Improvement Insights Blog

Ever wondered why it’s so hard to propagate improvements from one group to the next? Here’s why and what to do about it:

“Hi, I’m Jay Arthur, author of “Lean Six Sigma For Hospitals” and QI Macros [software].

“I was recently at one of the IHI presentations at their conference and they mentioned… “How long does it take for medicine to adopt a new practice?” On average it’s 17 years… 17 years. Doesn’t that sound ridiculous? I think penicillin was 25 years, and some of the other things… but 17 years?

“They say, “Well, you know, we haven’t peer reviewed that, so we have to peer review it so we can confirm that your hypothesis is correct and that we can actually…” Right? So everybody has to go out and run their own study to convince themselves that this thing will work and after 17 years in multiple peer review studies they say, “Ah, it might work.” This makes me crazy, right? This makes me crazy.

“I want you to consider the same as true in your organization. If you want people to make a change, they have to be engaged in the analysis and figuring out the countermeasures to implement in their organization or department or work group or whatever it is. So there’s no way for us to even…

“When I was leading groups, even if I knew the answer, I did not tell them. Why? Because I’m an outside guy; my job was to help them recognize and come up with the conclusion that would solve their problem. When they came up with a solution, guess what? They owned it. We didn’t need a thousand peer review studies, we just… they will own it if you help them go through root cause analysis, figure out what’s really going wrong and come up with the countermeasures. Then they’ll be committed to implementing them. They will not hesitate because they want to make life better for themselves and their customer.

“I mean this… and this is true across organizations. We used to talk about, “Well, you could replicate this improvement across…” No, you can’t, right? Because the next group over doesn’t believe your numbers and they want to do a peer review study. It’s almost easier to give them the data about their own organization, walk them through root cause analysis and countermeasures. They’ll come up with the same answer, but you’ll get much more commitment in reality. I wish we humans… you could just say, “That way.” You know, we’re not Marines; they won’t go that way, right? I had one guy that I worked with, and he said in the military when he was in the Navy, “We said ‘go there’ and people went there,” he said, “but in civilian life, that’s not how that works.”

“So take the time to guide people and help them come up with and figure out their answer, and they will implement it much more easily. That’s my Improvement Insight for this week. Let’s create a hassle-free America; hassle-free healthcare. Let’s go out and improve something this week.”