Memorial Healthcare System

Leaders want to have their work problems solved as soon as possible. They want things to be better and for their problems to simply ‘go away.’ Many times, they implement solutions without sufficient thought. Doing so may temporarily make things seem better, but many times such ‘band-aid’ quick fixes mask the problem and eventually lead to the problem getting even worse. If there were a ‘Magic Pill’ for every problem, there would be fewer and fewer problems; and eventually, ‘poof’ – there would be no problems at all.

Unfortunately, many times we jump to solutions without fully understanding what is behind the problem (its root cause). “The real problem with problem-solving is that most are focusing on improving their ‘performance’ instead of improving their process.”

I would argue that the best way to bring about real and sustained improvements is to focus on the process. Once we understand the process, we can determine where we are, we can identify things (steps in the process) that are not optimal, we can come up with a better way of doing things, and we can come up with a plan to sustain the new way of doing business (the new process).

Some organizations rely on a performance improvement methodology entitled MAGIC to solve their operational problems. MAGIC is an acronym for Measure – Assess – Generate Ideas – Implement – Check. I would venture to say that the MAGIC (magical) approach to performance improvement may sound good but is lacking. It lacks a true understanding (or definition) of the problem. It lacks real (meaningful) data analysis. It also lacks the necessary controls needed to ensure success.

In my opinion, the best way to solve operational problems is to focus on improving the process rather than on improving performance. The Process Improvement methodology that leads to successful and sustainable improvements is entitled DMAIC; an acronym for Define – Measure – Analyze – Improve (some add an I for Implement) – Control. While DMAIC may not be magical; its steps are methodically structured to bring about sustained success.

The ‘Define’ phase is one of the most important ones. It starts with identifying what is critical to quality from the customers’ perspective. It requires that a project ‘Charter’ be written to clarify what is being worked on (within scope) and what will not be worked on (out of scope). A SIPOC is a great tool to summarize the Suppliers, the process Inputs, a high-level (5 to 8-step) process map, the outputs, and the customers of the process. The Define phase also greatly benefits from doing a more detailed (step-by-step) map of the current (state) process (Process Map). To understand the problem, you want to go to where the work is being performed (by going to the ‘Gemba’). You want to see what is taking place and you want to ask questions such as, “Why?” (respectfully). You want to try to put yourself in ‘their shoes’ and see what is happening (not working) for those that are doing the work.

The ‘Measure’ phase consists of selecting and then measuring the data that is critical to quality. Hopefully, that data is available to you and hopefully, the data is good (accurate) and meaningful (tells a story); otherwise, you may need to come up with your data collection plan, such as manual data collection.