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The disciplines of Total Quality and Six Sigma methods have become prominent in many progressive health care organizations. Six Sigma was a very hot topic in the late 90’s when I worked for a Fortune 50 company .  In my first job in health care, the President of the company had everyone read a book about Six Sigma and announced that we would become a ‘Six Sigma Company.’  I’m not sure what a Six Sigma company looked like, but I am fairly certain we did not become one.

As I now read more about these quality programs and their principles, it brought to mind teachings on Total Quality I was exposed to in business school. The teachings revolved around a man named W. Edwards Deming, who was actually a long-time professor at the school I attended. I decided to pull out a couple of books on my shelf and refresh myself on Dr. Deming.

As the Japanese worked to rebuild their economy after World War II, Dr. Deming, an American statistician and quality control expert, was invited to present a series of lectures to Japanese engineers and business leaders.  Through the lectures Deming introduced the concept of total quality management to the attendees.

Deming’s teachings were enthusiastically received and embraced by many Japanese business leaders and became the foundation for Toyota’s now renowned Toyota Production System. (In the 2000’s Toyota strayed from Deming’s quality principles, which led to Toyota’s product quality issues and recall disaster – I will research this topic more for a future post).

Now, being a statistician, much of Deming’s teachings were based on applying statistical process control (SPC) to business.  SPC involves understanding variation and eliminating variation in business process. At the same time, many of the core principles of Deming’s teachings are very simple, but profound.

  • Quality is more than audits; quality must be built into every facet of a company.
  • Poor quality is not caused by workers. It is caused by a bad management system.
  • A commitment to quality must start at the top (executive management).
  • Make a commitment to proper training and continuous learning and improvement.
  • Create an environment where people feel secure and take pride and joy in their work.
  • Real profits are generated not through satisfied customers, but truly loyal customers.


Standard Company Deming Company
Quality is expensive Quality leads to lower costs
Defects are caused by workers Most defects are caused by the system
Buy at lowest cost Buy from vendors focused on quality
Motivate by fear Fear leads to disaster


The concepts of management and leadership drive much of Deming’s teachings.  The lesson is that poor management and leadership – not workers – are the cause of most business problems (any of us who have been in business for some time can share a real-life case study or two on this topic).

For anyone who is interested in business quality methodologies, I recommend learning more about Dr. Deming and his teachings.



Out of the Crisis, by W. Edwards Deming

Dr. Deming: The American Who Taught the Japanese About Quality, by Rafael Aguayo