Published: 15 Dec 2020
Stephanie Herring, Quality Manager at Wales Fertility Institute, UK, explains why the 8D approach should be applied when investigating non-conformances.
Within all aspects of any service, quality remains the integral commodity of how we continue to improve our services, our staff and ourselves. Working towards continual improvement can sometimes cause staff and service fatigue, due to the ongoing requirement to introduce either interim or long-term changes or amendments to new or embedded processes. However, if we manage both our quality management system(s) and our overall service quality, this fatigue can become our driver in ensuring that we make great strides towards providing a continually maturing service.
I want to remind us all of the ever-changing world of ‘quality’ and how by fully utilising the 8D approach to root cause investigation within quality management we can ensure that not only the quality management systems implemented by our services are enhanced, but so is the ownership of our service quality. Whether we are providing an NHS service, as in my case, or we are providing an actual product, utilising the 8D approach when investigating non-conformances can prove extremely empowering for all employees.
What is 8D?
Over the years, there have been many ways in which we have reviewed and managed our quality management systems. From Ishikawa to Six Sigma, we have all at one time or another switched to the ‘latest’ methodology to attempt to ensure that we are following the latest advice, while providing the evidence to show that we are keeping abreast of the latest developments.
When I first heard about the 8D approach (Congratulate your team), I raised it with our quality assurance team and the initial response was that because it hadn’t been used there was no appetite to trial it. I was then determined to break it down to show that there was no real change from the system that we were currently using (the seven principles of root cause analysis –) other than staff congratulations for participation in investigations or process changes. Feedback has always formed part of the root cause analysis (RCA) process but for ‘congratulations’, there appeared to be some management discomfort with the use of this terminology.
From the seven phases of the RCA process identified above, it is quick and easy to transition to the 8D approach from RCA by simply adding this one important process of staff congratulations. So, the question is: do we all routinely practice this? In all probability, the answer is yes, however, we should all strive to ensure that it is not only feedback that is provided but also staff congratulations, which should be considered as important as the other seven RCA process components, listed below.
- Step one: Identify the incident to be investigated/analysed
- Step two: Identify the team to carry out the RCA with agreed Terms of Reference
- Step three: Study the process and agree methods for gathering evidence
- Step four: Collect the facts and begin to analyse the data
- Step five: Search for causes
- Step six: Prepare the RCA report
- Step seven: Authorise the final report and provide feedback to staff.
We all utilise, on an autonomy basis, the seven principles of RCA, but can we honestly say we use the 8D problem-solving mechanism?
Giving staff a voice
Having an open and transparent working environment can often help staff to feel that they have a voice and can contribute positively to their organisation. It is vital that they are aware of the actual root cause of an incident and, more importantly, that they may hold the solution to the problem.
Failure to include staff who form part of the team or process that has led to the non-conformance or incident can mean that when undertaking the initial RCA, critical or evidential information is missed. Including the most appropriate staff ensures that the required knowledge, often from a ‘ground level’ of the current process, is obtained. Managerial lead of the overall investigation should continue, but acknowledgement that the operational staff, those at the coal face, are the most informed and often have crucial information to ensure that resolution or interim further prevention can be implemented. There is no hierarchy when investigating a problem that needs a resolution.
Giving credit when it’s due
So are we good at providing feedback? In my opinion, I think that this is a definite yes and leaps have been made within most quality systems to ensure that staff are provided with feedback to develop and improve themselves in their respective organisations. However, many organisations that have provided feedback to staff involved in investigations do not always congratulate them when a resolution is found.
When it comes to congratulating staff for their efforts, I personally don’t think this happens enough in businesses. Recently, when I congratulated a member of staff, following their involvement in the investigation of a non-conformance, which led to the requirement of a full RCA being performed , I was met initially with shyness in that ‘I was just doing my job’. Our staff are our greatest commodity, so it’s important to offer praise when it’s due. The sharing of the formal congratulations with other direct and indirect team members also lends itself to positive trends towards transparent reporting and improves preventative measure reporting. In our organisation, there seems to be an air of ownership and valid contribution when the staff, who are actively involved, have provided a service improvement change or reported an area of risk for preventative rather than corrective action. Staff feel valued and feel confident in raising potential process risks.
Even with a robust quality management system in place, we can’t say that non-conformances will never occur. Instead, we need to be aware that if there is a distinct reduction in non-conformance reporting, we should evaluate whether this is down to an improvement in the quality of our products or services, or whether staff do not feel empowered to report for fear of reprisal or even disciplinary action. When staff feel actively involved in all aspects of the quality management system and have a good understanding of the system’s requirements, then we are more accurately able to put a reduction in reporting down to good overall quality management.
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