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| Dr J P Pattanaik |
Over the years, healthcare organisations have adopted various quality tools and methods for enhancing efficiency of healthcare service delivery. Identifying the right tool and following the right methodology is essential for sustaining any quality improvement effort. This is true for any kind of organisations, thus; healthcare organisations cannot be an exception. The article comprehends how ‘Quality Function Deployment (QFD) – The House of Quality’, can be adopted to understand customer requirements, prioritise organisational strategic goals and reap optimum benefits from the available resources.
Evolution of QFD
“Time was when a man could order a pair of shoes directly from the cobbler. By measuring the foot himself and personally handling all aspects of manufacturing, the cobbler could assure the customer would be satisfied.”
– Dr Yoji Akao, Cofounder of QFD during one of his private lectures
QFD approach was developed in Japan in 1960s to understand the spoken and unspoken needs of customers and design high quality engineered products aiming at providing high value to customers. By 1970’s Mitsubishi Heavy Industries had demonstrated the positive impacts of the approach to the world. According to Akao, QFD “is a method for developing a design quality aimed at satisfying the consumer and then translating the consumer’s demand into design targets and major quality assurance points to be used throughout the production phase. … QFD is a way to assure the design quality while the product is still in the design stage.”
The three primary objectives in implementing QFD are:
- Prioritising spoken and unspoken customer wants and needs
- Translating these needs into technical characteristics and specifications
- Building and delivering a quality product or service by collectively aiming towards customer satisfaction
The primary areas of QFD application are product planning, part development, process planning, production planning and services planning. Since its origin, many organisations have adopted QFD and have reaped benefits from it. Today, its usage is not just limited to production or manufacturing organisations; service industries too have benefitted from this approach. QFD is now an integral part of various quality improvement methodologies such as lean six-sigma to name one. Healthcare organisations such as hospitals have adopted numerous quality improvement tools for efficiency enhancement including those practised in manufacturing and production industries. Studies reveal healthcare organisations have benefitted immensely from adoption of quality practices from other industries.
| Improves customer satisfaction |
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| Reduces implementation time |
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| Promotes teamwork |
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| Provides documentation |
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| Figure-1: Benefits of QFD | |
| (Adapted from James L. Brossert, Quality Function Deployment – A Practitioner’s Approach, Milwakaukee, WI: ASQC Quality Press, 1991) | |
Benefits of QFD
The QFD approach has been proved to be an effective tool for organisations of various types. QFD follows a methodical and rigorous approach to understand customer requirements and translates into product or service features thereby satisfying the customer needs; thus, providing right direction to the organisation needs. Figure 1 below summarises the benefits of QFD and how organisations can leverage the approach for achieving better efficiency.
Components of QFD : The house of quality
The most popular approach for QFD is the ‘house of quality’. As the name suggests the tool resembles shape of a house, thus the tool is been popularly called as ‘the House of Quality.’ It is a matrix that helps in identifying the spoken and unspoken needs, prioritising based on the perceived customer value and matching those against how an organisation will meet those requirements. The house of quality consists of following components.
- Voice of the customer – VoC (Whats)
- Voice of the business – VoB (Hows)
- Inter relationship matrix
- Technical matrix
- Technical correlations
- Planning matrix
Voice of the customer (VoC) – WHATS: The left side of the house represents customer requirements in other words ‘What’ your customers ask for in a product or service. Each of primary customer requirements is supported by secondary requirements to represent the primary needs in greater detail.
Voice of the organisation (VoB) – HOWS: The ceiling or the second floor represents the voice of the business or technical descriptors. It represents a tools and methods by which the organisation willing to meet the customer requirements. Further definition of the primary technical descriptors is accomplished by defining a list of secondary technical descriptors which represent the primary technical descriptors in greater detail.
Inter relationship matrix: The interior walls of the house represent the relationship between customer requirements and the technical descriptors. The relationship matrix represents graphically the degree of influence between each technical descriptor and each customer requirement.
Technical matrix: The foundation of the house represents the prioritised technical descriptors. The prioritisation is based on a number of factors such as benchmarking, degree of technical difficulty and the target value listed.
Technical correlations: The roof of the house represents technical correlations i.e. how the technical descriptors influence each other. This helps in identifying similar technical descriptors which have a synergy impact and/ or conflicting technical descriptors which might adversely impact the planning process.
Planning matrix: It represents prioritised customer requirements. The prioritised customer requirements are based on number of factors such as importance to customer, target value, scale-up factor, sales point and absolute weight.
QFD healthcare organisation – Lessons from practice
The problem: The health checks department of a tertiary care hospital had been receiving several customer complaints, thereby pulling the overall satisfaction index low. Since most visitors were asymptomatic, their needs were quite different from patients who visited to hospital for specific treatments. Though, the organisation had taken a few measures, it had not resulted in any significant improvement.
The approach: To understand customer needs who visit the preventive health checks department in a better way, the management decided to carry out a study based on QFD approach. The study was carried over a period of three months. To understand the customer needs better, the organisation followed a number of methods such as reviewing customer feedback, observation of customer behaviour, structured interviews with 50 per cent of the total visitors. The customers were asked to rate the various parameters based on their perceived value to them and how they rate the defined service characteristics. The organisation also carried out several brain storming sessions to identify the technical descriptors. Each customer requirement was examined to know how the same has been correlated with the technical descriptor (strong, medium or weak). A target value was set for each customer requirements. Same approach was followed for the technical descriptors. Customer requirements were prioritised based on the target value, scale of factor and sales point.
Similarly, the technical descriptors/business requirements were prioritised based on degree of technical difficulty, target value, absolute weight and relative weight.
The outcome: After a comprehensive analysis of customer requirements and the technical descriptors, the organisation was in a position to prioritise the action items. The organisation implemented the recommendations in the high priority areas. Over next few months, a steady improvement in customer satisfaction index was recorded.
Conclusion
Organisations need to prioritise the requirements which can have maximum impact on the outcome. It is essential for managers to identify the right approach to solve a problem keeping a right balance between the resources available and the target requirements to be met. QFD is an effective tool to prioritise decisions. Right quality management practices coupled with a strong leadership direction can yield great results for the organisation.
References:
1. Total Quality Management’ By Dale H. Besterfield et al, Pearson Education, Inc. (New Delhi -2005)
2. QFD Institute’ – The Official source for QFD (http://www.qfdi.org/what_is_qfd/what_is_qfd.htm)
3. ‘Quality Function Deployment’ By Creative Industries Research Institute (http://www.ciri.org.nz/downloads/Quality%20Function%20Deployment.pdf)
4. ‘American Society for Quality” (http://asq.org/learn-about-quality/qfd-quality-function-deployment/overview/overview.html)
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Quality function deployment qfd is a process of customer requirement behind the particular product.