Is This What Process Improvement Looks Like?

Rod Piechowski: Adam, I recently sent you the link to this video under the subjectline: “Failure is not an option?” Within minutes, we were typing through a conversation about process improvement, how to tell when it’s time to give up and when to keep pushing.

I have to admit that this video, which shows a series of SpaceX rockets either blowing up, falling over or missing their target completely, is fascinating to watch. What we are watching here is millions and millions of dollars turned into crumpled, burning rocket, quickly. On the other hand, it is exciting to sense the incredible progress being made, knowing that through persistence and vision, failure is temporary. Failure is a stepping-stone. Incremental failure is how the scientific method works. Each failure eliminates options, further illuminating the right path. As you noted in our conversation: “Fail early.” Right, Adam?

Adam Bazer: You’re right about the importance of failing early in reaching eventualsuccess, Rod—whether you are working to improve a process, a product, or something in your own personal life. Whether you are suggesting to fail early or fail fast, failure is like a big bowl of Wheaties for improvement. And you know what? We are all experts at failing fast and failing early. I don’t know about you, but I failed over and over again until I was able to get that whole crawling thing figured out, and don’t get me started on walking! Failed early and fast with that whole talking thing (my wife could bring up at least 20 instances proving that it is still a work in progress). Our whole lives we try, we fail, we try again, we fail again and so on until we get it right. But for some reason, failure gets a bad rap from most people. Why do you think that is, Rod?

Rod Piechowski: I do see your point, and maybe that’s what we’re really discussing here: the upside of failure. And we’re doing failure a favor, that poor downtrodden soul. I think there is a lot of pressure to succeed in our society.

In school, we are tested, and if we don’t answer the questions the way our teachers want them answered, we have “failed.” There is shame in failure, and I was raised with that understanding in my environment, as I’m sure more than a few others were too. Now I’ve come to think of failure as a good thing. But it was a process to get there. If I’m struggling to learn something, that doesn’t mean I’m a failure—it means I am learning. The good stuff is hard to learn sometimes, but it adds to my experiences and tools. I especially enjoy how learning new concepts puts a previous experience into a new context; from that point on, I see it differently.

As an aside, does it ever freak you out that when magicians watch other magicians perform, they see a completely different show than you and I do? That’s knowledge! I want to see the world differently, in a way that pushes innovation. Or learn to pull a rabbit out of a hat, at least.

Adam Bazer: I agree on wanting to see the world differently…not there on the rabbit, but then again, I’m not much of a hat guy. You bring up an important point regarding the language we use around failure in school, and its impact as we move into our professional lives. How do we better position failure as a win in the battle for gaining knowledge? “Congrats Johnny, you got an F! Now let’s figure out together where to go from here...” It is as important to learn about Thomas Edison’s many failures in invention to better appreciate how they strengthened his successes. And maybe it’s my Chicago bias, but I’d be failing (yeah!) this conversation to not to share this masterclass in the importance of failure on the road to success.

So we agree that that in our lives we both excel at failing early, and failing fast to gain knowledge and agency, and at the same time socialize failure as a shameful act (paging Dr. Freud, Dr. Freud, call on line 2…). And up to this point, we have only been talking about failure in a general sense, and not with failure’s fraught relationship with the healthcare industry, when the concept has actual people’s flesh and bone connected to it. Where it has actual organizations’ reputation and solvency connected to it. Healthcare organizations excel at analyzing root causes when examining failures in their clinical outcomes. Do you see anywhere where the healthcare industry or individual organizations are running mortality & morbity reports elsewhere in their organization, on their own operational processes? How are healthcare organizations embracing their failures, and learning from them?

Rod Piechowski: First, it’s not fair to include classic 90s Chicago Bulls related links in a blog post, because it’s too easy to get lost watching other Michael Jordan highlight videos! But, back to your question.

Yes, we increasingly see organizations who monitor their internal operations and their clinical outcomes. We see some amazing uses of information technology to improve readmission rates, reduce mortality and positively affect population health. And increasingly, what we see are organizations that realize information technology is not a patch to be applied, it is not a tool that magically fixes everything. In the high-performing operations, senior leadership ensures that its vision is aligned with its structure, operating model, and processes to ensure that technology is not just employed, but managed in such a way as to support that vision (here’s a great example from 2017 Davies award winner, Lehigh Valley Health Network). The high-performing providers know that health IT is not “an IT project.” It is an organizational asset.

Let’s get back to failure. At these organizations, failure isn’t measured in the short-term. Every step forward is a step toward knowledge and new insights. And when I think of it like this, the word failure begins to recede from my vocabulary.

The world is changing too fast to worry about failing. We must continue to adapt, like animals coming out of the water and learning to walk on the beach.


Learn about how healthcare organizations have embraced the value of health IT on the HIMSS Value Suite webpage.