The Next Level of Process Improvement

After many years of experience with process improvement, we have put together a method aptly named Big!mprovement. It works -- with high-performing teams producing big results, fast!

Here's a synopsis of the 6-step Big!mprovement method, which we bring to you with expert support--working with your team on important improvements. And if desired, at the same time we can set you up to integrate the method in your organization.

Conventional QI Methods	Big!mprovement Method
• 10-20 meetings over 6-18-months. Implementation plods along for many months more.	4.5-DAY INTENSIVE workshop followed by IMMEDIATE IMPLEMENTATION.
• Aims for incremental improvement over time.	Achieves BREAKTHROUGH (Big!) IMPROVEMENT quickly.
• Relies on the testing phase to discover potential problems with the redesign.	ANTICIPATES UNINTENDED CONSEQUENCES through simulation (the Process Walk) during the redesign work.
• Examines data and sets measures after months of team meetings.	Prepares trend data and impact calculations up front, and establishes MEASURES OF SUCCESS IN ADVANCE.
• Tends to ignore parts of the larger system that are beyond the boundaries of the process under study.	Explicitly RECOGNIZES SYSTEM-WIDE INTERDEPENDENCIES and addresses their implications during the redesign work.
• After initial classes in process tools and methods, staff are expected to know how to manage process improvement teams.	Provides a SUPPORTED method for team learning on important work.
• Tends to see implementation as the final step.	Includes a follow-up SUSTAINABILITY AUDIT to ensure lasting improvement.

How do I know Big!mprovement is right for my organization?
What if our team can't take 4.5 days for the Rapid Redesign step?
How has the Big!mprovement method been used?
How can I get the Big!mprovement method?
I'm an independent consultant. Can I use the Big!mprovement method with clients?

How do I know Big!mprovement is right for my organization?

Have you ever tried to improve your processes or results and were disappointed? Was the pace too slow, the size of the change too small, the results hardly significant? Did the recommendations go nowhere, did the team get distracted by other priorities? If so (and this is so common), then the Big!mprovement method may be right for your organization.

If, on the other hand, your existing approach to process improvement is achieving stunning successes in organizational performance, you probably don't need this.

What if our team can't take 4.5 days for the Rapid Redesign step?

We have found that the work to be done in a redesign team takes at least 36 hours of meetings, no matter what. Traditionally teams devote 10 to 20 meetings during a 6- to 18-month period, and they can't help but lose momentum. Big!mprovement compresses that time into one week, which has proven extraordinarily successful.

While we can support you in conducting the work over a longer time period in several one- or two-day sessions, we have found that teams are most successful when they can take the larger chunk of time together. Our supported, accelerated group process feels like magic, really!

The method has been used for a broad array of business processes as well as medical care processes. Examples of business applications abound. From our health care clients come some of the most compelling examples of effective use of the Big!mprovement method for preventing medical errors.

The hospital with too many wrong-side surgeries . Five wrong-side surgeries in just a few months got the attention of this hospital's leaders, yet there were no obvious commonalities among the cases: five different excellent surgeons, different operating rooms, different teams and a site-and-side marking procedure in place. There were, in fact, systemic issues discovered by the study team requiring a radical and rapid redesign of the surgery scheduling and admitting processes, changing the way these processes had been done for years.

The intensive-care unit with too many hospital-caused complications . This hospital, proud of its quality and intensive-care capabilities, had a Ventilator-Associated Pneumonia (VAP) rate above its peers in a national comparative database. Although up to date with recommended practices--raising the head of the bed, good infection control, instituting "ventilator bundle" orders--month after month, the high VAP rate persisted.

Using the Big!mprovement method enabled this hospital to find its own unique systemic issues and enabled its excellent leaders and staff to get behind real outcome improvement. They found that multiple factors were contributing to the high VAP rate. Rather than waiting to test, study and modify incremental improvements, the multidisciplinary team was energized to completely redesign their processes for the care of patients with ventilators, producing an immediate and sustained dramatic reduction in VAP rates as well as in the costs associated with this complication.

The clinic with too many out-of-control diabetics . A clinic and a health plan collaborated to reduce the proportion of members with diabetes with too-high A1c (long-term blood sugar) levels. The patients were distributed over a large region with higher-than-average incidence of diabetes to begin with, but how could the clinic brag about its high quality when so many patients were experiencing the devastating health effects of a chronic disease needlessly out of control? In a rapid redesign project, the clinic revolutionized its diabetes care processes while the health plan modified its data system, producing a dramatic improvement in health status.

How can I get the Big!mprovement method?

We bring Big!mprovement to your organization in one of two ways: (1) as consulting and technical support for an important improvement project, or (2) we can apply the method to an important improvement project while supporting your staff to integrate this approach within your organization. If it's the latter, then during the engagement we customize the approach and reference materials for you; so you are left with the improvement as well as capable staff and an organization structure that's effective for ongoing support.

I'm an independent consultant. Can I use the Big!mprovement method with clients?

Breakthrough Learning offers a site license to organizations that will use the Big!mprovement method and materials in-house. The way to use this method as a consultant is within a site-licensed client organization...not independently with other clients.