Improvement Guide

THE AUTHORS GERALD J. LANGLEY is a statistician, author, and consultant, and co-founder of Associates in Process Improvement (API), consulting firm that specializes in the improvement of quality and productivity. RONALD D. MOEN is a statistician, consultant, and teacher to industry, government, and education. He is co-founder of API. KEVIN M. NOLAN is a statistician, author, and consultant at API, where he focuses on developing methods and assisting organizations to accelerate their rate of improvement in quality and productivity. DR. THOMAS W. NOLAN is a statistician, author, and consultant, and co-founder of API. CLIFFORD L. NORMAN is a consultant with API whose work has emphasized the psychology of change. LLOYD P. PROVOST is a statistician who advises to organizations as an API associate.

• Foreword xiPreface xvAcknowledgments xviiiThe Authors xixIntroduction: The Improvement Guide, Second Edition 01PART ONE: INTRODUCTION TO IMPROVEMENT 13Chapter One: Changes That Result in Improvement 15Principles of Improvement 15The Model for Improvement 23Key Points from Chapter One 25Chapter Two: Skills to Support Improvement 27Supporting Change with Data 28Developing a Change 35Testing a Change 41Implementing a Change 43Spreading Improvements 44The Human Side of Change 45Key Points from Chapter Two 46Chapter Three: Improvement Case Studies 49Case Study 1: Improving the Morning Meeting 49Case Study 2: Improving Service in a Dental Office 54Case Study 3: Improving Methods for Teaching Biology 60Case Study 4: Contamination in Shipping Drums 63Case Study 5: Reducing Energy Use in School 66Key Points from Chapter Three 71PART TWO: METHODS FOR IMPROVEMENT 73Chapter Four: The Science of Improvement 75Profound Knowledge 76Milestones in the Development of Profound Knowledge 85Key Points from Chapter Four 88Chapter Five: Using the Model for Improvement 89What Are We Trying to Accomplish? 89How Will We Know That a Change is an Improvement? 93What Changes Can We Make That Will Result in Improvement? 96The Plan-Do-Study-Act Cycle 97Using the Cycle to Build Knowledge 100Key Points from Chapter Five 106Chapter Six: Developing a Change 109Some Typical Problems in Developing Changes 110Reactive Versus Fundamental Change 111Theory for Change 116Methods for Developing Fundamental Change 120Key Points from Chapter Six 136Chapter Seven: Testing a Change 139Applying the Science of Improvement to Testing 140Principles for Testing a Change 144Designs for Testing a Change 153Strategies for Testing 168Key Points from Chapter Seven 170Chapter Eight: Implementing a Change 173Testing a Change 174Implementing a Change 174Implementation as a Series of Cycles 175Implementing Changes to Achieve and Maintain Improvement 179The Social Aspects of Implementing a Change 186Key Points from Chapter Eight 193Chapter Nine: Spreading Improvements 195A Framework for Spread 196Phase for Organizational Readiness for Spread 197Phase for Developing an Initial Spread Plan 205Phase for Executing and Refining the Spread Plan 210Key Points from Chapter Nine 216Chapter Ten: Integrating Methods for the Improvement of Value 217Eliminating Quality Problems 218Reducing Costs While Maintaining or Improving Quality 224Expanding the Expectations of Customers to Increase Demand 230Developing an Environment Conducive to the Improvement of Value 235Key Points from Chapter Ten 236Chapter Eleven: Improving Large or Complex Systems 237Project Setup and Management 239Understanding the System and Developing High-Impact Changes 243Testing and Learning Systems 250Key Points from Chapter Eleven 262Chapter Twelve: Case Studies of Improvement Efforts 263Case Study 1: Reducing the Occurrence of No-Fault-Found Components 264Case Study 2: Improving the Drill Process 269Case Study 3: Reducing Infection and Mortality Rates in a Pediatric Intensive Care Unit 276Case Study 4: Improving Safety at a Manufacturing Plant 285Case Study 5: Improving the Credentialing Process at CareOregon 291Case Study 6: Improving Sales at a Specialty Chemical Company 292Key Points from Chapter Twelve 305PART THREE: IMPROVING VALUE AS A BUSINESS STRATEGY 307Chapter Thirteen: Making the Improvement of Value a Business Strategy 309Building the System of Improvement 312Key Points from Chapter Thirteen 328Chapter Fourteen: Developing Improvement Capability 331Developing Improvement Capability in the Workforce 333Organization to Support the Focus on Improvement 340Development of Other Capabilities 343Key Points from Chapter Fourteen 346Sample Agendas for Getting Started, Sponsors, and Improvement Advisors 348Development of Internal Improvement Advisors: Topical Agenda 352APPENDIXES 355Appendix A: A Resource Guide to Change Concepts 357How to Use Change Concepts 358The Change Concepts 363Appendix B: Tools and Methods to Support Improvement 409Methods and Tools for Viewing Systems and Processes 410Methods and Tools for Gathering Information 417Methods and Tools for Organizing Information 423Methods and Tools for Understanding Variation 433Methods and Tools for Understanding Relationships 440Methods and Tools for Project Management 442Standard Forms for Improvement Projects 445Appendix C: The Model for Improvement and Other Roadmaps 453Fundamental Questions for Improvement 454Alternative Roadmaps for Improvement Projects 456Summary 464Notes 465Index 479

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