CQI: using the Hoshin planning system to design an orientation process.

The Hoshin planning system, developed in Japan after World War II, includes management tools intended specifically for planning new processes. There are seven tools, which can be used individually or in any combination: affinity diagrams, interrelationship digraphs, systematic diagrams, matrix diagrams, process decision program charts, arrow diagrams and prioritization matrices. The radiology department at Carson-Tahoe Hospital formed a CQI team to improve the training of front office clerks. The team quickly discovered that a new orientation program was needed and decided to use Hoshin tools to create one. Using the tools, the team identified and prioritized all relevant factors, described specific tasks needed to complete the planning process and how long each would take, anticipated problems, and assigned areas of responsibility to members of the team. Each time the team grew weary or discouraged, the clarity and organization afforded by the tools helped them feel productive and in control of the process. The team was amazed at the creative ideas they generated through this 3-month-long process. Not only did they develop and implement a new orientation program, they also cultivated a stronger sense of pride and confidence in their work and each other.