{"id":919,"date":"2011-07-30T11:02:38","date_gmt":"2011-07-30T11:02:38","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=919"},"modified":"2011-07-30T11:02:38","modified_gmt":"2011-07-30T11:02:38","slug":"lub-hub-lub-hub-lub-hub","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=919","title":{"rendered":"Lub-Hub Lub-Hub Lub-Hub"},"content":{"rendered":"

\"\"<\/a>If you put\u00a0an ear to someones chest you can hear their heart “lub-dub lub-dub lub-dub”. The sound is caused by the valves in the heart closing, like softly slamming doors, as part of the wonderfully orchestrated\u00a0process\u00a0of pumping blood around the lungs and body. The heart is an impressive example of bioengineering but\u00a0it was not designed – it evolved over time – its elegance and efficiency emerged over a long journey of emergent\u00a0evolution. \u00a0The\u00a0lub-dub is a comforting sound – it signals regularity, predictability, and stabilty; and was probably the first and most familiar sound each of heard in\u00a0the womb. Our hearts are sensitive to our emotional state\u00a0– and it is no accident that the beat of music mirrors the beat of the heart: slow\u00a0means relaxed and fast\u00a0means aroused.<\/p>\n

Systems and processes have a heart beat too – but it is not usually audible. It can been seen though if the measures of a process are plotted as time series charts.\u00a0Only artificial\u00a0systems show\u00a0constant and unwavering behaviour\u00a0–\u00a0rigidity – \u00a0natural systems\u00a0have\u00a0cycles.\u00a0 The charts from natural systems\u00a0show the\u00a0“vital signs” of the system.\u00a0 One chart tells\u00a0us something of value – several charts considered together tell us much more.<\/p>\n

We can\u00a0measure and display\u00a0the electrical activity of the heart over time – it is called\u00a0an electrocardiogram (ECG) -literally “electric-heart-picture”; we can measure and display the movement of muscles, valves and\u00a0blood\u00a0by beaming\u00a0ultrasound\u00a0at the heart – an echocardiogram; we can visualise the pressure of the blood over time –\u00a0a plethysmocardiogram; and we can visualise\u00a0the sound the heart makes\u00a0– a phonocardiogram. When we\u00a0display the various\u00a0cardiograms on the same time scale one above the other we\u00a0get a much better understanding of how the\u00a0heart is behaving\u00a0 as a system.\u00a0And if we have learned what to expect to see with\u00a0in a normal heart we\u00a0can look for deviations from healthy behaviour and\u00a0use those to help us diagnose the cause.\u00a0\u00a0With experience the task of diagnosis\u00a0becomes a simple, effective and efficient pattern matching exercise.<\/p>\n

The same\u00a0is true of systems and processes – plotting the system\u00a0metrics as\u00a0time-series charts and searching for the tell-tale patterns of process disease\u00a0can be\u00a0a simple, quick and accurate technique: when you have learned what a\u00a0“healthy” process\u00a0looks like and which patterns are caused by which process\u00a0“diseases”.\u00a0 This\u00a0skill\u00a0is gained through Operations Management training and lots of practice with\u00a0the\u00a0guidance of an experienced practitioner.\u00a0Without this investment in developing knowlewdge\u00a0and understanding\u00a0there is a high risk\u00a0of making a wrong diagnosis and instituting an ineffective or even dangerous treatment.\u00a0 Confidence is good – competence is even better.<\/p>\n

The\u00a0objective of process diagnostics is to identify where and when the LUBs and HUBs appear are in the system:\u00a0a LUB is a “low\u00a0utilisation bottleneck” and a HUB is a “high utilisation bottleneck”.\u00a0 Both restrict flow but they do it in different ways and therefore require different management. If\u00a0we\u00a0confuse a LUB for a HUB\u00a0and choose the wrong treatent we can\u00a0unintentionally make the process sicker – or even kill the system completely. The intention is\u00a0OK but if we are not competent the\u00a0implementation will not be OK.<\/p>\n

Improvement Science\u00a0rests on\u00a0two foundations stones – Operations Management and Human Factors –\u00a0and managers of any process or system need an\u00a0understanding of both and to be able to apply their knowledge in practice with competence and confidence.\u00a0 Just as a\u00a0doctor\u00a0needs to understand\u00a0how the heart works and how to apply\u00a0this knowledge in clinical practice. Both technical and\u00a0emotional capability is needed – the Head and the Heart need each other.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

If you put\u00a0an ear to someones chest you can hear their heart “lub-dub lub-dub lub-dub”. The sound is caused by the valves in the heart closing, like softly slamming doors, as part of the wonderfully orchestrated\u00a0process\u00a0of pumping blood around the lungs and body. The heart is an impressive example of bioengineering but\u00a0it was not designed … <\/p>\n

Continue reading “Lub-Hub Lub-Hub Lub-Hub”<\/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":[22,35,42,43,46],"tags":[58,76,115,127,136,138,152,188,273,299],"class_list":["post-919","post","type-post","status-publish","format-standard","hentry","category-healthcare","category-reflections","category-how","category-why","category-teach","tag-beat","tag-constraint","tag-flow","tag-heart","tag-human-factors","tag-improvement","tag-knowledge","tag-operations-management","tag-systems","tag-understanding"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/919","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=919"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/919\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=919"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=919"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=919"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}