Improvement Insights Blog

Thrillers and detective novels always have two villains – -the bad guy and the internal bureaucracy. As a Quality Improvement hero, you will face the same problem. 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’ll admit it: I like to read thriller novels. I do, right? I just find them terrific… or detective mystery novels. Invariably the good guy has to go combat some bad actor somewhere. It could be the murderer, it could be a terrorist, it could be whatever it is, but the good guy almost invariably also has to fight the bureaucracy of his police department, the CIA, the FBI, the… whatever the heck it is, right? So they’re not only fighting the bad guy, but they’re fighting the people that are supposed to be supporting them.

“Now, if you’ve been around Quality Improvement at all, you’ll notice that you’re trying to defeat the defects, mistakes, errors, waste, rework, lost profit, patient harm that are going on out there. You’re trying to do good things in the world, and guess what? Somebody in the organization (and I call them the corporate immune system), they do not want things to change, and so you’re going to have to fight your own bureaucracy on top of fighting the thing that is not performing properly, right?

“So you’re going to have to fight the naysayers, the holdouts, the “that’s not the right data” people… oh my gosh! People will find every excuse in the world not to do anything to improve because it means they have to change something and they don’t want to change. Does this make sense?

“So, when you’re working on trying to make Quality Improvement, pay attention to the fact that the bureaucracy is going to try and fight you. I’ve always found it best to not engage the corporate immune system. If John or Susie does not want to be on your project, don’t let them on, right? “No, it’s okay, you don’t have to do that…” and guess what? They’ll stay out of your way and then eventually your results will make them look bad and they will come to you and ask you for help. At that point, that’s great.

“So that’s my Improvement Insight for this week: Pay attention to the bureaucracy and the corporate immune system. Let’s create a hassle-free America; hassle free healthcare. Let’s go out and improve something this week.”