A high-reliability organization (HRO) is an organization that has succeeded in avoiding catastrophes despite a high level of risk and complexity. Specific examples that have been studied, most famously by researchers Karl Weick and Kathleen Sutcliffe, include nuclear power plants, air traffic control systems, and naval aircraft carriers. Recently healthcare organizations have moved to adopt the HRO mindset as well. In each case, even a minor error could have catastrophic consequences.

The urgency to improve organizational performance is at an all-time high. Today’s customers expect more value for every dollar, knowledgeable employees are difficult to find and retain, competition is fierce, technology and data grow increasingly complex, and business models evolve ever more quickly. Given all of that and the complexity of modern organizations, a scatter-shot approach to improvement is not enough. Organizations need a systematic approach to incremental change that will drive them toward the ultimate goal of performance excellence.

The Baldrige Framework, which was developed in 1987 as a public-private partnership to be managed by the Department of Commerce, specifically the National Bureau of Standards (now called the National Institute of Standards and Technology – or NIST), provides a structure that organizations can use to diagnose weaknesses and set priorities for improvement. The approach has been proven to help organizations transform with respect to customer satisfaction, employee engagement, leadership effectiveness, resource optimization, and ultimately performance excellence.

High-reliability organizations (HROs) are those that successfully complete their missions despite massive complexity and high risk. Examples include the Federal Aviation Administration’s Air Traffic Control system, aircraft carriers, nuclear power plants, and NASA. In each case, even a minor error could have catastrophic consequences. Yet, adverse outcomes in these organizations are rare. How is it possible that we can go years without a commercial airline accident, but the guy at the drive through can’t seem to get your order right?

Are you trying to spread an improvement culture without the improvement software?

You invest in software for all of the important parts of your business, right?

People. That software exists for continuous improvement, too.

When you started on your improvement journey, you may not realize it, but you actually already made a technology decision. I bet you probably managed the work in spreadsheets and bulletin boards - these are technology! Now that you’re starting to engage more people in it, though, I bet that you’re finding that it’s hard to get the visibility you need to spread that culture efficiently and make sure nothing falls through the cracks. Your technology needs an upgrade.

You could theoretically use Dropbox and a folder structure to manage critical components of your business - say, for example, your medical records or accounting transactions - but I promise you, no one is putting their organizations at risk like that. They use software built specifically for the business issue you’re dealing with.

It continues to baffle me that organizations don’t take improvement software as seriously as they take their accounting platform or their medical records system.

Realizing that, it can be tempting to have your IT department build you a solution in SharePoint - which, out of the box, is just another document storage repository and an easy way to make website portals.

There’s not an IT department in the world that would volunteer to build a medical records system themselves when they know there’s software out there built specifically for this purpose. They understand that the resources it would take to build, maintain, and improve the system would be astronomical. I could wax poetic on the decision to build software vs. buying it, but I’ll spare you and just offer up this post and this one with more details on the topic.

Kaizen boards are excellent tools for visualizing the progress of work and capturing ideas for improvement. They give teams instant insight into the health of improvement and make excellent starting places for daily huddles and other meetings. When the Kaizen board is managed in online software, teams can collaborate across locations, the entire organization can benefit from collected knowledge, and the documents and other artifacts can be linked to items on the board, accelerating the pace of improvement.

Because of the popularity of digital Kaizen management, many software providers are offering up solutions that are marketed for that purpose. That’s good news for people concerned about continuous improvement, but there’s a catch. Not every solution is purpose-built for Kaizen. Some are general project management solutions with a new marketing spin, while others are rudimentary improvement tools at best.

Make sure to look for the following attributes in each solution you consider.

Kaizen events, also called Rapid Improvement Events, involve a team dedicating all of their energy for three to five days on solving a specific challenge or implementing targeted improvements. They are resource intensive, but effective tools for organizations that are dedicated to consistent and constant improvement.

Because they are so quick and consuming, it is essential to be well prepared. In fact, planning for the event should get as much care and attention as the event itself. Our clients who have been successful with event planning have found that it helps to have a standard pre-event template that can be used every time a Kaizen event occurs. This ensures that everyone is using the same standards and that the essential boxes are checked. The best improvement management software solutions allow you to set up your Kaizen Event Templates within the system to make it easy for everyone to access and report relevant information.

Of course, each organization is different, but here are the elements that we recommend considering when you set up your rapid improvement templates.

As a company providing continuous improvement software to organizations of all sizes around the world in a wide variety of industries, we're in the unique position of seeing how successful companies manage improvement, how they engage their employees, and the impact they achieve through top-down projects, bottom-up improvements, and strategy deployment. 

Continuous quality management (CQM) does not look the same in every organization. Some practice CQM as part of a business management philosophy like Lean or Six Sigma, while others implement it on its own. There are a bunch of tools and techniques that support CQM such as Gemba Walks, Catchball, and DMAIC that may or may not be used. However, there are some core principles that tie successful continuous quality management organizations together. They form the basis for the approach and are indispensable.

Quality Management is About Process Management

When you break it down, organizations are made up of hundreds, if not thousands of interlocking processes. The quality of the products or services that are delivered to external and internal customers alike is dependent on the quality of those processes. The financial health of the organization is dependent to a large extent on the efficiency of those processes. If you focus on the processes one at a time, you can fundamentally change the game and deal with the challenges facing your organization.

Quality management is not about placing blame on people. W. Edwards Deming believed that the system was responsible for 97% of the problems. The downside to simply blaming a person when quality standards are not met is that it prevents leaders investigating a bit more to find a root cause finding solutions that improve the performance of all the workers. If a worker makes a mistake, it is essential to ask why and find the process conditions that made the error possible.

One of the exciting things about the Lean management approach is that it is applied differently in every industry and organization. While it got its start in manufacturing, healthcare organizations have significantly benefited by using the same principles and practices with modifications. The exact tools and methods may vary from one organization to another, but there are a few core doctrines that Lean healthcare organizations all have in common. Together, they form a way of thinking that transforms organizations and changes the behavior of employees at every level of the org chart.

Lean healthcare is simply the use of the Lean business management philosophy in healthcare facilities. The goal of Lean is to reduce or eliminate waste in every procedure, process, and activity by applying the principals of continuous improvement. When an organization becomes Lean, there is an impact on every team member from operations and administrative staff and even clinicians. Everyone is tasked with identifying ways to eliminate any task or expense that does not add value for patients.

Why are members of the healthcare industry applying a business approach that got its start in manufacturing? According to the Centers for Medicare and Medicaid Services, national health spending is projected to grow at an average rate of 5.5 percent per year for 2017-26 and to reach $5.7 trillion by 2026. That rate of growth is simply unsustainable under existing conditions. A widespread shift in thinking and a sharp focus on customer value is necessary to keep the already overtaxed system from collapsing under increasing weight.
One change in thinking that is already becoming evident is the focus on growing more customer-centric and developing solutions that increase customer satisfaction while maintaining profitability. That’s where Lean’s focus on eliminating waste comes in. The central question, “Does this provide value for the customer,” is asked by every member of the organization, ensuring organizational alignment and consistent decision making.