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Abstract

Quality Function Deployment can be outlined as a specific method for evolving a design of high caliber particularly developed to content a consumer and then transforming the consumer’s desires and demands into particular design objectives. The current paper provides a report on Quality Function Deployment, showing its application areas, benefits and disadvantages. QFD matrix analyzed the customer demands and process requirements in the Ambulatory Care Clinic. The paper uses QFD matrix method, while utilized analysis tools are divided into three sections, including systems design implements, system analysis implements and system control implements. QFD matrix analysis of the Ambulatory Care Clinic demonstrates that such process requirements as electronic health records (score =81), more counseling for patients (score = 64), procedures rationalization (score =63), and lowering the work amount for physicians (score 63) are the ones with the highest priority. Thus, they should become the main objectives to process and implement. The paper also suggests the Ambulatory Care Clinic should focus on three major levels, including the patient, team and organizational ones in order to improve the business operation. 

Introduction

In the current emulative market setting, organizations and companies should focus on being first in the market with the most advanced technology. The capability to adjust to continual alteration is a principal key for any felicitous business. The elevating globalization forces all organizations to focus on customer satisfaction and requirements, thereby being required to remain open to new findings in order to maintain business. The tools and methods utilized in the evolvement process define the level of product and process and thus require attention. Quality Function Deployment (QFD) is known to be a system utilized to transform consumer requirements into relevant organization requirements at each stage, starting from the research and product evolvement to designing and manufacturing and finally to marketing and distribution. The current paper will research into Quality Function Deployment, its application areas, advantages and disadvantages.

Literature Review

Quality Function Deployment can be outlined as a means of enhancing a design caliber aimed at contenting the consumer and then transforming the consumer’s requirement into specific design objectives and main caliber affirmation points are supposed to be utilized all the way through the production period (Akao 2014). Raharjo, Xie and Brombacher (2011) believe that Quality Function Deployment can be regarded as a method of assuring that the design caliber will be obtained when the product or the process are still at the design stage.

 

Prasad and Chakraborty (2013) state that QFD incorporates two constituents, which are developed into the design procedure, including quality (caliber) and function. Therefore, Paryani, Masoudi and Cudney (2010) assume that QFD appears as a system for creating and designing a product or service grounded on customer requirements, which incorporate all members of the manufacturing or supplying organization. Akao (2014) presents that QFD method originated at Mitsubishi’s Kobe Shipyard in 1972, when the organization started utilizing a specific matrix, which put customer requirements on the vertical axle and the methods to meet these requirements on the horizontal axle. The method can be understood by outlining each of the terms in ‘Quality Function Deployment’ within the context of QFD. Hereby, Maritan and Panizzolo (2009) reveal that the first term with regard to ‘quality’ means the possibility to meet customer requirements. The second term ‘function’ is connected to the processes which should be applied and changes which should be made. The third term ‘deployment’ concerns those who will apply the processes and changes and the time when everything should be performed (Maritan & Panizzolo 2009). Miguel and Carnevalli (2008) state that the main objective of QFD is threefold. Firstly, it permits an organization to provide products of higher caliber to market faster and at a decreased price. Secondly, it allows the company to achieve customer stimulated product design. Finally, it provides a specific tracking system for the upcoming design or process enhancements (Miguel & Carnevalli 2008). The utilization of QFD demonstrates numerous outcomes, including better cognition of customer requirements, enhanced organization on evolvement projects, improved production introduction, lower level of design alterations in the following development, lower level of manufacturing start-up issues, and increased business. Thus, QFD obtains these outcomes by separating customer necessities into segments and defining methods for obtaining each of identified segments (Miguel & Carnevalli 2008). QFD also incorporates all constituents of the organization and appeases concurrent process and product design. Finally, QFD amalgamates the usage of other caliber implements, including, for example, Taguchi Methods (Miguel & Carnevalli 2008). QFD utilizes four phases in the process. The first one is known as product planning and concerns the process of designing the House of Quality (see Figure 1, Appendix 1).

Olewnik and Lewis (2008) demonstrate this QFD chart as a versatile implement, which can be utilized throughout the organization. The reason is that this is a method of summarizing basic data in a usable manner. In addition, it presents the voice of customers in regard to marketing, and managers utilize it to define fresh possibilities (Olewnik & Lewis 2008). Thus, the House of Quality appears as the first of numerous matrices in the QFD operation of transforming customer requirements into product necessities and system rectifications (see Figure 2, Appendix 2). The second phase is guided by engineering department and outlined as ‘product design’. The phase requires innovations and creative team in order to devise new product concepts and specifications (see Figure 2, Appendix 2). The third phase known as ‘process planning’ is guided by the manufacturing engineering. The process involves planning so that manufacturing procedures should include a flow chart and process parameters (also known as objective values) are supposed to be documented (see Figure 2, Appendix 2). The last phase is known as ‘process control’. Hence, all performance indicators are generated to monitor the production procedure, together with maintenance schedules and operator capabilities (see Figure 2, Appendix 2).

Application Areas of QFD

Paryani, Masoudi and Cudney (2010) demonstrate that Quality Function Deployment can be utilized in a broad variety of services, consumer products, emerging technology issues and military requirements. Generally speaking, QFD is typically utilized for product design and manufacturing industries. Nevertheless, QFD is also broadly utilized in other areas, including business process reengineering, medical treatment, caliber enhancement in the service industry, and education, among others (Miguel & Carnevalli 2008). Thus, in regard to education, QFD can be employed to enhance the quality of teaching (Kuo & Chen 2011). Andronikidis et al. (2009) reveal that QFD is also utilized in analyzing service caliber of convenience store chains. It also provides a set of methods for objective estimation, which gives the possibility of more tight combination of customer requirements with technology for caliber enhancement (Kuo & Chen 2011). The QFD is also applied to enhance caliber analysis implements. It allows one to find the weights of the degree of connections between caliber requirements and analyzes the connection between the required items with the fuzzy number method. Miguel (2007) depicts that the QFD is applied in ready-made clothing designs, providing customer-requirements-oriented approach. It gives the opportunity to transform consumer’s caliber requirements into measurable caliber properties. Moreover, it allows one to explore the major factors, which influence the design of ready-made clothes and product caliber (Clowney 2015). What is more, this method is applied in micro-sized enterprises, becoming a framework for integrating the balanced scorecard and value chain (Akao 2014). Apparently, this is a time when QFD is utilized as a constituent of a structured planning and analysis framework, providing the possibility for building e-business capacities. Finally, QFD can be used in general online retailing as it allows one to outline the outcomes and define the critical factors to achieve success (Raharjo, Xie & Brombacher 2011).

Advantages and Disadvantages of QFD

Akao (2014) suggests that Quality Function Deployment allows one to realize numerous benefits. The first group of benefits is ‘customer-driven’. The main concentration is related to the customer desires and the desires that an organization assumes as customer requirements. Therefore, the voice of customers stimulates the overall developmental process. The second benefit of QFD concerns competitive analysis as other available products in the marketplace are analyzed and estimated, while the organization’s product can be rated against the existing competition (Akao 2014). The third major benefit handles the decreased developmental time. The facts demonstrate that the probability of design alterations is lowered due to the fact that the QFD procedure focuses on enhancements, which should be made in order to content major and principal customer desires and demands. Precise attention to customer desires lowers the hazard that alterations will be required later during the project life cycle. Therefore, time is not wasted while evolving minor functions and characteristics (Akao 2014). The fourth advantage concerns lowered developmental costs and spendings. The final benefit handles documentation. The facts demonstrate that a knowledge basis is created and designed at the same time when QFD process is implemented. It presupposes that a historical record of the decision-making procedure is evolved (Akao 2014).

Regardless of all possible benefits, QFD has numerous disadvantages. Firstly, the method requires the appropriate organizational setting. Olewnik and Lewis (2008) demonstrate that QFD does not work appropriately within the distributive or departmental organizational structures and settings of huge businesses. The reason is that an efficient QFD setting extorts innovations, initiative teamwork and data spreading. Therefore, organizations might require first to undergo a complete reorganization in order to obtain the appropriate setting. The second disadvantage concerns customer-focused hazards (Kuo & Chen 2011). Efficient QFD requires precise data analysis. Moreover, improper analysis can lead to the acquisition of an immense amount of data, which triggers extra long decision tables, which complicate the prioritization of customer requirements (Miguel 2007). The third disadvantage concerns lowered level of adaptability to altering demands. Facts demonstrate that QFD system can make adaptation to altering customer requirements more expensive, severe and complicated. Nevertheless, due to the fact that customer requirements can change rapidly and with little warning, QFD demonstrates the possibility of leaving an organization with products that do not meet new necessities and are poorly marketed (Maritan & Panizzolo 2009). Finally, QFD depicts limited focus. The facts demonstrate that QFD focuses merely on what an organization had to do in order to contend its customers. A main disadvantage lies in the fact that it disregards other factors, including price, the length of the product life cycle, long-range strategy, development objectives, and existing accessible resources (Paryani, Masoudi & Cudney 2010).

Application of QFD in Ambulatory Care Clinic

Methodology

The systems implements demonstrated below appear to provide valuable assistance in cognition of the operation and management of complex systems. The utilized tools are divided into three sections, including systems design implements, system analysis implements and system control implements. The first type is utilized in order to create a new health care delivery system or process instead of enhancing the existent ones. The second type facilitates cognition of how complex systems operate, how they meet their objectives, and how their effectiveness can be enhanced regarding supplementary and competing objectives. The third type provides a clear apprehension of performance perspectives and the operating parameters necessary for meeting these perspectives. The third system is utilized to estimate parameters and adapt them in order to achieve necessary performance levels.

Analysis

Systems-design implements are originally utilized in order to create systems, which meet the requirements/desires of stakeholders (Table 1.). The health care system demonstrates that stakeholders incorporate patients requiring care, medical services providers, organizations which should operate effectively and provide an appropriate setting for medical personnel, patients, and members of the regulatory/fiscal setting, which should equip wholesale access to medical treatment. Therefore, the system is supposed to meet the requirements of all of these customers.

Table 1: Design tools

Tools and Research Area

Patients

Medical Personnel

Organization

Members of Regulatory/Fiscal Setting

Simultaneous engineering and QFD

 

+

+

 

Human-agents engineering

+

+

+

+

Failure analysis implements

 

+

+

 

 

 

 

 

The QFD analysis starts by enlisting customers’ requirements. The second step incorporates the transformation of necessities into requirements, which should be met to satisfy them (Fehlmann n.d.). The QFD “whats” and “hows” matrix in an ambulatory clinic is demonstrated in Table 2. The extended matrix appears in the subsequent Table 3.

Table 2: “Whats” and “Hows” for customers in an Ambulatory Care Clinic

Customer Wants (“Whats”)

System Characteristics (“Hows”)

Prepared admission to the physician of choice for the patient.

Lower the amount of work for physicians.

Enhanced management of physician workload.

Absence of bids for patients between steps during domestic treatment.

Provide seamless transfer service between departments.

Append personnel and costs.

Rationalization of procedures.

Lower quantity of repeated procedures throughout examination.

Generate electronic health records combined with decision endurance.

Nonappearance of diagnosis errors.

Utilization of electronic health records system.

Practice evidence-based medicine.

Better understanding by the patient of their role in insuring their health.

Provide more counseling for patients.

Improve patient access to information and knowledge.

Enlargement of time nurses spend with patients.

Lower level of paperwork.

Enhanced operating effectiveness.

Lower the costs.

 

Table 3: QFD Structure Matrix for Ambulatory Care Clinic

 

 

How’s (Process Requirements)
+ Directions from Target Value

What’s

(Customer Demands)

Importance Rating to the Customer

Lower the amount of work for physicians <---

Enhanced management of physician workload ---à

Seamless transfer service between departments ------à

Append personnel and costs ------à

Procedures rationalization--à

electronic health records ----à

evidence-based medicine ----à

more counseling for patients ----à

Lower the costs <---

Prepared admission to the physician of choice for the patient

5

 

 5

 

5

 

 

2

1

1

 5

 

Absence of bids for patients between steps during domestic treatment

3

 

 

 

5

 5

 5

 

 5

2

3

 

Lower quantity of repeated procedures throughout examination

2

 

5

 

 

2

 5

 

5

4

 5

3

Nonappearance of diagnosis errors

5

3

3

 

4

 

 

5

 5

 

3

Better understanding by the patient of their role in insuring their health

2

2

2

 

 

4

 

5

 5

 5

 

Enlargement of time nurses spend with patients

3

1

3

2

 

4

 

2

 5

1

Enhanced operating effectiveness

2

3

4

 

3

4

 

 5

2

 

 

5

Score

 

63

61

21

45

63

81

64

69

34

Current Average Value of CTQ

3.4

4.4

3

3.2

2.6

3.1

3.1

3

2.9

 

Discussion

QFD matrix analysis of an Ambulatory Care Clinic demonstrates that such process requirements as electronic health records (score =81), more counseling for patients (score = 64), procedures rationalization (score =63), and lowering the work amount for physicians (score 63) are the ones with the highest priority. Thus, they should become the main objectives to process and implement. The lowest score belongs to fluent transfer service between departments (score 21). Findings also reveal that end-users perceive ‘prepared admission to the physician of choice for the patient’ and ‘nonappearance of diagnosis errors’ as being of the outmost importance. The other demanded processes were at a low-to-average degree of satisfaction. Therefore, the QFD matrix depicts that there is a high requirement of redesigning activities, which should be combined with contribution from physicians and nurses. The provision of teamwork training and recording of enhancements in quality of care and safety demonstrate a high ratio of the provision of immediate benefits.

It is recommended to focus on three major levels, including the patient, team and organizational ones in order to improve the business operation of an Ambulatory Care Clinic. In regard to the patient level, the main focus should concern the provider-patient relationships by assuring that instructions are distinct and clear to the patient or stimulating the patient's active partaking in care operations. In regard to the team level, it is recommended to perform human-systems analysis, which can aid in assessing the efficiency of cross-checks among care categories. Talking about the organizational level, it is recommended to implement new software-in-depth systems, which will facilitate the continuity of care, while avoiding complicacy and fragmentations. The clinic is also advised to develop EMR training programs as electronic health records will enhance the operating effectiveness, become a basis for procedures rationalization and decrease the percentage of diagnosis errors. Finally, this will decrease the amount of physicians and nurses workload, allowing them to dedicate more time to patients.

Conclusion

Quality Function Deployment appears as a good system for the implementation in an organization or industry. The method does not create a specific design aimed at replacing the existent organization design procedure by any implements or schemes, but it rather supports the current organization’s design procedure. Moreover, QFD aids in bringing the voice of customers into the production procedure, which helps to lower the unnecessary costs and spendings. The method also appears as highly beneficial as it allows one to reduce the overall changing process time. The analysis of an Ambulatory Care Clinic helps to understand that QFD can be efficiently utilized in the design/redesign of care delivery systems in ambulatory clinics. The paper vividly demonstrates that QFD applications to the design of health care processes, especially at the care-team and organization levels, can provide solid and computable performance benefits regarding quality and effectiveness. QFD matrix reveals that such process requirements as electronic health records, extended counseling for patients, procedures rationalization, and reduction of physicians’ work amount appear to have the highest priority, which means that they should become the main objectives to process and implement. Finally, they can become a basic ground for focusing on three major levels, including the patient, team and organizational, in order to improve the business operation of the Ambulatory Care Clinic.

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