The value-stream improvement method described in Perfecting Patient Journeys differs from the traditional committee approach to making organizational changes. Both methods involve discussion and action, but the focus and timelines differ. Committee work is often a drawn-out process that involves lots of politics, negotiation, and compromise to get a result that everyone accepts. Value-stream improvement focuses on implementing change by running quick experiments to see what actually works – and what doesn’t. Here are some tips from the book for running rapid experiments.
A Quick Guide to Running Experiments
Many actions plans involve testing of new forms and procedures. If you’ve never run an experimental test, below are some tips to help you get started.
1. Determine the change (procedure, form, etc.) that you think will result in an improvement and draft a version that you want to test.
- Circulate the draft for review, gathering input from people who are most likely to recognize potential problems with the change.
- Make any needed revisions.
2. Determine how you will know that the change has had the impact (result) you want (i.e., decide what you want to observe/measure). Keep the simplest possible measurements that will still produce the information you will need to help you make decisions.
3. Develop a step-by-step procedure (Who? What? When? Where? How?) for trialing the change.
- Identify observers for the experiment. Provide them with instructions on what to observe and how to document their observations.
- Do a virtual run through of the experimental procedure with the people who will participate in it.
- Make additional changes as needed.
4. Secure any necessary permissions to run the experiment.
5. Develop an elevator speech for the experiment and inform other people who need to know. (Make sure to communicate in a way that ensures that the critical stakeholders get the information in a clear, concise, and timely way.)
6. Run the experiment.
7. Interview participants and get their feedback on what worked/what needs to change.
8. Review participant feedback and observer data and decide what happens next (options below):
- Repeat the experiment as designed but implement the next round under different conditions (e.g., on night shift, during peak hours, etc.). Assess the results.
- Revise the change and/or the procedure, repeat the experiment, and assess the results.
- Scrap the change and try a different approach to the problem you’re trying to address.
- Implement the change as standard work, train staff to use it, and monitor results (for consistency of implementation and impact).
9. Write a summary of your results and circulate to pilot participants and key stakeholders.
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Downloading forms, templates, and excerpts from Perfecting Patient Journeys.
Perfecting Patient Journeys is a guide to value-stream improvement for leaders of healthcare organizations who want to implement lean thinking and engage employees in solving problems in order to deliver better and more efficient care. Readers will learn how to identify and select a problem in the performance of a value stream, define a project scope, and create a shared understanding of what’s occurring in the value stream. Readers will also learn to develop a shared vision of an improved future, and hopefully work together to make that vision a reality.