Process Surgery - Diagnosis, Treatment, and Long Term Care

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Today's topic is a follow on to The Band-Aid Paradigm and we look at what to do, after removing the band-aids, to achieve true, sustained, process improvement. I thought I’d dig a little deeper into treating process improvements as we’d treat medical issues. Once we recognize the need to challenge assumptions that adding a process band-aid is the right solution, we can now start to look at the details in addressing the actual root cause. Three issues in process improvement regularly emerge that I’ll address; fixing the wrong problem, using the wrong tools, and not sustaining the improvement after implementing a solution.

Introduction

Building on the analogy of medicine, it’s essential to accept that before we start improving anything, we have to define the problem. While this is the first step in the DMAIC model (Define, Measure, Analyze, Improve, Control), I find that practitioners often fail to look up and around to determine if the problem they are looking at is actually the one that needs to be focused on.

I like to think of any problem that I’m looking at like a patient coming into the emergency room. I have to be very careful to look at the whole patient, not just the obvious wound. An obvious but superficial wound can often distract from the much more serious, but less obvious, damage. A great example was a Solider I knew in Iraq who was shot multiple times. In the haste to treat the obvious wounds, they missed the bullet that entered his armpit piercing internal organs. While his superficial wounds were treated, he nearly died of internal bleeding.

Stepping back and putting the patient in perspective and looking for the most important problems to solve is a critical step that tools, like the theory of constraints, help to address. Simply put, before you dive down to solve a problem, look up and around and make sure you’ve triaged and diagnosed the patient properly to start with.

The next problem that emerges in process improvement is in using the wrong tools. This is akin to a surgeon, removing the band-aids to get to the original wound, grabbing a handful of tools, and jabbing them in. While the process owners need to address their band-aid problem, the Six Sigma Expert needs to address their tool usage. What is familiar and comfortable may not work to solve this specific problem. The improvement team needs to understand the nature of the problem and critically select the right tools to apply.

As a surgery team works together, selecting specific tools for specific needs, so too should the process improvement team balance their tools for each specific patient. Also, just as a surgery team continues to improve their skills and continues adding new tools and new technologies to their portfolio so too should the process improvement team continuously learn and evolve.

I’ll caveat here that we also need to be careful to balance the pressure to use the newest and shiny tool when solid basics can quickly and confidently solve the problem. Applying the right tools takes conscious effort. Simple trade-off reviews such as team or stakeholder knowledge, and skills, as well as time and budget, are critical enablers in tool selection.

The last problem to resolve is in the sustainment of the improvement. DMAIC captures this in the Control step but too many projects just stop at Improve. Like a physical wound, doing the work to repair a process will also require rehabilitation and long-term care. Imagining your process improvements like a surgery patient in the recovery room with stitches and bandages can help contextualize the after-care required for your project.

We don’t expect a patient to be operated on and then released with no care plan or physical or occupational therapy. Therefore we need to recognize that the repaired process must be taken care of with process accountability (keeping it clean), process maturity (physical therapy), and a recognition that the process isn’t going to be at 100% capacity immediately until it’s fully rehabilitated. Success at this stage requires larger stakeholder involvement from the organization and takes much longer than most people anticipate or appreciate. This, in my experience, is the single greatest failure point in process improvement and cannot be overlooked.

Thinking of our process problems like human patients helps highlight some of the key failures of process improvement and remedies for those failures. We must start by ensuring we’ve properly triaged and diagnosed the problem then take the time to intentionally identify and apply the right tools in the proper sequence to fix the problem, and finally, dutifully rehabilitate the system back to full health.

I’d love to hear your comments about successes, or missteps in process improvement and what you learned!