TRIZ Helps Your Next Quality Improvement Project


By:  DMKashmer, MD MBA MBB


TRIZ Helps Generate Creative Ideas In A Focused Manner


An important factor in quality improvement projects, surprisingly, is creativity.  How do we generate and select interventions for a system?  How do we create entire new systems that have high levels of quality designed in?  The TRIZ tool (pronounced as “trees”) helps us design creative interventions in a focused, effective manner.


A Criticism Of Six Sigma & Lean Is That They Don’t Allow For Creativity


It’s a typical criticism:  Lean and the Six Sigma DMAIC pathway do not allow for creativity.  Clearly, to anyone who has participated in a DMAIC project, there is quite a bit of room for creativity.  Specifically, Six Sigma does not prescribe the specific interventions to make a system better.  It does, however, give certain philosophies like poka-yoke.


Poka-yoke Directs Us To Look For Creative Interventions


As we begin to explore TRIZ methodology, let’s take a moment to review one of the design philosophies routinely used by Six Sigma:  poka-yoke (pronounced “poke ah yoke”).  After all, the philosophic underpinnings of Six Sigma are what lead us to use TRIZ methodology in the hunt for creative, effective interventions.  Poka-yoke is an idea that guides us to make it easier to do the right thing.  That is, if we want physicians to record some piece of data on patients, we should make it very easy to input that data.  If we want someone to be somewhere on time, we should build a system that makes it as easy as possible to get to that place on time.  Poka-yoke says we should make it as easy as possible for a system / person to achieve the outcome we want.


This is challenging, often, for us in healthcare; we typically don’t see systems designed to make it easier to obtain a certain outcome.  We do get plenty of feedback telling us how important something is to do or how we MUST do something.  Yet we often have systems that conspire to make it difficult to achieve whichever item is being pushed.  However, let me share that processes which make it easier for us in healthcare do exist, and when we help create them it makes for a much more high-performing system.


In fact, poka-yoke design philosophy extends to many interventions.  For example, one trauma program with which I have participated needed to make sure trauma surgeons arrived to the trauma bay within 15 minutes of patient arrival to the trauma bay.  The team needed to make sure this happened more frequently than was typically occurring.  The poka-yoke design philosophy allowed the team to focus on specific interventions that made a higher probability the surgeon would be there on time.  This included NOT simply focusing on telling the surgeon ‘You need to do a better job’. Interventions included focusing on early identification and triage of trauma patients and positioning the call room physically closer to the trauma bay.  This type of poka-yoke design philosophy and associated interventions made it easier to do the right thing and achieve a timely arrival.


Now that we see how poka-yoke directs us to look for solutions to make it easier to do the right thing, where do we go to create them?  Typical tools that teams use to generate solutions include brainstorming, mind-mapping, and many other standard, creative tools.  Here, let’s add another tool to your toolbox that allows brainstorming along certain high-yield directions.  TRIZ methodology takes brainstorming sessions and focuses them in directions that are apt to be high-yield.  Here’s how.


TRIZ Tool Explained And Link To Where To Find It


The acronym TRIZ comes from the Russian wording equivalent of ‘Theory of inventive problem solving.‘   GS Altshuller and colleagues, between 1946 and 1985, reviewed world wide patent applications so as to determine themes and manners in which certain problems were solved.


Over time, the team identified fundamental conflicts that were at the heart of the many issues which the patents / designs attempted to resolve.  For example, some patents embodied a design used to make something stronger yet lighter.  These conflicts (and their solutions) were then codified into a TRIZ matrix.  TRIZ gives direction to resolve these conflicts by looking to how they have been resolved previously.  In other words, TRIZ is the process of codified creativity.  An oxymoron?  Maybe–yet TRIZ methodology has proven highly effective to accelerate our creative processes in the past.  You can use the TRIZ matrix here.


Consider this example of TRIZ applied to Six Sigma:  one of the challenges in designing a new system involved the trade off between strength of a product and weight of a product.  The TRIZ gave us focused ideas on how this problem has been solved across many, many, patents and designs throughout the world.  TRIZ focused meetings and sessions allowed us to be creative along certain highly productive lines. In fact, TRIZ methodology assisted us in many of our design projects and even in our DMAIC projects where brainstorming for intervention was more challenging.  TRIZ allows us to resolve the fundamental contradictions inherent in a problem in a codified, effective way.


In conclusion, TRIZ methodology gives us a focused tool that is often superior to the perhaps more routine brainstorming.  Once data have been reviewed and it is time to design an intervention, TRIZ methodology has been very handy for us.  There are multiple, online TRIZ resources including here, here and here. Remember, for your next quality improvement project, if you want to solve an issue with the forest in a creative fashion, look towards the TRIZ.


Questions, comments, or thoughts on TRIZ methodology in your quality improvement project?  Have you previously seen TRIZ methodology be successful for your project?  Let us know beneath.