LeanHealthcare_5whyIt was Christmas at the in-laws.  I know that doesn’t sound like a great start to the holiday but I love my wife’s family and we always have fun.  My favorite present opened on that chilly, 68 degree Christmas Eve night was a post-hunting season addition to my hunting bow: a new arrow rest.  After everyone had slipped off to slumber and was dreaming of ole’ Saint Nicholas, it was time to install it.

I ran into a bit of a road block. The old mount that was on my bow couldn’t be removed! I tried to pry it off with a screw driver and failed. Then, I proceeded to using muscle by ripping it out with a pair of pliers – it wouldn’t budge! Half past midnight I gave up in defeat. “I can sleep on it, right?”

The next morning I decided to give it another go. Did I try another method? Yes! A different pair of pliers so I could get a better grip on it. After straining my back and almost damaging my bow, I had an “a-ha” moment: I don’t know what problem I’m trying to solve. I need to study the problem!

There were many possibilities for the root cause of the issue. How about a Lean Healthcare tool? Let’s use the 5 Why’s:

  • What am I trying to solve? I want to get the mount removed from my bow.
    • Why can’t I remove it? Something is holding it in place that I cannot see.

Stop! I need to shine a light on this!

I pulled out a flashlight and a magnifying glass to examine the area. There was a hole that looked like it should have a screw that would potentially hold something in place, but there is no screw. “I still need to eliminate this as a root cause.” So, I study the hole with my flashlight, and Eureka, there is a torque screw deep inside the hole holding the mount in place! Back to my 5 Why’s analysis:

  • Why can’t I remove it? Because it’s being held in place by a torque screw that I can’t see.
    • Why can’t I see it? Because its deep inside the hole, tightened on the mount.

I used the flashlight to investigate the problem. With two twists of the right wrench the mount was removed and I was ready to enjoy my new arrow rest.

What can we learn from this silly story?

I’ve spent many hours on hospital performance improvement committees, project teams, and safety event task forces where we were all so eager to solve the problem.  And if we were half as good at identifying the root cause of the problem as we were at finding solutions, we would be the best project team ever!

Lean healthcare requires us to think differently about our approach to making real and lasting change that will solve the challenges we have taking care of patients each and every day.  We need to spend more time learning about the problem if we expect to find the best solution that moves us towards our ideal state.

Learn from my Christmas story. The next issue you encounter, take a breath, slow down, go and see the problem, and spend more time studying the problem than coming up with solutions to solve it. You may find the problem you were trying to solve was a lot different than your initial perception. I hope my tale can shed some light on a problem of your own.

WatkinsEricToday’s blog was written by Eric Watkins, senior manager at HPP.

Eric’s process improvement background includes emergency department value stream initiatives, EMR operational preparedness, physician practice patient flow, analytics and reporting process transformation, kaizen facilitation and other work.

Eric received his Master’s in Business Administration from the University of Tennessee in Operations and Supply Chain Management.


Image by Freepik

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