T-Minus 34 Days Until the Annual Lean Healthcare Transformation Summit – Problems and Messes

I’m counting down the days until the 5th Annual Lean Healthcare Transformation Summit, June 4-5 in Los Angeles, CA. I hope it helps in getting the word out. We are 34 days away, and we have 415 people registered!  More than half of the attendees are Healthcare Value Network members!  We produced this video that describes what you’ll see at the Summit.

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We hear a lot about problems and problem-solving.  When I think about this, I recall advice from Russell Ackoff. He’s one of the great thinkers on the topic of “thinking systemically” (and other topics).  I am currently re-reading one of his books, Management f-Laws: How Organizations Really Work, and a reading second book, Systems Thinking for Curious Managers.

How does this relate to problems?

Our team uses A3 thinking and an A3 tool to manage our work.  One part of the A3 shows our work as a system following the advice from another great systems thinking, Dr. W. Edwards Deming.  Dr. Deming shared this diagram with every audience he met with, starting with Japanese leaders, managers and engineers in the 1950s.

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Our version of managing our work as a system looks like this:

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That looks pretty neat and logical, right?  Well the way this really works (and looks) is more like this:

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This is a photo of the system drawn on one of the walls in our company’s office.  We started identifying current state, what’s working, what’s not, what needs to be better understood, etc.  So, we will continue to refine our view of the system and the areas we need to work on.

That work will never end.  Never.  It is continuous.  And its not as neat and tidy as we might like.  It kind of looks more like a mess.

This view reveals one of Russell Ackoff’s observations on problems.  Here are some of Ackoff’s thoughts:

‘Problems are abstractions. What managers actually experience are messes, which are complex systems of interacting problems. Problems are to messes what atoms are to desks. We experience desks, not the atoms they are made of; we experience messes, not the problems they are made of. No problem can be solved without affecting others in the system of which it is a part, usually without exacerbating them. A solution to a problem taken separately can create a much more serious problem than the problem solved. One can get rid of a bad heart by having it removed. One can avoid food poisoning by not eating. Solving problems taken separately can be a very dangerous thing.

“What do I mean by “mess?” The “mess” I am talking about is not what happens when you spill something on a floor or on your lap. It’s not about what your infant child does in her diaper. The “mess” I mean is not a single problem. I use “mess” to represent an interacting set of problems, a system of problems, that won’t be solved by any simple, single, narrow focus. The world’s problems are an interacting, inextricably connected cluster of disorders that thus far have eluded either resolution or solution, chiefly because they are approached as single or isolated concerns.”

A significant conclusion drawn by Ackoff is that, faced with a problem: you can’t do just one thing. You can’t change only one thing and expect to accomplish anything substantial on behalf of an entire system.

So we have problems, but we need to understand that we are most-likely dealing with “messes” (systems of problems).  You can learn more about what others are doing to deal with the “mess of healthcare” by attending the 5th Annual Lean Healthcare Transformation Summit.  We have 185 seats left.  I hope you will be in one of them.

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Clik here to view.