Practicing the Three Phases of Improvement! – The Problem Solving Phase 2

How can we practice improvement?

As explained in our first post “Practicing the Three Phases of Improvement!“, a Process Improvement Exercise has three important and necessary phases, 1) The Assessment Phase, 2) Problem Solving Phase, and 3) Implementation Phase. Later we explained two steps required in the Assessment Phase (“The Assessment, Phase 1/Step 1: Collecting Data,” and “The Assessment, Phase 1/Step 2: Analyzing Data“). We devote this article to the Problem Solving Phase.

During our PI Assessment Phase, we do not focus on solving problems. We only focus on finding ways to improve our processes and systems by uncovering problems (planting Red Flags) and/or finding examples of excellence so we can expand our success (planting Green Flags). The examples of excellence can be combined into Green Flag Reports of lessons learned by specific subjects (i.e., doctors schedules, customer service, phone volume, customer or work flow, wait times, etc.). Once we do that, we have a great benchmarking tool with examples to apply during later problem solving efforts.

Starting the Problem Solving Phase: The purpose of the problem solving phase is to find logical solutions for improvements to current processes or systems. Typically, problem-solving exercises have several logical chronological steps. The process begins with the selection and prioritization of which problems to tackle first.

Step 1 – Problem Selection – Problem Portfolio Management: – Before we can solve a specific problem, we must first select the problem to solve. Because, we do not have the time or resources to solve every problem, we must prioritize the universe of problems to generate a manageable list of doable high impact solutions. This prioritized list becomes a part of our ongoing Continuous Improvement efforts.

Therefore, after our assessments, we will have a list of process improvement candidates (the Red and Green Flags). This gives us a start at a portfolio of potential improvements, problems to solve, and examples of excellence to emulate. The prioritized list triggers the start of the problem solving efforts. Therefore, before we start problem solving, we manage the portfolio of of these symbolic flags. To manage the portfolio we start with selecting the selection criteria.

Criteria – All selection processes should begin with a list of criteria that supports the goals we are trying to achieve. When prioritizing the problems some of the criteria will become more important and weighted heavier. Therefore, we only need to select a few criteria to quantify the problems for prioritization. In the case of Process Improvement, we might simplify the criteria categories into three basic groups; (1.) Stakeholders, (2.) Problem’s Attributes and Constraints, and (3.) Solution Payoffs. The first two are more of a litmus test for problem selection while the Solution Payoff may be the deciding criteria. If the problem passes the litmus test, then we prioritize the survivors using the payoff.

Stakeholders – The stakeholders are people who have a interest in solving or not solving a particular problem. The stakeholders are more of a resource for information rather than actual criterion for decision-making. Nevertheless, if a key person wants a solution, then that problem will often advance to the top of the list. However, this is not the ideal way to prioritize a problem. Better is to quantify the benefits of the different solutions based on a set of selection criteria. The solutions should help us to advance our overall strategic and tactical organizational goals. Therefore, when deciding on the key criteria for prioritizing a list of problems, the selection team should interview several stakeholders:
1. The Organizational Leaders,
2. The Sponsors and Champions of the Problems/Projects,
3. Those Most Affected within the Organizations (The Front-line Workers),
4. Those Most Affected Outside the Organization (Vendors, and Customers), and
5. Those with the Expertise Required to Find the Solutions.

Problem Attributes and Constraints – Attributes and Constraints of the problem are the non-functional requirements and details related to the business, operations, nature of the problem/project, and the environmental/cultural issues of the organization.
1. Desire to Change – An important constraint to making a solution happen is the stakeholders’ desires for a change. Without a desire to make things better, there will be no commitment to make the changes required by a solution happen. There has to be a desire for change by the leaders, staff/workers, and possibly other stakeholders.
2. Solvability – Is the problem solvable within the key constraints such as time, resources (people, money, other), state of the art technology and Expertise, Politics, and other Cultural and Comfort Levels?
3. Ease to Solve – Even solvable problems require levels of effort that may make them impractical to solve. Is the effort worth it? Are ideas available? Do we have the talent or other resources to solve the problem? Is the knowledge base available or is expertise or training available?

Payoff of Solution – With the other attributes met, there is a desire to change among the key stakeholders, the problem is solvable, and the effort seems reasonable. The next question is, “What is the payoff of making a change?” The measures of payoff may involve the following:
1. Biggest Bang for the Buck – Where can we spend our resources, time, and effort to get the best return on our investment? What are the interrelated systems issues? Can we leverage our efforts to make multiple impacts with a single solution (kill two birds with one stone)? Is there a place where we can make a large impact based on small changes (80/20 Rule)? How could our solution for a specific problem impact key metrics?
2. Brings in Revenue (Makes us Money) – Would a specific solution increase revenue?
3. Minimizes Time – Does the specific solution save time?
4. Avoids Costs – Does a specific solution decrease costs?
5. Improves Quality – Will the solution improve quality?
6. Avoids Penalties – Will a change avoid penalties?
7. Patient/Customer/Provider/Staff Satisfaction – Will a change increase stakeholders’ satisfaction or bring other cultural or political benefits?
8. Minimize Waste – Will it make us more Lean?

Step 2 – Planning for Problem Solving Efforts – Once we have the problems selected and prioritized then planning becomes important. Treat the problem solving efforts as a project and plan for resources (right people and expertise), space, time, and other needs to start solving the list of problems.

Step 3 – Preparation and Defining the Selected Problem(s) – In the words of John Dewey (an American Educator and Philosopher), “A problem well stated is a problem half solved.” One thing that all problem-solving systems should have in common are the words, “Define the Problem.” Sometimes called the Preparation Phase[i] of Problem Solving, the first step focuses on just understanding the problem. We probably did much of the preparation work during the assessment phase. However, the problem solving team may decide to collect and analyze additional information to close any gaps. Like our assessment phase, the problem solving preparation phase has a couple steps:

Build Understanding – Understanding relates to defining and identifying the problems. We start understanding the current situation during our PI Assessment Phase by collecting information and then analyzing it. However, because the goal of the assessment phase is just to find places to improve, it is likely we need to do some additional work to fully understand the Red Flags.
Gaining Insight – Gaining insight also relates to analyzing the problem. As we collect more information and start analyzing it, we gain more insight into the specific problem to solve. Numerical data is often easier to understand than qualitative information, which often calls for more reading and cross-referencing. However, I have found that one good comment minimizes the need for elaborate analysis. For example, we may collect customer surveys and collect all kinds of metrics and go through great efforts analyzing wait times and on hold times. Only to find that the comments of the customers only point out how rude our staff is. Therefore, the real problem solution to poor customer service ratings may be simple customer service training.

Step 4 – Idea Generation Cycle – “The best way to get a good idea is to get a lot of ideas.” By Linus Pauling American Chemist. Once we identify and define a specific problem the team can start the idea cycle. Think of an idea generation cycle as more than just brainstorming. Brainstorming works for simpler problems but sometimes the problems are complicated and require more effort and engineering to solve. The idea cycle continues until solution or abandonment. A idea generation cycle may include – Brainstorming, Incubating, and Understanding – then repeat. The “eureka moment” often comes during rest after all the hard work is done.

Step 5 – Problem Evaluation Funnel – Once the ideas for solutions are collected, the next steps are to consolidate, evaluate the best ideas, and then drive to the final solution. The goal of the evaluation step is to drive our efforts to a signal SMART solution (A Specific, Measurable, Agreed On, Reasonable, and Timely Solution). We can think of this step as a funneling effort with three steps: 1. Narrow to the Few Best Possible Ideas/Solutions, 2. Evaluate the Best Solutions (Based on Root-Causes, return of investment, etc.), 3. Narrow the Few Best Solution to a Final Smart Solution (A Specific, Measurable, Agreed On, Reasonable, and Timely Solution).

Process Improvement Phase 3 – Implementation– Once we decide on the final solution, the next PI Phase relates to implementing the change. Many times all three phases of the PI efforts may overlap. Even during the implementation phase, we may find that additional analysis is needed and additional problem solving is required.

How can we practice improvement?

To improve, good usable data has to be collected and then analyzed. Once we find candidates for improvement, effort is required to find the best solutions. How can you participate? Keep a look out for ways to improve and be open-minded. As you have ideas, do not jump to conclusions; instead, think in terms of information to collect that will help validate your concerns. Share your observations with those in your organization and those on the Process Improvement teams. Participate in data collection, the follow up analysis, and follow up with good problem solving steps. Finally volunteer to help implement well-thought-out solutions.

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