Quality Improvement Essentials
A Note on Behavior Change
Solutions often look great on the written page but fail miserably in implementation, and there are many reasons why. It would take an encyclopedia to address them all, but when thinking about a quality improvement project its usually helpful to consider one - what change in behavior is needed for the improvement effort to be successful?
W. Edwards Deming's fabled red beads experiment teaches us that individual performance can't change a stable system, even one that is stable but under-performing. So the first thing we have to keep in mind is that we should never blame people for performance problems that result from a flawed process:
The implications for behavior change are:
- It's imperative to communicate (when recognized) that issues result from process rather than individual behavior
- Individual blame or reward cannot change the outcome of a stable system
- Its imperative to differentiate common and special causes of variation in the system or process
- we must recognize when process owners are doing their best to make a flawed system work
- while process owners may have strong opinions about how the system should change, changes are more likely to be effective if they are identified in process data