Wednesday, July 2, 2014

Focus and Leverage Part 358

In my last posting I told you that the next several postings would apply to healthcare improvement.  I also told you that I wanted to to re-visit the concept of being a satisficer versus being an optimizer as you approach improvement and it is this topic that I want to present today.

Boaz Ronen, Joseph Pliskin and Shimeon published a book entitled, Focused Operations Management for Health Services Organizations and in it they discussed two, distinctly different mind-sets as it’s related to improvement, being an optimizer versus being a satisficer.  So let me first provide the author’s definition of each.

  • Optimizer: A decision maker who wants to make the best possible decision without consideration of time constraints

  • Satisficer: A decision maker who is satisfied with a reasonable solution that will clearly improve the system

So what’s the real difference between these two types of decision makers as it applies to process improvement?  The authors tell us the for an optimizer to reach an optimal decision, they must generate all possible alternatives, then gather all the information, then build a model that will evaluate the alternatives and finally choose the best one.  This obviously requires time, effort, and money.  Let’s face it, building the optimal model to evaluate all of the alternatives is time and labor-intensive. And while the optimizer may find the perfect solution, it may simply come too late and in our dynamic world today, we all know that changes must happen frequently.  Timely decisions must be made which makes life challenging for the optimizer.

The authors tell us that Herb Simon suggested that decision makers should behave as satisficers and that they should seek to reach a satisfactory solution and not an optimal one.  They further explain that a satisficer wins by complying with two basic principles:

  • Set a high enough level of aspiration consistent with market conditions, competition, and investor expectations

  • Adopt an approach of continuous improvement

    • A one-time improvement gives the firm a temporary edg

    • Without continuous improvement, the temporary edge will be lost

The authors provide an example of a hospital (Hospital A) wanting to computerize patient records, so they hires a consulting firm to develop the system.  The problem was that it took six years to develop a system and two years later, the technology changed, making their new system obsolete.  A competing hospital (Hospital B) adopted and adapted a computerized patient record system used in other hospitals and within one year, it worked reasonably well.  Hospital A sought the optimal solution while Hospital B settled for a satisfactory solution.

The point is, if your management style is one that searches for an optimal solution, valuable time is lost making improvements.  I consider myself to be a satisticer and as such, in my work, I am attempting to provide rapid improvement in a step-wise fashion something like the following graphic:

By approaching improvement in this manner, I have found that dramatic improvements come very quickly and continue to get better and better as time passes by.  I highly recommend this approach because, if for no other reason, the leadership of organizations are able to see imrovements in very short order.  And when they see improvement, it’s much easier to sell your improvement methodology to them again.  I just finished an engagement in a religious hospital and was able to convince the engaged team to adopt the mentality of a satisficer and, in so doing, improvement happened and it did so quickly.

In my next posting, we’ll dive deeper into improvement tools and techniques that healthcare organizations can use to make their own rapid improvements happen.

Bob Sproull


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