Use Questions to Find Solutions

In today’s hectic healthcare environment we tend to look for immediate solutions to problems. In our haste to “put out fires,” we implement process changes that may offer immediate improvement however the problem that caused the “fire” often still exists. A more effective way to achieve lasting improvement is to use system analysis techniques when making a change in a process. System analysis involves interviewing process owners and managers to gain
a broader understanding of the problem so that better solutions can be developed.

The lack of a system approach to performance improvement results in wasted trouble-shooting efforts. Those attempting to solve problems may not always comprehend the unique area of concern and the environment in which the process resides. That’s why involving users and customers of the process are so important when solving problems.

Question Those Involved

A quick and effective questioning tool that can be applied in all environments consists of a series of six age-old questions: WHY, WHAT, WHERE, WHO, WHEN and HOW. Use these questions when interviewing and trying to understand an existing process or problem. Comments and insights from users can be elicited simply by asking:

Why do we need this process/procedure?
Why do we need this method?
Why is this situation a problem?
What is the purpose of this process/task?
Where is this process done?
Who does this process/task?
When is it done?
When does it have to be done?
How is it accomplished?

Getting the answers to the why, what, where, who, when and how questions and documenting the answers with flowcharts and narratives clarifies the process being studied. Each question presents a different focus on the process because it requires the responder to further clarify the activities in another way.

Once a process is understood and defined, another series of questions can be used to determine if the current process steps are really necessary. This is done by looking at each component of the process narrative and flowchart and asking: Can this task be eliminated? Changed? Combined? Simplified? Asking for improvement recommendations can be a very powerful and insightful question. Often the answers are in front of us. We just need to solicit
input from those closest to the process. By asking users and those ultimately responsible for the process for their thoughts and recommendations, a list of alternative solutions can be compiled. This step is an important way of getting everyone involved in the solution planning. Users of the process will have more buy-in to the changes if their ideas are accepted.

Other Data Gathering

When putting together a clear understanding of the problem, other data gathering strategies may be needed to complement the questioning technique. One form of data gathering is observation. Observing a process in the users own environment, or getting a demonstration of the process or problem, combined with asking the aforementioned questions, provides valuable insights. Visit the area where the process is done and experience what people see and feel. Surveys can also reveal issues that might not be uncovered any other way. A person completing a brief 5-minute survey may disclose issues, problematic tasks, or solutions not found through other data gathering techniques. Extensive data gathering provides an
opportunity to continually ask questions until the problem is defined from all perspectives – process owners, management and others impacted. And, with each technique don’t forget to ask, "What do you recommend?"

Systematic Problem Solving

When everyone involved in a process is brought together in a room to solve a problem, they often become engaged in a chaotic and unstructured discussion of quick fix solutions. Using system analysis techniques, the leader of the discussion can focus people on what is needed to achieve lasting results. The asking of why, what, where, who, when and how provides problem-solvers with a structure for achieving the best solutions. By questioning whether process tasks can be eliminated, combined, changed or simplified, the process becomes further defined. This leads to development of a more efficient process. The "what do you recommend?" question recognizes those closest to the process often have the best solution.

To Learn More: Patrice L. Spath is available for in-house presentations on this and other health care performance improvement topics. For further details, visit Brown-Spath & Associates on the web at: http://www.brownspath.com or write to: Brown-Spath & Associates, PO Box 721, Forest Grove, OR 97116.

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