I have used Adaptive Design in clinics & hospitals nationwide and always see the positive results & innovation that generates more and better care at continually lower cost. But it can be difficult to comprehend working adaptively because “you cannot know until you see; and you cannot see until you do.”
Here is a simple way to “know by seeing and doing.” Watch the 3-minute video (link below) of a Radiology Department staff meeting about four months after starting Adaptive Design, then follow the instructions on “knowing by seeing and doing.”
See – Watch the video
Do – By answering a series of questions while you watch.
Know – Check your answers on the key when you finish.
Then you’ll know how to provide more care for continually lower cost.
Some background of video: The video opens with the camera on the Director of Radiology for this health system. The camera then pans to the left to an RN who was one of five “learner/leader/teachers” this unit developed to do Adaptive Design. Other learner/leader/teachers are to her left. The Manager of Radiology is the woman to her right.
Questions to consider while you watch the Rad Video
- What was the problem they were seeking to solve? Whose problem was it?
- What did they do prior to learning to do Adaptive Design?
- Why could they not find a solution? What were they treating?
- What did the nurse really want to focus on that she couldn’t before?
- What’s different now?
- How can rapid experimentation be safe? What happens when a test fails?
- How was their thinking changed after they learned Adaptive Design?
- Change is hard; what made it easier for them? What sustains it?
- They are providing more care, but are they lowering costs? How do they know?
- What did they find they had more of using Adaptive Design and what’s really important?
View video here (Password: 43rad)
Answers for Rad Video:
- Patients were coming in for procedures in the morning & staff couldn’t take care of their patients on time. In Adaptive Design, the staff saw it as “our problem,” not management’s, the patients, the doctors or someone else.
- Workarounds. “We are really good a workarounds.”
- “We were treating the symptoms, not the cause.”
- Her patients.
- “Instead of sitting & discussing in meetings,” they took action; designing small experiments (A3’s) to solve problems and improve.
- Experiments were safe to fail and failure only led to more tests and more learning.
- They were all working as a team, “it’s not management against employees….”
- “Doing” it together, and “seeing” the results; then you “know.”
- Eliminating waste; she doesn’t have to audit the process, she knows because she sees and does. Also, if someone does need an audit, it’s easy to design a small experiment to document savings as you make them, in real-time.
- Time with patients.
Adaptive Design is a inspirational set of simple rules, methods, skills and tools that make everyone accountable for patient-centered innovation as part of their everyday work. Unlike other event or project-based, process reengineering approaches, Adaptive Design is a low risk, high reward, self-sustaining system for designing, doing and improving complex work, both within and across disciplines.
In Adaptive Design, Quality is not a Department and Improvement is not a project; they are everyone’s job every day.