Here’s a question I received recently: What kinds of indicators tell you if you are going in the right — or wrong — direction in your work?
I decided to answer it here, as a public Q&A, because it merits crowd-sourcing.
One way to measure success or failure is to take a systematic approach, as we do when we pursue Quality Improvement (QI). Dr. Mike Evans has a new video explaining the concept:
The key questions can be applied at an individual level (as in: I want to cut down on my smoking) or at an organizational level (as in: we want to improve rates of hand-washing in our hospital). Here they are:
Question #1: What are you going to improve and by how much?
Question #2: How will you know if a change is an improvement?
Question #3: What changes can you make that will lead to the improvement?
But what if you want early indicators that you are geared toward success? What if you can’t afford to wait for all the data to come in — or you have flexibility and can shift course if the weather vane swings toward failure?
The QI video explores another concept that is helpful here: Innovation Fatigue — that moment when you realize that your team is NOT as excited as you are about making a change.
Hunter Gatewood described in a 2008 talk how, when presented with an innovation, some people are like happy dogs in a pile of sticks and others are like cautious cats, watching and waiting to see what blows up in the dogs’ faces. A lesson I took was to watch for both types of people on my team. I could count on the early adopters (the happy dogs) to try new things, but I always knew we were on the right track when my late adopter (cautious cat) colleagues signed on.
So that’s another measure: know your team and use them as a barometer.
Another technique is to employ scenario planning, which I find to be really fun and useful. You first carefully assess the current field you are playing on, including all the possible factors that could change it — the knowns and the unknowns. You then try different combinations of possible outcomes — if X happens, then we can expect Y to grow — and write narratives to fit each one. (I found 3 resources for those who want to learn more: short, medium, and book-length.)
Now I’d like to hear from people about their personal “right track/wrong track” indicators. Wearing your failures on your sleeve may be fashionable in Silicon Valley, but it can be difficult for individuals — or other industries — to acknowledge and own it publicly.
When and where have you seen a well-told failure narrative? How might we make failure an authentic part of the public conversation about health and health care?
Please share your thoughts in the comments. And remember: if you don’t want to use your real name, it’s OK to post under a pseudonym or to email me directly (susannahRfox at gmail — note the R, please).