Couverture de Five-minute Deming: The Deming chain reaction

Five-minute Deming: The Deming chain reaction

Five-minute Deming: The Deming chain reaction

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 Most leaders feel pressure in the same places. Costs creep up. Capacity feels tight. Customers wait longer than they should. Staff are busy, sometimes exhausted, and still the results don’t seem to move. The natural response is familiar. Push productivity. Raise targets. Add oversight. Ask people to move faster. It feels responsible. It looks like leadership.And yet, very often, it quietly makes things worse.W. Edwards Deming offered a different way to think about improvement—one that runs counter to that instinct. In Out of the Crisis, he described what he called the chain reaction: a cause‑and‑effect sequence that begins not with cost or productivity, but with quality. Deming was clear that this was not a motivational idea. It was an explanation of how systems actually improve.If you improve quality, Deming said, “The result is a chain reaction—lower costs, better competitive position, happier people on the job, jobs, and more jobs.” Each outcome depends on the one before it. Miss the starting point, and the rest of the chain never really takes hold.The result [of improving quality] is a chain reaction—lower costs, better competitive position, happier people on the job, jobs, and more jobs.— W. Edwards DemingThe logic behind the chainAt first glance, Deming’s chain reaction looks almost too simple: improve quality, and good things follow. But Deming was not offering encouragement or aspiration. He was offering a way of thinking that depends on sequence. The chain reaction works only when its links unfold in the right order.It starts with quality. When quality improves, costs come down—not because someone demanded savings, but because waste leaves the system. Deming described the mechanism plainly: “Improvement of quality transfers waste of man‑hours and of machine‑time into the manufacture of good product and better service.” In practice, this shows up as less rework, fewer mistakes, and fewer delays and snags. Time that was once spent fixing problems is freed to do useful work.Improvement of quality transfers waste of man‑hours and of machine‑time into the manufacture of good product and better service.— W. Edwards DemingAs that waste leaves, capacity returns. Only then does productivity improve—not because people are working harder, but because the system is able to work as intended. Over time, better quality and lower total cost translate into better value. Trust strengthens. Performance stabilizes. The organization can stay viable—or, in mission‑driven settings, continue to serve. Jobs become easier to protect, and growth becomes possible.The meaning of qualityIn many organizations, the word quality is narrowed to outputs, results, or compliance measures. Deming’s meaning was broader and explicitly managerial. He tied quality to meeting the needs of the customer, present and future, and placed responsibility squarely with leadership. Quality, in Deming’s sense, is not about effort. It is about how the work itself is designed.Operationally, quality shows up as reliability. The work arrives ready. Prerequisites are clear and present. Information is complete. Handoffs do not require rescue. The process is capable of producing a good result without looping back on itself. When those conditions are not met, the system creates rework—and that rework is where cost and capacity quietly disappear.Watching the chain reaction at workRiverview Health System’s specialty clinic had an eight-week wait for new appointments. Pressure was mounting. Access needed to improve, but headcount was frozen. Maria, the clinic operations director, saw the same pattern week after week. The clinic was full. The staff were busy. And the backlog wasn’t moving.“Everyone is working flat out,” she said during a Monday review. “But the waiting list isn’t changing.”Instead of asking people to work harder, Maria asked a different question: where is the system creating rework? She and the medical director agreed to look more closely.“Let’s stop guessing,” he said. “Let’s count how often work comes back.”For two days, the team tracked repeat work. They categorized callbacks, delays, and corrections tied to referral defects, missing prerequisites, authorization issues, unclear orders, and documentation rework. When they reviewed the results, the answer was unmistakable.“Nearly a third of our calls aren’t new demand,” Maria said quietly. “They’re cleanup.”That made the starting point clear. Quality had to be addressed at the entry point. They focused on new rheumatology referrals. The core problem wasn’t clinical judgment. It was incomplete information. Intake staff chased labs. Nurses re-triaged. Visits ran late because prerequisites were missing.“If we fixed this upstream,” the medical director observed, “the whole day would change.”The team redesigned the referral process. Required fields were clarified. Prerequisites were explicit. If ...
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