August 22, 1966 M20-2

CHAPTER 1. GENERAL QUALITY CONTROL INSTRUCTIONS

1.01 QUALITY

The word \"quality\" does not have the meaning of \"best\" in an
absolute sense be­cause it cannot be thought of apart from cost. In terms
of DVB operations, \"quality\" means \"best\" for accomplishing program
needs and the VA mission within available resources and reasonable
costs.

1.02 QUALITY CONTROL

a\. The expression \"quality control\" is used in the broad sense of the
control of quality by whatever methods may be used. The expression
\"statistical quality control\" is used in referring to the control of
quality by statistical methods and the use of statistical tools such as
probability sampling, control charts, control limits, and other special
tech­niques and devices used to aid in decision making. A \"quality
control system\" is one which coordinates the quality\--development,
quality\--maintenance, and quality\--improvement efforts of the various
groups in an organization to accomplish fully acceptable quality in
final services and end products within available resources and
reasonable costs.

b\. The word \"quality\" refers to key characteristics of performance,
end products and decisions which can be measured or counted. These
characteristics are primarily accuracy, timeliness, condition, and
compliance. They have acceptable and unacceptable levels as determined
by management. The acceptable levels represent standards to be met.

c\. The word \"control\" represents a management tool with the four
basic steps outlined below. Effective quality control requires all four
of these steps. If any step is missing, effective control is lost.

\(1\) Setting acceptable quality levels or standards.

\(2\) Appraising actual quality levels achieved in relation to the
standards.

\(3\) Acting when standards are not met.

\(4\) Planning for improved quality through improved performance.

1.03 OBJECTIVES OF QUALITY CONTROL IN DVB

a\. To develop and maintain a quality system which, on an organized
technical basis, plans and controls the quality of DVB services and end
products through all stages of development and processing.

b\. To identify and isolate, for purposes of continuous control and
improvement, those areas where quality presents problems in terms of
substandard service to veterans, excessive operating costs, etc.

c\. To identify the causes of errors, deficiencies, discrepancies, undue
delays, excessive costs, and other quality defects which can be
eliminated.

d\. To determine the actions required to eliminate the causes of quality
defects,

and schedule these actions for accomplishment and long-term quality
improvement.

e\. To develop and maintain the best quality levels which operations are
capable

of producing to achieve department goals of doing all work right the
first time with continu­ing cost improvement.

1.04 BYPRODUCTS OF EFFECTIVE QUALITY CONTROL

The techniques of effective quality control, properly applied to
operations, bring about desirable byproducts which cannot be achieved as
well in any other way. For example:

a\. Quality control provides essential information for establishing and
improving quality standards, and for preparing definite instructions for
inspection or review proce­dures.

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b. Quality control provides a sound basis for self-audits, surveys, and
other\
techniques of evaluating performance and costs in quality terms.

c\. Quality control leads to the establishment of effective quality
review where none has existed before.

1.05 QUALITY CONTROL METHODS

a\. General. [Effective quality control and positive management action
to improve]{.underline} [quality levels]{.underline} are [required for
all DVB activities. This]{.underline} includes all [operations
and]{.underline} work [performed by VA employees and by outside persons
and organizations performing VA work]{.underline} [on a fee or a
contractual basis]{.underline}. Methods used to determine quality levels
and to improve quality on an organized technical basis will vary with
the nature and volume of work per­formed. The methods may consist of
regular supervision and training, mandatory or op­tional reviews and spot
checks, controls of various kinds including cost controls, or formal
control procedures such as statistical quality control. Regular
supervision and special training will be applied whether or not
mandatory quality reviews and control plans are prescribed by higher
authority.

b\. [Personnel Selection, Supervision and Training]{.underline}. Careful
selection, promotion and reassignment of individual employees to develop
and maintain a competent work force, coupled with regular supervision
and training, are basic to effective quality control and improvement.
Every [supervisor is expected and required]{.underline} to know how well
each [employee]{.underline} [under his supervision, including fee basis
and contractual personnel, performs assigned]{.underline} [work. He is
required to provide special reviews]{.underline} in all [areas where
serious quality]{.underline} defects [or excessive costs are known or
suspected and to take whatever action is indicated to]{.underline}
assure [that all work performed meets the standards of acceptable
quality. In the]{.underline} absence of
[stand]{.underline}­[ards]{.underline} prescribed by [higher
authority]{.underline} local standards will be established as [necessary
to]{.underline} as­[sure quality work performance]{.underline}. Formal
program quality control procedures are intended to aid supervisors in
accomplishing effective quality control, but do not in themselves
replace regular supervision and spot checks based on the trained
supervisor\'s special know-how.

C. Statistical Quality [Control]{.underline}. Statistical quality
control is particularly useful and economical for application to large
volume operations of a repetitive nature. However, statistical methods
will be applied whenever considered appropriate or necessary to assure
reliable and economical quality control over services and end products.

1.06 RESPONSIBILITIES

a\. DVB Service [Directors are responsible]{.underline} for:

\(1\) Establishing and maintaining on an organized technical basis
formal qual­ity control procedures to plan and control the quality and
cost of their respective program services and end products through all
stages of de­velopment and processing. With respect to field station
operations which are most highly correlated with program end product
quality and cost, this includes:

\(a\) Development of sound quality review sampling procedures.

\(b\) Maintenance of adequate control data to identify deficiencies and
to determine the management action required to remove the causes of
quality defects and excessive costs; and,

\(c\) Maintenance of a reliable quality reporting system for program
evaluation and improvement purposes.

\(2\) Formulating and recommending to the Chief Benefits Director
quality performance standards based on the best quality levels program
opera­tions are capable of producing with available resources.

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\(3\) Conducting regular periodic studies to assure continued validity
of the program quality standards and the reliability of the quality
reporting system, and to determine the need for modification or
abandonment of specific standards and reporting procedures in relation
to changing operating needs.

\(4\) Appraising for the Chief Benefits Director the effectiveness,
efficiency, and economy of established standards in implementing public
laws and attaining program objectives.

\(5\) Keeping Field Directors informed on field station quality matters,
par­ticularly on serious and persistent \"out of control\" situations.

b\. Field [Directors are]{.underline} responsible for:

\(1\) Effective and economical operation of formal program quality
control systems at field stations.

\(2\) Continuing control and evaluation of the quality and economy of
field station management and operations.

\(3\) Providing assistance and guidance to field station Managers in
achieving the best quality levels that field station operations are
capable of pro­ducing within available resources and reasonable costs.

C. Field Station Managers/Directors are responsible for:

\(1\) Maintaining effective quality and cost control over all work
performed, including the effective and economical operation of mandatory
program quality control systems and the establishment of necessary local
quality standards and controls.

\(2\) Identifying and recording the causes of quality defects and
excessive costs as a basis for determining the management action
required to remove these causes.

\(3\) Accomplishing identifiable quality and cost improvements which
ca.-, be made at the field station level.

\(4\) Recommending to the Field Director actions or assistance required
at the department level to improve the quality of operations and reduce
costs, including standards and mandatory procedures.

1.07 ORGANIZING FOR QUALITY CONTROL

a\. Because quality is in fact e b. it may [develop]{.underline} into
nobody\'s job.

For this reason, specific functional responsibility to make quality
control work effectively must be assigned:

\(1\) At the department level within each program area by the
responsible DVB Service Director.

\(2\) At the field station level by the Manager.

b\. Responsibilities that may be properly assigned at the department
level \'Within each program area include the following:

\(1\) Devising quality control procedures and preparing necessary
written in­structions and forms for field station and department needs.

\(2\) Advising field station and department staff personnel on specific
quality control applications.

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\(3\) Providing for Central Office validation of local quality findings
by review of completed work units.

\(4\) Continually reviewing quality control records, charts, reports,
cost data, etc., to determine whether specific quality control
applications are still needed, or whether they should be revised or
discontinued.

\(5\) Providing a quality information system, a feedback of quality and
cost findings to line management officials responsible for production
and to staff personnel responsible for program procedures and other
mandatory requirements which influence the quality and cost of work done
at field stations.

\(6\) Calling attention of field station officials and department staff
heads to any situations requiring their attention, as indicated by the
quality con­trol charts, reports, cost data, and other records
maintained.

\(7\) Evaluating the quality levels for higher management in periodic
reports.

C. Functional responsibilities that may be properly assigned at the
field station level include the following:

\(1\) Advising and training supervisors in effective quality control
methods, and in implementing formal program quality control procedures
such as statistical quality control.

\(2\) Devising necessary local quality and cost control procedures, and
pre­paring written instructions for supervisors.

\(3\) Conducting validation checks of quality control procedures,
findings, and records to assure that effective action is taken to
control and improve quality levels and eliminate excessive costs.

\(4\) Recommending to the Manager specific actions to improve the
effective­ness and economy of station quality control activities.

\(5\) Orienting new employees to start them off in the right direction
toward \" quality mindedness\" and \"doing all work right the first
time.\"

d\. Setting program or local field station quality standards involves
many policy and cost matters. Therefore, program and field station
personnel to whom functional re­sponsibilities for quality control are
assigned should actively participate in setting quality standards, but
should not be given exclusive authority for setting standards.

e\. Personnel to whom functional responsibilities for quality control
are assigned should be selected carefully. The right person may be
described as a practical man whose thinking is not grooved in the ruts
of time honored work practices. He should be thoroughly familiar with
the theoretical concepts of quality control and have the ability to
reduce them to a practical level and apply them. He also should have the
temperament to exert mild pressure constantly to assure that quality
control and improvement will remain a coopera­tive effort of supervisory
and staff groups. Above all, he should be able to get along well with
others. Sales ability is as important as technical ability. Common sense
and good judgment are also essential.

1.08 QUALITY CONTROL PRINCIPLES

a\. [Quality control is aimed at preventing mistakes (errors) and
excessive costs]{.underline} [through improving
performance]{.underline}. The determination of what the quality level
is, is not in itself quality control. Moreover, although the inspection
of completed work and the correc­tion of individual work units in error
should improve the quality of finished work, this is not quality
control. Correcting mistakes after they are made is not the same as
preventing the mistakes from being made. If the purpose of quality
review were to find and correct [all]{.underline} mistakes so that the
final product is error-free, then no less than 100 percent inspection
would be required. In fact, under some circumstances 200 or 300 percent
inspection, or even more, might be required to detect and correct errors
missed in the first, second or later reviews,

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b\. Quality review (inspection) in itself is not quality control\--it is
only the first step in the quality control process. [When work units are
reviewed for quality and practically no effort is made to find and
eliminate the causes of deficiencies, this is wasted
effort]{.underline}. It does very little toward improving quality.

c\. To provide for adequate quality control it is neither necessary nor
economical in most situations to make 100 percent checks of work done.
[The objective in determining]{.underline}

[an adequate sample size to be used for any particular operation on a
recurring basis is to be used for any particular operation on a
recurring basis is to minimize the cost without undue sacrifice of
reliability]{.underline}. Determining the point at which the balance
between cost and reliability should be made is a judgment matter. Where
the pur­pose of sampling is to estimate the quality level of a given lot
of completed work, the nearer a sample is to the lot size the less the
conclusions about the quality of the lot must be quali­fied. A 100
percent review of work done is expensive, but in certain situations may
be necessary due to the high cost of errors or serious consequences
involved. In most quality [control]{.underline} situations, a 100
percent review only serves to increase to an unwarranted degree our
knowledge of the quality level. A 50 percent review is questionable
since it produces neither the reliability of a 100 percent review nor
the economy of an adequate sample. [The only]{.underline} significant
advantage of increasing an adequate sample volume is that of finding
certain [additional]{.underline} errors and [having them
corrected.]{.underline} If it is worth the additional cost to find these
particular errors, then the expense of a 100 percent review or more to
find and correct all the errors that may be identified would be
justified.

d\. The quality of a sample of work units drawn from a continuing
process or flow of work items represents only an estimate of the actual
quality level of the operation. There [may]{.underline} be considerable
variation in sample estimates without any change in the actual quality
level of an operation. An estimate of the quality level based on a
single small sample of work units will not provide enough information
for a valid quality evaluation.\
\
e. Sample estimates of a process quality level are subject to two types
of\
variation:

\(1\) Chance variation due to [sampling and]{.underline} to other random
causes which can-

not be eliminated.\
(2) Assignable variation, reflecting the presence in the population of
specific

which can be found and eliminated.\
f. A series of relatively small random samples can be used:\
(1) To determine the best quality a process or a procedure can produce.

\(2\) [To]{.underline} provide a valid estimate of the quality level
actually [produced]{.underline}.

1.09 ERROR OR QUALITY DEFECT

a\. Two basic rules for determining what should be classified as an
error or a quality defect for quality control purposes are:

\(1\) An error or a quality defect must be material in the sense that it
would impair or adversely affect operations, costs, services, or end
products.

\(2\) It must definable.

b\. Therefore, in quality control an error or a quality defect is any
non conformance of the work unit with specified requirements. If
specified requirements are superflu­ous, unreasonable, or otherwise
improper, a workunit may be \"in error\" by definition only.

1.10 SAMPLING PROCEDURES

a\. The method or procedures followed to select workunits for quality
review de­termine whether a probability or a non probability sample is
obtained, There are marked [differences]{.underline} between these two
types of samples which [influence the purposes for which each may be
used,]{.underline} as explained below:

\(1\) Probability Sample. A probability sample is one in which each unit
and

each combination of units in the lot or population under scrutiny [has
a]{.underline}

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[known chance of being selected]{.underline}. Therefore, probability
samples lend themselves to mathematical evaluation of the sampling
error, and provide assurance as to the absence of bias in the selection
of work units.

\(2\) [Non probability Sample]{.underline}. Conversely, a non
probability sample is one in which each unit and each combination of
units in the lot or population under scrutiny does not have [a known
chance of being]{.underline} selected. Therefore, non probability
samples do not lend themselves to mathematical evalua­tion of the
sampling error, and do not provide assurance as to the absence of bias
in the selection of work units.

b\. There are many varieties of probability samples, but for DVB
purposes we are concerned mainly with the most basic type, the simple or
unrestricted random sample. With respect to non probability samples, we
are concerned mainly with the judgment sample. The specific differences
between each of these types of samples are described below. These
differences demonstrate the need for designing sample selection
procedures in recognition of the purposes for which the sample data will
be used.

\(1\) [Random Sample]{.underline}. A simple random sample is one in
which each unit and each combination of units in the population has an
equal chance of being selected. The procedures used to select a random
sample should give every unit in the population an equal chance of
getting into the sample and prevent the inclusion of one unit from
affecting whether or not any other unit is included in the remainder of
the sample. In sampling the infinite population of a work process, we
are limited in practice to a sampling from those work units actually
processed. However, we may assume that a simple random sample of the
process is taken if at each stage of sample selection every work unit
has an equal chance of being included in the sample.

\(2\) [Judgment Sample]{.underline}. A judgment sample is one in which
judgment rather than a random procedure is used to select the units to
comprise the sample. Judgment samples of a work process are usually
taken to follow-up on specific types of errors, to review specific
procedures, or to review work completed in specific areas. Information
obtained from judgment samples provides a basis for recommendations c o
n c e r n i n g technical assistance and action to improve quality or
reduce costs in specific areas. Since selection is not random, the
sample data cannot be used reliably to estimate the quality level, or to
determine whether or not an acceptable quality level has been met.

c\. [100% Sample.]{.underline}, In quality control, the basic purpose of
sample quality reviews is to find, not the situation that prevails at a
particular moment, but the underlying tenden­cies and relations in the
work process which coupled with chance modifications determine the
approximate quality level. As a basis for quality generalizations and
decisions for action, a so-called 100% sample is only a sample of an
infinite work process. In a continuing work process, for example, a
review of all the work units produced in a day, a week, a month, a year,
etc., comprises a sample of the work units produced over a longer
(infinite) period of time.

d\. The \"Table of Random Sampling Numbers\" provided in appendix c may
be

utilized to assure selection of sample items on a random basis.

e\. Responsibility begins with the first level of full-time supervision
for application of proper sampling procedures to assure valid quality
reviews and reports. The follow­ing principles will be observed in
conducting quality control activities:

\(1\) Actual quality reviews may be performed as assigned by fully
qualified employees other than full-time supervisors provided no
employee reviews his own work.

\(2\) Certain operations, such as authorization and payment actions, are
some­times subjected to sample reviews and so-called 100% reviews as a
part

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of the regular operating procedure or processing cycle. Subsequent
sample quality reviews required will not be performed by the same
em­ployee who made the previous review, nor by the employee who performed
the original work action being checked.

f\. Intermediate and higher level supervisors have the added
responsibility of validating quality review findings, including the
propriety of the sampling procedures used to obtain the quality control
data reported.

1.11 FEEDBACK\--KEY TO QUALITY PLANNING AND CONTROL

a\. The real key to quality planning and control is the feedback
phase\--the flow of information on performance back to the planning
phase where it can help in future planning. Specific steps must be taken
to insure accurate, timely and reliable feedback because it will not
occur automatically. There are several techniques for achieving
feedback. Quality review reports are the primary feedback in the quality
functions. Complaints from any source are an essential part of the
feedback,

b\. The important point is that the feedback phase tells management
officials, from the first-level supervisor and up, specifically what
errors and other defects must be eliminated promptly, and what kind of
deficiencies reflect a need for improved planning to achieve better
quality. It is not enough to abound in quality reviews, to make
recommenda­tions, and to correct on the spot work which has not been done
right. Adequate time and effort must also be devoted to quality planning
for improvement.

1.12 TIMELINESS OF OPERATIONS

a\. \"Timeliness\" in itself is a significant public relations media
which demands continuous control and improvement effort. Service
Directors are responsible for estab­lishing and maintaining timeliness
standards and controls for field station operations in their respective
program areas which are most highly correlated with end product
timeliness. Managers/Directors of field stations are responsible for
establishing and maintain­ing additional timeliness standards and
controls needed locally to assure prompt service and preclude
complaints.

b\. End products of a substantive or critical nature pending at the
close of each operating performance report period will be classified by
pending age groups for reporting and analysis purposes. End products
comprising substantive claims and issues will also be controlled on an
individual case basis to assure prompt and correct final disposition.

c\. Control procedures relating to substantive end products will provide
for di­vision supervisory reviews of individual cases pending for
excessive time periods to assure that:

\(1\) Each VA action which can be [completed]{.underline} has been
accomplished.

\(2\) There are no avoidable delays.

\(3\) The veteran or other interested person has been given a timely
interim

reply(s), through correspondence or a telephone call, to keep him
informed and to preclude additional inquiries or a complaint.

d\. Substantive end products pending for a significant period beyond the
time speci­fied for division supervisory reviews will be identified and
listed, together with the reasons for the pending status, for attention
by the Manager/Director as to additional remedies needed. Similarly,
cases still pending for a significant period beyond the time specified
for the Manager I s/Director\'s review will be identified and reported
to the Field Director for Department review and appropriate action to
eliminate avoidable delays in future cases.

1.13 COMPLAINTS\--SIGNIFICANT QUALITY INDICATOR

a\. Prompt and correct service is a vital factor in molding the public
impression of each DVB field station and of overall VA operations.
Complaints from any source are

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part of the feedback information which must be analyzed continuously to
identify quality defects and areas needing improvement. By definition,
\"complaints\" include all forms of incoming communications which state
or otherwise indicate [that prompt or correct VA]{.underline} serv­ice
has not been provided. Communications expressing disagreement with the
effect of VA decisions are excluded.

b\. In addition to the basic VA requirements in MP-1, part II, chapters
5 and 10, for processing complaint and congressional mail, the
procedures and controls outlined below will be applied at all DVB field
stations:

\(1\) Direct all congressional and complaint communications to the
personal attention of the Manager for priority handling to assure prompt
and cor­rect disposition of all pertinent issues.

\(2\) Acknowledge congressional and complaint correspondence within 2
work­days of receipt if a complete reply cannot be made within 5
workdays.

\(3\) Conduct regular studies of complaint situations to identify
underlying causes which can be eliminated.

\(4\) Whenever prompt and correct service cannot be provided for reasons
beyond field station control, report these situations to the Field
Director for assistance. Submit full information for department action
and indicate whether the matter involves congressional or other special
interest.

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