Chapter 3

The BEST-Tool: Checklist of Criteria for the Assessment of a Best Practice

This chapter describes the BEST-method and details of the BEST-tool and closes with some experiences, tips, and tricks used by the authors to maximize the effectiveness of the BEST-tool.

BEST is an acronym for: “a Better way to Excellent results and Success through the application of an appropriate Tool.” This method consists in the assessment of 1) the approaches used in the Best Practice, 2) the achieved results, and 3) the process of the Best Practice. The assessment is supported by the BEST-tool, which consists of checklists of criteria and characteristics of Best Practice activities.

There are two types of the BEST-tool: a detailed one, which is called the BEST-tool, and a shorter version, which is called the BEST Quick Scan.

Sections 3.1–3.4 describe the components of the BEST-tool. The tool consists of four components: Enabler, Results, Process, and Format. Each component contains several criteria. Finally, each criterion consists of one or more characteristics.

3.1 Assessment of the Approaches Used in a Best Practice

3.1.1 Enabler

The enabler is the method, approach, or process used by the company to achieve the results they are documenting as a Best Practice. Whether a formal model such as the Malcolm Baldrige Performance Excellence Model, the European Foundation for Quality Management Model, a Quality Management System, Hoshin Kanri,* or another structured organizational design process, an enabler has the same basic format for the management of the chosen model. This format can be separated into four phases which reflect the phases of the Plan-Do-Check-Act (PDCA)-cycle. Each of these phases contains several criteria.

* https://en.wikipedia.org/wiki/Hoshin_Kanri accessed 12/28/2019.

The PDCA-cycle is used to organize the sequence of the Enabler component. This model encourages observation and planning to identify the requirements of a process, develop effective actions, pilot the solution, measure the results, and then document the changes and new process to hold the gains. This tool is a good beginning approach for improvement in an organization, regardless of operating maturity. A complete listing of the criteria and characteristics of a Best Practice using the PDCA-approach is presented in Figures 3.3 and 3.4. These Excel tables can also be downloaded from our website www.comatech.be.

More mature organizations may wish to use other improvement methods, as mentioned in Chapter 1. The steps are basically the same. The criteria and characteristics will need to be associated with the sequence of steps required of whichever approach is chosen by the organization.

3.1.2 Plan

The Plan phase consists of 8 criteria and 16 characteristics which should be present in a Best Practice document. Figure 3.3 BEST-tool (complete and detailed checklist) gives the complete listing of criteria and characteristics for the Plan phase of the Enabler (PDCA). The following discussion provides an explanation of the value of including these criteria and characteristics into a Best Practice document.

The eight criteria for the Plan stage are:

  1. 1. Description
  2. 2. Stakeholders
  3. 3. Responsibilities
  4. 4. Key performance indicators (KPIs) and performance indicators (PIs)
  5. 5. Deployment and segmentation
  6. 6. Prevention
  7. 7. Benchmarking
  8. 8. Data

Let us discuss criterion by criterion. The first criterion consists of four characteristics.

  1. 1. Description
    • – The approach is repeatable and based on reliable data and information.
    • – The core process is identified and described.
    • – The methods are documented.
    • – The process reflects common sense and is well thought out (logical sequence, clearly linked to organizational strategy, interactions with other processes and sub-processes).

The approach is repeatable and based on reliable data and information.

This seems obvious; however, the authors have unfortunately seen that information can be manipulated to support the allegation of a Best Practice.

BOX 3.1 Manipulation of Information

Scenario: A newly appointed general manager reports that he has excelled in his new assignment. Productivity and profit increased more than 3% annually over the last two years. He can also prove an increase of customer satisfaction over the last two years. His conclusion: the company is flourishing thanks to his policies and decisions.

Interpretation of the scenario: the manager’s allegation seems logical and the first tendency is to believe his report. The general manager has been in position for only three years. When the data are plotted over the last 10 years, it becomes apparent that the increase in productivity and customer satisfaction started more than 7 years ago. If the reader had this data before reading the manager’s report, he would not have believed the general manager. The reader would recognize the general manager as a manipulator with only one goal: to improve his personal image.

The core process is identified and described.

Not everything done in an organization is of equal importance. A small number of core processes contribute to the realization of the strategic and business plans. A Best Practice is always based upon one of the core processes.

The methods are documented.

People familiar with ISO* and Kaizen, know that only documented methods lead to repeatable processes and reliable products and services. Documentation of the method is not enough. The documents need to be regularly updated. A systematic revision of the documents is proof that people learn. Only when every activity within the process is documented, can we ensure that the supplied products and services are reliable. When the processes are systematically reviewed and revised, the processes then become simple, straightforward, more transparent, and robust.

* ISO is a label for the International Standardization Organization. ISO standards have much in common with the principles of better regulation: consistent, transparent, and targeted. Developed through the consensus of globally established experts and regulators, governments count on ISO standards to help develop better regulations. ISO standards provide a strong basis that can be applied in the development of national and international regulation. Not only do ISO standards help save time, they are essential tools for reducing barriers to international trade. ISO has developed over 23,157 International Standards. Source : ISO.org.

The process reflects common sense and is well thought out (logical sequence, clearly linked to organizational strategy, interactions with other processes and sub-processes).

Processes rarely work in a vacuum. The outputs of a previous process become inputs to a subsequent process. Core processes must support the overarching goals of the organization and align with the strategic plan. Measures must be in place that clearly reflect the appropriate outcomes of the system of processes identified in the Best Practice.

  1. 2. Stakeholders
    • – The process is tailored to the needs, requirements, and expectations of interested parties (stakeholders).
    • – The indicators and targets are set and the relationship with the core process is clearly defined.

The process is tailored to the needs, requirements, and expectations of interested parties (stakeholders).

Every key process has at least one stakeholder. The number of stakeholders depends on the complexity of the function and the Best Practice described. Each stakeholder has specific needs, requirements, and expectations. The organization has a method to determine these needs, requirements, and expectations.

The concept of stakeholders is illustrated with a service example in Table 3.1, i.e. a hotel in a city. This city is visited by business travelers and tourists.

Table 3.1 Stakeholders of a hotel

List of stakeholders and their expectations:

  • Business customers: late check-in, Wi-Fi, available seminar facilities, complaint resolution
  • Tourists: tourism information, complaint resolution
  • Shareholders: profitable growth, room occupancy
  • Hotel school: apprenticeships
  • City: employment, sponsoring local initiatives
  • Society: energy saving, CO2 reduction
  • Employees: stable employment, training, motivation
  • Suppliers: on-time payment, new business

This list is certainly not complete but illustrates how many stakeholders an organization can have and the variety of expectations to be addressed.

The indicators and targets are set and the relationship with the core processes is clearly defined.

For each stakeholder expectation, the hotel in example 3.2 will have at least one key performance indicator (KPI), or measure of performance. Each of these KPIs must be tracked and reported in the Best Practice.

Table 3.2 illustrates that not only does the contractor have expectations for the current contract, but he also has expectations for future work.

Table 3.2 List of expectations of a contractor at an industrial plant

Current contractor expectations of industrial plant management

  • Clear contract
  • Work specifications
  • Payment on time
  • Safe environment

Future expectations of the contractor

  • New contracts
  • Repeat business
  • Expansion of existing business lines
  • Development of new opportunities

The expectations, needs, and requirements for every stakeholder are translated into one or more KPIs.

  1. 3. Responsibilities
    • – The responsibilities and accountabilities are clearly defined.
    • – Each process has a process owner.
    • – The process description considers the skills and experiences required by the persons responsible for carrying out the process and approaches.

The responsibilities and accountabilities are clearly defined

Accountability is an outcome of the assignment of responsibility. All too often, an organization designates responsibility for a process without holding the designee accountable for the results of their actions. Two definitions of Accountability are:

  1. 1. The obligation of an individual or organization to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner. It also includes the responsibility for money or other entrusted property.*
  2. 2. Taking the personal responsibility to do what you say you’ll do within the timeframe you’ve agreed to do it.

* http://www.businessdictionary.com accessed 12/23/2017.

Greg Bustin, http://www.bustin.com/tough-love-accountability-workshop accessed 12/23/2017.

Each process has a process owner

From these two definitions it is expected that the process described in the Best Practice mentions the title of the person accountable for the management of the process and the corresponding results. As illustrated in Chapter 6, many case studies of Best Practices do not mention a name or function.

Benefits of applying the concept of accountability:

  • Someone (e.g. a backup) is always responsible for taking initiative, making decisions, and monitoring a process and KPI, even when the primary accountable person is absent (sickness, holiday, business trip, etc.).
  • The process is audited and revised regularly. These updates are identified through a higher process document revision number.
  • The KPI shows a gradual improvement of achieved results. As management of the process becomes increasingly better, so will results improve.

The process description describes the skills and experience required by the persons responsible for carrying out the process and approaches.

Training is provided so that the individual performs the process in a way that delivers reliable products and services. It is the responsibility of the process owner to check whether all operators receive appropriate training.

BOX 3.2 New Hire Training

A company is active in a cyclic business. It recruits temporary workers a few months before a high workload cycle starts. The production manager explains the methods and activities briefly. After a few hours, the new hire can become productive in his new assignment.

Although new employee training is a very common practice, this training does not always assure that the new operator can do the job without producing defective products. Defective products reduce the reliability of the process. In Chapter 6 examples will illustrate that very few organizations pay attention to the effectiveness of new employee training.

  1. 4. KPIs and PIs
    • – Each process contains one or more KPI and one or more PI.

Besides a full description of the process, the assessor expects to see which KPIs are used and how these are managed. These KPIs must be completely described (see later in this chapter under “Format”) leading to the achievement of the planned results. We expect in all cases that the results are aligned to the strategy of the organization.

If it is difficult to demonstrate an alignment between the results and the organization’s strategy, ask: “To what extent is it worthwhile to describe this Best Practice?” Only important subjects and processes are worth the effort to develop and bring to a higher (process) maturity level.

It is easier to determine which type of indicator needs to be managed once the process is described. KPIs can be classified into four groups: input, process, output, and outcome indicators.

The example in Figure 3.1 explains the difference between these four types of indicators. We use a well-known process, i.e. cooking.

Figure 3.1 Types of indicators for the cooking process.

A practical example of indicators from industry is illustrated in Box 3.3. In an industrial plant, safety is an important issue. Many different indicators can be used based on the situation.

BOX 3.3 Safety Indicators in a Chemical Plant

INPUT INDICATORS

  • Number of people attending safety training (PI)
  • Number of hours of safety training provided (PI)
  • Number of safety incidents (PI)
  • Planning of safety audits (PI)
  • Budget for safety training (PI)
  • Number of trainers (PI)

THROUGHPUT OR PROCESS INDICATORS

  • Number of work sessions/workshops on safety provided to the team (PI)
  • Number of suggestions implemented (PI)
  • Number of safety audits (PI)
  • Revision of Standard Operating Procedures (SOPs) and work instructions (PI)
  • Number of audits performed by process owner (PI)

OUTPUT OR LEADING INDICATORS

  • Number of safety improvement suggestions introduced by operators recognized (PI)
  • Number of suggestions successfully implemented (PI)
  • Frequency rate of accidents (KPI)
  • Absenteeism due to safety accidents (KPI)
  • Number of corrective actions taken and implemented (PI)
  • Number of people recognized for their efforts and results (PI)
  • Number of revisions of safety processes (PI)
  • Decrease of operating costs because of safety improvements (KPI)

EFFECT, OUTCOME, OR LAGGING INDICATORS

  • Severity index of accidents (no loss of production) (KPI)
  • Lower insurance rates due to a high safety level (KPI)
  • Plant is the sector benchmark (KPI)
  • No damage to the surrounding community (KPI)

Legend: PI, Performance Indicator; KPI, Key Performance Indicator

The number of sample indicators in Box 3.3 may be overwhelming for those new to quality improvement. The list separates measures between input and process indicators, on the one hand, and output and outcome indicators, on the other. Box 3.3 also illustrates that some indicators are PIs and others KPIs. The generic PI gives a result that does not necessarily contribute to the achievement of the strategy (e.g. the number of incidents). The KPI level of measurement contributes to the achievement of the business plan and/or strategic plan of the organization (e.g. decrease operating costs).

Indicators are often developed without understanding the difference between output and outcome indicators. Output indicators measure whether the product or service delivered by the process meets the criteria for which it is designed. An outcome or impact indicator describes whether the product or service meets the needs of the customer for whom it is intended. For a process to be a Best Practice, both output and outcome indicators must be monitored and validated.

If the Best Practice doesn’t mention output and outcome indicators, we cannot verify its status as a Best Practice. The first question the owner of the Best Practice should ask is: “How does this process contribute to the achievement of the business and strategic plan of the organization?” The answer to this question suggests the type of results (and KPI) to be measured.

As illustrated in Chapter 6 (BEST Quick Scan), not all the investigated case studies mention the indicators tracked to document the performance of the process, nor do they differentiate between performance indicators at the process level and KPIs at the results level. It is difficult to speak of a Best Practice when there is no validation of the accuracy of the results this process will deliver.

  1. 5. Deployment and Segmentation
    • – The description of the process and approaches considers the specificities of all segments of the organization (division, department, work unit) and the variety of products and services.

To have a complete picture of the organization, you need to check how well all work units have performed. There could be significant variation in performance between work units. This drill down to individual segments or work units is what the tool calls deployment of the results.

BOX 3.4 Deployment of the Results

For an organization, the overall budget can be in balance, but some departments have a budget in the positive and other departments in the negative. Showing the result for individual departments will reveal which departments perform well and which need improvement.

It is not enough to give an overall view of the results. The results can be aggregated across the whole organization, or they can be segmented according to individual work units. Let us illustrate this with an example from the automotive industry: segmentation of customers.

BOX 3.5 Car Dealer, Segmentation According to the Customer Type

A car dealer has different segments of customers for the same car model. The expectations of younger customers may not be the same as retired customers. Therefore, it would be better to show purchasing results and feature preferences for each of these segments separately.

The same is true for other types of customers: civil servants, operators, professionals (doctors, pharmacists, public notaries, architects, etc.), teachers, and retired persons. All these groups have different needs, expectations, and requirements – even if they buy the same product, e.g. food from a supermarket.

  1. 6. Prevention
    • – Prevention is built into the process.
    • – The core process description considers the specific circumstances of the organization and prevention is integrated into the daily work.

Prevention is built into the process

All quality and safety professionals are familiar with the concept of prevention. This means that preventive measures are developed and incorporated into the process flow. Therefore, the number of safety incidents and non-conformities is kept to a minimum.

The core process description considers the specific circumstances of the organization and prevention is integrated into the daily work

Prevention can be integrated into a process in several ways: systematic training and retraining of individuals, systematic revision of SOPs and work instructions, application of poka-yoke,* audit and revision of the process, application of Total Productive Maintenance (TPM), application of Lean Six Sigma (LSS), or other strategic organizational approaches.

* Westcott, Russell T. and Duffy, Grace L. The Certified Quality Improvement Associate Handbook, 3rd ed., ASQ Quality Press, Milwaukee, WI, (2015), pp. 154, 155.

Manos, Anthony, and Vincent, Chad, Editors, The Lean Handbook, ASQ Quality Press, Milwaukee, WI, (2012), pp. 116–123.

Arthur, Jay, Lean Six Sigma Demystified, McGraw Hill, New York, (2011).

It is remarkable that in most Best Practice case studies the authors examined in preparing this text, only a few documented the concept of prevention (see Chapter 6).

  1. 7. Benchmarking
    • – The process description considers similar benchmarks and Best-in-Class examples.

The reason for including this characteristic is to avoid arrogance. When results and approaches are compared with the Best-in-Class, it becomes clear where and what kind of improvements need to be executed. Failing to compare our own results and approaches with others may cause us to think our processes work very well, when there are improvements that can be realized.

BOX 3.6 What We Can Learn from Others

Assume a civil servant is responsible for the economic development of his country. One benchmark is the experience of Singapore. This city-state realized an uninterrupted economic growth of more than 4% per annum for more than 40 years. If the civil servant takes the factors of economic growth in Singapore as a benchmark, he will discover which factors are the foundation for their success. Then he can compare these factors to those being employed by his own country. From this analysis he then establishes an improvement action plan to correct the gaps in his country’s economic activities.*

* Ghesquiere, Henri, Singapore’s Success, Engineering Economic Growth, Thomson Learning, Mason, OH, (2007).

There is a caution to be noted in benchmarking. Do not try to make an exact copy of the benchmark. The situation and circumstances of the company documenting their Best-in-Class processes are different from yours. Take the concepts and apply them to the characteristics and requirements of your own organization.

The example in Box 3.6 is helpful for another reason. Occasionally in the West comments may be made that Singapore is not a good example because their experiences cannot be translated in our culture’s economic situation. When considering benchmarking, it is more important to take the attitude of: 1) “if they can, why can’t we?” without prejudice and 2) only when the situation is different (and better) can we learn from others. Learning happens when we have an open mind. We must be eager to learn and prepared to act if we are to change our usual way of doing things.

US President Woodrow Wilson (1856–1924) stated: “As a nation, we can never learn either from our own weaknesses or our own virtues by comparing ourselves with ourselves.” Change the word “nation” to “organization” in this sentence and the message becomes crystal clear.

Ghesquiere, Henri, Singapore’s Success, Engineering Economic Growth, Thomson Learning, Mason, OH, (2007) Chapter 6. Singapore: Past, Future and What Other Countries Might Learn.

  1. 8. Data
    • – The measurement methods are described clearly and unambiguously, including securing the relevance, integrity, and reliability of the measurement results.
    • – The data are presented at the proper level of segmentation to effectively reflect performance and results at different levels of the organization.

The measurement methods are described clearly and unambiguously, including securing the relevance, integrity, and reliability of the measurement results

In this criterion, we emphasize all aspects of the measuring method. We need to have a detailed and precise measuring method. This could be an international standard such as ISO* or ASTM, but it can also be an internally developed measurement method. There are some important points to consider:

* ISO creates documents that provide requirements, specifications, guidelines, or characteristics that can be used consistently to ensure that materials, products, processes, and services are fit for their purpose. https://www.iso.org/standards.html.

ASTM is an international standards and testing organization with headquarters in West Conshohocken, Pennsylvania, and offices in Belgium, Canada, China, Mexico, and Washington, D.C. It was founded in 1898 by a group of Pennsylvania Railroad engineers and scientists, led by chemist Charles Benjamin Dudley, to address the frequent rail breaks in the fast-growing railroad industry. Originally called the American Society for Testing and Materials, it changed its name to ASTM International in 2001. The association has more than 30,000 members, classified as users, producers, consumers, and general interest. The latter are usually academics and consultants. ASTM develops and publishes technical standards that are arrived at through consensus and used on a voluntary basis for a wide variety of products, materials, systems, and services. To date, some 12,000 ASTM standards are used around the world with 143 technical standard writing committees. The standards are developed in accordance with the guiding principles of the World Trade Organization which include “coherence, consensus, development dimensions, effectiveness, impartiality, openness, relevance, and transparency.” ASTM internal standards fall into six categories: test method, specification, classification, practice, guide, and terminology standards. Each year ASTM International publishes the Annual Book of ASTM Standards. http://www.craftechind.com/what-is-astm-international/.

  • Sampling: the sampling method is done in a professional way. Consider an existing sampling method such as an ISO standard or other proven method. Sometimes the sample the organization takes for their measurement is too small or not representative of the population (lot). A good sample is taken in an approved manner and is representative of the whole lot.
  • The parameters are clearly defined for the measuring method.
  • The precision of the method is known. This is included in the measuring procedure and checked on a regular basis.
  • Calibration methods of the measuring instruments are available and applied.
  • Precision and accuracy are known and there is a method to check it.

BOX 3.7 Sampling Method

Only five customers are interviewed in a customer satisfaction survey.

When you have thousands of customers and prospects, too small a sample can lead to incorrect conclusions. The small sample of this example is not representative.

BOX 3.8 Measuring Method, Cycle Time

A retail bank offers mortgages to their customers. Management decides to use cycle time for mortgage approval as one way to measure the performance of the bank. Target: the total cycle time should be less than eight days.

In the example given in Box 3.8, cycle time initially looks to be clearly defined. However, a second look raises some questions. To be more precise in measuring, consider the following questions:

  • Is cycle time expressed in working days, calendar days, or bank working days?
  • At which point in the process does the cycle start: when the customer initially applies for the mortgage or when the first offer is made by the bank?
  • Likewise, what is the endpoint of the cycle?

It was originally assumed that the process was described in enough detail to be consistently measured. This is often not the case.

BOX 3.9 Precision

Many chemical and microbiological measurements are done in a medical lab daily. It is important that all measurement instruments are calibrated on a regular basis. This ongoing calibration routine allows the laboratory manager to assure measurement results are precise and reliable.

In the situation described in Box 3.9, calibration is part of the measurement method. The gap between the measured value and the true value is zero when equipment is correctly calibrated.

BOX 3.10 Accuracy

Measurement of workers’ skills, customer satisfaction, etc. demonstrates a (natural) variation in results. This variation can be expressed as standard deviation.

The better the process is under control, the lower the variation (standard deviation) will be. This minimal standard deviation will be present when the process is under control. Statistical Process Control (SPC)* charts are used to minimize variation and maintain processes within control limits. In many situations, process performance is not statistically monitored or put under control (see examples in Chapter 6).

* Statistical process control, https://en.wikipedia.org/wiki/Statistical_Process_Control accessed 12/28/2019.

The data are presented at the proper level of segmentation to effectively reflect performance and results at different levels of the organization

Segmentation and deployment were already mentioned in the fifth criterion “Deployment and Segmentation.” Here we present the data at the different levels of the organization and we analyze the performance for this segmentation.

3.1.3 Do

The Do phase consists of five criteria and seven characteristics. This phase is generally the best developed in most organizations.

The five criteria for the Do phase are:

  1. 1. Implementation
  2. 2. Deployment
  3. 3. Cause-effect
  4. 4. Accountability
  5. 5. SMART*

* SMART is an acronym, giving criteria to guide in the setting of objectives. Each corporate, department, and section objective should be: Specific – target a specific area for achievement or improvement; Measurable – quantify or at least suggest an indicator of progress; Assignable – specify who will do it; Realistic – state what results can realistically be achieved, given available resources.; Time-related – specify when the result(s) can be achieved.

  1. 1. Implementation
    • – The daily activities are in conformance with the process descriptions and documented methods.
    • – The implementation of the core process is integrated into daily work.

The daily activities are in conformance with the process descriptions and documented methods.

This criterion verifies that tasks are performed as described in the documented process. Very often no process description is available (see examples in Chapter 6). When there is no formal description of the process, everyone in the process tries “to work at their best” in the way they understand “how to do the work.” Consequently, there is great variation of outcome from the process. This is the opposite of a Best Practice. A reliable process consists of activities that are standardized and documented. What is described and documented is also executed and vice versa.

The implementation of the core process is integrated into daily work.

It is not enough to have a process which is nicely described if it is not put into practice. What is done in daily life is exactly the same as what is documented.

  1. 2. Deployment
    • – The approach is used by all appropriate work units.

It is not enough that one service or department applies what is described in the process. All work units (teams, services, departments, plants, business units, etc.) must apply the requirements of the process in the same way.

Deployment of the Best Practices approach must be organized not only horizontally across functions, but also vertically from top management to the front lines of the organization.

  1. 3. Cause-effect
    • – The use of the process leads to concrete and measurable results.

Results caused by unstable or undocumented approaches are not reliable. Therefore, applied methods must be improved in such a way that results can be predicted over time. Reliable and robust approaches lead to reliable results.

Many people have difficulty understanding the cause-effect relationship or in explaining it to collaborators. Process owners are responsible for the effective use of cause and effect analysis and to explain it to operators.

BOX 3.11 Profit

A general manager claims responsibility for the increase of profit because of his management actions.

If the general manager does not explain why this increase is due specifically to his management actions, his statement is “management by fiction.” The manager must clearly describe the series of efforts and investments he pursued over the last five years, showing proof of increase of productivity and quality, and a decrease in scrap and defects. Only with clear cause and effect attribution can he claim that his management actions lead to the increase in profit.

The example in Box 3.11 shows a common pitfall. If the Best Practice describes the exceptional results as an accomplishment of a single person (e.g. the general manager), double-check the context of the situation. It could be that the Best Practice is more a public relations paper than a true Best Practice.

  1. 4. Accountability
    • – All employees and managers clearly exhibit how they are responsible and accountable for their assigned tasks.

The Accountability characteristic as part of the Responsibilities criteria in the Plan phase describes the way the company is organized, i.e. the description of the applied method. Accountability in the Do phase addresses the implementation of methods.

A Culture of Accountability is the manner through which people develop successful solutions daily. It is the approach necessary to find answers, overcome obstacles, and deliver results. People in a Culture of Accountability follow through to make sure they do what they say they will do, commit themselves to getting to the truth, and feel free to say what needs to be said.*

* Connors, Roger and Smith, Tom, How Did That Happen? Holding People Accountable for Results the Positive, Principled Way, Publisher Portfolio, 2009. Penguin Group (USA) Inc. New York.

The process owner has the necessary authority to achieve planned objectives and is held accountable for overall performance and results. Therefore, when the process owner notices issues reflected in a KPI, he finds solutions and implements improvements. He doesn’t wait until problems occur; he addresses the issue proactively. The process owner takes the initiative not only to put improvements in place, but also to audit the process regularly.

  1. 5. SMART
    • – KPIs and PIs are used systematically.
    • – SMART decisions are made, and action plans are developed.

KPIs and PIs are used systematically.

Indicators are used systematically. The word “systematic” means on a regular basis, e.g. weekly or monthly.

Each indicator has his target. These targets are formulated using the SMART criteria, i.e. Specific, Measurable, Actionable, Realistic, and Time-bound. Some additional useful criteria for targets are: Accountable, Ambitious, and Relevant.

The target is set to be ambitious, but realistic. All too often we see that people put their targets too low, so that they easily achieve the target. This is a reflection of a defensive thinking style. The achieved results are mediocre and don’t belong to a Best Practice.

SMART decisions are made, and action plans are developed.

KPIs should be reviewed and discussed, SMART decisions made, and actions assigned for prevention or improvement on a consistent cycle. Benchmarking using a Best Practice requires clear, measurable action that can be translated into the situation of the user.

If the criteria of the Do phase are well described, the original organization as well as a benchmarking partner may expect to achieve effective results. If excellent results are desired, the two next phases, Check and Act must be actively applied.

3.1.4 Check

The Check phase consists of four criteria and 13 characteristics. The role of the process owner is very important in this phase. Without the participation of the process owner, it is very difficult to achieve excellent results.

The four criteria for the Check phase are:

  1. 1. Integration
  2. 2. Monitoring
  3. 3. Audit
  4. 4. Adjustment and learning
  1. 1. Integration
    • – Plans, processes, results, analysis, learning, and actions are harmonized across process and work units to support organization-wide goals.

There are two types of activities: one related with the process of the Best Practice and one with the “normal daily” activities. When the Best Practice is viewed as separate from daily work, collaborators experience the activities of the Best Practice as a burden and an extra workload. When the process is integrated consistently into daily activities, there is no differentiation between a Best Practice and “what we do every day.”

Processes must be integrated to be truly effective. Much is written about the danger of conducting activities in silos. For excellent results, processes must be developed to work with related processes. KPIs must reflect the reality of the interdependence of processes to meet desired outcomes.

Management does not always appreciate the benefit of process integration. When researching a Best Practice, be alert when a manager says there is no time, headcount, or budget to spend on theoretical concepts such as learning and process management. This reactive type of management indicates the process owner does not understand the value of the broader picture of the organization and how processes must work together. The reactive manager rarely engages in prioritization or strategic problem solving. The manager and his organization are always busy with short-term firefighting, rather than effective, strategically beneficial activities.

  1. 2. Monitoring
    • – The performance of each core process is regularly measured and monitored.
    • – The results obtained related to a core process are regularly discussed with all relevant stakeholders.
    • – The method to determine the target value of the KPI (target) is validated and opportunities for improvement are recorded.
    • – Relevance, integrity, completeness, and reliability of the results achieved are checked.

The performance of each core process is regularly measured and monitored.

The performance of the process is monitored in two ways: 1) through a weekly or monthly meeting where the KPIs are reviewed by the management team and 2) improving the process by eliminating non-value-added activities.

The obtained results related to a core process are regularly discussed with all relevant stakeholders.

All aspects of results management are addressed in the KPI review meeting. All those directly concerned participate in the discussion and decide which actions to take to reach expected results.

The method to determine the target value of the KPI (target) is validated and opportunities for improvement are recorded.

The process owner has a method to determine targets. The concerned stakeholder validates the targets of the KPIs. As said earlier, the agreed targets are ambitious, but nevertheless realistic. The process owner with all people concerned, including the relevant stakeholders, examines and reports the areas for improvement.

Relevance, integrity, completeness, and reliability of the results achieved are checked.

The process management team consistently monitors the relevance, integrity, completeness, and reliability of the achieved results. Notice that the process owner has to examine four subjects systematically:

  1. 1. Are the data and results relevant for our Best Practice? Do these data contribute directly and positively to the realization of the strategic goals?
  2. 2. Does the data have integrity? Can we trust the results presented?
  3. 3. Are the data and results complete? Think about the deployment and segmentation of the results.
  4. 4. Are the data reliable? You can only make correct decisions based upon correct (reliable) data.

From our experience we see that many people don’t ask themselves these kinds of questions.

In a May 2019 APQC* survey, 91% of respondents reported supporting or managing process improvement efforts, with 62.5% establishing a process performance dashboard and 46.4% utilizing auditing to gather information for improvement opportunities. This confirms our finding that many so-called Best Practices are not truly a Best Practice because they miss, among others, characteristics, a performance dashboard and a systematic audit of the process.

* APQC is the world's foremost authority in benchmarking, best practices, process and performance improvement, and knowledge management. APQC membership includes access to the ever-growing Resource Library, with more than 5000 research-based best practices, benchmarks and metrics, case studies, and other valuable APQC content.Source : apqc.org.

Lyke-Ho-Gland, Holly and Morgan, Lochlyn, Putting Process Frameworks into Action, APQC Survey Summary Report Announcement materials. May 2019, APQC, slide 11.

  1. 3. Audit
    • – Each core process owner audits his or her process regularly.
    • – The process owner examines what can be done to bring the core process to a higher maturity level (to determine improvement opportunities).

Each core process owner audits his or her process regularly.

Regular audits are an excellent way to manage the processes and KPIs better. Regularly means that processes are audited at least once a year. The audits not only confirm what is performing effectively, but also where new opportunities for improvement exist.

The process owner examines what can be done to bring the core process to a higher maturity level (to determine improvement opportunities).

Using audits to improve processes helps the organization grow to higher levels of performance maturity.

  1. 4. Adjustment and Learning
    • – Deviations from the desired and/or planned results serve as input for the improvement and revision of the core process and/or approaches.
    • – Identification of problems related to the sufficient availability and appropriate resources such as budget, machinery, equipment, provisions, tools, and Information Technology (software, hardware, networking, security, etc.).
    • – Identification of an adequate number of employees and/or of shortcomings of skills and experiences of employees in the process and/or approaches.
    • – Comparison of the results obtained with the benchmark and Best-in-Class.
    • – Prioritization of opportunities for improvement.
    • – Encouragement of breakthrough change to the approach applied through innovation.

The first three characteristics of this criterion are concerned with solving problems in a pragmatic way. The Check phase is a time for verifying the stability of the process through problem-solving techniques.*

* Westcott, Russell T. and Duffy, Grace L. The Certified Quality Improvement Associate Handbook, 3rd ed., Quality Press, Milwaukee, WI, (2015) p. 131.

Deviations from the desired and/or planned results serve as input for the improvement and revision of the core process and/or approaches.

People familiar with Kaizen know that there is always a better way to do things. Even small improvement activities need to be done on a regular basis (daily, weekly). When an improvement is executed, you need to revise the standards, SOP, work instructions, etc. You increase the revision number. This higher revision number is also a visualization of the learning process.

Identification of problems related to the sufficient availability and appropriate resources such as budget, machinery, equipment, provisions, tools, and Information Technology (software, hardware, networking, security, etc.).

Shortage of resources needs to be addressed. It is the responsibility of the process owner to maintain stability of the process. The process owner shall take the necessary actions and decisions when there are not enough available resources.

Identification of an adequate number of employees and/or of shortcomings of skills and experiences of employees in the process and/or approaches.

The process owner needs not only adequate technical resources but also collaborators. He won’t be able to achieve excellent results if there are not enough collaborators to perform the tasks and/or if there is a lack of collaborator skills. It is the responsibility of the process owner to verify that every collaborator knows the work instructions very well and applies these in detail in daily life. He also has to verify that all collaborators doing the same job are doing the task in an identical way. There is only one best way to perform the task.

Comparison of the results obtained with the benchmark and Best-in-Class.

Results are not only compared with an internal target, but also with other Best-in-Class examples. Getting feedback from third parties is the best way to stay informed of excellent approaches or results.

Prioritization of opportunities for improvement

Prioritizing opportunities for improvement is a constant challenge. The list of opportunities will generally be much greater than can be addressed in a reasonable amount of time. The process owner must constantly balance resources and time to prioritize the improvement opportunities.

Encouragement of breakthrough change to the approach applied through innovation.

Continuous improvement can be done by application of techniques like Kaizen,* Statistical Process Control, and LSS. Besides continuous improvement, breakthrough improvements are also possible. Breakthrough becomes necessary when the strategic plan requires productivity increases of 10% or more. In that situation there are two options: 1) reengineer the whole process§ or 2) automate the process. The second option may require significant investment.

* Duffy, Grace L. Modular Kaizen, Continuous and Breakthrough Improvement, Quality Press, Milwaukee, WI, (2014) pp. 15–25.

Burke, Sarah E. and Silvestrini, Rachel T. The Certified Quality Engineer Handbook, 4th ed., Quality Press, Milwaukee, WI, (2017).

Kubiak, T. M. and Benbow, Donald W. The Certified Six Sigma Black Belt Handbook, 3rd ed., Quality Press, Milwaukee, WI, (2016).

§ Ibid, p. 19.

The Check phase encompasses techniques for stabilizing processes and for finding areas for improvement. To complete the development of a Best-in-Class process, we must put these techniques into practice, i.e. to Act. The last step in the PDCA-cycle is the opportunity to prepare a new Plan, i.e. document gains realized and cycle back to step 1 in the PDCA-cycle.

3.1.5 Act

The Act phase consists of five criteria and eight characteristics.

The five criteria for the Check phase are:

  1. 1. Improvement
  2. 2. Process
  3. 3. Resources
  4. 4. Knowledge and experience
  5. 5. Benchmarks
  1. 1. Improvement
    • – The output of the measurement and learning is analyzed and used to identify additional improvements – to prioritize, to plan, and to implement these opportunities for further improvement.

The Check phase introduces ideas and areas for improvement. The Act phase closes the feedback loop. After analyzing results of the Plan, Do, and Check phases, the Act phase is to plan and implement improvements prioritized through the Adjustment and Learning characteristics of the Check phase. Those with the greatest leverage or return get priority in the new Plan phase.

Normally you’ll have a long list of possible improvement activities. You have to prioritize the improvement opportunities. By applying the Pareto principle,* you take the 20% improvement opportunities which will deliver 80% of the planned results.

* https://en.wikipedia.org/wiki/Pareto_principle accessed 12/28/2019.

  1. 2. Process
    • – The process, methods, and approaches are revised and improved in response to the findings gained in the Check phase.

The key words here are revised and improved. Verify revision numbers of procedures, instructions, processes, and KPIs currently followed. SOPs, instructions, and measurements should be reviewed at least annually. Most organizations do not have a scheduled cycle to revise and improve these materials. This is the responsibility of the process owner.

It is not enough, however, to revise and improve the process and documentation; it is necessary to train the people who are working with the process on these changes. Alerting the workforce of changes is often forgotten, only to have confusion and a loss of improvement when people slide back to the old way of doing things.

  1. 3. Resources
    • – The amount and nature of the resources that were adjusted because of the findings in the Check phase are documented.
    • – The number of employees assigned to the process is adjusted considering the opportunities of improvement and the outcome of the process, methods, and approaches.

The amount and nature of the resources that were adjusted because of the findings in the Check phase are documented.

The process owner makes a detailed analysis of the resources required. A plan is developed to overcome resource barriers (budget, equipment, etc.). In case of a complex process, it might be necessary to rebalance workload across portions of the activity. Fortunately, as productivity increases, resources (people, equipment, …) can be returned to other parts of the business.

The number of employees assigned to the process is adjusted considering the opportunities of improvement and the outcome of the process, methods, and approaches.

The process owner takes the necessary initiatives to ensure that there are enough collaborators to perform the activities in his area. Having the adequate number of collaborators is not enough; he also needs to verify to what extent the skills of the collaborators correspond to the needs.

  1. 4. Knowledge and Experience
    • – New training and/or refresher training is given to meet the findings gained in the Check phase.
    • – Refinements and innovations are shared with other relevant work units and processes.
    • – The knowledge and experience of those involved in the process are documented and validated as Best-in-Class or Benchmark level.

New training and/or refresher training is given to meet the findings gained in the Check phase.

The findings of the Check phase lead to a training program of specific topics for the collaborators.

Refinements and innovations are shared with other relevant work units and processes.

Individuals and teams have an opportunity to share their ideas, results achieved, and experiences with other teams.

The knowledge and experience of those involved in the process are documented and validated as Best-in-Class or Benchmark level.

Key words here are knowledge and experience. How are these two concepts put into practice? Is there systematic progress in the development of process knowledge, procedures, and activities? When this systematic progress is successful, organizational knowledge approaches the status of wisdom. Only a few organizations can demonstrate this level of progress.

Not every professional can demonstrate that he or she has learned more than they knew last year or has made progress in their professional situation. This progress can be achieved through on-the-job-training, formal training, video sessions such as webinars or open training, etc. The following non-exclusive set of questions may suggest how knowledge and experience can be developed.

  • How many days of training per year has the participant attended?
  • Are individuals and teams better in finding solutions for the problems encountered in their daily work each year?
  • Is there an increase in the number of suggestions to improve team productivity and quality, and to decrease costs and cycle times?
  • Do workers make suggestions to integrate preventative measures into the process?

Positive answers to questions such as these are a measure of the development of personal knowledge and experience.

  1. 5. Benchmark
    • – The organization can be set as a model for other organizations.

We can learn from others. The reverse is also true. Others can learn from us. This criterion explores to what extent your organization can be used as a benchmark for others. If other organizations are referring to your organization as well organized, with processes producing excellent results, you can indeed conclude that you are a benchmark in your sector.

This section has described in detail what makes an improvement model (PDCA) an excellent enabler for developing a Best Practice. An enabler without results provides no tangible target. The next section describes the requirements for the achievement of excellent results.

3.2 Assessment of the Achieved Results

3.2.1 Results

This section consists of 7 criteria and 20 characteristics. The criteria and related characteristics are listed in Figure 3.4. The reader will note that just as processes are interdependent, so are the criteria for the enabler and the results. The enabler describes the activity. The results describe the characteristic outcomes of the activity.

The seven criteria for the results are:

  1. 1. Scope and relevance
  2. 2. Integrity of data
  3. 3. Segmentation
  4. 4. Trends
  5. 5. Targets
  6. 6. Comparisons with targets and benchmarks
  7. 7. Cause-effect

We have to avoid a classic pitfall: some people have the tendency again to describe approaches here, such as methods, procedures and instructions, i.e. enabling elements. Don’t do that. What you have to describe in this criterion for results are data and results.

  1. 1. Scope and Relevance
    • – The results are aligned with the expectations and needs of the relevant stakeholders.
    • – The results are aligned with policy and strategy of the organization.
    • – The most important key results are identified and prioritized.
    • – The relationship between the results is understood.

The results are aligned with the expectations and needs of the relevant stakeholders.

It is not enough to have a general alignment with shareholders’ needs and expectations. All the stakeholders’ needs and expectations must be met, including customers, employees, suppliers, contractors, partners, society, sponsors, etc. Here you have to give the results as aligned with those needs and expectations.

The results are aligned with policy and strategy of the organization.

It has been stated previously that a Best Practice describes the essential and important activities of the organization. Therefore, an alignment must exist between the Best Practice and the achievement of the Business and/or Strategic Plan of the organization. Here the results are shown.

The most important key results are identified and prioritized.

There may be different types of results depending on the process under study. It is necessary to define which results are important and which results have the highest priority for sustainability and improvement.

When monitoring a process, there can be input, process, output, and outcome indicators. Each of these indicators measures a result. Considering all these different measures, one Best Practice can have many results. The Best Practice must describe which of these results are most critical to process excellence and what relationship exists between those results. For example, see Enabler criterion number 3: KPIs and PIs, Figure 3.1.

The relationship between the results is understood.

If you present the KPIs in a process way, such as Figure 3.1, you can see immediately the relationships between results. Of course, you may also explain the relationship between results with words.

  1. 2. Integrity of data
    • – Results are timely.
    • – Results are reliable and accurate.

Results are timely.

Not only the level of the target, e.g. a 10% increase of productivity or a 20% decrease of the cycle time for delivering the permit, but also when these results are achieved, i.e. the deadline, is important. You can’t move fast and forward if you have to wait weeks before you get the results.

Results are reliable and accurate.

Process assessment must stop if there is a problem with the integrity of the data. It is not useful to make an assessment based upon unreliable results.

BOX 3.12 Unreliable Results

An internal safety audit is conducted in a large industrial plant. The audit findings are clear: there is a series of unacceptable non-conformities. The supervisor of the audited cell hears this negative report and demands the auditor to describe his findings less negatively. The division head, who is not happy with the report either, changes some wording and deletes the most negative examples to make the message sound more acceptable. The report goes to a higher level. The department manager is also not happy with the report. He further “polishes” the text and then passes it to the general manager. The general manager, overall, is satisfied with the “sanitized” audit report because he feared negative findings and the report he receives puts his mind at rest. The final decision is that no major steps for corrective action need to be taken.

This example, based upon the actual experience of one of the authors, illustrates how company culture can lead to unreliable results and incorrect decisions. It is clear from this example that if there is incorrect information included in a process description or supporting reports, it is not worthwhile to investigate additional aspects of a Best Practice. On-site interviews often uncover incidents where the documentation of a process is inconsistent with actual performance.

BOX 3.13 Missing Data in Customer Complaint Treatment

All customer complaints are logged into a software application in chronological order. Occasionally customers have submitted a complaint that was confusing or seemed odd to the person entering the data. The data entry clerk would not enter these confusing complaints.

Filtering complaints before capture is a common occurrence. Terms such as “real” complaints and “unaccepted” complaints are used. When complaints are screened before entry into the complaint handling system, the data base does not reflect the totality of customer concerns.

There is a risk in filtering complaints before including them in the data base. If the goal is to reduce the number of complaints and the manager sees an increase, he or she is tempted to omit “the least important” complaints. When the data is corrupted by inappropriate filtering, it is impossible to make correct decisions based upon the existing data and results.

  1. 3. Segmentation
    • – Results are segmented in a suitable manner
      • by region, country
      • by department, business line, division, unit
      • by product and service type

Segmentation or stratification of information may make it easier to focus on the correct action. Combining too much data smooths out performance highs or lows that would ordinarily prompt questions.

A real Best Practice always shows the results by its segmentation.

Sometimes the graphs created to present data analysis are too complicated. Try to limit the number of lines in a graph to three or four. It is easier and faster to assess five simple graphs than a single graph with too many lines.

  1. 4. Trends
    • – Trends are positive for five years or more.
    • – Results are sustainable and show good performance.

Trends are positive for five years or more.

A reliable Best Practice should demonstrate a positive trend of improving results for more than 5 years, and preferably, 10 years. It is not possible to draw a conclusion from a set of results for three years. We know that many people think that a progress in results for three years will last for more years. In our experience this is not true. Reason: there are so many changes in the context of the organization, that these can have a negative effect on the results. Therefore, we prefer a 10-year positive trend. Then you can more safely say that you have a true positive trend.

Results are sustainable and show good performance.

A positive trend should be sustained for more than five years. Positive results for a significant period increase the probability that these results are not an accident but are sustainable.

When illustrating the trend of positive results, it is not enough to simply show a line graph of the trending period. It is more useful as a benchmark if the backup data showing the performance measures of the last 5 or 10 years are provided in an accompanying table. If the actual data is competitively sensitive, percentages may be better than raw figures.

  1. 5. Targets
    • – Targets for core results are set.
    • – Targets are suitable.
    • – Targets are achieved.

Targets for core results are set.

The expectation for claiming a Best Practice is to have ambitious performance targets. It is sometimes difficult, however, to tell whether the results achieved are ambitious. When the Best Practice describes the method of setting objectives and targets, it is easier for the benchmarking partner to ascertain whether the presented results are indeed excellent. Exceptional improvements vary across industries. Providing some baseline of performance expectation helps the reader of the Best Practice truly appreciate the results obtained.

Targets are suitable.

This seems logical, but it isn’t always the case. Box 3.14 provides an example of target setting, based upon a real production situation.

BOX 3.14 Increase in Productivity

A production manager sets an annual target for a 3% productivity increase. When asked why he targets only a 3% increase, he answers “because we always set a 3% target. This satisfies our general manager.” Based upon the production reports of the last year, it would be realistic to set a 7% productivity increase instead of 3%. However, the production manager refused to accept this “too ambitious target.” When he is asked to explain his motivation for a non-ambitious target (3%), his explanation is simple: “because I will get my bonus at the end of the year when I achieve my planned objective of 3%. If I plan 7% and maybe only achieve 5%, I will not get my bonus.”

This example makes two important points:

  1. 1) Company culture plays an important role in setting targets (i.e. the production manager feels punished when he “only” achieves a 5% productivity increase instead of the planned 7%. On the other hand, he feels rewarded if he achieves the 3% goal and gets his bonus.
  2. 2) The method for setting objectives and targets is important. Evidence of what prompts the creation of the target must be in the description of the Best Practice.

Targets are achieved.

Setting ambitious targets means also that you’ll only achieve these targets in 70% or 80% of the cases. If you achieve 100% of all your targets, then you have to investigate whether these targets were “ambitious.”

The authors have observed that occasionally targets are not set for the coming year but established at the end of the period. A target that is set to correspond with the performance already attained is a form of manipulation. The target should always be set at the beginning of the performance period to reflect the desired performance, not the performance that can easily or has already been attained.

  1. 6. Comparisons with targets and benchmarks
    • – Comparisons for core results are made.
    • – Comparisons are suitable.
    • – Comparisons are favorable.

Why do we need to compare ourselves with a Benchmark or other Best Practice? This avoids complacency and allows you to learn from a good example. This can inspire you to make further improvements in your Best Practice.

Comparisons for core results are made.

It is obvious that you not only compare your Best Practice with others, but also that your achieved results are equal or better than the Benchmark.

Setting targets as a comparison for benchmarking is important. Criterion 6 (Comparisons with targets and benchmarks) takes criterion 5 (Targets) to the next level. Not only are targets set at the beginning of the performance cycle, but they are also compared with the results achieved. The additional characteristic in criterion 6 is that the comparison of target and achieved performance is favorable. Not only is the process following requirements, but the process meets or exceeds the targets set at the beginning of the performance period (for more information on PI and KPI, refer to the Plan phase in the Enabler section).

Comparisons are suitable.

By comparing your Best Practice with a Benchmark, you must pay attention to the fact that it is logical to make that comparison with that specific external organization.

Comparisons are favorable.

You compare your achieved results with the Best-in-Class or Benchmark. If you can say that in most cases, e.g. 75%, your achieved results are better than the Benchmark, you have an excellent result.

Once results have been achieved and compared with a benchmark, the owner of the KPI should ask: “What have I learned? What action do I need to take to adjust the process or improve it further?”

  1. 7. Cause-effect
    • – The results are clearly achieved through the chosen approach (cause-effect).
    • – The relation between results achieved and the approach taken (the enabler) are understood.
    • – Based on the evidence presented, confidence should be high that the positive performance will continue, i.e. the results are sustainable.

The results are clearly achieved through the chosen approach (cause-effect).

The cause-effect criterion is the opposite of achieving results by accident. The owner of the Best Practice must explain how the methods and approaches are used and how they lead to excellent results.

The relation between results achieved and the approach taken (the enabler) are understood.

The better the owner understands the relationship between the achieved results and the approach taken, the easier it becomes to undertake further corrective actions, i.e. improvement initiatives and preventative measures.

Based on the evidence presented, confidence should be high that the positive performance will continue, i.e. the results are sustainable.

When the relationship is understood and corrective actions are taken in a structured and systematic way, you’ll discover that the results become predictable and sustainable.

3.2.2 Test of Results Criteria on a Real-Life Example

The following Figure 3.2 gives a presentation of results of a real-life example of Primary and Secondary Syphilis treatment in different hospitals. Let us apply the seven criteria of the Results part of the BEST-tool on this example.

Figure 3.2 Incidence rate of P&S Syphilis at Nashville, Memphis, Tennessee, and the USA (period 1994–2001).* P&S: Primary and Secondary Syphilis.

* Bialek, Ron, Duffy, Grace L. and Moran, John W. The Public Health Quality Improvement Handbook, Quality Press, Milwaukee, WI, (2009), Bailey, Stephanie, M.D., MSHSA, Chapter 12: Already Doing It and Not Knowing It.

The following text analyzes the material available in the syphilis case study with the list of results criteria described above.

  1. 1. Scope and relevance
     Not available
     There is an introduction of the reason for choosing the project, although with not enough detail in this case study to validate the scope and relevance. The credentials of the author imply that the scope and relevance are closely aligned with the public health charter and are appropriate.
  2. 2. Integrity of data
     Not available
     It is reasonable to assume the data is correct based on the professional credentials of the health sector author.
  3. 3. Segmentation
    Yes, we see here the segmented results for Nashville, Memphis, Tennessee, and the USA.
  4. 4. Trends
     The results for Nashville show a positive trend of reduced incidence for only the last three years. On the contrary, the results for Memphis and Tennessee show a positive trend of reduced incidence for eight years.
  5. 5. Targets
     Not available
     It is difficult to say whether these results are ambitious and excellent. We can assume that targets are implicitly present in comparison with the state and US results.
  6. 6. Comparison with targets and benchmarking
     Caution must be taken when assuming excellent performance. A benchmark should always be the Best-in-Class, never the average. Therefore, it is not known whether the US result is a benchmark. A true benchmark city in the USA would be one that is larger than 200,000 inhabitants which is ranked as number one in the reduction of cases of primary and secondary syphilis.
  7. 7. Cause and effect
     Not available
     Although this level of information is not present in the limited six-page case study, the relationship is probably evident in more detailed project reports.

3.2.3 Conclusion

When this graph is first studied, it appears most impressive. Comparing the information with that required by the BEST-tool reveals that complete data is not available for four of the seven criteria. This observation is not to say that the project was not extremely successful. The case study was not written to provide all the information to be used as a Best Practice by benchmarking partners. Only when all the seven criteria for “results” are described in a positive way, is there enough information for a benchmarking partner to improve their own similar process and be assured of achieving excellent results.

Even when all seven criteria for results are described, it cannot be definitively concluded that this is an example of a Best Practice. It is too early in the improvement cycle to establish sustainability. A full Best Practice case study will apply the checklists of enabler (PDCA), results, process, and format. This case study, however, has a good foundation for being expanded into a true Best Practice document.

The next section describes the assessment criteria for documenting a Best Practice process.

3.3 Assessment of the Management of the Best Practice Process

3.3.1 Definition of a Process

An activity or group of activities that takes an input, adds value to it, and provides an output to an internal or external customer; a planned and repetitive sequence of steps by which a defined product or service is delivered.*

* Westcott, Russell T. and Duffy, Grace L. The Certified Quality Improvement Associate Handbook, 3rd ed., Quality Press, Milwaukee, WI, (2015) p. 238.

The process that is described for a Best Practice is often illustrated through a flowchart . Formatting the flowchart into four columns (Who, Where, When, How) provides a complete and transparent process description (see example of Blood Draw Process in Chapter 7).

A process description provides evidence that the company is well organized, activities are standardized, and results are reliable and repeatable. In only a few case studies analyzed in the research for this book have the authors seen a process description that provided evidence of reliability and repeatability. Remember that for a Best Practice, all four components must be linked together: 1) Enabler (PDCA), 2) Results, 3) Process description and 4) Format of the Best Practice, i.e. the detailed documentation of the Best Practice.

The following is a closer look at the characteristics of the management of a process. This segment is comprised of nine criteria. Table 3.3 shows a complete listing of the criteria for the management of a process.

Table 3.3 Assessment of the management of the process of a best practice

Legend: KPI = key performance indicator; NOK = not complete; OK = complete

  1. 1. Owner of key process

The key process owner is usually a member of executive management. When executive management is assigned responsibility, the message to the organization is that this is a critical process. W. Edwards Deming is often alleged to have said that 85% of organizational problems are management controllable, while only 15% are worker controllable.* Process management is a typical function for an executive manager, not a line manager. A process description is nothing more than a description of how work is done. As described through the concept of Kaizen, there is only one best way to do things; we need to arrange the process and activities in such a way that this “best way of doing things” is achieved in a repeatable way.

* Westcott, Russell T. and Duffy, Grace L. The Certified Quality Improvement Associate Handbook, 3rd ed., Quality Press, Milwaukee, WI, (2015) p. 13.

  1. 2. Integrity

Integrity is a difficult criterion to describe, since it is an intangible concept. The comparison between integrity and the lack of it, however, is recognizable. Lack of integrity presents itself in a business in many ways: fraud, corruption, bribery, misappropriation of funds, laundered money, tax evasion, etc. The temptation to manipulate processes for organizational or personal gain is real. The pressure to maintain the appearance of a Best Practice can prompt inappropriate behavior in activities such as purchasing, military equipment sales, financial (banks, trading firms) or global transactions such as oil, and agricultural crops.

Reliable process management is dependent upon the integrity with which the organization functions. The way we organize and monitor activities allows or prevents inappropriate behavior. Building transparency into critical processes is a way to encourage integrity in the workplace.

BOX 3.15 Purchasing Department

The management of activities for sending Requests for Pricing is separated from the management of activities for ordering the materials from the supplier. Having two different managers involved with the purchasing process reduces the possibility of inappropriate behavior.

BOX 3.16 Bank

To discourage fraud in a bank, high ranking officers are required to take all their holidays. The concern is that someone who comes into the office on a holiday might be hiding transactions from all but a small number of accomplices. A manager who is always in the office may be a signal of inappropriate behavior: to keep illicit transactions fully under control. Another signal is staying late in the office when everyone else has returned home. Managers are rotated out of position every two years to minimize improper use of their authority.

These two examples illustrate the importance of integrity and transparency.

  1. 3. Risk management

Does the organization assess risks to business on an annual basis and take the necessary preventive actions? Are these preventive activities integrated into the process description?

The risks to a business can be diverse: environmental, safety, currency exchange, political risks (export to certain developing countries), food safety, health risks, labor accidents, etc. The business maturity of a company performing processes at Best-in-Class level will be aware of their risks and be actively managing to reduce their exposures.

  1. 4. Relation with strategic plan

A company should only invest the extra time, and resources in developing a Best Practice where it expects to gain the highest return. The highest return means there is a positive contribution to the achievement of organizational strategic objectives. The alignment of the process with the strategy of the organization should be clearly documented.

  1. 5. Adding value

Each project consists of a sum of value adding and non-value adding activities. Masaaki Imai uses the Japanese word “muda” to identify non-value adding activities as waste.* A process is managed in a professional way when there is an approach used to systematically decrease the amount of muda. Imai taught us that there is much more muda than real added value in a process. Therefore, there is always an opportunity for improvement. People familiar with LSS know that the improvement process is endless and results not only in increased productivity, but also customer and employee satisfaction, and the satisfaction of partners and society.

* Imai, Masaaki, Gemba Kaizen, A Commonsense, Low-Cost Approach to Management, McGraw Hill, New York, (1997).

BOX 3.17 EXAMPLE OF APPLICATION OF REDUCTION OF MUDA

An Ontario District Health Unit realized their patients were wasting time getting from the lobby to their scheduled medical appointment. A recent office re-arrangement had moved several medical suites. The receptionist had not been informed of these changes. Patients were confused, often returning to the lobby in frustration. A process improvement team recognized the time being wasted and the bottleneck in the lobby caused by patients trying to find the correct treatment area. An updated map of the facility, with treatment areas highlighted, was created for the receptionist and distributed to all employees. New signage was placed in the lobby providing directions to major areas of the building. These new tools got patients where they needed to go quickly and reduced the bottleneck from the lobby.

  1. 6. Systematic simplification

If waste is removed from the process on a systematic basis, the process becomes simple and transparent.

Once the process is flowcharted and understood, inefficiencies and conflicts in the process become more obvious. Misinterpretations of wording and instructions can be corrected to further simplify the process. Effectively managing the process leads to reduced waste. Eventually the process becomes transparent* .

* Van Nuland, Yves and Duffy, Grace L. Professional Process Management, The Quality Management Forum, ASQ Quality Management Division, Milwaukee, WI (2019) vol 45 number 4 pp. 1–11.

  1. 7. KPI

Every key process has at least one KPI. The importance of KPIs is described in criteria in earlier sections of this chapter.

  1. 8. Audit

A key process is audited at least annually either by the owner of the process or by a third party. It is difficult to recognize gaps in performance in activities that are seen every day. Someone not directly involved with the daily tasks can more easily see imperfections. A scheduled program of process audits allows the organization to make gradual and continuous improvement. Integrating continuous improvement into daily activities is the most effective way to sustain performance.

  1. 9. Maturity level of process

The concept of maturity levels for process management is explained in Chapter 2. There is a logical sequence of actions that allow an organization to increase their level of operating maturity over time.

Thus far, Chapter 3 has described the first three components of a Best Practice: enabler (PDCA), results, and process management. The fourth and last assessment component is the description of the format.

3.4 Assessment of the Format of a Best Practice

The last point in the complete assessment of a Best Practice is how the Best Practice is described and documented. There are 13 criteria for the format that can be examined. The objective is not to create a lengthy document, but a document that is precise and explains all the characteristics described in the BEST-tool.

The details of how to write a Best Practice are shared in Chapter 4. Table 3.4 introduces the table of criteria for the assessment of the format of a Best Practice.

Table 3.4 Assessment of the description of the format of a best practice

*The RADAR logic provides a structured approach to question the performance of an organization. It also supports the scoring mechanism behind the EFQM Excellence Award. Source : efqm.org.

Legend: KPI = key performance indicator; NOK = not complete; OK = complete; PDCA = Plan-Do-Check-Act

3.5 Use of the BEST-Tool (Complete and Detailed Checklist)

Chapter 2 explained the content of the BEST-method and introduced the requirements of a true Best Practice. The criteria are separated into components of: Enabler, Results, Process, and Format. All four components are brought together in a comprehensive Excel checklist. This set of Excel worksheets provides not only an overview of the complete assessment, but also a way to focus on the areas of strength and improvement. Excel spreadsheets containing these checklists are available free to the reader on the author website. Refer to information in the Introduction to this text for links to the downloadable materials.

The Excel table represented in Figure 3.3 consists of four sections, including:

Figure 3.3 Criteria for the evaluation of the approaches (enablers) of a Best Practice process. Use of BEST-tool (complete and detailed checklist).

Enabler: 22 criteria and 44 characteristics

Results: 7 criteria and 20 characteristics

Process: 9 criteria

Format: 13 criteria

Is such a detailed framework necessary to assess a Best Practice? Remember: we use the full BEST-tool only for those processes which are key for success and contribute in a positive way to the achievement of the strategy of the organization. It is only through comprehensive analysis and improvement can we establish and manage excellent processes (enablers) (Figure 3.4).

Figure 3.4 Criteria for the evaluation of the results of a Best Practice process (complete and detailed checklist).

The first step for assessing a case study as a Best Practice is to read the document. Once the document has been read through completely, use the sequence of Excel tables, row by row, and characteristic by characteristic to assess whether the information required to follow a Best Practice is available within the document. Score each characteristic as indicated by the columns from 0% to 100% or Not Described. Add comments as appropriate to help remember any details useful for implementing the Best Practice characteristic.

Chapter 5 presents examples of how the BEST-tool is applied in the complete and detailed format.

3.6 Use of the BEST Quick Scan Tool

The first part of Chapter 3 describes the complete and detailed BEST-tool checklist. The detailed checklist consists of 22 criteria and 44 characteristics for the enabler component and 7 criteria and 20 characteristics for the results component. Finally, you have 9 criteria for the management of the process component and 13 criteria for the format of the process component.

However, there are many case studies or project reports that are too short to apply this detailed checklist. The case study was probably not intended to present a full Best Practice, but only share information for recognition or other reporting purposes. For these documents, the authors have developed a shorter checklist, i.e. BEST Quick Scan. This abbreviated tool considers only the 7 criteria for the Results and 22 criteria for the Enabler. Process and Format criteria are considered in the same way as the detailed BEST-tool checklist. Figure 3.5 illustrates the BEST Quick Scan criteria.

Figure 3.5 BEST Quick Scan (checklist).

When analyzing a true Best Practice which has been described in detail, the BEST-tool (detailed checklist) is the appropriate choice. When researching a shorter document, it is more effective to use the BEST Quick Scan. This easier and faster tool provides a high-level assessment to decide whether there is enough data to warrant contacting the document author for further information.

The authors learned after applications of assessment of numerous examples of so-called Best Practices, to first apply the BEST Quick Scan tool because you can have an initial overview of the extent of Best Practice in less than 20 minutes. From this assessment you can decide to continue and apply the complete and detailed BEST-tool. We have seen that more than 90% of the co-called Best Practices on the Internet can be better assessed with the BEST Quick Scan. Reason: these are not Best Practices at all. Realize that we can only draw conclusions based upon the text available on the Internet. We cannot assume more than is presented in the materials posted. Perhaps in the real context of that organization it could be a real Best Practice.

Assign one of the three codes in Figure 3.5 for each criterion listed in the table. Chapter 6 provides examples of numerous assessments using the BEST Quick Scan. Assessment here is done on only the criteria level, not the characteristic level.

The BEST Quick Scan tool does not require a score. If researching the case study as a benchmark, only a general comparison can be made, prompting the development of an improvement plan based on assumptions made in a gap analysis between the case study functions and those of the benchmarking company. If the BEST Quick Scan is used as an assessment of a case study being written as a Best Practice, the criteria will serve as a guide to improve the text.

3.7 Experiences, Tips, and Tricks

3.7.1 Incomplete Best Practices

The more complete and more detailed the Best Practice is, the better it can be assessed. More information also makes it easier to comment upon the application for each criterion. Most of the case studies of Best Practices analyzed in this book were too short to deliver precise comments. This is not meant as an insult to the writers of the case studies used. It is simply to say that most reports documenting process performance are not written to be used as Best Practices. They are written as a general sharing of process results or a celebration of project completion. Those looking to use case studies as benchmarks for their own process improvement should be aware that there is rarely enough information in a short document to perform a valid gap analysis between that organizational function and their own.

As mentioned earlier, when the criteria in the Plan phase are weak, it is not worthwhile to continue analyzing the case study. In Chapters 5 and 6, the authors chose to apply all components of the BEST-tool or the BEST Quick Scan, knowing that information was missing. Our premise was that the partial information in the case study hinted that stronger data existed within the organization. Several of the examples in Chapters 5 and 6 suggest that an on-site visit would uncover the missing information.

From our experience the criteria in the Enabler and Results components, often weakly or not developed, are described in Table 3.5.

Table 3.5 Criteria in the Enabler and Results components often weakly described

Plan

Description, stakeholders, responsibilities, KPIs, segmentation, prevention, benchmarking, and data

Do

Cause and effect, accountability, SMART measures

Check

Audit, adjustment, and learning

Act

Processes, resources, knowledge and experience, benchmark

Results

Scope and relevance, integrity of data, trends, targets, comparisons, cause and effect

Legend: KPI = key performance indicator

It is possible that the information has been developed, but not included in the documented case study. Often, an on-site visit or a scripted interview will uncover the required information.

3.7.2 Complete Best Practices

A complete Best Practice consists of the four following components:

  1. 1. Description of the enabler (this text uses the PDCA sequence)
  2. 2. Description of the results
  3. 3. Description of the process
  4. 4. Format of the Best Practice

It is unrealistic to expect to achieve 100% in each characteristic in the checklist. A perfect organization does not exist. Be satisfied if the case study complies with approximately 75–80% of all the characteristics of the BEST-tool. An 80% score is reflective of a true Best Practice. Any process assessed at an 80% level is something to be proud of.

3.7.3 Scores

Scores in the BEST-tool suggest to what extent a criterion or characteristic has been developed or where improvements are necessary.

The tool gives rough estimates such as 0%, 25%, 50%, 75%, and 100% of whether the characteristic is completely described. It is not necessary to be exacting on these estimates. It is more the first impression of how completely the characteristic is described that is important. The authors recommend the assessor spend no more than one minute per criterion in scoring it. Ten seconds would be even better.

The objective is not to achieve a 100% rating in each characteristic. Case studies published by recipients of the US Malcolm Baldrige Award or the European Foundation for Quality Model Excellence Award reflect scores in a range of 60–70%. A score of 100% should only be given if the criterion or characteristic is fully developed. Do not spend significant energy and time in the scoring process.

We urge the reader not to use the BEST-tool for publicly scoring a Best Practice written by another. The objective of the BEST-method is to help the reader understand the requirements for developing and implementing a true Best Practice. The criteria and characteristics are guides to develop the approach (enabler), measures (results), process, and format to implement and document a Best Practice of their own.

3.7.4 Realistic Tool

The authors realize that the rigors of the BEST-tool may appear overwhelming. The objective is not to find weaknesses or to make judgments about whether a case study is a Best Practice. The real objective of the book is to discover where improvements are feasible (compared with the ideal situation) and how to document a Best Practice so it can be used by others for their improvement efforts.

An unexpected advantage of the BEST-tool is the recognition that a professional tool is needed to measure the degree of excellence of a Best Practice. Most of the case studies researched as a Best Practice are not complete enough to achieve an excellent rating. Comparison with the characteristics of a Best Practice is intended to highlight opportunities for improvement.

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