{"id":5658,"date":"2017-11-25T13:49:03","date_gmt":"2017-11-25T12:49:03","guid":{"rendered":"http:\/\/www.improvementscience.co.uk\/blog\/?p=5658"},"modified":"2017-11-25T13:49:03","modified_gmt":"2017-11-25T12:49:03","slug":"the-turkeys-voting-for-xmas-trap","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=5658","title":{"rendered":"The Turkeys Voting For Xmas Trap"},"content":{"rendered":"<p style=\"text-align: left\"><a href=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2017\/11\/Xmas_Turkey.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-5659\" src=\"http:\/\/www.improvementscience.co.uk\/blog\/wp-content\/uploads\/2017\/11\/Xmas_Turkey.png\" alt=\"\" width=\"300\" height=\"369\" \/><\/a>One of the quickest and easiest ways to kill an improvement initiative stone dead is to label it as a &#8220;<em>cost improvement program<\/em>&#8221; or C.I.P.<\/p>\n<p style=\"text-align: left\">Everyone knows that the biggest single contributor to cost is salaries.<\/p>\n<p style=\"text-align: left\">So cost reduction means head count reduction which mean people lose their jobs and their livelihood.<\/p>\n<p style=\"text-align: left\">Who is going to sign up to that?<\/p>\n<p style=\"text-align: left\">It would be like turkeys voting for Xmas.<\/p>\n<p style=\"text-align: left\">There must be a better approach?<\/p>\n<p style=\"text-align: left\">Yes. There is.<\/p>\n<hr \/>\n<p style=\"text-align: left\">Over the last few weeks, groups of curious skeptics have experienced the immediate impact of systems engineering theory, techniques and tools in a health care context.<\/p>\n<p style=\"text-align: left\">They experienced queues, delays and chaos evaporate in front of their eyes &#8230; and it cost nothing to achieve. No extra resources. No extra capacity. No extra cash.<\/p>\n<p style=\"text-align: left\">Their reaction was &#8220;surprise and delight&#8221;.<\/p>\n<p style=\"text-align: left\">But &#8230; it also exposed a problem.\u00a0 An undiscussable problem.<\/p>\n<hr \/>\n<p style=\"text-align: left\">Queues and chaos require expensive resources to manage.<\/p>\n<p style=\"text-align: left\">We call them triagers, progress-chasers, and fire-fighters.\u00a0 And when the queues and chaos evaporate then their jobs do too.<\/p>\n<p style=\"text-align: left\">The problem is that the very people who are needed to make the change happen are the ones who become surplus-to-requirement as a result of the change.<\/p>\n<p style=\"text-align: left\">So change does not happen.<\/p>\n<p style=\"text-align: left\">It would like turkeys voting for Xmas.<\/p>\n<hr \/>\n<p style=\"text-align: left\">The way around this impasse is to anticipate the effect and to proactively plan to re-invest the resource that is released.\u00a0 And to re-invest it doing a more interesting and more worthwhile jobs than queue-and-chaos management.<\/p>\n<p style=\"text-align: left\">One opportunity for re-investment is called <em>time-buffering<\/em> which is an effective way to improve resilience to variation, especially in an unscheduled care context.<\/p>\n<p style=\"text-align: left\">Another opportunity for re-investment is <em>tail-gunning<\/em>\u00a0the chronic backlogs until they are down to a safe and sensible size.<\/p>\n<p style=\"text-align: left\">And many complain that they do not have time to learn about improvement because they are too busy managing the current chaos.<\/p>\n<p style=\"text-align: left\">So, another opportunity for re-investment is <em>training<\/em> &#8211; oneself first and then others.<\/p>\n<hr \/>\n<p style=\"text-align: center\">R.I.P.\u00a0 \u00a0 C.I.P.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the quickest and easiest ways to kill an improvement initiative stone dead is to label it as a &#8220;cost improvement program&#8221; or C.I.P. Everyone knows that the biggest single contributor to cost is salaries. So cost reduction means head count reduction which mean people lose their jobs and their livelihood. Who is going &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/hcse.blog\/?p=5658\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;The Turkeys Voting For Xmas Trap&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,6,28,32,40,42,43,45,46,48],"tags":[],"class_list":["post-5658","post","type-post","status-publish","format-standard","hentry","category-4n-chart","category-6m-design","category-metaphors","category-productivity","category-sfqp","category-how","category-why","category-what","category-teach","category-trust"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/5658","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=5658"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/5658\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}