A Funny Thing Happened on the Way to Quality Improvement

The quality vs. transformation disconnect continues

Wed, 01/28/2015 - 00:00

I've been presenting at the Institute for Healthcare Improvement (IHI) annual forum for 21 consecutive years. Maybe the biggest surprise from these two decades has been the awesome power of simply "plotting the dots," i.e., plotting important organizational data in their naturally occurring time order. I have evolved to using fewer, simpler tools in my consulting and have never been more effective.

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My all-day course at the forum demonstrated this with a wide variety of data from real situations. I showed how the power of this simple philosophy could be the back door through which improvement practitioners could educate their managers and executives in the best possible way—by getting eye-opening results. I also emphasized the need to learn and use common-cause strategies, which are not generally taught. All this requires very few tools, but it does require a total change in mindset regarding improvement. I'm not comparing myself to Deming, but I realized that he was always criticized for the virtual lack of tools taught in his seminars. Twenty years of hard study has made me evolve to a similar approach to improvement.

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Comments

The "Quality Belt Era" has perpetuated the lack of critical thinking. Check the box of the tools you learned and get a prize or certification. Without critical thinking skills no new tools to solve problems will be developed. Stuck in an era of copying old tools. Does innovation really matter in this era?

Our education systems are setting up for failure with this same thinking. Standardized tests are dominating our schools. How many tests do you sit down and take at work? Wrong skills and wrong method. The ability to read a control chart - a fundamental for any organization is still not being taught in most schools. My daughter's math teacher didn't even know what a control chart was - ashame.

The challenging part of the Deming philosophy is that it is not a "connect the dots" exercise - it is a learning one. Thank God!

I am a green belt who moved into healthcare from automotive via food. At a senior level, my organisation appears to value black belts or master black belts but not green belts. It also seems to be doing Service Improvement as a knee-jerk reaction, playing catch up, and bandies around words learnt at Toyota without doing the study. They are enforcing '8 steps' and 'PDSA' from on high, and it's turning people off. I wanted to implement G8D 6 years ago, when I arrived, but was told it wouldn't work. I live by the Deming Cycle, and luckily, so do the teams I work most closely with. Don't get me started on control charts; I was once asked by a manager here why I even knew about SPC!

I know I still have much to learn, I've been involved in Quality for 20 years, the last 9 in managerial roles. It saddens me that Qualicrats even exist - and they do here. My philosophy has always been that Quality and Gemba are intrinsically linked, and other than some supervision and responsibility (as per ISO etc), Gemba is where Quality is made to happen, not from some disconnected ivory tower. I love my job, and am passionate about our patients, but so frustrated by the Qualicracy. There are some good people in the Qualicracy here, don't get me wrong, but I feel a deep sense of unease about what's expected and how it should be delivered; a disturbance in the Force, if you will.

Connecting the dots and ticking the boxes sets my teeth on edge - it's not why we are here, we are here to investigate and learn!

Submitted by LJS on Wed, 01/28/2015 - 11:48

"I also emphasized the need to learn and use common-cause strategies, which are not generally taught. "

Could you say more about this?  What are some of the common-cause strategies that you find useful?

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