{"id":3773,"date":"2014-10-04T12:13:41","date_gmt":"2014-10-04T12:13:41","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=3773"},"modified":"2014-10-04T12:13:41","modified_gmt":"2014-10-04T12:13:41","slug":"wacky-language","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=3773","title":{"rendered":"Wacky Language"},"content":{"rendered":"<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2014\/10\/wacky_language.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-3775\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2014\/10\/wacky_language.png\" alt=\"wacky_language\" width=\"299\" height=\"218\" srcset=\"https:\/\/hcse.blog\/wp-content\/uploads\/2014\/10\/wacky_language.png 375w, https:\/\/hcse.blog\/wp-content\/uploads\/2014\/10\/wacky_language-300x218.png 300w\" sizes=\"auto, (max-width: 299px) 100vw, 299px\" \/><\/a>All innovative ideas are inevitably associated with new language.<\/p>\n<p style=\"text-align: left\">Familiar words used in an unfamiliar context so that the language sounds &#8216;wacky&#8217; to those in the current paradigm.<\/p>\n<p style=\"text-align: left\">Improvement science is no different.<\/p>\n<p style=\"text-align: left\">A problem arises when familiar words are used in a new context and therefore with a different meaning. Confusion.<\/p>\n<p style=\"text-align: left\">So we try to avoid this cognitive confusion by inventing new words, or by using foreign words that are &#8216;correct&#8217; but unfamiliar.<\/p>\n<p style=\"text-align: left\">This use of novel and foreign language exposes us to another danger: the evolution of a clique of self-appointed experts who speak the new and &#8216;wacky&#8217; language.<\/p>\n<p style=\"text-align: left\">This self-appointed expert clique can actually hinder change because it can result yet another us-and-them division.\u00a0 Another tribe. More discussion. More confusion. Less improvement.<\/p>\n<hr \/>\n<p style=\"text-align: left\">So it is important for an effective facilitator-of-improvement to define any new language using the language of the current paradigm.\u00a0 This can be achieved by sharing examples of new concepts and their language in familiar contexts and with familiar words, because we learn what words mean from their use-in-context.<\/p>\n<p style=\"text-align: left\">For example:<\/p>\n<p style=\"text-align: left\">The word &#8216;capacity&#8217; is familiar and we all know what we think it means.\u00a0 So when we link it to another familiar word, &#8216;demand&#8217;, then we feel comfortable that we understand what the phrase &#8216;demand-and-capacity&#8217; means.<\/p>\n<p style=\"text-align: left\">But do we?<\/p>\n<p style=\"text-align: left\">The act of recognising a word is a use of memory or knowledge. Understanding what a word means requires more &#8230; it requires knowing the context in which the word is used.\u00a0 It means understanding the concept that the word is a label for.<\/p>\n<p style=\"text-align: left\">To a practitioner of flow science the word &#8216;capacity&#8217; is confusing &#8211; because it is too fuzzy.\u00a0 There are many different forms of capacity: flow-capacity, space-capacity, time-capacity, and so on.\u00a0 Each has a different unit and they are not interchangeable. So the unqualified term &#8216;capacity&#8217; will trigger the question:<\/p>\n<p style=\"text-align: left;padding-left: 30px\"><em>What sort of capacity are you referring to<\/em>?<\/p>\n<p style=\"text-align: left\">[And if that is not the reaction then you may be talking to someone who has little understanding of flow science].<\/p>\n<hr \/>\n<p style=\"text-align: left\">Then there are the foreign words that are used as new labels for old concepts.<\/p>\n<p style=\"text-align: left\">Lean zealots seem particularly fond of peppering their monologues with Japanese words that are meaningless to anyone else but other Lean zealots.\u00a0 Words like <em>muda <\/em>and <em>muri<\/em> and <em>mura <\/em>which are labels for important and useful flow science concepts &#8230; but the foreign name gives no clue as to what that essential concept is!<\/p>\n<p style=\"text-align: left\">[<em>And for a bit of harmless sport ask a Lean zealot to explain what these three words actually mean but only using\u00a0 language that you understand. If they cannot to your satisfaction then you have exposed the niggle. And if they can then it is worth asking &#8216;What is the added value of the foreign language?&#8217;<\/em>]<\/p>\n<p style=\"text-align: left\">And for those who are curious to know the essential concepts that these four-letter M words refer to:<\/p>\n<p style=\"text-align: left\"><em><strong> muda<\/strong> means &#8216;waste&#8217; and refers to the effects of poor process design in terms of the extra time (and cost) required for the process to achieve its intended purpose.\u00a0 A linked concept is a &#8216;niggle&#8217; which is the negative emotional effect of a poor process design.<\/em><\/p>\n<p style=\"text-align: left\"><em><strong>muri<\/strong> means &#8216;overburdening&#8217; and can be illustrated\u00a0 with an example.\u00a0 Suppose you work in a system where there is always a big backlog of work waiting to be done &#8230; a large queue of patients in the waiting room &#8230; a big heap of notes on the trolley. That &#8216;burden&#8217; generates stress and leads to other risky behaviours such as rushing, corner-cutting, deflection and overspill. It is also an outcome of poor process design, so\u00a0 is avoidable.<br \/>\n<\/em><\/p>\n<p style=\"text-align: left\"><em><strong>mura<\/strong> means variation or uncertainty. Again an example helps. Suppose we are running an emergency service then, by definition, a we have no idea what medical problem the next patient that comes through the door will present us with. It could be trivial or life-threatening. That is unplanned and expected variation and is part of the what we need our service to be designed to handle.\u00a0 Suppose when we arrive for our shift that we have no idea how many staff will be available to do the work because people phone in sick at the last minute and there is no resilience on the staffing capacity.\u00a0 Our day could be calm-and-capable (and rewarding) or chaotic-and-incapable (and unrewarding).\u00a0 It is the stress of not knowing that creates the emotional and cultural damage, and is the expected outcome of incompetent process design. And is avoidable.<br \/>\n<\/em><\/p>\n<hr \/>\n<p style=\"text-align: left\">And finally we come to words that are not foreign but are not very familiar either.<\/p>\n<p style=\"text-align: left\">Words like <em>praxis<\/em>.<\/p>\n<p style=\"text-align: left\">This sounds like &#8216;practice&#8217; but is not spelt the same. So is the the same?<\/p>\n<p style=\"text-align: left\">And it sounds like a medical condition called <em>dyspraxia <\/em>which means:\u00a0<em> poor coordination of movement<\/em>.<\/p>\n<p style=\"text-align: left\">And when we look up <em>praxis<\/em> in an English dictionary we discover that one definition is:<\/p>\n<p style=\"padding-left: 30px;text-align: left\"><em>the practice and practical side of a profession or field of study, as opposed to theory<\/em>.<\/p>\n<p style=\"text-align: left\">Ah ah! So <em>praxis<\/em> is a label for the the concept of &#8216;how to&#8217; &#8230; and someone who has this &#8216;know how&#8217; is called a <em>practitioner<\/em>.\u00a0 That makes sense.<\/p>\n<p style=\"text-align: left\">On deeper reflection we might then describe our poor collective process design capability as <em>dyspraxic<\/em> or uncoordinated. That feels about right too.<\/p>\n<hr \/>\n<p style=\"text-align: left\">An improvement science practitioner (ISP) is someone who knows the science of improvement; and can demonstrate their know-how in practice; and can explain the principles that underpin their <em>praxis<\/em> using the language of the learner. Without any wacky language.<\/p>\n<p style=\"text-align: left\">So if we want to diagnose and treat our <em>organisational dyspraxia<\/em>;<\/p>\n<p style=\"text-align: left\">&#8230; and if we want smooth and efficient services (i.e. elimination of chaos and reduction of cost);<\/p>\n<p style=\"text-align: left\">&#8230; and if we want to learn this know-how,\u00a0 practice or <em>praxis;<\/em><\/p>\n<p style=\"text-align: left\">&#8230; then we could study the Foundations of Improvement Science in Healthcare (FISH);<\/p>\n<p style=\"text-align: left\">&#8230; and we could seek the wisdom of\u00a0 the growing Community of Healthcare Improvement Practitioners (CHIPs).<\/p>\n<hr \/>\n<p style=\"text-align: left\">\n<p style=\"text-align: left\">FISH &amp; CHIPs &#8230; a new use for a familiar phrase?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>All innovative ideas are inevitably associated with new language. Familiar words used in an unfamiliar context so that the language sounds &#8216;wacky&#8217; to those in the current paradigm. Improvement science is no different. A problem arises when familiar words are used in a new context and therefore with a different meaning. Confusion. So we try &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/hcse.blog\/?p=3773\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Wacky Language&#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":[19,20,22,24,26,35,43,45,46],"tags":[],"class_list":["post-3773","post","type-post","status-publish","format-standard","hentry","category-fish","category-flow","category-healthcare","category-improvementology","category-isp","category-reflections","category-why","category-what","category-teach"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/3773","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=3773"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/3773\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3773"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3773"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3773"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}