This Is What Happens When You Respond To One Bad Case

By now, you know how I feel about responding to one (or a few) cases with big changes to your system.  Now I know that sometimes cases are so extra-ordinary, dramatic, or horrific that something has to be done owing to public pressure, legal issues, or some extenuating circumstances.  But, guess what, it turns out that responding to one (or just a few) cases leads to a worsening of your system’s performance.

Remember…responding to just one case leads to a worsening of your system’s performance.

Don’t believe me?  I don’t expect you to!  I didn’t believe it either until I learned about statistical process control.

I remember a video I watched that really drove this point home for me.  And I’ve spent more than 30 hours online looking for a copy of that video to share with you, my healthcare friends, so that you’d share in this revelation with me!

Beneath, I’ve shared a link to this incredible video.  Remember, as you watch, that the process involved could be manufacturing a part, caring for a patient, or arriving on time for a trauma activation…the processes and data involved don’t know (or care) when it comes to using the powerful tools of statistical process control!

The process involved could be manufacturing a part, caring for a patient, or arriving on time for a trauma activation…the data involved don’t know or care when it comes to using statistical process control!

Bottom line…adjusting a system based on one extraordinary case leads to worse outcomes overall.  That’s why it’s so important to use the tools of statistical process control and to improve your system as a whole…because doing that will get us much further and will eliminate those extra-ordinary cases in the future.  Adjusting based on an attention-getting case will often just make things worse!

Click the link or photo beneath to view this incredibly useful demonstration.  (Source:  by the way, this video is from a Villanova University course on Lean Six Sigma…and it’s the best I’ve ever seen on this topic!)

https://www.dropbox.com/s/3c1h21inxtvrdpu/Lecture_18_Quincunx_Process_Demonstration.MP4?dl=0