Improvement Insights Blog
Use Technology to Lock In Quality Improvements
People are error prone. If you want to lock in improvements, use your existing technology to mistake-proof the change. Here’s how:
“I was working with one group of folks in a hospital, and they were complaining about the fact that the doctors were doing these electronic medical records, but they couldn’t get them to complete all the forms and all the fields that were needed to be able to bill the insurance company for the services provided. I was listening to them talk, and they were talking about how they were going to try and train the doctors to do all these things and do all this stuff, and I said, “Wait. This is an electronic medical records system. I bet your EMS folks and IT could figure out how.”
“You know, it’s just like anything else. It’s like airline reservations: you cannot make or complete an airline reservation unless all the fields and important information are filled out. You can’t do it, it won’t let you. I told them, “I think that what you ought to do is set it up so that the fields that they forget to do mean that they can’t close that customer patient record until they’ve got everything checked off in all the boxes.” They looked at me like I was a miracle worker, that this was some brave new insight. No, it’s not.
“Now, one of the problems with trying to train people to do things correctly is they forget or they miss a step or they drop a step or they’re busy or… I don’t know what happens, right? But if your IT system will not let them do it, guess what? They have to. So this is a way to mistake-proof all of these transactions. If there’s anything IT related, and I’ve done this myself: In the early days of QI Macros, if you selected a column of data on one side and then you skipped over and you selected some over here if you were off by even a single row, Excel would not let you use that data. It would say “This isn’t selected properly.” Then people blame me because I was asking them to select data. So what I did was I mistake-proofed it. I said, “If you select this and you select that and you get an extra row, I’m going to make this one an extra row longer so we can copy it and paste it.” I mistake-proofed that. I’ve been endlessly trying to mistake-proof all the interactions with QI Macros ever since.
“So I want you to get this idea if there’s an IT system involved, there might be a way to automate it so that it prevents all of the mistakes people can make.
“I’m Jay Arthur, author of “Lean Six Sigma Demystified” and QI Macros [software]. That’s my Improvement Insight for this week: Use technology to mistake proof anything you can. Let’s create a hassle-free America; hassle-free healthcare. Let’s go out and improve something this week.”