{"id":2657,"date":"2013-01-19T17:19:14","date_gmt":"2013-01-19T17:19:14","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=2657"},"modified":"2013-01-19T17:19:14","modified_gmt":"2013-01-19T17:19:14","slug":"a-ray-of-hope","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=2657","title":{"rendered":"A Ray Of Hope"},"content":{"rendered":"<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/stick_figure_shovel_snow_anim_150_wht_9579.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-2658\" alt=\"stick_figure_shovel_snow_anim_150_wht_9579\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/stick_figure_shovel_snow_anim_150_wht_9579.gif\" width=\"150\" height=\"116\" \/><\/a>It does not seem to take much to bring a real system to an almost standstill.\u00a0 Six inches of snow falling between 10 AM and 2 PM in a Friday in January seems to be enough!<\/p>\n<p style=\"text-align: left\">It was not so much the amount of snow &#8211; it was the timing.\u00a0\u00a0The decision to close many schools was not made until\u00a0after the\u00a0pupils had arrived &#8211; and it created a logistical nightmare for parents.\u00a0<\/p>\n<p style=\"text-align: left\">Many people suddenly\u00a0needed to get home before they expected which created an early rush hour and gridlocked the road system.<\/p>\n<p style=\"text-align: left\">The same number of people travelled the same distance\u00a0in the same way as they would normally &#8211; it just took them a lot longer.\u00a0\u00a0And the queues created\u00a0more problems as people tried to find work-arounds to\u00a0bypass the traffic jams.<\/p>\n<p style=\"text-align: left\">How many thousands of hours of life-time was wasted sitting in near-stationary queues of cars? How many millions of poundsworth of productivity was lost? How much will the catchup\u00a0cost?\u00a0<\/p>\n<p style=\"text-align: left\">And\u00a0yet while we grumble we shrug our shoulders and say &#8220;<em>It is just one of those things. We cannot control the weather.\u00a0We just have to grin and bear it<\/em>.&#8221;\u00a0\u00a0<\/p>\n<p style=\"text-align: left\">Actually we do <strong>not<\/strong> have to. And we do not need a weather machine to control the weather. Mother Nature is what it is.<\/p>\n<p style=\"text-align: left\">Exactly the same behaviour happens in many systems &#8211; and our\u00a0conclusion is the same.\u00a0\u00a0We assume the chaos and queues are\u00a0inevitable.<\/p>\n<p style=\"text-align: left\"><strong>They\u00a0are not.<\/strong><\/p>\n<p style=\"text-align: left\">They are\u00a0symptoms of the system design &#8211; and specifically they are\u00a0the inevitable outcomes\u00a0of the <strong>time-design<\/strong><strong>.<\/strong><\/p>\n<p style=\"text-align: left\">But it is tricky to visualise the time-design of a system.\u00a0 We can see the manifestations of\u00a0the poor time-design,\u00a0the queues and chaos, but we do not so easily\u00a0perceive the causes. So the\u00a0poor time-design persists. We are not completely useless though; there are lots of obvious things we can do. We can devise ingenious ways to manage the queues; we can build warehouses to hold the queues; we can track\u00a0the jobs\u00a0in the queues using sophisticated and expensive information technology; we can identify the <em>hot spots;<\/em> we can recruit and deploy expediters, problem-solvers and fire-fighters to facilitate\u00a0the flow through the\u00a0hottest of them; and we can pump capacity and money into\u00a0defences, drains and dramatics. And\u00a0our\u00a0efforts\u00a0seem to work so we\u00a0congratulate ourselves and conclude that these actions are the <strong>only<\/strong> ones that work.\u00a0 And we keep clamouring for more and more resources. More capacity,\u00a0MORE capacity,\u00a0MORE CAPACITY.<\/p>\n<p style=\"text-align: left\">Until we run out of money!<\/p>\n<p style=\"text-align: left\">And then we\u00a0have to stop asking for more. And then we start rationing. And then we start cost-cutting. And then\u00a0the chaos and queues get worse.\u00a0<\/p>\n<p style=\"text-align: left\">And all the time we are not aware that our initial assumptions were <strong>wrong<\/strong>.<\/p>\n<p style=\"text-align: left\">The chaos and queues\u00a0are <strong>not<\/strong> inevitable. They are a sign of the time-design of our system. So\u00a0we <strong>do<\/strong> have\u00a0other options.\u00a0\u00a0We can improve the time-design of\u00a0our system.\u00a0We do\u00a0not need to change the\u00a0safety-design; nor the quality-design; nor the\u00a0money-design.\u00a0 Just improving the time-design will be enough. For now.<\/p>\n<p style=\"text-align: left\">So the $64,000,000 question is <strong>&#8220;How?&#8221;<\/strong><\/p>\n<p style=\"text-align: left\">Before we explore that we need to demonstrate <strong>What<\/strong> is possible. How big is the prize?<\/p>\n<p style=\"text-align: left\">The class of system design problem that cause particular angst\u00a0are called <strong>mixed-priority mixed-complexity\u00a0crossed-stream<\/strong> designs.\u00a0\u00a0We encounter dozens of them in our daily life and we\u00a0are not aware of it.\u00a0 One of particular interest to many is called a <em>hospital<\/em>. The <em>mixed-priority<\/em> dimension is the need to\u00a0manage some patients as emergencies, some as urgent and some as routine. The <em>mixed-complexity<\/em> dimension is that some patients are easy and some\u00a0are complex.\u00a0The <em>crossed-stream<\/em> dimension is the\u00a0aggregation of\u00a0specialised resources into departments. Expensive equipment and specific expertise.\u00a0\u00a0We then attempt to\u00a0push\u00a0patients\u00a0with different priorites\u00a0long different paths\u00a0through these different departments\u00a0. And it is\u00a0a management nightmare!\u00a0<\/p>\n<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2011\/08\/Blueprint1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-973\" alt=\"Blueprint\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2011\/08\/Blueprint1.jpg\" width=\"230\" height=\"137\" \/><\/a>Our\u00a0usual and &#8220;obvious&#8221; response to this challenge is called a <strong>carve-out design. <\/strong>And that means we chop up our available resource capacity into chunks.\u00a0\u00a0And we do that in two ways: chunks of time and chunks of\u00a0space.\u00a0 We try to simplify the problem by dissecting it\u00a0into bits that we can understand. We separate the emergency departments from the \u00a0planned-care facilities. We separate outpatients from inpatients.\u00a0We separate medicine from\u00a0surgery\u00a0&#8211; and we then intellectually dissect our patients\u00a0into\u00a0organ systems: brains, lungs, hearts, guts,\u00a0bones, skin, and so on &#8211; and we create separate departments for each one. Neurology, Respiratory, Cardiology, Gastroenterology, Orthopaedics, Dermatology to list just a few.\u00a0And then we become locked into the carve-out design silos\u00a0like prisoners in cages of our own making.<\/p>\n<p style=\"text-align: left\">And so it is within the departments that are sub-systems of the bigger system. Simplification, dissection and separation. <em>Ad absurdam<\/em>.<\/p>\n<p style=\"text-align: left\">The major drawback with\u00a0our carve-up design\u00a0strategy is that it\u00a0actually\u00a0makes the system <strong>more<\/strong> complicated.\u00a0 The number of necessary links between the separate parts grows exponentially.\u00a0 And each link can hold a small queue of waiting tasks\u00a0&#8211; just as each side road can hold a queue of waiting cars. The collective complexity is incomprehensible. The cumulative queue is enormous.\u00a0The opportunity for confusion and error grows exponentially. Safety and quality fall and cost rises.\u00a0Carve-out is an inferior time-design.<\/p>\n<p style=\"text-align: left\">But our goal is correct: <em>we do need to simplify the system\u00a0so that means simplifying the time-design<\/em>.<\/p>\n<p style=\"text-align: left\">To illustrate\u00a0the potential of this &#8216;simplify the time-design&#8217; approach\u00a0we need\u00a0a real example.<\/p>\n<p style=\"text-align: left\">One way to do this is to create a real system with lots of carve-out time-design built into it and\u00a0then we can observe how it behaves &#8211; in reality. A carefully designed Table Top Game is one way to do this\u00a0&#8211; one where the players have defined Roles and\u00a0by following the Rules they collectively create a real system that we can map, measure and modify. With our Table Top Team trained and ready to go we\u00a0then\u00a0pump realistic tasks\u00a0into\u00a0our realistic system and measure how long they\u00a0take in reality to appear out of the other side. And we\u00a0then use the real data to plot some real\u00a0time-series charts. Not theoretical general ones &#8211; real specific ones. And then we use the actual charts to diagnose the actual causes of the actual queues and actual chaos.<\/p>\n<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/TimeDesign_Before.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2659\" alt=\"TimeDesign_Before\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/TimeDesign_Before-300x197.jpg\" width=\"300\" height=\"197\" srcset=\"https:\/\/hcse.blog\/wp-content\/uploads\/2013\/01\/TimeDesign_Before-300x197.jpg 300w, https:\/\/hcse.blog\/wp-content\/uploads\/2013\/01\/TimeDesign_Before.jpg 500w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>This is\u00a0the time-series chart of a real\u00a0Time-Design Game that has been designed\u00a0using an actual hospital department and real observation data.\u00a0 Which department it was is not of importance because\u00a0it could have been one of many. Carve-out is everywhere.<\/p>\n<p style=\"text-align: left\">During one run of the Game the\u00a0Team processed 186 tasks and the chart shows\u00a0how long each task took from arriving to leaving (the game\u00a0was designed to do the work in seconds when in the real department it took minutes &#8211; and this was done so that one working day could be condensed from 8 hours into 8 minutes!)<\/p>\n<p style=\"text-align: left\">There was a mix of priority: some tasks were more urgent than others. There was a mix of complexity: some tasks required more steps\u00a0that others. The paths crossed at separate steps where different\u00a0people did defined work using different skills and special equipment.\u00a0 There were handoffs between all of the steps on all of the streams. There were\u00a0\u00a0lots of links. There were many queues. There\u00a0were ample opportunities for confusion and errors.<\/p>\n<p style=\"text-align: left\">But the design of the real process\u00a0was such that the work\u00a0was delivered\u00a0to a high quality &#8211;\u00a0there were very few\u00a0output errors. The yield was very high.\u00a0The design was effective.\u00a0The resources required to achieve this quality were represented by the hours of people-time availability &#8211; the capacity. The cost. And the work\u00a0was stressful, chaotic, pressured, and important &#8211; so it got done. Everyone was busy. Everyone pulled together. They helped each other out. They were not idle. They were a good team. The design was efficient.<\/p>\n<p style=\"text-align: left\">The thin blue line on the time-series chart is the &#8220;time target&#8221; set by the Organisation.\u00a0\u00a0But\u00a0the effective and efficient system design only achieved it 77% of the time.\u00a0\u00a0So the &#8220;obvious&#8221; solution was to\u00a0clamour for more people\u00a0and\u00a0for more space and for more equipment so that the work can be done more quickly to deliver more jobs on-time.\u00a0 Unfortunately the Rules of the Time-Design Game\u00a0do\u00a0not allow this more-money option. There is no more money.<\/p>\n<p style=\"text-align: left\">To succeed at the Time-Design Game the team\u00a0must find a way to improve their delivery time performance with the capacity they have and also to deliver the same quality.\u00a0 But this\u00a0is impossible! If it were\u00a0possible then the\u00a0solution would be obvious and they would be doing it already. No one can\u00a0succeed on the Time-Design Game.\u00a0<\/p>\n<p style=\"text-align: left\"><strong>Wrong.<\/strong> It is possible.\u00a0\u00a0And the assumption that the solution is obvious is incorrect.\u00a0The solution\u00a0is not obvious &#8211; at least to the untrained eye.<\/p>\n<p style=\"text-align: left\">To the trained eye the\u00a0time-series chart shows the characteristic signals of a carve-out time-design.\u00a0The high task-to-task variation is highly suggestive as is the pattern of some of the earlier arrivals\u00a0having a longer lead time. An experienced\u00a0system\u00a0designer can diagnose a carve-out time-design\u00a0from a set of time-series charts\u00a0of\u00a0a process\u00a0just as a doctor can diagnose\u00a0the disease from\u00a0the vital signs chart for\u00a0a patient.\u00a0 And when the diagnosis is confirmed with a verification test then\u00a0the time-<strong>Re<\/strong>design phase can start.\u00a0<\/p>\n<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/TimeDesign_AfterPhase1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2660\" alt=\"TimeDesign_AfterPhase1\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2013\/01\/TimeDesign_AfterPhase1-300x197.jpg\" width=\"300\" height=\"197\" srcset=\"https:\/\/hcse.blog\/wp-content\/uploads\/2013\/01\/TimeDesign_AfterPhase1-300x197.jpg 300w, https:\/\/hcse.blog\/wp-content\/uploads\/2013\/01\/TimeDesign_AfterPhase1.jpg 500w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>This chart shows what happened\u00a0after the time-design of the system was changed &#8211; after some of the carve-out design was modified.\u00a0The\u00a0Y-axis scale is the same as before &#8211; and the delivery time improvement\u00a0is <strong>dramatic<\/strong>. The Time-ReDesigned\u00a0system is now delivering 98% achievement of the &#8220;on time target&#8221;.<\/p>\n<p style=\"text-align: left\">The important thing to be aware of is that <em>exactly the same work was done, using exactly the same steps, and exactly the same resources<\/em>. No one had to be retrained, released or recruited.\u00a0 The quality was not impaired.\u00a0And the cost was actually less because\u00a0less overtime was needed to mop up the spillover of work at the end of the day.<\/p>\n<p style=\"text-align: left\">And the Time-ReDesigned\u00a0system feels better to work in. It is not chaotic;\u00a0flow is much smoother;\u00a0and it is busy\u00a0yet\u00a0relaxed and even fun.\u00a0\u00a0The same activity is achieved\u00a0by the same people\u00a0doing the same work\u00a0in the same sequence. Only the Time-Design has changed. A change that delivered a win for the workers!<\/p>\n<p style=\"text-align: left\">What was the impact of this cost-saving improvement on the customers of this service? They can now be 98%\u00a0confident that they will get their task completed\u00a0correctly in less than 120 minutes.\u00a0 Before the Time-Redesign the 98% confidence limit was 470 minutes! So this is a win for the customers too!<\/p>\n<p style=\"text-align: left\">And the Time-ReDesigned system is less expensive so\u00a0it is a win for whoever is paying.<\/p>\n<p style=\"text-align: left\">Same safety and quality, quicker with less variation, and\u00a0at lower cost. Win-Win-Win.<\/p>\n<p style=\"text-align: left\">And the usual reaction to playing the Time-ReDesign Game is incredulous disbelief.\u00a0 Some describe it as a &#8220;light bulb&#8221; moment when they see how the diagnosis of the carve-out time-design\u00a0is made and and how the Time-ReDesign is done. They say &#8220;<em>If I had not seen it with my own eyes I would not have believed it<\/em>.&#8221;\u00a0And they say &#8220;<em>The solutions are\u00a0simple but not obvious<\/em>!&#8221; And they say &#8220;<em>I wish I had learned this years ago<\/em>!&#8221;\u00a0 And thay apologise for being so skeptical before.<\/p>\n<p style=\"text-align: left\">And there are those who are too\u00a0complacent, too careful or too cynical to\u00a0play the Time-ReDesign Game (which is about 80% of people actually)\u00a0&#8211;\u00a0and who deny themselves\u00a0the opportunity of\u00a0a win-win-win outcome.\u00a0And that is their choice. They can\u00a0continue to grin and bear it &#8211; for a while longer.\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p style=\"text-align: left\">And for the 20% who want to learn how to do <em>Time ReDesign<\/em> for real in their actual systems there is now\u00a0a <strong>Ray Of Hope<\/strong>.<\/p>\n<p style=\"text-align: left\">And the Ray of Hope\u00a0is illuminating\u00a0a signpost on which is written &#8220;<em>This Way to Improvementology<\/em>&#8220;.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It does not seem to take much to bring a real system to an almost standstill.\u00a0 Six inches of snow falling between 10 AM and 2 PM in a Friday in January seems to be enough! It was not so much the amount of snow &#8211; it was the timing.\u00a0\u00a0The decision to close many schools &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/hcse.blog\/?p=2657\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;A Ray Of Hope&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,7,12,15,17,19,20,24,30,32,42,44,45],"tags":[],"class_list":["post-2657","post","type-post","status-publish","format-standard","hentry","category-6m-design","category-baseline","category-carveout","category-design","category-examples","category-fish","category-flow","category-improvementology","category-operations","category-productivity","category-how","category-three-wins-r","category-what"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/2657","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2657"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/2657\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2657"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2657"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2657"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}