My focus this week has been to ask the question “What blocks improvement?”. The answers that I found most interesting were “I didn’t realise there was a problem.” and “I feel there is a problem but I don’t know where to focus my attention.” This set me pondering and eventually I had a bit of an “eureka” moment. It isn’t something that is present that creates this blindness – it is something that is missing. And the only way you can see what isn’t there is by comparison with when it is there – just like the game of “Spot the Difference”. When I compared what I saw with what I know is possible the thing I didn’t see was a fast-feedback loop. Hence the doodle. It appears that there are at least four dimensions to feedback – sign, magnitude, accuracy and timing. The speed of the feedback needs to be appropriate to the speed of the improvement; so if we want rapid improvement we need a fast-and-accurate feedback loop – a learning loop. A slow or inaccurate learning loop not only doesn’t work – it can actually make the problem worse. So, my take-home this week is to actively search for the learning loops and if I don’t see one then I have something to focus on improving.
Health Care Systems Engineering Blog