From Davis Balestracci -- Connecting the "Big Dots" to the "Little Dots"...without Math

Published: Mon, 02/15/16

From Davis Balestracci -- Connecting the "Big Dots" to the "Little Dots"...without Math

We graduated our first round of residents last month, and asked them to present their 'golden nugget' of learning to the rest of the group. Several of them recalled your presentation as their pivotal epiphany in their time as a resident. – Wisconsin Hospital Association director of quality

[~ 850 words:  Take 3-1/2 to 5 minutes to read over a break or lunch]

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Once again:  the case for Built-in Improvement vs. Bolt-on Quality

Hi, Folks,

This newsletter is based on some ideas from my respected colleague Mark Hamel.  Despite the lean framework, these ideas apply to any improvement approach – all of which come from the same theory, lean included.

Over the past 35 years, quality has evolved from the necessary evil of quality assurance to what can easily become a self-sustaining organizational improvement sub-industry.  Many leaders continue to try to inspire people with scheduled, cliche-ridden speeches (or videos) full of passionate lip service about committing to excellence, becoming world class, and dazzling customers;  but the reality of yet another public announcement of the leader's own (vague) commitment seems to yield -- predictably -- vague results that stem from the naive hope for "improvement in general" -- as well as, perhaps, increased cultural cynicism? 

Most improvement approaches remain bolt-on to current organizational cultures, which, as many of you have discovered, guarantees an exhausting daily battle against the enormous demon of the status quo -- you know, the "real work."  Since this type of improvement process seems to be perfectly designed to get this result, using our very own improvement language, isn't it time to consider another process?

True excellence demands a transformation to a built-in improvement approach that must begin by eradicating the status quo of tolerated executive and managerial behaviors that do not visibly support it.  

The Big Dot / Little Dot Synergy

Hamel uses Nobel Prize-winning economist Friedrich Hayek’s concept of two types of knowledge to support the rationale with which he approaches lean.

1.    Aggregate knowledge (big dots):   Macro-level data and financial and operational performance information and analysis.  

The purpose of these data is to be able to absorb the big picture, set direction and formulate strategy.  They are usually the realm of top leaders.  

Hamel makes the point that even a sufficient aggregate of such knowledge in the hands (or head) of leaders will have limitations if they lack a key lean ingredient -- humility -- which is also necessary for any leader truly and deeply committed to transformation to true excellence. 

If humility is beneath me, leadership is beyond me.  --  John Miller (the QBQ! guy)

There is a distinct danger that relying solely on this type of knowledge can create the grand illusion that leaders know best.  As President Dwight D. Eisenhower once said in the 1950s:  To an engineer in his office with pencil and paper, farming looks pretty easy.

[And if improvement "leaders" aren't careful, they can easily fall into this trap as well (Mea culpa!)]

2.    Knowledge of the particular circumstances of time and place (little dots).

This type of knowledge is derived from real-life, consistent immersion in the actual daily work.

People who possess this knowledge do the actual work at the actual place and are grounded with an astute conscious awareness of the daily realities of their environment.  

Note:  not all people sufficiently grasp the reality of their situation – their lean (or improvement) thinking may be immature or perhaps they’re not interested in acknowledging reality.  It’s up to the leaders to help this along.

In any event, with proper coaching and a good lean management system to facilitate problem identification and the targeting and flow of ideas, the people with this second type of knowledge are the proper and most effective force to conduct kaizen (continual daily incremental improvements).  More about this in my next newsletter.

•    The best lean teaching emphatically insists that leaders should religiously go see, ask why, and show respect, which should also be true for any serious improvement approach.  To be ultimately effective, it must be a formal component within the context of mandatory, well-developed leader standardized work.

[Where is the time going to come from to do this?  See Chapter 2 of Data Sanity -- up to half of leadership time spent in routine meetings can be freed up!  Click here for a summary.]

•    Leaders need to periodically participate in kaizen activities firsthand with the stakeholders. This will force leaders to go directly to the gemba (actual workplace where the value is added), rigorously observe reality, earn some of the necessary insight, and, only then, share in local PDSA.

Similarly, the front-line “particular knowledge folks” should obtain a least a modicum of aggregate knowledge to expand their line of sight.  The incorporation of frequent regular visual process performance metric reviews -- measures related to people, quality, delivery, cost, and rate of continuous improvement -- should become part of their natural work team huddles.

It's All About Formally Addressing the Need for Balance, BUT...

Hamel emphasizes that one type of knowledge is not better than the other. Every organization needs both to survive and ultimately thrive. Like most things in life, there needs to be a balance.

BUT:   here is Mark’s humble advice to the "aggregate people" – set policy and create alignment, establish the lean ecosystem vis-a-vis lean management systems, model lean leadership behaviors, challenge, encourage, and coach the “particular folks” …and in a large measure, get out of their way.

Establishing an atmosphere of true kaizen is a most non-trivial matter and isn't as simple as telling everyone that they are empowered to implement good ideas.  Such an effort needs to be anchored in a strong, everyday lean (improvement) culture (partially addressed in my last newsletter).  Mark’s suggestions for a robust framework to do this will be the subject of next time.

Until then...

Kind regards,
P.S. Are you ready to stop being frustrated by a vague improvement process that rests
on hope for "improvement in general" on vague problems while being perfectly designed
for vague support, vague data and vague results?

Wouldn't you rather get better faster...and get the respect you deserve with results that get attention?

Data Sanity is my unique synthesis of sane use of data, culture change, and leadership as the road to excellence.  Click here for ordering information [Note:  an e-edition is available] or here for a copy of its Preface and chapter summaries (fill out the form).

* Chapters 3 & 4 talk about how to create a culture where "improvement as built-in" is hardwired into organizational DNA

For the novice, no single book on improvement offers a more complete and accessible summary.  For the intermediate, no other source is more likely to resolve areas of chronic confusion, such as in statistics or the psychology of motivation.  For the master, no overview will have a longer shelf life in offering great examples pithy vignettes, or linkages among topics to draw upon for both personal learning and resources for teaching others. -- Dr. Donald Berwick

Listen to my 10-minute podcast or watch my 10-minute video interview at the bottom of my home page: .

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