Quality Review Newsletter – October 2013

On August 17, 1987, Northwest Flight 255 took off from DetroitAirport and just about made it over the overpass…just about. Six crew and 148 passengers were killed. (There was one young girl who, though badly injured, did survive.)

The aircraft was modern, the crew well trained – there are clear controls for almost every situation. What then? It appears that the flaps and slats were not fully extended to get full lift. It also appears that there was a failure to use a checklist to confirm proper configuration. Also, a breaker that provided a warning about these conditions may have been “disabled”. Our intent is not to find fault – but to use this as example that regardless how “robust” a system may be designed and implemented, our confidence must come from a clear unequivocal expectation that the organization is operating the way we expect. (I.e. The system as provided is being used.)

Design the systems for the organization, implement and then provide the means to ensure what is expected to occur does ACTUALLY continue to work as expected. Then recognize that nothing is forever. This is not profound but a truism that – when forgotten – is forgotten at our own peril! My simple message is that the only thing that is certain is that there will be change. Rather than making this article TOO dark, we will proceed, over time, to try and describe, as simply as possible, means and tools to deal with the change that will occur.

Let’s go back to our pilot and co-pilot. Why weren’t the checklists complete? Busy, distracted, complacent, tired, pressured…this could sound like any of us.  The circuit breaker being disabled because they could give “false” warnings on the runway – which could be an irritation or a distraction. Not excuses – just being human.

The ISO 9001:2008 standard we commonly refer to does not prescribe for us what we need to do. It describes for us common expectations for any management system. They are generic – Vanilla!  There is nothing in this standard that doesn’t make sense when properly applied. What is essential is that we need to mold and sculpt and craft this system in a manner that it will work for us. The standard provides a structure, but we have to understand the nature of the work we do in order to use the system in the most opportunistic manner. The actual operations of the organization can sometimes be as much of a mystery as the standard. It is our intent over the next several articles to not just clarify what is expected – we’ve done that for years – but to provide some examples – that will promote the use of the system NOW – but allow for the change that is both natural and relentless.

Back to Flight 255 for just a moment. One of the reasons we use examples with aircraft so frequently, is that even with these examples – and with close to a million miles in the air – I’m still very comfortable flying. There is great redundancy in the systems. A small additional fact is that the people providing the product/service are also going along for the ride. (There is some small comfort there.)

Think about some of our own problems, failures, non-conformances, big or small. Most happenings are not a result of one thing – but a number of things occurring – a sequence of events – which on their own might be painful, but not harmful. “For want of a nail the shoe was lost, for want of a shoe the horse was lost, for want of a horse the knight was lost…” you get the picture. If we can understand clearly the nature and expectations for our organizations, how events unfold and where and how we can apply control – we then have the best conditions for success – and unlikely to have to say, “It never should have happened”.

In the next article we will start right at the beginning with an attempt to help understand and apply the “process approach”. Articles to follow will attempt to clarify and provide the means to adapt additional system requirements to organizations’ abilities and expectations.

I usually end my articles with “the lion and antelope”. I do not do that as an “admonition” (I don’t get to use that word much), but as an understanding of the effort that “you” must make and do make. If we can help with ideas that allow you to take a little less time, to provide a little better product or service  – and allow you a little more satisfaction – that’s as good as it gets.

ISORE – Eye strain resulting from writing procedures and work instructions.

ISOAP – Detergent used to clean up before the Registration Audit.

ISO-SO – Not a full blown nonconformance; something that’s just getting by.

ISOCIAL – A party thrown to celebrate passing an ISO audit.

ISODA – Beverage served at an isocial.

ISOB – The shedding of tears resulting from receiving too many audit nonconformances.

ISOHAPPY – The pure joy of conformity!

ISONO-NO  –  Activity leading to a nonconformance.

BISON – Official ISO mascot.

ISORRY – Response to a Corrective Action Request.

ISOMETRICS – Used to measure quality objectives.

ISOLATION – How the management representative feels when introducing the new system.

The following is a typical auditing scenario that might be found when auditing an ISO 9001:2008 QMS for clause 8.2.3 Monitoring and Measurement of Processes.  Read the scenario to determine if you think it would be conforming or nonconforming, then read the answer and explanation.

Support Information – ISO 9001:2008 Clause 8.2.3

“The organization shall apply suitable methods for monitoring and, where applicable, measurement of the quality management system processes.  These methods shall demonstrate the ability of the processes to achieve planned results.  When planned results are not achieved, correction and corrective action shall be taken, as appropriate.

NOTE: When determining suitable methods, it is advisable that the organization consider the type and extent of monitoring or measurement appropriate to each of its processes in relation to their impact on the conformity to product requirements and on the effectiveness of the quality management system.”

Scenario

When auditing a car rental business, the auditor asked to see evidence of monitoring and measuring processes. The rental manager said that because they were a service business they did not have any production processes and did not need to monitor or measure their processes.

Answer

Possibly nonconforming of Clause 8.2.3 Monitoring and Measurement of Processes.

Explanation

Further clarification is required here. This may be a case of misunderstanding the standard and what a “process” really is. The standard is not just referring to production processes here and includes all types of processes, such as management, support, administration, and service processes.  Chances are that this company is already monitoring and measuring processes through internal audits, reviewing contracts, measuring customer satisfaction, customer complaints, nonconformances, and measuring how fast cars can be cleaned, etc. If none of these activities are being done, then it is nonconforming.  If they are performing some of them, then most likely they are conforming.

Other possible ‘process’ measurements could include (these do not necessarily all apply to a service orientated business):

Studies today reveal that the modern day employee feels overworked, over-regulated, under-leisured, and under-benefitted. Well, regardless of how we currently feel, conditions are vastly better than we could have hoped for 150 years ago!  Have a read through these workplace rules found in the ruins of a London office building dated 1852:

This firm has reduced the hours of work, and the clerical staff will now only have to be present between the hours of 6 a.m. and 7 p.m. weekdays.

Clothing must be of sober nature. The clerical staff will not disport themselves in raiment of bright colours, nor will they wear hose unless in good repair.

Overshoes and topcoats may not be worn in the office, but neck scarves and headwear may be worn in inclement weather.

A stove is provided for the benefit of the clerical staff. Coal and wood must be kept in the locker. It is recommended that each member of the clerical staff bring four pounds of coal each day during the cold weather.
No member of the clerical staff may leave the room without permission from the supervisor.

No talking is allowed during business hours. 

The craving for tobacco, wine, or spirits is a human weakness, and as such is forbidden to all members of the clerical staff.

Now that the hours of business have been drastically reduced, the partaking of food is allowed between 11:30 and noon, but work will not on any account cease!!!

Members of the clerical staff will provide their own pens. A new sharpener is available on application to the supervisor.

The supervisor will nominate a senior clerk to be responsible for the cleanliness of the main office and the supervisor’s private office. All boys and juniors will report to him 40 minutes before prayers and will remain after closing hours for similar work. Brushes, brooms, scrubbers, and soap are provided by the owners.

The owners recognize the generosity of the new labour laws, but will expect a great rise in output of work to compensate for these near Utopian conditions.”

“Make things as simple as possible, but not simpler.”

– Albert Einstein