| Understanding process improvement involves both an | | | | what people wanted when they first entered the |
| art and a science. It's all about how value is created | | | | hospital. Each group was falling prey to the substitution |
| for the customer. Typically, you discover that a | | | | fallacy. Doctors assumed that patients didn't need to |
| process is only partially connected to what customers | | | | see them right away, when in fact patients rated an |
| want. Instead, it's deepest roots are in tradition and | | | | initial "hello" from the doctor as the most important part |
| habit. When does a motion picture project move from | | | | of the intake process. |
| editorial review to pre-production? At what point does | | | | Conducting the research to understand what |
| a truck leave the loading dock? How do we decide to | | | | customers do want is critical to overcoming the |
| shut down our production line for maintenance? Often | | | | substitution fallacy. It requires being willing to ask tough |
| it's decided subjectively - by how a manager or | | | | questions. How does one best assess when it's time |
| supervisor has done it all his life. | | | | for the truck to leave the loading dock? When it's |
| We name this the substitution fallacy. We often make | | | | completed? Or when the customer wants to receive |
| the assumption that we can substitute what worked | | | | the order? |
| well previously with the best solution now. Or at a | | | | Developing policies is important, too, because it reduces |
| different level, we mistakenly believe we can substitute | | | | the opportunity for substitution fallacy. If some process |
| our own preferences for those of our customers. We | | | | or decision repeats itself regularly, it should be covered |
| ask, "What's the right color for our packaging?" We | | | | in a written policy. (One common problem with policies |
| assume that if we find the packaging appealing, so will | | | | is that they easily fall prey to a variation of the |
| our customers. We imagine that our wants, our | | | | substitution fallacy. We figure that the policy must be |
| desires, and our needs are the same as theirs. | | | | correct and therefore must be followed, even when |
| But by using systems thinking, we can start to imagine | | | | circumstances have shifted!) In high-performing |
| that our customers' desires may be diametrically | | | | organizations, people are encouraged to challenge |
| different from our own. For example, when a large | | | | whether or not a process is right: "Is this policy up to |
| hospital in California wanted to re-engineer its patient | | | | date? Are we capturing all the truly important factors? |
| intake process, it found that doctors, nurses, and | | | | If not, then the policy needs to be re-written. |
| hospital administrators each had their own ideas about | | | | |