Hi folks,
In our last installment we talked about the need for a process to be justified by the ends – that a process cannot justify itself.
Thankfully there are plenty of processes that are well justified by their appropriateness and their results. We’ve talked about checklists before, and I want to share a similar example.
Peter Pronovost is a critical care specialist at Johns Hopkins Hospital. In 2001, he tackled a leading cause of unnecessary death in hospitals – line infections. He did so by developing a simple process and accompanying checklist that doctors and nurses could use when inserting a line:
- Wash hands with soap
- Clean the patient’s skin with chlorhexidine antiseptic
- Put sterile drapes over the entire patient
- Wear a sterile mask, hat, gown, and gloves
- Put a sterile dressing over the catheter site once the line is in
There’s nothing revolutionary here. These steps had been taught for years. But by distilling them into a simple process and creating a checklist procedure around them, the line infection rate dropped from 11% to 0%.
And while Pronovost’s own words echo the message of the last entry, “the use of checklists is not the endgame. Reduced infection rates are,” there is clearly much value in a process that saves thousands of lives.
“But Rex, I’m not a doctor/nurse and no process of mine is going to directly save lives. Thanks for setting the bar unreasonably high!”
I get that. It’s easier to justify a process when the outcome is saving a life. But if we abstract this example, I think we can observe some of the characteristics of a good process:
- Simplicity – the process should be distilled into it simplest possible form. Yes, some processes are inherently complex, but even the most complex can be explained in plain language. And simplicity is rewarded! A teenager won $400,000 for his 7 minute video explaining the theory of relativity.
- Causation – This is challenging, but the burden of proof is on us process owners. Within reason, we should be able to show causation for the impact we’re seeking. If we can’t draw a reasonable line from the process to the output, we can’t justify the process.
- Positive ROI – We need an end that outweighs the investment of the means. If you invest X in a process, you want >X in return. This isn’t always easy to measure, but ultimately somebody within the organization needs to make the call on upfront costs, priorities, opportunity costs, etc.
These requirements aren’t good only for new processes, either. Periodic examination of existing processes is needed as organizations grow, capabilities evolve, and priorities change – leaving processes outdated, misaligned, and inefficient.
Good processes aren’t a burden – they’re an asset. They help organizations generate predictable, high-quality results. But good process rarely emerge fully-formed and they rarely stand the test of time. Those of us charged with the wellbeing of an organization are obligated to accept only the processes that meet our standards – simplicity, causation, and positive ROI – and once we do, reevaluate them periodically to make sure they’re still up to par.
Rex