quality and
• Price
• Cost
• Productivity
• Profitability
• Environment

Quality as a Strategy
• Reviewed strategic planning frameworks to help us
achieve results
• Align vision, mission, values, strategy and operations
• Have you ever experienced mis-alignment? What
happened?
• What will you do differently?
Homework
• Deming believed poor quality was not the fault of the
workers, but resulted from management. Do you agree?
Explain why or why not. (~1-2 pages)
• Select 2 of Deming’s 14 points, describe how the points
could have improved quality in a business or volunteer
organization you have been involved with. (~1 page each)
• Discuss some of the ways leaders resolve conflict in

organizations. Which of these ways have you found to be
most effective? Why?
• Why do companies that focus on their customers often
develop a set of ethics that includes valuing employees?
Please make your answer as substantive as possible.
Go Forth…
People are the engine of
creativity and innovation
That’s YOU
Law is a system of rules that a country recognizes as regulating
the actions of people and may enforce by the imposition of
penalties. Every country has its own laws that hold their people
accountable for following and obeying. It's important to know
the laws of the country you live in or the country you visit
because you will be responsible for your actions if you are
caught breaking them. Every country had its own way on
dealing with people who committed the same crime. For
example, if you are caught stealing in Iraq you will get your
hand cut off no matter the value of the item you were caught
stealing. In the United States of America if you are caught

stealing your punishment will come down to the type of theft
you committed whether it will be petty larceny or arm robbery
and the value of the item you are caught stealing in order to
decide your punishment.
The Islamic law does not recognize any form of government
instituted by man, only a government that follows the laws of
Allah. Such is government of Saudi Arabia that forbids the
existence of any religion other than Islam and arrests and
prosecutes anyone who wears a cross or carries a bible. Islamic
law declares that there are two different types of people, those
who believe in Islam and those who don’t, and they do not
apply the laws equally.It may seem harsh but if you want to
understand Islamic law you need to understand its history. Is
Islamic law is ordered in the United States. Islamic law comes
from the holy book the Quran. These laws are strict because
they are believed to be the written word of God and if you break
these laws you are breaking God's word on the proper way to
live your life.
The proper term for Islamic law is called the Shariah law. The
Shariah law is the legal system developed from the Quran
and Hadith (the written documents from the last prophet
Muhammed). The origin differs between the two sects of Islam
Sunni and Shia. Once again if you want to understand the
Islamic law you have to understand its history. Muslims in
Arabic countries are divided into two main sects the Sunnis and
Shia. The split originates in a disagreement after the death of
the Prophet Muhammad over who should lead the Muslim
community. Sunni Muslims regard themselves as the orthodox
and the originators of Islam. The Shia claimed the right of
Muhammad's son in law Ali and his descendants to lead the
Islamic community. The Sunni and the Shia have been divided
for centuries. This is what also impacts their laws.
In America our laws are not divided by a person's religion. In
American our laws were created so all who live in the United
States should follow. In America laws differ from state to state.

For example in New Jersey there is no death penalty law.
However in the state of Texas there is a death penalty. Laws
differ from state to state because they are created to suit their
own individual state’s needs. America’s state laws are protected
under the constitution, and are allowed to create and enforce
whatever laws they want. However, federal laws are the same
across all state boards. In the United States the Constitution is
the source of the law, but it was never designed to address every
legal question. The United States Constitution provides the
groundwork for all of the laws in the United States of America.
Hence, all characteristics of the criminal justice are governed
and organized by the guarantees in the U.S. Constitution.
Though, the early history of criminal justice system was
comparatively free from intrusion by the Supreme Court, even
when it appeared that individual jurisdictions were appealing in
behavior that may have disrupted the Constitutional rights of
suspects or criminal defendants. During the past 50 years, the
court has converted more active and involved in the process of
shielding Civil Rights and giving teeth to the rights assured in
the Constitution. Inside the Constitution, there are two bases of
law, common law and statutory law. This law comes from the
judicial branch. The United States government is divided into
three branches. D's branches are the legislative branch, the
executive branch, and the judicial branch.
Though our laws are different. There are a group of people who
desire to have a different set of laws applied to them here in the
United States of America. Muslims who follow the
political/religious crusade called Islam and their law called
Sharia. Muslims appearing in various courts in America have
requested to have their Sharia laws applied to them in place of
our civil and criminal laws. Though it has been ruled out. This
has become so repetitive to some legislators have started to
worry that there would be two diverse laws and Sharia would
become an additional for the Constitution. The state of

Oklahoma passed a law that would prevent courts within the
state to implement any religious or international law and the
U.S. Court of Appeals settled with lawyers representing the
Hamas terrorist supporting group CAIR to overturn the
Oklahoma law because it would categorize against Muslims.
One more important aspect is that Muslim scholars do not see
Islam as an "evolving” religion. Meaning that the legal and
ethical values of Islam do not change with the times but are
constant and perpetual for all ages and times. However, as will
be debated, there are many differences of the application of
Sharia in the Islamic world. But even these differences are still
founded on the one essential binding characteristic of Islamic
law - namely, the Qur'an.
While fairness is one of the foundations of the United States
law, a non-Muslim, under Sharia, is not permitted to inherit any
part of the estate of a deceased Muslim. Under Sharia law
Muslims are allowed to commit acts of violence that is not
allowed in civil law. This was taken out in a New Jersey court
that originally ruled a Muslim man could beat his wife. Sharia
law prohibits freedom of speech, treats women as less equal to
their male counterparts in cases of rape and adultery and family
disputes. Sharia law calls for the most barbaric a heartless
treatment of anyone convicted for petty crimes of theft with
penalties of cutting off hands and feet. Sharia law says that no
one may criticize Islam or even use the texts in the Koran or the
life of Mohammad that would cause humiliation to Muslims. In
plain language, Sharia law is a conflict to the laws of the United
States of America. If Sharia law would be allowed in our courts
it would be virtually unmanageable to prosecute any Muslim for
any crime in contradiction of a non-Muslim or even against the
United States of America, itself.
There is really no association between American law and Sharia
law. There is a very piercing difference. There are no
illustrations in which I know where the laws of the United

States don’t include adultery or homosexual affairs. It is the
accountability of the people to account for themselves. While
the Sharia law would put to death anyone who would commit
adultery and or fornication. A woman would be put to death not
a male. In America, if a woman were to commit adultery she
would not be put to death by stoning. She would just have to
face penalties of her actions if her spouse were to find out. The
Sharia does not separate church and state. The church is the
state. In The Unites States they are both separate entities.
References
shariainamerica.com/
http://www.huffingtonpost.com/2013/07/29/sharia-law-usa-
states-ban_n_3660813.html
http://www.thepoliticalinsider.com/muslims-try-pass-sharia-
law-alabama-citizens-say-hell-watch/
http://topics.nytimes.com/top/news/us/series/american_exceptio
n/index.html
http://topics.nytimes.com/top/reference/timestopics/subjects/j/ju
dges/index.html
http://www.upi.com/Top_News/US/2013/05/19/Under-the-US-
Supreme-Court-Islamic-law-in-US-courts/64481368948600/
http://topics.nytimes.com/top/reference/timestopics/subjects/s/s
haria_islamic_law/index.html

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