Why did TQM Fail?

-	Employees take their cues from mgmt. more
-	Executive & middle mgmt. oversights more
-	Didn't integrate quality into organizational structure more

Why do major change initiatives fail?

-	Part 1: The eight major reasons for failure.
-	Part 2: Consequences of these errors?

Confessions of a shot messenger

Balestracci D & Barlow J. Quality Improvement: Practical Applications for Medical Group Practice, 2nd Edition. Englewood, CO. Center for Research in Ambulatory Health Care Administration (CRAHCA), 1996 [ISBN 1-56829-015-2] ($8). I have been asked to do a 3rd edition, so the price is a true bargain. (The statistical content is not going to change much at all and I still feel good about recommending this 2nd edition.)

[Available to order from the Medical Group Management Association (MGMA) by calling the its Service Center toll-free at (877)-275-6462 or (303)-397-7888.

Orders can also be placed in the online store at www.mgma.com. Search the store with the keywords "quality improvement" or go directly to the description of the item by clicking here ]

This book was a labor of love. I tried to take a realistic, honest, straightforward, conversational approach (with "Italian passion") to quality (Deming slant) with the emphasis on statistical thinking (not techniques) as the "anchor" for a healthy quality effort (Not only special projects, but hidden opportunities in everyday work)--for use in the real world.

The key emphasis is looking at all work as a process and understanding variation. This also includes the process of how data in general are used in organizations and the resulting rampant unintended damage (and "crazy-making") caused by inappropriate reactions to variation. Eight common statistical "traps" are exposed to help you transition to a philosophy of Data "Sanity." Sorry, folks, but did you know that whether or not you understand statistics, you are already using statistics? The good news: You can forget practically everything you've learned in the required "Statistics from Hell 101" course (and many of you are saying at this moment, "Don't worry... we already have!"). Oh, and by all means, please hand a copy of this book to your managers. It's for them, too!

No sanitized examples or platitudes here! I've included many varieties of examples and exercises (with excruciatingly detailed solutions provided) with real data that have routinely come across my desk. There is thorough discussion, in "English," of data plotting & charts (including some critical control charts) appropriate to service industries and medicine. For those of you who have to communicate results to mathematically impaired audiences, I also discuss an intuitively simple, less-threatening alternative to control charts - a run chart.

I tried to put together an extensive reference list and have also included a chapter on dealing with "those darn humans."

Even though the title says "health care," this book is for any quality practitioner in any industry, especially a service industry.

No statistical overload-I promise - Just a healthy dose of counter - intuitive common sense.

Amazon review:
Practical and helpful for real world clinicians, July 9, 2002
Reviewer: Steve Tarzynski, MD, MPH (Santa Monica, CA United States)
Balestracci and Barlow provide a clear and concise approach on improving medical care in a group practice setting. Areas covered include a primer on quality improvement theory and methods, good and bad uses of data, examples of improvement efforts, and presentation of simple yet powerful statistical methods that help clinicians in the real world of day-to-day care. The text is well written, well edited, and with just a little bite of humor to it. Worth every penny to busy physicians, nurses, and other health care professionals and managers interested in improving care.

Recommended Resources	view all

-Why do major change initiatives fail? - Part 2 -Morris Massey Video -What is the cost of dis-Harmony in one's organization? -FREE STUFF -Video Review: "Gaining Control -- The Franklin Reality Model"