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There is a lot of confusion when talking about quality. Every author uses his own definition of quality and in discussions about quality improvements participants are not aware that everyone has his own view on how to handle quality. Moreover, cultural differences not only change the quantity of quality and the range of its indicators, but its meaning as a whole. It seems to be that the common German understanding sticks more to hard quality aspects, let's say producing the best no matter what it will cost and not caring about the emotional customers' satisfaction. The American understanding strongly involves the customers' wishes in its quality definition reflected by the importance of product research. The Japanese quality understanding also involves the customer, but statistical control is added which is to cut costs in the long run, and bring highly reliable products at reasonable prices.
Looking closer to the formal definition of quality by a country's Standardising Institutes and its authors, partly reflects the above observation.
3.1.1 German Quality Definition
The German DIN55350 defines QUALITY:
"The entirety of properties and attributes of a product or service, relate to the suitability to fulfil given requirements."
Although the definition makes the link to given requirements, it does not answer the question who will determine these requirements; will it be the selling company, their engineers, a person of unquestioned formal authority (in our case the ophthalmologist) or will it be the person who will live with the service or product respectively?
3.1.2 Japanese Quality Definitions
The Japanese JIS terminology standard Z8101-1981 defines QUALITY CONTROL as:
A system of methods for the cost effective provision of goods or services whose quality is fit for the purchaser's requirements.
[Ish90p.1]
This understanding of quality includes the cost aspect and gives the answer of who decides on the requirements: it's neither the engineer nor a person of special authority, but solely the client.
Ishikawa even goes a further:
The quality that people will buy with satisfaction.
[Ish90p.16].
In order to fulfil this definition he recommends the following five attitudes [Ish90p.17ff]:
1. The four aspects of quality:
Q(quality): quality characteristics in their narrow sense.
Performance, purity, strength, dimensions, tolerance, reliability, etc..
C(cost): characteristics related to cost and price; cost control and profit control
D(delivery): characteristics related to quantities and lead times (quantity control)
S(service): problems arising after products have been shipped; product characteristics
requiring follow up.
2. Complaints:
There exist three manners to react to complaints: Old style companies often ignored complaints with the mentality that the client was be lucky enough to be one of the rare owners of their unique product. Secondly, a company can start OUTSIDE ACTION- satisfying the customer on actual claims for compensation by free replacement, money compensation, etc.; the reaction is measured by speed and sincerity. Thirdly, a company can take INTERNAL ACTION of actual claims and moreover of complaints unaccompanied by claims. The latter approach uses the vital and cheap information of its customers to improve its products. Recurrence prevention will lead to higher backward-looking qualities and the practical hints from their customers which are taken care of will raise the forward-looking qualities. | 
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