Process Improvement


Book Cover

 

This week we conclude our re-read of The Checklist Manifesto with a few final thoughts and notes and a restatement of a checklist for a checklist that Stephen Adams contributed in the comments for Chapter 9 – they deserve more exposure.  A few of the key takeaways are: (more…)

Book Cover

 

This week we tackle Chapter 9 of The Checklist Manifesto .  The Save is the final chapter in the book.  Next week we will discuss our final thoughts and decide on the next book.  In chapter 9 Atul Gawande expresses his experiences with the surgical checklist he helped to create.  A combination of emotion and evidence.

The Save is the shortest chapter in The Checklist Manifesto weighing in at only 5 pages.  Perhaps I should have considered the chapter when we talked about The Fix (chapter 8) but I even though the chapter is short the message is important.  The two major points in this chapter are:

  1. Don’t be a hypocrite.  Change agents must eat their own dog food. In this instance, Gawande talked about how he used the checklist in his own practice.  When you are helping to shape change, using your own advice provides a number of benefits. Those benefits include generating feedback based on first-hand observation and taking and holding the moral high ground.
  2. Checklists are effective at improving outcomes.  In the chapter, the author references several examples, including one that saved a patients life, of how checklists are effective to help improve outcomes and generate the conversations between team members.

Given the title of the book, wrapping the up the book with a statement about the effectiveness of checklists is not a shock.  The example of a patient that nearly died that is the backbone of the chapter is important as a final statement because it reiterates that we have to think and talk about what we are doing even if we have performed the action a hundred times before.  Gawande’s message is not dissimilar to the message that L. David Marquet delivered when he described deliberate actions. Our actions regardless of the outcome will have an impact on the world around us, therefore, try to make the impact as positive as possible. Our review of chapter 8 (last week) ended with the admonition “try a checklist,”  After chapter 9 I would add, “because our actions matter.”

We need your input to choose the next book.  I will cut off the poll on October 3rd. Make sure your voice is heard!

Remember to buy a copy of The Checklist Manifesto and READ along!

Previous Installments:

Week 9 – The Hero In The Age of Checklistshttps://bit.ly/2PWu2TC

Week 8 – The Fix – https://bit.ly/2NeKyBE

Week 7 – The Checklist Factoryhttps://bit.ly/2wV3yu3

Week 6 – The First Tryhttps://bit.ly/2Q0PhVt

Week 5 – The Ideahttps://bit.ly/2PCs0Zz

Week 4 – The End Of The Master Builderhttps://bit.ly/2BmIGBc

Week 3 – The Checklisthttps://bit.ly/2KMhVFR

Week 2 – The Problem With Extreme Complexityhttps://bit.ly/2AGZQZX

Week 1 – Approach and Introductionhttps://bit.ly/2LYi9Lv

In week 6 of re-read of The Checklist Manifesto by Atul Gawande (use the link and buy a copy so you can read along) we read about Atul’s first try using a checklist to solve a big problem.  The Chapter is titled The First Try. Let’s just say it is a learning opportunity.

The chapter starts with an example of Dr. Gawande engaging with the World Health Organization (WHO) to help address safety because of the massive increase in the number of surgeries. The problem was not that surgeries were being done, surgery saves lives, but rather the number of complications that happened in conjunction with the surgeries. The rate of post-surgical complications was unacceptably high. (more…)

Today we begin the read of the The Checklist Manifesto by Atul Gawande (use the link and buy a copy so you can read along). The version of the book we are reading is published by Metropolitan Book, 2009 and is the 22nd printing. The book has nine chapters and with acknowledgments has 209 pages. My reading plan is one chapter per week, therefore, the re-read will span 11 weeks (including today).  

Introduction

Until relatively recently I did not read forewords and introductions. I think I have missed a lot of contexts. The Checklist Manifesto starts with two stories from the medical arena. In the first story, the doctor missed a piece of knowledge that nearly killed the patient. If the attending physician had asked about the type of weapon that caused the wound the patient would have had less of an issue. In the second story, the surgical team missed a slight (but important) treatment deviation that stopped the patient’s heart. The patient only survived because the team stumbled over the deviation in the norm.

Prior to writing The Checklist Manifesto the paper, Toward a Theory of Medical Fallibility (note the paper, although thought provoking is difficult to get. I found a source to read online but a copy is $18 USD) made a major impact on Gawande’s thought process. The paper lays out a framework to understand why mistakes are made. There are two overall categories of mistakes. The first is due to havingonly partial understanding. For example, trying to generate cold fusion and failing, falls into this category because no one knows how to generate cold fusion, we have a partial understanding. The second category is ineptitude. Ineptitude describes incidences that in which knowledge exists but is not applied correctly. Checklists, and therefore the book, are a tool to attack the second type of incident. The idea, that some mistakes or errors are controllable and some are not might not sound earth-shattering. Not adopting a way to deal with those that are controllable is disconcerting.  

The introduction was worth the price of admission! Why didn’t I read introductions and forewords in the past . . . silly me.

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SPaMCAST 493 features our essay titled Thoughts on Kaizen The punchline is that the goal of continuous improvement is to help teams to eliminate waste (Muda, Muri, Mura), while improving an organization’s capability to deliver value.

Our second column features Jeremy Berriault.  In this installment of the QA Corner (https://qacorner.blog/).  Jeremy and I talked about his upcoming appearance at QAI Quest. Jeremy is talking about TDD test cases and participating in the Managers Solutions Workshop.  

Anchoring the cast is  Wolfram Müller. Wolfram co-authored Hyper-Productive Knowledge Work Performance, The TameFlow Approach with Steve Tendon.  We talk about Chapter 22 titled In Practice with Scrum.  Wolfram can be found on LinkedIn at https://bit.ly/2qXvgnw

Re-Read Saturday News

In week eight of the re-read of L. David Marquet’s Turn the Ship Around! we discuss chapters 10 and 11, titled Under Way on Nuclear Power and  I Intend To . . .”.

Current Installment:

Week 8: Under Way on Nuclear Power and ”I Intend To . . .” – https://bit.ly/2rnvkgx (more…)

You can ride the continuous improvement train forever!

Kaizen is the Japanese word for improvement. In business, that definition gets expanded to encompass a broader meaning. Kaizen in the workplace is continuous improvement generated by numerous small, incremental changes. Because the changes generated through a Kaizen approach are small they are identified, analyzed, piloted and implemented quickly, shortcutting bureaucracy that drives the cost of change upward. Kaizen shortens the cycle time from idea generation to value delivery. The pedigree of Kaizen traces back to the idea of continuous improvement, which is one of the central tenants of the Toyota Production System (TPS). The scope of continuous improvement programs can include the whole organization: from the executive offices to the shop floor, and address issues impacting process and flow. Kaizen, continuous improvement, is industry and technology agnostic and is applicable in all walks of life. Kaizen might be the most democratic approach to change. Regardless of whether an organization takes a pluralistic approach, the goal of continuous improvement is to help teams to eliminate waste (Muda, Muri, Mura), while improving an organization’s capability to deliver value. (more…)

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Software Process and Measurement Cast 490 features a return visit from Michael West.  Michael West is the author of Return On Process (ROP): Getting Real Performance Results from Process and Real Process Improvement Using the CMMI Michael and I talked process improvement and how process improvement translates to the bottom line.  Mr West originally appeared on the SPaMCAST 308 [https://bit.ly/2ITlKsf]

Michael’s bio:

Michael West is a life-long practitioner and student of process improvement. He is the co-founder of Natural Systems Process Improvement (Natural SPI), a consultancy specializing in designing, developing, and deploying process systems that enable measurable business performance improvement gains. Mr. West’s process insights and innovations have helped many organizations in various sectors of the economy achieve real process and performance improvement. His process consulting clients include ATK, Autodesk, AVL, BAE, BB&T, Crane Aerospace, DCS, Deloitte, Sandia National Labs, Reliability First, and the US Navy. Mr. West frequently presents and speaks at industry conferences, and is the author of Real Process Improvement Using the CMMI (CRC Press, 2004) and Return On Process (ROP): Getting Real Performance Results from Process Improvement (CRC Press, 2013).

Contact Michael at:

Web: http://www.naturalspi.com/

Email: michael@naturalspi.com

Twitter: @ItsTheProcess

Re-Read Saturday News

In week five of the re-read of L. David Marquet’s Turn the Ship Around! (https://amzn.to/2qujXmL) we tackle chapters five and six.  These two chapters, titled Call to Action and Whatever They Tell Me To Do! continue to tell the stories that form the basis for Marquet’s leadership model.

Current Installment:

Week 5: Call to Action and Whatever they tell me to do!https://bit.ly/2IXZugS


Previous Installments: (more…)

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