The Dilution Syndrome

Dilution: the act of making something weaker in force, content or value

Syndrome: a characteristic combination of opinions, emotions, or behavior

As the pressures mount in healthcare for increased quality and improved outcomes while at the same time decreasing costs, I am worried that we are continuing to jump to solutions that load more strategies and initiatives into outdated and insufficient management systems; I am concerned that our reactive thinking and behaviors are continuing to dilute the amazing potential that our healthcare organizations are capable of; I am concerned about our passionate healthcare teams just continuing to get thrashed;   I am worried about our leaders burning out. 

I am not discounting the broken the reimbursement and financing systems, poor quality and cost transparency, etc. at national  & local levels – but these are also not acceptable excuses.

A year and a half ago, I ranted a bit on “Strategy by Starvation” among various organizations; i.e. not focusing on the critical few and therefore attempting to execute to too many things at once.  I had more questions than answers back then; still do…

With the Dilution Syndrome in mind, “What would happen if we used the extremely simple (but hard to do well) PDSA method at the top level of our healthcare organizations?” 

“What might be the outcome after going to see current reality in the gemba, and truly grasping the current conditions?”  “What might we learn sitting with the experts (i.e. front line providers and patients) and diligently brainstorming the root causes and then going back to gemba to verify?”

“What would the pareto tell us about the 20% that contributes to 80% of the gap?”  “What might be the true critical few discovered?”

“What rapid cycle experiments of change might executives sponsor?” And if the gap was reduced, “What standards and standard processes might be put in place to hold the gain?”

Just asking…

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