PREFACE TO DATA SANITY: A QUANTUM LEAP TO UNPRECEDENTED RESULTS This book remains an ongoing labor of love that began in 1994. It summarizes the wisdom I have obtained by applying, relentlessly, quality improvement philosophy. As so many of us have painfully discovered, true progress can seem virtually glacial (more about that in the Introduction). If there is to be the “quantum leap to unprecedented results” in the book title, the time has come for people in improvement roles to be far more pro-active in working cooperatively in true partnership with boards, executive management, and physician leadership in addition to staff. I hope this book will provide you with both a catalyst and conduit to do this. It demonstrates a new way of thinking via a common organizational language based in process and understanding variation to moti- vate more productive daily conversations…for everyone. This shift in thinking will take nothing less than a shift to a vision of “the transformed organization” with improvement actually “built-in” to organiza- tional DNA. I’m providing an innovative roadmap that most of you will find quite challenging; but the rewards awaiting you are many. DATA INSANITY CONTINUES UNABATED The rampant waste caused by poor everyday organizational use of data continues. Many high level executives have no idea of the vast potential that exists to have their organizations take “a quantum leap to unprecedented results” through the common language alluded to in the last section. I call it “da- ta sanity” – new, more productive conversations in reaction to the everyday use of data and the result- ing meetings and actions. In executives’ defense, given their experiences with business school statistics courses and the sta- tistics taught by the consulting groups many hire, I must say this lack of awareness truly isn’t their fault! It’s time for people working in improvement to own this fact, stop the excuses, stop training that is noth- ing short of legalized torture, stop tolerating the executive attitude of “give me the 10-minute overview,” and do something about changing their perceptions of improvement and, especially, statistics. To be fair, many people in improvement have had the exact same experiences with statistics in required courses, on-line belt training, and project facilitation training and are naively passing on the only experi- ence they know. All of this is the wrong focus – and the wrong material. Implicit in these is an ap- proach that is “bolt-on” to the current ways of doing work. I hope to show you an intriguing alternative that can be hardwired or “built-in” to your current cul- ture. All it requires of participants are the abilities to: (1) count to eight, (2) subtract two numbers (this “advanced” technique could involve some borrowing), (3) sort a list of numbers, (4) use simple multipli- cation and addition, and (4) think critically, which is missing in most training. The time is far overdue to stop the everyday madness of meetings where data are involved, much of which I like to call MBLC (“Management by Little Circles”) – poring over data tables drawing “little circles” and demanding explanations for why a number is different from either its predecessor or an ar- bitrary goal. Unfortunately, in these meetings, there are as many different sets of circles as there are people in the room! And then there are other meetings where pages and pages of data displays such as bar graphs, trend lines, “traffic light” and variance reports are handed out – which will be shown in Chapter 2 to be virtually useless – that make a person wish, “When I die, let it be in a meeting. The difference between life and death will be barely perceptible.” All this activity – in addition to the activity that actually produces these reports and analyses – is waste, pure and simple! In fact, it is far worse than that. Well-meaning, but incorrect conclusions and actions resulting from these meetings unwittingly inflict damage on good, hard-working front-line peo- ple, demoralize culture, and actually make things worse, certainly no better. I challenge Lean practi- tioners to recognize this as a source of waste and calculate its cost. Davis Balestracci – Data Sanity: A Quantum Leap to Unprecedented Results - Introduction 1 Chapter 2 – the biggest improvement from the last edition – is targeted to boards, executives, and middle management to show the unknown and untapped power of some basic tools that will cause a profound change in conversations…and results. It is also targeted to improvement professionals. This is your chance to learn how to stop boring these powerful people to death and, instead, become willing allies in getting them desired results beyond their wildest dreams. The 10 Lessons in Chapter 2 are designed to show how routine meetings with everyday data can be transformed – and create the awareness that you are swimming in more daily opportunity than you (and your leadership) ever could have imagined. It will create far more impact than many current “bolt- on” projects that fall into the trap of using vague teams generating vague data on vague problems re- sulting in vague solutions…and getting vague results (put focused attention on anything and it im- proves). I am talking here about “built-in” transformation – that will make such projects more focused on key strategic areas (Chapter 9). Your job will become far more interesting – and effective. “PLOT THE DOTS” AND WATCH THE CONVERSATIONS CHANGE Once again, please stop delivering or studying statistical training that continues to be nothing short of legalized torture. The wrong things are being taught, perpetuated…and misused. Some of the big- gest myths perpetuated relate to the concept of Normal distribution, which will rarely be mentioned in this book. Statistical training needs major surgery. It should no longer teach people statistics, but in- stead teach them how to solve their problems…and make lasting improvements by thinking critically. Organizational education is another major revision in this edition and will be discussed in Chapter 9. As the final lesson in Chapter 2 will show, leaders can no longer continue to abdicate their respon- sibility for learning basic methods for understanding and dealing with variation. And it’s also time that promotions reflected a person’s willingness to use them routinely, be successful with them, and teach them to their direct reports. I will still spend a lot of time on the use and interpretation of the statistical techniques of run charts and control charts of process data. I continue to be amazed at the awesome power of simply “plotting the dots,” as are the audiences I address. Trust me: An increased emphasis on “process” in the context of understanding variation will develop your intuition as to proper tool use – and you won’t need as many (Many traditional tools are covered in Chapter 8). One other purpose of this book is to show the importance of critical thinking in conjunction with the use of simple tools…and respect for “the process.” LOGIC + HUMANS = CHANGE? THINK AGAIN! Chapters 3 and 4 (formerly Chapters 4 and 5 in the previous edition) have been streamlined to es- sential leadership skills and a context that will create an atmosphere where improvement can flourish. However, as shown in Exhibit 1.2 in Chapter 1 and described further in Chapter 9, a crucial phase in transformation is to create a critical mass of 25 to 30 percent of leadership employing both data sanity principles and the leadership skills of Chapters 3 and 4. Ongoing change continues to be relentless in people’s everyday lives with the perceived need be- ing “even bigger… even better… even faster… even more… right now!” Given this and the economic woes of the past five years, people’s anxiety levels still guarantee that “You name it…and somebody’s mad!” I hope this book can give you the skills see your job through a newer (and saner) lens – and to an- ticipate and manage the inevitable “disgustingly predictable” resistance you will encounter – without getting an ulcer (my leadership mantras in Chapter 3 should help). My wish is for you to use its princi- ples to gain the support – and respect – of your organizational culture. THERE IS NO “MAGIC BULLET” Davis Balestracci – Data Sanity: A Quantum Leap to Unprecedented Results - Introduction 2 Be careful: Books and consultants continue to try their best to seduce you with (ultimately disap- pointing) easy answers, templates, and fancy Japanese words – and this book isn’t one of them. I do, however, promise you realistic, practical answers that may not initially seem easy, but will address deep causes, get your desired results and hold these gains…if you do your homework. At this moment, a technique called “rapid cycle PDSA”(Plan-Do-Study-Act) is ubiquitously being touted as the “cure all” – and it might be…if used in conjunction with the principles in this book. If any of you have tried it and are frustrated, you have good reason. Take a look at my article series in the Resources of Chapter 8. If you read this book and learn its lessons about “human variation,” I promise you success in dealing with rapid cycle PDSA’s lurking realities. SO, SPECIFICALLY, WHAT ARE THE CHANGES IN THIS 4TH EDITION? The main changes in this edition are the elimination of the former Chapter 3 on Balanced Score- cards and radical revision of Chapters 2 and 9. Projects are still very necessary for organizational improvement, but they must be seen in the con- text of cultural transformation. And Data Sanity will catalyze this process and the use of everyday data to create the time to do effective, more strategic projects.