Model for Improvement applied to different problems: The type of problem matters!

While I believe the Model for Improvement provides a solid general foundation for improving any situation, specific problem-solving  methods  that call for standardization are particularly useful.  These methods can help people to act to reduce defects and build reliable performance into  on-going operations.

Improvement and Problem-solving are Linked but not Identical in Application

You can pose any problem as an improvement opportunity:  a partial or full solution to a problem will yield a better state of affairs than the unsolved problem.   Hence a solved problem will have improved the system in which the problem arose.

You can also pose any improvement opportunity as a problem:  in improvement, you seek to get closer to an aim, starting from where you are.  Hence, you start with a gap between where you are and where you want to get.   That gap is the problem.

So it looks like improvement and problem-solving are equivalent in the sense that you can express any problem as an improvement opportunity and any improvement opportunity as a problem.

The Model for Improvement is an algorithm to improve any situation.  If you accept that improvement and problem-solving are equivalent, the Model for Improvement can be applied to any problem.

Does that mean the Model for Improvement is the best algorithm for solving any problem?  No.  In some settings, it may be more efficient to tackle problems directly.

Types of Problems

Gerry Nadler in The Planning and Design Approach (Wiley:  1981) — abbreviated PDA — describes seven types of problems, aligned with a list of seven “human purposeful activities”:

1. Assure self-preservation and survival of the species:  self-preservation
2. Operate and supervise an existing solution or system:  operate and supervise
3. Create or restructure a situation-specific solution or system: plan and design
4. Search for generalizations:  research
5. Evaluate performance of previous solutions or other purposeful activities:  evaluate
6. Gain skills or acquire knowledge about existing information and generalizations:  learn
7. Experience leisure:  leisure.

As Nadler points out, the “types are not mutually exclusive:  each may be involved with, and depend on, the other.  For example, successful planning and design frequently requires, at various points in a project, research, evaluation, learning, and operating and supervising.” (p. 19, PDA)

The Model for Improvement can be applied to each of the seven types, more or less efficiently.

Operating and Supervising; Planning and Design

Two activities from Nadler’s list account for much of the work by organizations:  Operating and Supervising (O&S) and Planning and Design (P&D).

“O&S concerns systems and solutions that people participate in routinely, expecting fairly standardized results.” (p. 19 PDA)

 “Planning and design activities result in custom-made solutions, policies, and designs, that restructure existing systems or create new ones….P&D is concerned with imagining, designing, and implementing new and restructured systems and solutions, O&S with maintaining them.  The latter stresses standardization and routine, the former flexibility and innovation.” (p. 20, PDA)

The Model for Improvement works well right off the shelf for Planning and Design activities as defined by Nadler.

However, Model for Improvement applied to Operating and Supervising problems can cause users to stumble. Here’s why: Holding the gains is implicit in the Model for Improvement but improvers usually need explicit guidance.

On the other hand, there are various frameworks developed to solve problems in O&S settings that give explicit advice about holding the gains--for example, Lean’s A3 problem-solving, Six Sigma's Design-Measure-Analyze-Improve-Control model, and the QC Story (Chapter 10, Statistical Methods for Quality Improvement, AOTS, Tokyo 1985.)  

Standardized work is one way to hold the gains of a proposed solution, a systematic approach to teaching, monitoring and assuring reliable work practices. A useful reference for healthcare applications: Getting to Standard Work in Healthcare (2012) by Patrick Graupp and Martha Purrier, CRC Press, Boca Raton, FL.

A hint that you may be working in an O&S setting is whether it feels natural to characterize problems in terms of defects. A defect is a specific type of problem, an undesired result of a job, as succinctly described by Kume and Takehashi, authors of the QC Story chapter in the AOTS book cited above.

Interim Conclusion

In work with colleagues these days, I now try to understand the type of situation or problem they’re tackling.   I use the Model for Improvement as my fundamental mental framework across all settings but I especially appreciate and support the application of specific problem-solving frameworks in operating and supervising situations.

Faking the Numbers in Atlanta

You can see a lot just by looking: European Infant Mortality and GDP in Motion