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Byline: Charles S. Lauer
There are so many books about the healthcare industry that I often wonder who has the time to sort through them all. I must get a couple of dozen new ones a year. Most of these I set aside, thinking I might come back to them, but I seldom do. Occasionally, however, there is one that I pick up and have trouble putting down. One recent such book is The Nun and the Bureaucrat-How They Found an Unlikely Cure for America's Sick Hospitals by Louis Savary, a statistician and theologian, and Clare Crawford-Mason, a journalist.
The book has a powerful ...
For most of the last fifty years, the United States was the leading economic force in the world, at one point controlling a third of the total world economy and making half of the manufactured goods. Yet today Americans buy more from other countries than we sell to them: what happened? While U.S. companies were concentrating on producing the greatest quantity at the lowest price—the strategy which resulted in economic world domination after World War II—the rules of the game changed. The focus now is not how many you make, but how well you make them, an approach first perfected by the Japanese.
Ironically, it was Americans who taught Japan about managing for quality. QUALITY OR ELSE describes the training program instituted to help rebuild the Japanese economy after the war. The teaching of W. Edwards Deming had the profoundest and most lasting impact, and an entire chapter is devoted to an analysis of the differences between his theories and those of the other three major quality experts (Juran, Crosby, and Feigenbaum). This sort of theoretical discussion is not the authors’ strong suit (they cheerfully admit that they’re journalists, not technical experts), but the bulk of the book is devoted to more practical matters.
These include success stories: small companies (Romac Industries), large corporations (Motorola), even a public school (Mount Edgecumbe High in Sitka, Alaska). Chapters cover the current state of U.S. business education and the government deficit (part of the problem), and the Malcolm Baldrige National Quality Award (part of the solution). Personal interviews were the main research technique (the book is a companion to a PBS series), so this is certainly not a rigorous survey; but Dobyns and Crawford-Mason did interview the right people, and quotes read better than statistics.
This casual quality is the main drawback of QUALITY OR ELSE: Reported rather than researched, much of its argument directed at the heart rather than the head, it ignores complexities in its urgent call to action. But it does offer a broad, readable discussion of an important area largely dominated by books devoted to the theories of one of the quality gurus.