Process analysis and improvement

Problem-solving, like healthcare, involves two distinct sets of activity: diagnosis and improvement. Diagnosing involves identifying and understanding the problem, and improvement then takes over in finding the solution to cure the patient, applying it and making sure it works.

A common process for diagnosis and improvement is as follows:

Problem analysis flowchart

Diagnosis

Diagnosis involves gaining a deep understanding the situation for which appropriate improvements can be applied. It is a common trap to implement 'improvements' that seem to be common sense, yet do not work in practice. Diagnosing this, it is often found that the pressure to act and 'do something' typically leads to 'improvements' that do not address the real problem or root cause.

Problem

The first activity of problem-solving is to identify what improvement is required. Although you may be told that something is wrong, it may not be a complete description and early discovery is thus needed to explore and define the problem more rigorously.

  • Capturing of initial issues and other 'pain' and using this to direct early analysis.
  • Identification of stakeholders and understanding their needs and perceptions.
  • Clarification of standards, requirements and other constraints.
  • Selection of measures and targets by which performance is assessed and hence gaps identified.
  • Bounding the problem, in order to focus diagnosis and improvement.
  • Agreeing the work to be done.
  • Recruiting the team of people to work on the problem, gaining commitment for their time.

Analysis

Analysis goes from the initial description of the problem to gaining facts and data about the problem that allows you to narrow down your activities towards an effective solution. Where possible, this should be a quantitative analysis, using numerical data. Some problems do not yield such information, in which case the analysis may be qualitative.

  • Mapping of processes and systems to enable communication, focus and further analysis.
  • Measurement of processes to determine performance gaps against constraints.
  • Interviewing of people in the process to determine events and perceptions.
  • Structuring of information gained to identify patterns and relationships.
  • Prioritising performance gaps to identify those to address first.
  • Identifying causes of key gaps to determine why gaps are occurring.

Note that you may discover that the original problem with which you were presented is not the real problem or that there are more significant issues to address. In such cases a return to the Problem stage is necessary to redefine the work required.

Improvement

Improvement involves the development of solutions to the diagnosed problem and then implementing them. This activity has two very different parts. The development of the appropriate improvement is often relatively straightforward if the diagnosis is done well. Where difficulties more often lie is in the deployment of these changes in an organization that is unwilling or unable to adopt them.

Improvement activities may hence include:

Solution

A good analysis will often point to a clear solution, although often a certain amount of creativity may be needed to identify an effective way of addressing causes and closing gaps.

  • Identifying innovative and practical changes that will close target gaps.
  • Developing of solutions to be implemented.
  • Testing solutions to verify they meet requirements and will work in practice.

Implementation

Sometimes implementing a solution is easy, but often it requires significant change and can take more work than the rest of the project as you persuade people to accept changes and educate them in new ways.

  • Building and managing commitment required to implement the solutions.
  • Educating people to support both operational and emotional changes.
  • Implementing the changes, including changes of processes and organisation.
  • Managing resistance to changes, including marshalling of senior management support.
  • Supporting the implementation, answering questions and addressing operational problems.

Assessment

It is important to assess and otherwise measure the success of the solution and hence determine what further action may be needed.

  • Measuring the actual improvements in the target gaps.
  • Monitoring for unexpected side-effects.
  • Looping back to earlier stages to make further improvements and corrections.
  • Survey of stakeholders for perception of changes.

Solutions that work well in the lab do not always translate well into the real world and a pragmatic approach is needed, going back to the drawing board as necessary to revise what will be used. Sometimes also the solution is just fine, but the implementation leaves much to be desired.

Completion

After the solution is proven successful, there are a range of activities to tidy up and close out the project.

  • Communication of successes and learnings.
  • Handing over activities for 'business as usual' management.
  • Celebrating successes and rewarding the team.
  • Closing the project, writing final reports and archiving material.

Comment on this article

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I think the model is missing "Sustain". For any improvement to be effective it must be sustained. This takes leadership from the users and the stakeholders

Anthony Glinos

18 June 2009 17:28

Chartered Quality Institute

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