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National Public Health Improvement Initiative (NPHII)

2011 National Public Health Improvement Initiative (NPHII)
Grantee Meeting

Atlanta, Georgia
March 30 – April 1, 2011

Quality Improvement Methods and Tools

Speakers: John Moran, PhD, Senior Quality Advisor, PHF

Description: This was an introductory session on quality improvement methods and tools. This session:

  • Described Quality Improvement (QI)
  • Reviewed the difference between Big QI and little qi
  • Described the use of the Plan-Do-Check-Act (PDCA) approach to quality improvement
  • Described the concept of Rapid Cycle PDCA
  • Provided the basic quality improvement tools in a defined sequence
  • Assisted in identifying areas needing improvement
  • Reviewed of the 7 basic quality improvement tools with a focus on Flow Charting and Cause and Effect Diagrams
  • Identified the "how's" and "why's" to "root causes" of problems
  • Clarified how QI gets accomplished in Teams
  • Explained the Top Ten Reasons QI fails and how to overcome them

Quality Improvement Methods and Tools [PDF - 3.32MB]

Questions and Answers:
Q: What is Quality Function Deployment (QFD)?

A: QFD is a process of developing customer needs into responses. QFD also is a method to capture the voice of the customer and to learn what they want and need. PHF in collaboration with the American Society for Quality (ASQ) has developed a book on QFD that can be accessed at

Q: What is the difference between run charts and control charts?

A: A control chart identifies the upper and lower control limits. A run chart is a graphic representation of process performance data tracked over time and represents continuous data.

Q: On the cause and effect diagram – what is the top box?

A: The key or major cause (materials, policies, equipment, people, etc.) would be the header or first cause that impacts the effect.

Q: What is the best method to identify from the cause and affect diagram which areas to focus on?

A: A team should focus on the area you can control in your sub causal categories.

Q: During a cause and effect diagram exercise, wouldn’t it be more useful to brainstorm the five different heading before focusing on one heading?

A: Silent brainstorming can be useful to create the five headings on your fishbone diagram. Be flexible and meet your team where they are in the process.

Q: What if you can’t control the culture at your organization, such as lateness?

A: Even if you can’t control an agency culture, which accepts lateness – you may still be able to affect it by talking about it and bringing it into the open or by arriving on time yourself.

Q: How would you define the customer if the objective of the intervention is policy development?

A: Consider who the end user of your intervention is; in this case it would be government, politicians, or citizens. Review the various touch points of customer interaction throughout the policy development process and use this information to improve the final product.

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