Process Purpose and Process Quality

In last week’s post, I discussed how Purpose is missing from the typical process mapping tool SIPOC (Suppler – Input – Process – Output – Customer) and how adding it can positively affect our process improvement. Today, I’d like to discuss how Purpose affects process quality.

There has long been a debate in the quality profession about the definition of quality. Some define quality as “fitness for use” (Joseph Juran); some as “conformance to requirements” (Philip Crosby). I believe the addition of Purpose to our process map promotes both definitions.

First, the ability of the designed Output to meet the Purpose of the process (the value or reason the process exists) is fitness for use. Second, how well the actual Output of the process meets the designed Output is “conformance to requirements.”

Let me give you an example: a medical billing operation needs to send the various components of the bill to the payor or insurer. This may include a medical bill (UB or HCFA) and various supporting documentation (medical records, lab results, etc.). The designed Output would describe the exact pieces of documentation that need to be sent (knowing they might be different for different types of bills. This description would satisfy the first definition of quality – “fitness for use.”

Now the worker actually creating the medical bill package to send may or may not include the relevant information. He may include extra pieces of information, or not send information that is required. This meets the second definition of quality – “conformance to requirements.”

Now this appears to be common sense – a chef creates a recipe that appeals to the palate (fitness for use) and the cooks may or may not follow the recipe (conformance to requirements). But far too often we don’t evaluate the ability of the designed Output to meet the purpose of the process, and instead blindly try to make the output conform to some potentially invalid standard.

Next time you are involved in a process improvement exercise, start with the Purpose, then evaluate whether the designed Output is the best way to meet that Purpose, then work on ensuring all actual Output conforms to the designed Output.

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