Striking a balance between between celebration and acceleration.Recently, I've been thinking a great deal about pacing. When I recall CCRMC's efforts with System Redesign which began in 2005, I remember many of the crucial lessons learned from our participation in the IHI 100k lives Campaign. One year ago today I wrote about our redesign efforts and again today my thoughts drift to System Redesign, an important anchor in our transformation efforts.
Although System Redesign is no longer a group, but rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize and embed real and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to them. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I did but I thought I would throw that in for good measure! We learned how important it is not only to acknowledge and celebrate all efforts even what seems the smallest accomplishments, but also to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left behind. Celebration and acceleration, do you remember?
Like so many of you, I too am eager for a new day - hence, my original question about pacing. How big do we design and how fast do we go? If I draw from the original lessons learned I would look to real time observations and proven science. What would Deming say if we could ask him? It is well documented that he did believe and teach that all transformation begins with the indvidual. Many of the tests we designed began with one patient, one doctor, one nurse, one day, one shift, one time...you get the idea. You can learn more about the Model For Improvement and how we at CCRMC have used it in our improvement efforts here.