How to Get Better Results

02/08/2022 Compiled by Valmeek Kudesia

Paths to Better Results

Our healthcare system is so complex that unable to adequately describe its own complexity and everywhere is powered by individuals who are

• • compassionate

  • highly-skilled

  • motivated to improve and give best efforts EVERY DAY

Despite our earnest efforts, we can be misled (categories below) to conclude we have "better results" vs truly improving our care system.

Distort the System

• Mask problem e.g. quick-patch

• Transfer problem to another area e.g. reassign resources and produce errors in another part of system

Distort the Data

• Ad hoc change how observations are classified e.g. change when timer starts

• Ad hoc change which observations are important

Improve the System

• is hard, takes mature organization

• requires grasp actual end-to-end state of affairs; then will easily distinguish "distortion" vs "improvement" (see optimize the whole)

• Requires [[knowledge-about-variation]] or else will mistake variation ⟶ evidence of failure or success

• Requires [[understanding-proxy-nature-of-data]] or else ⟶ led astray when proxy association changes over time

Reference

Fourth Generation Management, Brian Joiner