Effective management of health and safety programs: a practical guide, 3rd edition. Moser R Jr., ed. Berverly Farms, MA: OEM Press, 2008 Mar; :403-415
During the past few decades business writers have increasingly emphasized the importance of qualiry in determining the success or failure of a company [1,2]. One of the eight attributes of successful companies discussed in "In Search of Excellence" is that of staying close to the customer by providing exceptional service and quality products . Indeed, at the time of the book's publication, the authors noted that the leading companies had almost an "obsession" with quality. Whether dealing with a product - or, in the case of most health and safery activities, a service - these organizations placed zealous emphasis on quality. In some instances, this emphasis made little financial sense in the short run, as when products with "minor" defects were discarded rather than being placed on sale. In the long run, however, the quality standards resulted in increased sales that made the organizations recognized leaders. Examples included Procter & Gamble, Caterpillar, Deere, HewlettPackard, and similar "name" businesses. In other companies, when quality was allowed to decrease, the leadership position also suffered. Today, many large and small organizations have embraced quality-improvement programs in an effort to improve "customer" satisfaction and profitability. More recently, the concept of Six Sigma, with the goal of reducing errors to 3.4 defects per million opportunities or "products," has reinforced the emphasis on quality. In essence, the theory is that products should fall within six standard deviations (six sigma), thus reducing outliers (errors) to 3.4 per million .