Pam Senesac, Anita Morris, Sai Cherala, Joan Johnston, and Ruth Aboagye on Improving Performance: Facts, Flowcharts, Fishbones, Five Whys, and the Failure

What do one doctor, three nurses and an MBA have in common? More than you might think . . . We’re Pam Senesac, Anita Morris, Sai Cherala, Joan Johnston, and Ruth Aboagye, members of the Healthcare Innovation & Quality unit at UMass Medical School’s Center for Health Policy and Research, dedicated to individual and organizational Performance Improvement (PI) in our global efforts to evaluate our work. In a PI project, it’s tempting to jump ahead to “fixing the problem.” STOP, take the scenic route, explore different avenues, meet the challenges head on, and enjoy the journey. The results will be a marked improvement and more sustainable. During our PI journeys, we’ve acquired some nuggets of wisdom we’d like to share with you.

Hot Tips:

  • Plan things out well from the start. Don’t be afraid to revisit and change plans if needed.
  • Come to the table equipped with data. It’s key to tracking progress and measuring success.
  • Take the time to research and think through your implementation plan. It makes monitoring and sustaining improvement effortless.

Lessons Learned: When pondering a performance issue, use these 4 field-tested tools to get through the journey.

  • Get the Facts: In today’s fast-paced environment, the impetus to problem-solve in real time sometimes inhibits long-term organizational process improvement. Gather as much data on your current process as possible; understand what you have and why you have it. This provides a good baseline and helps measure the impact of interventions. There is a metric for every process and outcome.
  • Chart the Flow of the Process: A picture of the current process in all its glorious complexity helps everyone understand the process, identify any gaps or other issues, and informs your improvement plans.
  • Use a Fishbone Diagram to brainstorm potential causes: A Fishbone helps describe the context. What is the environment? What is this process trying to achieve? What conditions impact or influence the condition being addressed? Why are we doing it? How do we put it together and stay true to our core values? With these questions in mind, list potential causes that may be contributing to the situation at hand.
  • Get to the Root Cause, not just the first cause or pause, with Five Whys: Thoroughly understand why your system is the way it is. Armed with potential causes, ask WHY as many times as needed to help you identify the root cause and where to target your improvement intervention. You’re looking for the diagnosis, not the symptom.

Finally, remember, it’s OKAY to fail. Knowing what doesn’t work hones your skills and focuses future efforts. Fail fast, learn from the experience, and move on.

Rad Resource: Use this link to learn more about these 3 PI tools and many others.

Do you have questions, concerns, kudos, or content to extend this aea365 contribution? Please add them in the comments section for this post on the aea365 webpage so that we may enrich our community of practice. Would you like to submit an aea365 Tip? Please send a note of interest to aea365@eval.org . aea365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators.

1 thought on “Pam Senesac, Anita Morris, Sai Cherala, Joan Johnston, and Ruth Aboagye on Improving Performance: Facts, Flowcharts, Fishbones, Five Whys, and the Failure”

  1. Pingback: Laura Sefton, Judy Savageau, and Linda Cabral on Post-Project Debriefings as Part of Performance Improvement · AEA365

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