There is much enthusiasm these days about “Kaizen“ in Health Care (and rightfully so, it’s a great philosophy). It is a Japanese term meaning:
‘Change for the better’ or ‘improvement’. A business philosophy of continuous cost reduction, reducing quality problems, and delivery time reduction through rapid, team-based improvement activity.
However, it is often pursued without due attention to it’s prequel, “Control”:
“the activity of ensuring conformance to the requirements and taking corrective action when necessary to correct problems and maintain stable performance”
(Evans, Lindsay, Management and Control of Quality 6th ed)
Control is necessary for effective daily management of processes and involves process goals, measurement and evaluation. Without control, it is premature to talk meaningfully about improvement (or “Kaizen“).
For example, let’s say that a Community Care Access Centre wishes to run a Kaizen Event to improve the timeliness for new client assessments. First ask the following questions:
- What is the “target” level of timeliness?
- What is the “current” level of timeliness?
- How close are we?
If these questions cannot be answered, then there is no basis for effective daily management and it is time for a control rather than kaizen improvement exercises.
Do you ever hear leaders in health care speak about the number of kaizen or other improvement events they held last month or last year? Be careful. This isn’t a measure of mission impact nor of organizational performance. First seek to control, then improve, because you can’t improve a process out of control.