Duke Rohe, Performance Improvement
M.D. Anderson Cancer Center
Let’s face it, the half-life change is getting shorter all the time and those who know how to navigate it successfully are getting fewer. Most organization are not short on think-power from their employees, they are simply short on the tools to make improvement happen and the environment to stimulate this type thinking. Transferring the fervor and knowledge of how to make improvement happen faster to the workforce is becoming an essential skill.
This presentation will describe how to generate tools that have high utility and how to engage the workforce to draw on them. The attendees will receive diskette packed with tools ready to modify and use. Categories of tools include: innovation, change, knowledge management, service, teams, reengineering, project management, process, even a tool on how to make a tool. One of the tools is a robust Reengineering Change Methodology in electronic form. These can be the starter fluid for igniting an accelerated emphasis on improvement in your organization.
Oh and the author’s zany style of communication comes with the presentation.
Purpose for creating a tool
What’s a tool
How to Begin
How to serve it up
How to spread it around
A test of the best
Honor your sources
A tool’s best compliment
The worst tool: It’s the great one that is never shared
from that tool-a-week geek, dare-to-share Duke
Duke Rohe, Office of Performance Improvement
M.D. Anderson Cancer Center
Healthcare cannot afford to continue growing at marginal rates of improvement when so much more can be accomplished. There are many in the workforce who would be encouraged to do more: think harder, risk more, and accomplish greater things, if they just had the tools to help them along. Remember watching the movie 2001 A Space Odyssey and the cavemen at the beginning discovered the use of a tool (you can hear the theme song now). Tools help us do significantly more than we can without them: with much more ease, in much less time. This proceeding is not to inform you, but to encourage you to learn how to make tools, share tools, and use tools to speed improvement efforts to you and to those around you.
Here’s an offer…
To start your own “improvement movement”, request a set of tools from Duke Rohe at Drohe@pdq.net. You’ll get tools designed to add value, add service, and direct projects. There are complex tools such as the Change Management Tool kit, which is a 500 step multi-level methodology ready to run on Microsoft Project or Excel. There are thought-provoking notes taken at conferences such as this one. There are even ones that make you smile. All are designed to help accelerate the success of altering and strengthening processes.
and a challenge…
Here’s the challenge. After reading this and getting these tools: add to their value by improving them and making new ones of your own. The ultimate compliment to a tool’s originator is that you improve the tool and share it with others. Share with as many as may gain by them.
It is insufficient for change to be relegated to a few
consultants, management engineers or change geeks. The progress is too slow, too shallow and often short-lived. We need an entire workforce trying things
out. We need masses dissatisfied with
waste and hungry for improvement. These
tools can be the starter-fluid for individuals designing their own
solutions. If management engineers have
done their jobs well, the project is a success, the line staff have learned new
skills, and the workforce is looking for the next thing to fix. The management engineer’s fingerprints are
no more on the outcome than anyone else’s.
Purpose 4 creating a
tool
I got into cool tool-making working as a consultant in a small firm. Time is money, and a wise firm does not reinvent too often or it is out of business. It takes longer to make a tool, but once it is made, its lifetime use could be a dozen. Consider making a tool any time there is a chance for reuse. Here are a few purposes performance improvement tools might serve:
· Accelerate learning - Something is always easier to build the second time you do it. Lessons learned, do-do’s, don’t-do’s: all help accelerate the learning of the ones injecting change the first time around. Let’s admit it, change is usually something we don’t do just for fun. So most of us aren’t equipped with the same set of change skills, and here is where tools can help. Tools supplement our skills, helping us determine how to figure out what we need to know and do it faster.
· Give a guide of predictability - An old American Indian proverb states (with tom-toms beating) that “it is better to know there is a waterfall ahead than to hear one ahead”. If you are starting from scratch designing a project, you may be “feeling” your way around the project too much.
· Provide a roadmap for similar territory. A previous methodology may not be the path you take, but it gives you assurance of what has worked in the past and you can go from there. It has amazing effects in opening considerations of what needs to be included to achieve success or avoid disaster.
· Replicate knowledge efficiently from one application to another. Recycle what you know so others can use it. How often have you seen similar problems repeated over time, or repeated in a shade different form in another department? Tools, and the knowledge of their availability can impact this.
· Eliminate the waste of reinventing knowledge and learning through error. Waste comes in many forms and organizations are guilty of throwing their best resources into reinventing things that have previously been developed. Given a limited amount of energy for change, which seems to get shorter by the day, rework is ridiculous.
· A good idea is good. A good idea times 50 is mighty good. Every time you think of a good idea, there are bound to be 50 departments over the course of time that might use a modification of that idea. The power of a tool is in making it known and available to as many as might gain by it. Any less and you have incurred waste.
What
za tool
What qualifies? Anything that can help someone think a little clearer or with more confidence about a change effort. Size does not matter. In fact, the simpler the better.
· Forms, bullet-format notes, new thought-provokers, proverbial wisdom
· Icebreakers and debriefs, tests that lead you to your answer
· Questions that drive folks to their solutions, action item trackers
· Common sense revisited, notable quoteables, comic reliefs
· A guide or pattern for achieving results, doing things right and avoiding pitfalls
· List of how-to’s, have-you’s, do-do’s, don’t-do’s and how-do-you-do’s (checking to see if you are reading)
· Summary notes that will inspire and inform. Summary of books, conferences…
· Step-by-step procedures, observations of causes and effects
· Concepts translated from one industry to the next
· New knowledge or thought-provoking abstracts
· Macro-rich spreadsheets and databases with multiple applications
· Checklists, visual examples
· Complex methodologies boiled down to their pertinent points
· Personal pieces that bring life to life, heart warmers, life expanders
· Little techniques that bring great results
· Summary of ideas that have worked elsewhere
· Lessons learned from a project, especially the “never do this”
· Samples, examples and starter fluid for an application
· Handouts that have routine use
· Best practices for accomplishing a goal
So anything that helps someone, dislodges status quo thinking, or that might add value to the change climate of the organization counts.
How
2 Begin
So what are the steps of developing a tool that will have repeated use through the years? Imagine you are the only one in the organization who can help (you always did want to be a hero) pioneer through a change.
· Become the resident knowledge sharer in your organization (for the good of the organization and your recognition) Every time you put something out that has possible value to others, you are associated with that growth: whether you invented the tool or not. You have to be selective here. If 80% of your shared items have no value, then guess what you are associated with? The trick is to create a network of prospective users who have interest in the tools you are sending.
· Begin taking notes as if you were the CNN reporter for your organization. When you are at a conference, listen as if you were the only source of knowledge for the organization. You will find something crucial from the conference. Your listening becomes more acute, your attention is on a search-and-find mission.
· Look for the scaffolding behind your project work that would guide others to an even better success. It is like having an out-of-the-body project experience. What were the contexts of the steps taken that made it a success. What should you have done to reduce the land mines you stepped on during implementation?
· Look for business models, cause and effect relationships, and organizational behavior as candidates for tools. Usually success comes by design and not by accident. Understand the clockwork, the four or five driving principles that make the project a success.
· Look at the scaffolding behind how people think and act and fill in the missing pieces that keep them from experiencing success. Many people know the obvious, they are just short on the missing pieces. You gain high leverage when you can understand the thinking behind the thinking and cause others to consider what is often overlooked. Your experience may help them with that.
· Gain an intense dissatisfaction with reinventing knowledge or having to create what has already been created. It ought to cause discomfort to redo anything. It is pure waste. And for you to have knowledge that another part of the organization needs and not share it is waste.
· Become the source for helpful tools and news around the organization. Even if you don’t originate it, you are associated with the genius through sharing it.
· Think in questions that lead people to the right action/answer. It is almost fun to sit on the sidelines of a project and think of the questions that should be asked to insure success. It is like being a critic and having it result in a positive outcome.
· Bridge the gap between the need-to-know need-to-share of communication When these two pieces meet, you drive out communication loss. If we had the information and resources we needed when we needed it, we usually could be 30% more productive. You may not have resources, but communication can always be improved.
· Think of ways you can engage staff to continue resolving their own challenges. Tools are about exciting the brain cells of others. They help the ones cutting a new path not only to do it easier, but deeper and with more confidence.
· Think of ways to stimulate thinking of what might be overlooked. Tools can be mind-triggers to explore those areas not considered. Simply a series of “Have you considered” questions opens the mind to explore possible steps that can hone out waste in a similar project.
· Practice paranoia to get folks to surface those landmines that sink success. At the end of each project, we ought to look back and ask what would we have done differently to make the trip easier. Change efforts die more from what is not done than from what is done. Imagining yourself in the seat of the folks effected by a change will find those not-so-obvious project stoppers
· Help the user maintain a beginning-to-end view while trenching through the details. Tools can help the team members maintain a Hi-Lo perspective. A high view of where you are going in the scheme of things yet enough detail there to show how you will get from where you are to where you need to be.
· Read what works in other industry. Find the “no duh-uh” application that people discount or tend to overlook. I am still convinced that application of the concept of visual control, building instruction/resource into the point of action, would knock out a third of the waste due to inadvertent error. It is free to implement, understood in 15 minutes, and ignored by most because of its simplicity. http://www.hdinc.com/hot_topic_8-97.html
· Itemize those things you wish you had known or done differently from the beginning. Don’t waste those “I shoulda done…” thoughts. Instead of letting them beat you up, keep them from beating someone else up. See, now you are turning into a therapist.
· File these electronically by how they might be used: communication, teams, project management, process improvement… for quick reference. Great tools are a waste if they cannot be found or used. At the beginning of a tool, give a stage setting for how it might be used. File the tools in folders that are intuitive to someone searching for them. Having the tools filed multiple ways is fine. Indexing and cataloging are great for helping a search along. And if you are more high tech - set a search engine function in it.
How 2 serve it up
· Think simplicity, bite-size chunks, understandable by the “little people.” The reason we get stuck in the mud is complexity. Think modular, little lessons a munchkin could understand.
· Offer no more than is needed, no less than is needed to be successful. Carve out the unnecessary. A tool’s purpose is not to show what you know, but to help someone else along. It also has to have enough description so that its use is evident to most.
· Give folks a menu for the best results There are many ways to get to the top of a mountain of change. Some are better than others so give them the ingredients and the directions for success. Another thought-provoking option, write the tool in the reverse form: a menu for disaster.
· Make it fun, interesting. Not everything in healthcare has to taste bad, hurt or be boring. Turn it upside down: “For worst results, do this.” Think of fresh ways to engage people’s minds. You’ll notice I don’t write always in complete sentences. Guess what – you don’t think in complete sentences. Anything more than what is needed is a waste.
· One page is best. Longer tends to discourage the searcher. Long means it is hard to understand. In fact, challenge yourself to relay learning in one page (font 12 now). Someone searching for a tool won’t dig too deeply to extract what is useful.
· Categorize where possible, use font types to make it easy/interesting to read. This is just as much a part of communication as is the message communicated.
· Spend time to groom it. Give me more time and I’ll write you a shorter letter…Mark Twain This is the hardest for me, because by nature, I’m a slob. C+ work in a tool is OK, but its use grows as it clearly communicates what is needed. On the other side, perfection in a tool can waste energies. For the slob, if better is possible, then good is not enough. For the perfectionist, better is never good enough.
· Put your name and department on it: a Duke original, contributed by Duke, modified by Duke, forgotten by Duke. It doesn’t insure security, but it surely shows you are providing support to your organization. You are attempting to help others and that is honored by most.
How 2 spread it around
· Distribute it via email. Grow your network of “Weekly Reader” subscribers by shaping your audience. First broadcast tools to a broad audience then have them request to remain on your list. Periodically, send out teaser tools to the masses and ask those interested to reply if they want to be on your distribution list. One of the best compliments is to see what you have shared stuck on a bulletin board as an fyi.
· Offer it to periodicals, newsletters, professional journals, conferences. New knowledge, even a way to serve up old knowledge, is constantly sought out by publishing organizations. You never know what will tweak their interest. And it is certainly a good way of getting knowledge out there.
· Network it with your peers in other areas. It creates a favor-mentality on the other end. Those who have been shared with love to return the favor. What goes around, comes around.
· Give it away internally. Got a need? Here’s a tool. The leverage of a good tool is making it known to all those who may need it. This requires marketing, reminding, and easy-to-find access.
· Put these filed tools out on a common server for all to access. Periodically refresh the users’ memory of what’s out there. This quadruples its use.
· The most valuable tool fills a need and is given away for free.
A test of da best
· The best tools have function over time in numerous applications.
· V = B x U: Value = the benefit of the tool times its use (if it is free or very reasonable and available, its value will grow). Others will seek out its creator and that is worth a bundle.
Honor your sources
If you use their stuff, acknowledge them.
A tool’s best compliment
Someone else improves on it or shares it with a peer.
How 2 end
The worst tool is an ingenious one that is never created nor shared.
What you put into life is also a measure of what you get out of it. Don’t cheat yourself.