From Davis Balestracci -- Why do Most People Continue Futile Efforts to "Bolt-on" a "Built-in" Transformation Process?

Published: Mon, 07/18/16

From Davis Balestracci -- Why do Most People Continue Futile Efforts to "Bolt-on" a "Built-in" Transformation Process?
If I had to reduce my message for management to just a few words, I'd say it all had to do with reducing variation.   -- W. Edwards Deming

[~890 words:  take 4 or 5 minutes to read over a break or lunch]

[Note:  Jim Clemmer and I have no mutual financial interests]

Have We Lost Sight of Some 20- to 30-year Old BASICS?

Hi, Folks,

Thanks to a seminar with Heero Hacquebord in 1988, I saw the need to transform to a new mindset of “improvement as built-in” versus “quality as bolt-on."  The ensuing 28 years have convinced me more than ever that one can never overemphasize the concepts of "process" and "variation"

There is still far too much teaching of quality tools – and now even more advanced tools – while lacking deep understanding of this basic context. Results continue to be predictably glacial. 

  • People don't need tools, they need to know how to solve their problems.

There is no better summary than Jim Clemmer’s 1993 quote below on why we should begin by blaming processes, not people. Laminate it, hand it out generously, and use it to eradicate "blame" in your culture -- both in yourself and any meetings you attend:

Only about 15 percent of [problems] can be traced to someone who didn't care or wasn't conscientious enough.  But the last person to touch the process, pass the product, or deliver the service may have been burned out by ceaseless [problem-solving]; overwhelmed with the volume of work or problems; turned off by a "snoopervising" manager; out of touch with who his or her team's customers are and what they value; unrewarded and unrecognized for efforts to improve things; poorly trained; given shoddy material, tools, or information to work with; not given feedback on when and how products or services went wrong; measured (and rewarded or punished) by management for results conflicting with his or her immediate customer's needs; unsure of how to resolve issues and jointly fix  a process with other functions; trying to protect himself or herself or the team from searches for the guilty; unaware of where to go for help.  All this lies within the system, processes, structure, or practices of the organization."
--Jim Clemmer, Firing on All Cylinders (1993) (still well-worth your time)

By the end of his life (1993), W. Edwards Deming thought the 15 percent was more like 4 percent.

In 1996, Heero Hacquebord’ wrote a brilliant article about his problem-laden back surgery experience.  It is written entirely from the viewpoint of Deming theory, and I consider it a mandatory read -- and re-read and re-read.  Even if you don't work in healthcare, perhaps you can think about a personal hospital experience or one of a relative.  Ask yourselves:  Could this easily happen again tomorrow?  If so, what has all the hard work on quality truly improved?

Can you see how elements in the quote above manifested in the article...and are manifesting daily in your organizations?  How do you become aware of them?

During the 1988 seminar, I asked Mr. Hacquebord a question, and his answer has forever stuck with me: 

Projects are necessary, but they are not sufficient.  It's not about the problems that march into your office. The most important problems are the ones of which no one is aware

Are You "Perfectly Designed" to Have Such Things Occur? (Yes)

Consider your organizational culture as it currently exists:

Jim Clemmer (my emphases):

  • If we are unhappy with the behavior of people on our team or in our organization, we need to take a closer look at the system and structure they're working in. If they behave like bureaucrats, they're likely working in a bureaucracy. If they're not customer focused, they're probably using systems and working in structure that wasn't designed to serve the servers and/or customers. If they're not innovative, they're likely working in a controlled and inflexible organization. If they resist change, they're probably not working in a learning organization that values growth and development. If they're not good team players, they're likely working in an organization designed for individual performance. Good performers, in a poorly designed structure, will take on the shape of the structure.

  • It's like the strange pumpkin I once saw at a county fair. It had been grown in a four-cornered Mason jar. The jar had since been broken and removed. The remaining pumpkin was shaped exactly like a small Mason jar. Beside it was a pumpkin from the same batch of seeds that was allowed to grow without constraints. It was about five times bigger. Organization structures and systems have the same effect on the people in them. They either limit or liberate their performance potential. Many organizations induce learned helplessness.

Dr. Donald Berwick's 5 Classic Questions...from 1989

Dr. Donald Berwick’s seminal 1989 editorial hasn’t aged one day:

  • Do you ever waste time waiting when you should not have to?
  • Do you ever redo your work because something failed the first time?
  • Do the procedures you use waste steps, duplicate efforts, or frustrate you through their unpredictability?
  • Is information that you need ever lost?
  • Does communication ever fail?

What types of things (undesirable variation) do these cause? --  For clinical outcomes?  The patient? Colleagues?

In the case of the last one regarding communication, you could ask, "What kinds of things do we observe in our culture that result from poor communication?" – i.e., process breakdowns ("Meetings," anyone?). 

Brian Joiner:  Vague solutions to vague problems yield vague results.

I see people drowning in efforts to test well-meaning solutions to to the everyday problems that march into their offices -- most of which are treated as special causes.  Are they treating only symptoms of deeper problems, adding unneeded complexity, and diluting precious energy for true improvement?

Ponder:  What are the problems of which you might not be aware? Might a root cause analysis of all of your root cause analyses shed some insight?

Note the dates used in this newsletter (1988, 1989, 1993, and 1996):  Is it time to "rewind" and go back to some 20- to 30-year old basics?

Until next time...

Kind regards,
P.S. Imagine my surprise when I saw this in one of Clemmer's newsletters: 
"Data Sanity Pulls Together Quality Improvement Tools, Leadership, and Culture"
"Davis has written a highly useful and very rare book. Highly useful in the way it's jammed full of practical tips, tools, and techniques drawn from his extensive study, hands-on applications, and global experience. Data Sanity is very rare because it balances the analytical elements of improvement tools with the key catalysts of leadership and culture change. This extensive guide book can be a handbook for revolutionary breakthrough.

"I love the passion and broad perspective he brings to pulling together statistical methods, process management, measurement, and survey methodologies with leadership and culture. After years of extensive effort, his new work is a comprehensive resource book synthesizing so much of what's needed to drive dramatic organization improvement. Focused especially on healthcare management, its lessons, advice, and experiences are very applicable to most other industries.

"Davis and I first met in 1995 when he attended a workshop I presented at an Institute for Healthcare Improvement conference in San Diego. He was then using my second book, Firing on All Cylinders: The Service/Quality System for High-Powered Corporate Performance, with his current organization to help in their quality improvement efforts. Since that workshop, we've stayed in touch with each others work as Davis moved out on his own as an independent consultant to provide his depth of research, experience, and leadership insights to many other organizations."

Click here for information on ordering Data Sanity:  A Quantum Leap to Unprecedented Results: 
[Note:  an e-edition is available] or here for a copy of its Preface and chapter summaries (fill out the form on the page).

[UK and other international readers who want a hard copy:  ordering through U.S. Amazon is your best bet]

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