healthpoliticstechnology

Quality is Free

The Covid-19 pandemic is causing us to retreat to our cocoons as we try to stay safe and “bend the curve” of the viruses’ spread. It is also providing us the opportunity to think and reflect on the lessons we may be able to take away from this experience. One of the most prominent lessons reverberating inside my head is one I found quite awhile ago in a book called Quality is Free.

I encountered this book more than 30 years ago, when I was a young tech entrepreneur living in New Jersey. At the time, I was busy building the company, Telecom Analysis Systems, that I had started in my basement a few years earlier. I had left a successful career as a product development engineer at AT&T Bell Laboratories, but had almost no experience creating a modern manufacturing process for the complex telecommunications instruments my company was developing. What little experience I did have came from my two-year stint as a General Motors Institute/AC Spark Plug co-op student, and my Bell Labs experience interfacing with the AT&T Western Electric manufacturing engineers. Those experiences left me with the impression that a manufacturing process was a build/inspect sequence: first you assemble the product, then you have quality inspectors check for errors. (Remember that little “INSPECTED BY #7” slip inside your package of fresh new underwear?). The prevailing view was that the ubiquitous “quality inspection” step, with its attendant Quality Control (QC) staff and quality management hierarchy, was an expensive but necessary evil. The book “Quality is Free” turned that thinking on it’s head, and presented the idea that if you build quality into and throughout a manufacturing process, you can achieve a product that consistently adheres to quality standards without the QC overhead and bureaucracy. The idea is to design a manufacturing process that prevents failures, or makes them so rare that a separate “quality control” function becomes unnecessary. Though it requires time and money and expertise to create a process that prevents failures, a process that yields frequent failures costs much more, because responding to failures is expensive and time consuming. This is what gives rise to the notion that “quality is free,” i.e., it pays for itself. In fact, the most striking conclusion I drew from the book is that a well designed manufacturing process can actually save money – lots of money. My company co-founders and I applied the “quality is free” principle repeatedly as we built and then sold a multi-million dollar international business.

At this point you may be asking what all of this has to do with the current coronavirus pandemic. Well, lots actually. Our national government’s plans for dealing with a threat to its citizens amounts to a set of processes. The threat might be a terrorist attack, or food-borne illness, or an extreme weather event, or a previously unknown biological agent like Covid-19. We expect our government to have well-developed plans (processes) to deal with any significant anticipated threat, to prevent it from causing widespread death and destruction. We want our government’s processes to be so well designed that they prevent failure, because mopping up after a failure occurs can be extremely expensive.

An example of a well designed process for addressing a threat is the U.S. government response to the deadly 2014-2016 Ebola outbreak in Africa. We had experts on the scene in Africa who, together with local health agencies and the World Health Organization (WHO), detected and addressed the threat at an early stage. The result is that Ebola did not become a pandemic that killed hundreds of thousands of people around the world. Only two people contracted the disease while on U.S. soil, and neither died. Our government’s processes were effective in addressing the Ebola outbreak at its source and avoiding any large scale impact in the U.S. Even so, the Ebola outbreak stimulated much concern about a deadly pandemic reaching our shores. In response to this concern, the Obama administration further refined and enhanced the U.S. government’s processes by developing a “pandemic preparedness playbook” and establishing a health unit within the National Security Council responsible for leading the country’s response to disease outbreaks. Thus the United States had, at the highest levels of government, a set of processes designed to detect and mitigate a biological threat emanating from anyplace on the globe.

Sure, there were costs associated with “standing up” a biological threat detection and response team in the White House. There are always costs associated with establishing a process that yields a quality product – the “product” in this case being a pandemic-free society. Those costs were justified by the fact that a low quality result – the occurrence of a global pandemic – would be much more costly. Again, in this case, quality is not only free, it actually saves a tremendous amount of money.

If we are to believe various news accounts, the Trump administration, when it assumed office in 2017, did away with the Obama administration pandemic playbook and subsequently dismantled the White House pandemic response team. Apparently the Obama administration plan was replaced with, in effect, no plan. There was no apparent national strategy for addressing a biologic threat; no clear chain of command for coordinating a response; woefully insufficient supplies of equipment like protective gear for health care workers (PPE) and ventilators. The lack of a clear plan meant that the administration understandably had to go into emergency response mode. Their process (or in this case, lack of process) yielded failure on a massive scale, so they had to come up with a response on the fly. The problem is that their response was bumbling, inconsistent, incoherent, highly politicized, and often mean spirited. So we are witness to a double whammy – the governments poor biological threat processes yielded failure (widespread disease in the U.S.), and the response to the failure was itself deeply flawed.

Photo credit: Upslash

Our government’s poor or nonexistent processes for dealing with a biological threat yielded failure: the presence of Covid-19 outbreaks in the U.S. Dealing with that failure would have been costly enough, and would have exceeded the cost of developing and maintaining good processes. However, adding insult to injury, our government’s response to the failure was itself poor, which yielded millions of infected u.s. citizens and, as of this writing, more than 115,000 dead. Families shattered; businesses devastated or shuttered; careers put on hold. The financial cost is unprecedented, given the massive amounts of money the government has had to inject, via borrowing, to prop up the economy. Knowledgeable observers have put the cost in the range of $3.5 trillion dollars, and counting. These incredibly high costs are directly attributable to the administration’s original failure, and the failed response to the failure. In the engineering world I live in, we call that failure squared.

I hope this Covid-19 pandemic has taught us a lesson. Whether the issue is disease, or climate change, or the environment, or nuclear proliferation, or so many other important subjects, the development of effective plans and processes saves much more than it costs. In fact, these days, such plans and processes could preserve our very existence.

Yes indeed, Quality is Free.

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