Understanding and Misunderstanding Variation

Guest post by John Hunter, author of Management Matters: Building Enterprise Capability.

YouTube video

This webcast shows Mike Stoecklein’s presentation, Understanding and Misunderstanding Variation in Healthcare, at the 2015 Deming Research Seminar.

The companion research paper that Mike wrote, Understanding and Misunderstanding Variation in Healthcare is packed with additional information on the topics he discusses and includes a summary of interviews with 40 individuals from 33 healthcare organizations and consulting companies regarding three areas of inquiry:

  1. the current state of healthcare management’s understanding and responding to variation when they have data,
  2. their current understanding of how the principle of variation applies when data are not present (including the management of people), and
  3. a description of what is being taught and advice given around the principle of “understanding and managing variation.”

In the talk Mike referenced Dr. Deming’s quote from If Japan Can… Why Can’t We:

American management thinks that they can just copy from Japan—but they don’t know what to copy!

Mike goes on to elaborate about this problem:

We think we can merely lift the methods and techniques that we see in great companies, like Toyota and others, and that we can have it [a strong and effective management system] as well. What we don’t understand is that our prevailing systems are based on these things, such as the short term focus, focus on the numbers, focus on results, focus on people (it’s a shame and blame sort of a culture), you divide the organization into parts and you manage the parts… [but] it is the interaction of the parts that is important, and then we try to manage from the office, we try to manage from the board room, we don’t go around and we don’t really understand what is going in the work world, and we infuse competition we don’t have collaboration and we think we are going to get the same results you see with a Toyota Production System, or something else, but we don’t. Because those systems are not going to drive those outcomes.

This quote captures one of the central aspects of Deming’s ideas on management: that we need to view the organization as a system. It is not as simple as adopting a couple practices and getting the same results another organization gets from those same practices. The interactions between the existing organization and the new practices will be different. This makes management challenging but it also makes our jobs of improving management continually interesting and full of opportunities to learn.

As usual Mike presents many great ideas and his understanding of Deming’s ideas in depth allows him to understand and express the interconnection of Deming’s ideas. As he said:

As I was trying to understand “why am I not hearing more about understanding variation, I kept getting pointed to the other 3 areas of the System of Profound Knowledge.

To learn what you can from Mike’s talk will likely require delving into the thoughts behind many of his statements. The links provided here will help you do that. And reading his paper will help you do that (it is packed with a great deal more valuable information). High value content is packed into every minute of this talk.

Related: Application of Deming’s System of Profound Knowledge in HealthcareWe Need to Understand Variation to Manage EffectivelyThe Degree of InterdependenceOptimize the Overall System Not the Individual ComponentsEnumerative and Analytic Studies

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