Introduction to Model for Improvement (Part 1)
Recently, a client came to me excitedly telling me that she had discovered a software package that would improve the work scheduling in her clinic and hence efficiency.
Her only concern was the cost. It was much more expensive than she had clearance to spend in her budget.
As a business Coach, my first question to her was: “How do you know this will work?”.
My second question was: “Is there any way to test this idea on a small scale?”
She asked, “Why?”, and I asked her back: “What are the upsides to this solution as you see them?”
When she had responded, I followed up with: “What are the potential downsides of it?”
In this video, we introduce the first part of The Model for Improvement – The 3 Questions:
1. What are we trying to accomplish?
2. How will we know a change is an improvement?
3. What changes can we make that will result in an improvement?
We describe, how our client had applied The Model for Improvement to a problem she had with clinic scheduling and efficiency. We go on to describe how this helped her build a plan of action and start some rapid tests to determine what solutions might be most effective to improve their clinic’s efficiency.
The Model for Improvement applies the Scientific Method to Business Project Management. It has been widely used by all sorts of industries including:
- Healthcare (where it is promulgated by the Institute for Healthcare Improvement)
- Manufacturing
- Service Industries
- Process Industries
The second part of the model are PDSA (or Learning) Cycles and will be addressed in our next video.
What makes The Model For Improvement unique is that it can be applied to anything, in any industry.
- Improvement of existing products, services and customer experiences
- Improvement of existing processes
- Improvement of whole business (sub) systems
- Product, service and experience innovation
- Process Innovation
- Business Model Innovation
- Spread of change (Collaboratives)
If are interested to know more, contact us.
Music and video editing by Priya Thomas
If you prefer to read the contents of the video, here’s the transcript.
Good morning, good afternoon and good evening, wherever you are watching this from. I’m David Thomas from Profound Knowledge Partners Asia.
Recently, a client came to me excitedly telling me that she had discovered a software package that would improve the work scheduling in her clinic and hence efficiency.
Her only concern was the cost. It was much more expensive than she had clearance to spend in her budget.
As a business Coach, my first question to her was: “How do you know this will work?”.
My second question was: “Is there any way to test this idea on a small scale?”
She asked, “Why?”, and I asked her back: “What are the upsides to this solution as you see them?”
When she had responded, I followed up with: “What are the potential downsides of it?”
As we brainstormed all of the potential consequences if this went wrong, she lost her initial enthusiasm. We discussed the fact that even if the software could technically do what she wanted, it may not actually lead to the improvement she was hoping for, because there were many more issues than just a scheduling tool involved.
But rather than leave her deflated, I went on to ask her 3 sets of questions:
1. “What are you trying to accomplish here with this idea?” … “Let’s describe the improvement you want to see.”
Once we had defined that, I went on to the next question set:
2. “How will you know that any changes you make will be an improvement?” … “What measures and data would tell you that things have gotten better, and that the problem has not just shifted elsewhere?” … “And do you have the systems to gather the data you want?”
After talking further, and coming up with a few ideas around measures and goals, we moved on to the 3rd question set:
3. “You had the idea around this app for scheduling the work -What other ideas do you have that might improve the efficiency of the way your team works?” …“Are there any alternatives?”
We generated a list of ideas, and I went on to ask:
“Why do you think such changes might work?”,
“How quickly can we go about testing these ideas?”,
“Who has the right subject matter knowledge to be involved in these tests?”, and
“How will you make decisions about which ideas might be best to take forward and implement?”
In a short time, we had established a course of action to quickly determine:
1. If the software she had looked at might be the best option, or whether alternatives might prove more effective, and
2. What else, aside from installing a piece of IT, might contribute to the organisation’s work efficiency
In a very practical way, we had started to apply the Model of Improvement to her business problem, and had begun to help her come up with a plan of action that would reduce the risk of failure, and enhance the likelihood of success, in investing to improve the working efficiency of the business.
Lets talk more about the Model for Improvement.
So, What is the Model For Improvement?
It’s a framework that takes the Scientific Method and applies it to improvement project management. It is widely used in Healthcare, and has been adopted globally by the Institute for Healthcare Improvement (IHI), along with other sectors such as:
- Electronics manufacturing and distribution
- Other types Manufacturing
- Service industries
- Process industries
Within many of these industries, failure, including failure to innovate, can be fatal.
The Model for Improvement was developed by Associates in Process Improvement (API) in the early 1990s, based on the previous work of Dr. W. Edwards Deming and Walter A Shewhart. It was published in 1996 in API’s seminal book: “The Improvement Guide: A Practical Approach to Enhancing Organizational Performance.”, which is now in its 3rd edition.
The Model for Improvement brings together 2 important parts: The first part includes 3 guiding questions that direct the project and provide clarity to both the sponsors and project team:
The first question is: “What are we trying to accomplish?”
- This sets the objective for the project … basically, what outcome we want.
In the example I mentioned earlier, the clinic manager outlined that they wanted to make better use of clinic resources,both staff and equipment, with less empty slots, as well as fewer scheduling conflicts, in the daily calendar.
The 2nd question is: “How will we know a change is an improvement?”
- This establishes the data and measures that will need to be collected as evidence that the changes being made are actually resulting in improvement.
- Such measures typically include outcome measures, process measures and balancing measures.
In the case of the clinic, we defined measures around doctor, room and equipment usage, as well as client and staff satisfaction and the number of cross-clinic referrals, along with some financial measures, including Return On Investment.
And … The 3rd question in the Model For Improvement is: “What changes can we make that will result in an improvement?”
- This prompts us to tabulate and maintain a list of ideas that we can experiment with in order to determine if they truly will make things better as we predict, or otherwise.
- We use the measures defined in the 2nd question to prove the effectiveness of these ideas.
- The ideas then lead on to trial and learning, in the 2nd part of the model.
In the case of the clinic, we discussed suggestions around rostering, opening times, providing more visibility to vacant slots for clients, and exploring a number of alternative IT solutions.
Rather than making the decision herself, the clinic manager decided to pull together a small team of subject matter experts – that is those currently involved in the work – to run the project and determine what solutions really were the most effective.
She set out her expectations in the form of a project charter, which she wrote together with the project team, and agreed they would review progress with her on weekly basis.
With the project direction established, the 2nd part of the Model for Improvement is running the trial and learning part … PDSA Cycles.
These are founded on the Scientific Method, as it applies to business:
- Forming an Hypothesis
- Planning an experiment to test that hypothesis
- Conducting the experiment and observing what happens
- Reviewing the results, comparing them with your initial hypothesis,
- And then,taking action based on what you have learned.
I will go into more details on PDSA Cycles in our next video.
In the case of our client, she and her team now had a plan of action and could start some rapid tests to determine what solutions might be most effective to improve their clinic’s efficiency.
As Improvement Scientists, Business Coaches and Consultants, specialising in Strategy, Innovation and Change, we’d love to explore your challenges and help you build solutions to navigate your organisation’s critical transitions.
If you’d like to learn more about the Model for Improvement, email or message us today, or check out the Improvement Guide book.
You will find the links in the description below.
Over time we will continue to explore Growth Transition challenges in this channel.
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Thank you for watching and see you in the next one!
Links:
Associates in Process Improvement
http://www.apiweb.org/index.php
Institute for Healthcare Improvement
http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., Provost, L. P., 2009. “The Improvement Guide: A Practical Approach to Enhancing Organizational Performance”, 3rd Ed., 2009, Jossey Bass
https://www.pkpasia.com/recommended-reading/