What does a 13-person military team need to survive in Iraq and Afghanistan for five days by themselves without any base support? What types of protective gear and critical life saving items are needed? How much? Inside the storage warehouse of the 56th Security Forces Squadron (56SFS) at Luke AFB where these items are stored are the massive 463L aircraft pallets that hold up to 10,000 lb of equipment. These readiness pallets must be all set to ship in 24 hours even if one hasn't shipped in three years. Having the inventory in stock when needed is imperative. Matthew Owen, Resource Advisor 56 SFS, knows precisely the items needed for the readiness pallets, from the food and water to the weapons and ammunition. Managing these supplies and other types of inventory are his top priority.

Radio frequency identification (RFID) systems are widely used for applications that include inventory management, package tracking, toll collection, passport identification, and airport luggage security. More recently, these systems have found their way into medical environments to track patients, equipment assets, and staff members.

However, there is currently no published standardized, repeatable methodology by which manufacturers of RFID equipment or medical devices can assess potential issues with electromagnetic interference and evaluate means to mitigate them.

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n his inauguration speech, President Obama called for improving health care quality and reducing costs. In 2008, U.S. health care costs exceeded $2.4 trillion and are expected to climb to $3.1 trillion by 2012, according to the National Coalition on Health Care.

Of these costs, 25 percent to 40 percent are caused by unnecessary delays, defects, and deviations that can be easily corrected with lean Six Sigma. That’s $600 billion to nearly $1 trillion dollars a year in unnecessary costs.

Although most visits to the emergency department (ED) take two to four hours (from admission to discharge), the Robert Wood Johnson University Hospital in Hamilton, New Jersey, a 2005 Baldrige Award winner, does it in 38 minutes for a discharged patient. The hospital offers a 30-minute door-to-doctor guarantee. The staff accomplished this by rethinking the emergency experience from the patient’s point of view.

The clinical side isn’t the only issue to be addressed. Health care operations—billing, ordering, and so on—waste even more money. Insurance companies are quick to reject claims and slow to pay the claims they do accept, which causes more problems. One health care provider found ways, using lean Six Sigma, to reduce denied claims by $330,000 a month.

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n emergency response organization differs substantially from our usual public health organization for day-to-day business. However, as the spring 2009 H1N1 (also referred to as swine flu) outbreak highlighted, usual public health processes are fundamental for effectively responding to a public health emergency. The key challenge we will face in the fall and winter of 2009 is not the planning for an H1N1 outbreak but the establishment of clear criteria for the public health workforce to determine priorities in their jurisdictions.

The federal government grants for emergency preparedness to states and local jurisdictions include a program element that requires a Homeland Security Exercise Evaluation. A key aspect of this requirement is an improvement plan based on learning from required exercises of the preparedness plans. However, a 20-page after-action report may not be helpful in real-time decision making. The challenge is to make these reports actionable and nimble. Using quality improvement (QI) methods and tools alongside our situation status reports as actual information and data unfolds can be an invaluable way to determine next steps in our response cycle.

To Chris Collins, lean and Six Sigma, just like government and business management, go hand in hand.

In Erie County, where he fiercely advocates that a lean government can and will save taxpayers millions of dollars, Chris Collins became the first county executive in the nation to implement lean Six Sigma in a government setting.

A businessman with 35 years of private sector experience, Collins runs Erie County like a business, with what he calls “The 3 Rs”—reforming Erie County government—rebuilding the local economy—and ultimately, reducing taxes. Needless to say, the road to getting there is paved by lean Six Sigma all the way. To date, 19 Erie County employees are trained and certified Six Sigma Green Belts. Forty employees earned Yellow Belts and more than 250 employees are trained in lean Six Sigma. Bill Carey, a lean Six Sigma Black Belt, is the program director of the county.

The lean and Six Sigma methodologies have helped the county accrue savings of nearly $144,000 by streamlining social services application workflow. The county reduced the cost of repairing of park equipment by $95,000 annually. It has reduced the backlog of child support enforcement cases from 7,281 to 103 cases in less than one year.

“It’s a messy world,” says Dusty Gibbs while walking past piles of copper wiring and kitchen sinks in the warehouse of Kirschbaum & Krupp (K&K) Metal Recycling LLC. “But this is about as clean and organized as it gets.”

Gibbs would know. As the new co-owner of K&K—and a longtime co-owner of Residual Materials, another scrap metal recycling operation in Grand Forks, North Dakota—he has been in the metal recycling business for more than 30 years. He purchased K&K in 2006 with Mitch, his brother, and Henry Wang, a business partner in China. In an effort to improve K&K and drive industry standards into the 21st century, they have spent the better part of two years making the company as lean—and green—as possible.

It seems to be working. One year after purchasing the business, the owners saw revenues balloon from $48.4 million in 2006 to $83.6 million in 2007. Current sales are as much as five million pounds of metal a month, and the company saves about 55 million pounds of nonferrous metals from landfills every year.

Why did the current financial crisis occur? Among other things, we could point to greed, ethics, and policy creation. However, could we also consider commonplace business management systems and their metric-creation practices as a source for encouraging and amplifying these and other unhealthy behaviors?

Before answering this question, consider another aspect of the issue: Do you think that the cliché “Tell me how you measure me and I will tell you how I will behave” describes a stimulus that could have contributed to the destructive behaviors that led to our economic problems of the day? I believe that many current business system metrics and resulting actions to achieve measurement goals did contribute to our current economic problems.

One week in May, I spoke on “Risk in the Supply Chain and Other Changes” at the World Conference on Quality and Improvement (WCQI), the Macon, Georgia, ASQ section, and the Atlanta, Georgia, ASQ section.

My message was that many business rules and assumptions have changed radically since September 2008, especially those in supply management. I would almost say that most business rules have been “reset.” Harvard Business Review says that we need to understand and live with the new “normal.”

The new “normal” in supply management

Let’s look at some of the changes. We are moving from global stability to global uncertainty. We can see this everywhere we look, with the increasing unemployment rate, financial crises, and global warming. We are moving from safe trade to pirated trade. Who would have thought that we’d have Somali, Philippine, and Southeast Asian pirates, who disrupt global trade and add risk to the supply chain.

If you have ever found equipment that is out of calibration, then you know it is not something to take lightly. Whether you manufacture children’s toys or automobile tires, you know that the implications and ramifications of the decisions you make can be devastating for your company. Although the requirements from the ISO 9001 standard regarding equipment found to be out of calibration are simple and succinct, this is not something to take for granted. If you ensure that the processes for handling nonconforming equipment are in place and if you take into consideration the steps provided below, you will be ready to handle and perhaps avoid out-of-calibration conditions.

Equipment found out of tolerance

When calibrating your equipment and finding it to be out of tolerance, ISO 9001 requires you to consider the product that was inspected with such equipment as suspect product. Aside from quarantining the equipment for further adjustments and calibration, the first question you need to ask is: Does the calibration data suggest the equipment was broken, minimally out of tolerance, or grossly out of tolerance? Was it out of tolerance in the range in which it was used?

The story of how one Michigan-based automotive supplier, GHSP, embraced the quality circle process and very quickly earned a spot as a leader from one of the most demanding customers in the business 

There’s still a little surprise in Beth Koch’s voice when she talks about the Honda of America Manufacturing’s Fall 2008 Supplier Quality Circle Competition.

“We were very proud of what we had been able to do for our company,” says Koch, a quality facilitator at GHSP’s Hart, Michigan plant. “But we were very shocked when we won. Very shocked.”

She wasn’t the only one who was surprised. GHSP, a supplier of mechatronics to the global surface transportation industry, in its first appearance at the fall event, stormed in and swept the competition away, winning first place in the two main categories—problem solving and project circle—as well as first place for the best display board. It was the first time a supplier had won both categories at the competition, which was attended that year by as many as 100 suppliers to Honda and 600 people.