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Step 5: Control

Step 5: Control continued


Quality Tool:
Control Spreadsheet
Control Chart
Audit the Controls
Mistake Proofing
Failure Mode and Effect
Analysis

Control Spreadsheet

Control
Spreadsheet

A quality control spreadsheet summarizes


the plan of action for a process out of
control. It usually includes:

Control variable (what is measured)


How measured
Where and "when measured
Standard
Who analyzes
Who acts
What is done

Control Spreadsheet

What
Done

Who
Acts

Who
Analyzes

Check staff
and
equipment
status.
Check status
of changing
rooms.
Advise
technicians/
radiologists.

Clinic
administrator

Receptionist

Standard
7 (Seven)
minutes
maximum

Where
Measured

How
Measured

Control
Variable

Reception
area

Difference
between
appointment
time and
time seen by
Physician

Minutes in
waiting
room

Control Charts

Audit the
Controls

Effective audits answer two


questions:
The intended results being
achieved?
Are the quality controls being
followed?

Audit the Controls continued


To ensure that its work
continues to be effective, a
team needs to include the
following in its remedy:
Routine reporting of results.
Clear documentation of
controls.

Audit the Controls continued


Report Results

Routinely reported to a level of


management prepared to monitor
progress and respond if gains are not
held.
If admitting times from the Emergency
Room have been improved, then
performance-actual times for
admissions from the ER-might be
included in a monthly quality report
delivered to the Quality Council and the
management teams for Admitting and
the ER.

Audit the Controls continued

Document Controls
Cleary document all the critical
elements of the control process so
they can be effectively audited.
One way to do this is to develop a
quality control manual that
documents all the organization's
quality control systems in terms of
goals, measurements, and
feedback loop responsibilities.

Mistake
Proofing

To determine methods that will


ensure that a process will not allow
defects.
To ensure that tasks can only be done
the right way.
A mistake is any wrong action or
statement proceeding from faulty
judgment, inadequate knowledge, or
inattention.
A mistake is an action; a defect is the
result.
You may have heard the term pokayoke, which is Japanese for a

Poka-yoke or mistake proofing


helps operators (employees)
work more easily and
eliminates troubles
associated with defects. Even
if an operator makes a
mistake, poka-yoke measures
will prevent a defect from
being passed on to the next
step in the process.

This will further reduce costs by


eliminating inspection time.
Were surrounded by mistake proofing.
Electric coffee pots have automatic shut-offs.
bathroom or outside electric circuits have
ground fault
interrupter circuit breakers,
medicines are sold in tamper-proof packaging
and child-proof containers,
computers ask, Are you sure? after the user
selects important operations such as to delete
or to close a program

When to use
When a process step has been identified
where human error can cause mistakes or
defects to occur, especially in processes that
rely on the workers attention, skill or
experience.
In a service process, where the customer can
make an error which affects the output.
At a hand-off step in a process, when output
or (for service processes) the customer is
transferred to another worker.
When a minor error early in the process
causes major problems later in the process.
When the consequences of an error are
expensive or dangerous

and
Effects
Analysis

Stage to Use:
Identify opportunities for
Improvement and the most
important control subjects.

Purpose:
To examine a prospective
design for possible ways in
which failure can occur so that
actions can be taken to
eliminate the possibility of

Failure Mode and Effects Analysis continued


Steps in Failure Mode and Effects
Analysis

1. Set up a process flow diagram.


2. Retrace the process flow diagram, assuming the worst,
to figure out what could go wrong along the way.
3. Decide what the effects of failure might be on the
reminder of the process.
4. Rank the estimated possibility of occurrence using the
following scale: 1= remote possibility; 5 = possibility;
and 10 = almost certain
5. Rank the estimated severity of the overall failure using
the following scale: 1 = will not cause patient harm; 5
= may affect patient adversely; and 10 = injury or
death will occur.
6. Rank the estimated like hood that failure will be
detected before accident takes place: 1 = will always
be detected; 5 = might be detected; and 10 =
detection not possible.
7. Calculate the "Critical index" (multiplying numbers of

Failure Mode and Effects Analysis continued


Failure Mode and Effects Analysis Form Entry
Explanation
1.Item - Item to which analysis applies.
2.Analysis Engineer - An engineer in charge of
design project.
3.Function - Function of the item as user perceives
it. This description should be as broad as
possible.
4.Mode of Failure - A mode in which the item will
fail as perceived by user.
5. Mechanism and Ca use of Failure - What
causes failure to occur?
6. Effects of Failure - What effects will this
failure have on the user or nearby person or
nearby property?

Failure Mode and Effects Analysis continued


7. Frequency of Occurrence (1-10) - How often
is this failure expected to occur? This column is
subjectively rated on a 1 to 10 basis.
1 = Rare Occurrence
10 = Almost certain occurrence
8. Degree of Severity (1 -10) - How severe is
the effect of this failure on the user or anything
else? This column is subjectively rated on a 1 to
10 basis.
1 = Insignificant loss to user.
10 = Product inoperable or major replacement
cost or safety hazard.

9. Degree of Detection (1-10) - can problem be


detected by the user before it does the
damage? This column is subjectively rated on a
1 to 10 basis.
1 = Certain detection before failure.
10 = No detection possible before failure.
10. Risk Priority Number (1-1,000) Order of
problem solving priority is given by multiplying
numbers in columns 7, 8, and 9.
11. Design Action - Action to reduce risk priority
number.
12. Design Validation - Method to verify the
design motion.

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