Deming's "deadly diseases"

While Dr W. Edwards Deming drew out 14 points for industry, he also identified several commonly held wrong beliefs that he called the "deadly diseases". Some of these (such as the first) are direct corollaries to his 14 points; some less so. Of the seven diseases, Deming felt that the first five were generally applicable and that (at the time of writing) the last two were more associated with the USA.

The "Seven Deadly Diseases" include:
   1. Lack of constancy of purpose
   2. Emphasis on short-term profits: this includes trying to meet quarterly / annual financial targets
   3. Evaluation by performance, merit rating, or annual review of performance
   4. Mobility of management: this includes management moving round / being moved (restructuring....)
   5. Running a company on visible figures alone: a real problem - and ignoring what you don't know / can't see / can't measure
   6. Excessive medical costs: the cost of medical insurance in the USA was becoming such a problem in industry (even in the 1980s) that for one company, the cost of medical insurance for staff outweighed the cost of raw materials
   7. Excessive costs of warranty, fueled by lawyers who work for contingency fees

Deming also identifed what he felt were a real but "A Lesser Category of Obstacles", including
   1. Neglecting long-range planning: what Deming called "hope for instant pudding": that is, "an expectation of quick results without effort and without sufficient education to do the job"
   2. Relying on technology to solve problems: the "supposition that solving problems, automation, gadgets, and new machinery will transform industry": it won't, but getting the workers involved in quality improvement (and encouraging & equipping them) will
   3. Seeking examples to follow rather than developing solutions: "no number of examples of success or failure in the improvement of quality and productivity would indicate to the enquirer what success his company would have. His success would depend totally on his knowledge of the 14 points and of the diseases and obstacles, and the efforts that he himself puts forth."
   4. Excuses, such as "our problems are different" - because we are doctors/nurses/astronauts/...: different, perhaps, but with similar principles
   5. Obsolescence in school that management skill can be taught in classes: people not being properly numerate (esp. those with MBAs), not understanding right statistics
   6. Reliance on quality control departments rather than management, supervisors, managers of purchasing, and production workers
   7. Placing blame on workforces who are only responsible for 15% of mistakes where the system desired by management is responsible for 85% of the unintended consequences
   8. Relying on quality inspection rather than improving product quality

By now, you may recognize some of these in the organizations you may have observed (I'm sure none of the ones we work for would ever do these...); I hope they set you thinking about what we might do differently in UK health care.