‘Just Do It!’ Still Won’t Do It

Even good ideas must be subject to critical thinking

I remember all too well the “quality circles will solve everything” craze during the 1980s, which died a miserable death. During this time I was exposed to Joseph Juran’s wisdom about quality circles from his outstanding Juran on Quality Improvement video series from the 1970s. He was adamant: They must be separate from an organization’s formal quality improvement efforts and used only to solve everyday, localized, frontline problems—the 80 percent of the processes causing 20 percent of the problems.

For quality circles to be effective, they must be built into a mature, overall organizational improvement process that is actively working on the majority of problems, those 80 percent that are caused by only 20 percent of the processes.

A hot topic at the moment, especially in healthcare, is rapid cycle PDSA (plan-do-study-act). In many cases, I’m seeing it presented as a “Go on... just do it!” process for everyman to test good ideas in his routine work as a way to work around sluggish management.

The rallying cry is: “What can we do now? By next week? By Tuesday? By tomorrow?”

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Comments

Some comments

Hi Davis-

There is a pre-step to PDSA and it is to "unlearn" meaning we need to understand the system, Customer-in. This is an extension of figure 1 from Dr. Deming's Out of the Crisis. System understanding needs to come before process understanding, because many processes are products of the functional separation of work - meaning design flaws are inherent to the system. So, I would say "respect the system" and this is far different than process.

If standardization exists, does it exist for the right reasons? Manufacturing is different to service. Standardization may be driving in avoidable demand from customers. Just standardizing without an unlearn step and without understanding what is happening in reality is a mistake.

Standardization should be developed or "pulled" by people doing the work. Building standard work from the hierarchy or from support areas is another mistake. Adoption through audit is a good way to disrespect people. Understanding is needed not compliance as compliance is coercive in nature.

I have found it better to work to axioms and principles in many cases rather than standardized work. Variety is the driver of what action to take. Service has greater variety.

This really caught my eye:

"Standardized work needs to be lived with for some measure of time before changes should be experimented with or instituted. I’ve witnessed folks immediately dismissing standardized work, which was SDCA’d in an identical process from another location, as insufficient when compared to their organic, nonstandardized work—and then desiring to change it or just plain ignore it.”

Yes, they should dismiss standardized work if the process is similar and the demands are different. The ones doing the work would know best and have to be engaged. If you do not get their acceptance you have little chance of future improvement from the worker as they await the next mandate.

Tripp

I totally agree [Response to Tripp Babbitt's Comment below]

Thank you for that feedback. I absolutely agree with you, Tripp. I was just trying to shed some light on the rapid cycle PDSA that seems to be the fad du jour, especially in healthcare.

In the current version of The TEAM Handbook, their former Six Sources of Problems of a process has now added a seventh step as the first:

1. Inadequate knowledge of customer needs

2. Inadequate knowledge of how the process works

3. Inadequate knowledge of how the process should work.

As you point out, the customer needs to be kept in mind when looking at the gap between (2) and (3).

As you well know, the subtlety of systems thinking takes a long time to truly understand -- and you do that VERY well.

Meanwhile, people are practicing improvement, and the esoteric nature of systems thinking eludes many of them. If you were to say what you just wrote to a roomful of people, you would get mostly blank faces (and many glazed eyes) staring back at you.

Speaking of "customer," we (in improvement) also have to meet OUR customers where they're at. Some of the Deming folks are getting a little too "preachy" about systems thinking. You are one of the few who can shed light meaningfully -- but it takes time. Think of the time it took us to truly understand the nature of Deming's Profound Knowledge. If only transition were "linear"...

If we can instill critical thinking in their daily work, they might have a chance at seeing the bigger picture you suggest. It's probably best for the executives to get that message first so that they can facilitate the improvement process through their leadership of managing everyday work accordingly.

Davis

This can't be done in a room

Writing articles makes things tough to decipher and I doubt that I would say what I wrote in a room, unless . . . I could take them to the work and show them.

Meeting customers where they are at makes perfect sense, it is pragmatic to do so. Since systems thinking is part of SoPK, I can imagine why the Deming community might sound preachy. I don't believe being pragmatic and introducing basic concepts of systems thinking should be at odds. It just means we need to find new approaches to do so.

Critical thinking is defined a reasonable, reflective, responsible and skillful thinking that helps us decide what to do. Sorry, if I sound preachy but systems thinking and PDSA go hand-in-hand. The System of Profound Knowledge is indeed a system. We need to learn need to analyze, but also need to be able to synthesize.