I used to think science was reserved for academics, inventors, and people who conduct research for a living.  I thought you had to have a Ph.D. to “do” science and that science was only done by scientists toiling away in a laboratory performing controlled experiments.  Formal experiments and controlled research are indeed the most recognizable manifestations of science.  But more broadly, scientific thinking is a model for creative human endeavor.  In that sense, it is a way of learning and broadening our knowledge.  What I’ve also found in my 25 years of working to help people improve, is that scientific thinking is also an effective way to set and accomplish challenging objectives.

LeanHealthcare_scientificthinking

Does this seem familiar?  You analyze data and study a work process.  You formulate a hypothesis about something you deliberately plan to introduce or change.  You study the results of what actually happens.  And you use the knowledge gained to improve the process and share with others.

American inventor and innovator Thomas Edison epitomizes scientific thinking.  When Edison invented the lightbulb, he certainly did not achieve success on his first try.  He made many attempts before he succeeded in creating a functioning light bulb.  Each of those failed attempts helped him learn something on his path to inventing the light bulb.  We can learn from Edison’s iterative and ongoing attempts.

The PDSA cycle is sometimes called the Deming cycle because it was Dr. W. Edwards Deming who created the model in its current form.  Deming, a modest man, called it the Shewhart Cycle after his mentor Walter Shewhart who introduced the concept to him.  PDSA, or Plan-Do-Study-Act, is an iterative, four-stage problem-solving model used for improving a process or carrying out change.

Plan
When you have an idea for improvement it is important to plan a test. You can’t assume that all ideas for improvement will work perfectly, so it is often advisable to test on a small scale first to work out the kinks before spreading the change.

Do
Perform the test or the experiment. Collect the data; note any special occurrences during the test.

Study
Analyze the data and the results (as well as any special occurrences) to see what was learned.

Act
Decide what action to take as a result of the test. This may include implementing the change on a broad scale, abandoning a change that didn’t work, deciding to test additional changes, and installing a monitoring process to ensure that changes stick.

LeanHealthcare_PDSA

Deming emphasized iterating towards an improved system, so these four steps should repeated over and over as part of a never-ending cycle of continual improvement, with each cycle getting us closer to our goal or ideal state.

This iterative approach is based on a number of values and beliefs, including:

  • our knowledge and skills are limited, but improving
  • not every good idea will succeed
  • failure is a part of learning
  • learning for improvement can come from failure or less than perfect results
  • experimentation can be valuable
  • data for analysis is critical to improvement
  • a need for taking calculated risks

At the start of a project, key information may not be known.  Scientific thinking via PDSA provides feedback to justify our guesses (hypotheses) and increase our knowledge.  Rather than trying to find a perfect solution the first time, it is often more feasible to make incremental improvements.  With the improved knowledge, we may even choose to refine or alter the goal (ideal state).

PDSA is about rapid tests of ideas and initiatives for improvement.  It is a scientific mindset that urges one to use less money, fewer people, and/or shorter time frames in pursuit of goals.  And it can be applied to all types of work processes and improvement activities.


Aaron Fausz, Director for Lean Healthcare and Process Improvement at HPPToday’s blog was written by Aaron Fausz, Ph.D., senior consulting director at HPP.

Aaron has 25 years of experience helping organizations align and improve their personnel and technical systems to accomplish strategic business objectives.  He has consulted with leading healthcare organizations across the country and has proven success guiding organizations through strategically driven changes and enhancing business performance.  Aaron also has significant experience in needs assessment, best practice analysis, performance measurement, process improvement, and behavioral change management.

Aaron holds a Ph.D. in Industrial/Organizational Psychology from the University of Tennessee with a minor in Industrial Engineering.

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