On Improving Health care from the Inside Out
- The first step to improvement in health care is getting inside the problem. Don’t talk about what we think happens, watch what actually happens. Don’t assume what patients/clients think is important, ask them. Follow the process from the start to finish. Study the system in which the problem exists.
On Quality Improvement Exercises
- We don’t see quality improvement as a sprint or a fit of enthusiasm. It is a sustained leadership directed, in part, at perfecting your core processes- the ones that most of your staff are involved in, and that deliver value to your clients.
- Don’t automate wasteful processes – obliterate them. Align clinical priorities and technology priorities to enable better care.
On the Importance of People
- Drive out fear! Most improvement can not be accomplished without staff involvement. They know their work and are best suited for identifying and driving out waste. An employee who is afraid of losing his/her job will not be able to contribute.
- The reality is, most health care organizations have a laundry list of what they would like to do, if they only had the time. Keep this list ready, and be prepared to invest in retraining.
- How do you find out what “value” is? Ask. All improvement activities must be centred around the concept of generating value for the patient or client.
On Process Visualization Tools
- What’s the best process mapping method? The best type of map is the one that serves your objectives. We draw upon several different methods to visualize a process, depending on the problem to be solved, and the audience involved. And, since we have been doing this so long, we have refined conventional workflow and value stream mapping into something uniquely ‘Doleweerd Consulting’ in nature.
. For example, to improve workflow or to automate, we prefer to use Ben Graham Process Maps. To undertake quality improvement, value stream maps are very powerful. To show processes that contain many variables that can change over time, we might choose State Dependent Process Mapping. Finally, for a managerial audience that likes to think conceptually, an overview of a process created using simpler tools like MS Viso or flow charts, will do the trick.
On Quality Improvement Tools
- We don’t apply every quality improvement tool just because we can – we do what is relevant for getting results in the scenario in question. Whether that is value stream mapping, Ishikawa Diagrams, waste walks or rapid cycle improvement events – the right tool at the right time is everything.