Which type of change?
- Problem is clearly defined
- Involves changing product/process
- Solved by experts
•Faces less resistance
Change may not even be noticeable
•No “loss” experienced
Improvement of current practice
TECHNICAL CHANGE
Take a blood pressure medication
Require airbags in new vehicles
Repair broken bone via surgery
Create a new drug interaction alert
Provide influenza vaccines for employees during work hours
Which type of change?
- Problem hard to clearly define
- Involves changing hearts and minds
- Solved by stakeholders
•Resistance is high
choose between contradictory values
Experience loss
•Require new practice
ADAPTIVE CHANGE
Adapt lifestyle to increase exercise, reduce stress, and eat healthier
Convince people to drive more safely
Reduce participation in high risk activities
Improve prescriber interaction with alert systems
Convince employees that getting influenza vaccine is important
Donald Norman User Centered Design
– Six Strategies
- Make important information visible
- Simplify the structure of tasks
- Affordances and Natural Mapping
- Use constraints (forcing functions) to guide the user
- Make it easy to reverse error prone operations and hard to carry out non-reversible ones.
- Standardize and simplify actions
Donald Norman User Centered Design
– Six Strategies
Affordance vs Natural Mapping
•Affordance:
A characteristic of equipment that communicates how it is to be used.
•Natural mapping:
intuitive relationship between the control and its function.
- *Six Sigma & DMAIC**
- *“Lean”**
Lean = Process that looks at making systems more Efficient
Six Sigma = Systems more safe / less faults
•Define
–Define the problem–Identify the “customer”
•Measure
–Establish current baselines as the basis for improvement
•Analyze
–Analyze/prioritize problems (latent conditions)
–Consider risks associated with proposed solutions
•Improve
–Consider starting with a pilot–Prepare stakeholders for the change
–Collect data along the way–Implement
•Control
–Lock in the gains–Manage resistance–Celebrate wins
PDSA
Cycle
PLAN
Seek Sponsorship / Identify Stakeholders
Include stakeholder input (Go to the Gemba – “The Real Place”)
Plan for Resistance (especially if level of adaptive change is high)
DO
•Communicate (up and down the ladder)
Though education is a low level intervention, it is almost always necessary to include with higher level interventions
STUDY
Share data –Stakeholders can be highly driven by data on their own performance
Share successes
ACT
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