Applying the Lens of Profound Knowledge


So let’s take this
idea and now apply it to our concept of handwashing. Every time you bring
a team together, they’re going to start
coming up with ideas. The question is,
how are you going to be able to actually put them
through a process to break down that complexity to make sense
so that you can move forward and make test of change? So let’s think about the
system aspects of hand hygiene. We know that different
systems in the hospital have different complexity and
different need for infection control. So the neonatal ICU, the
surgery areas, physical therapy, administration– all of those have
different requirements in terms of the necessity
for hand hygiene. It’s more likely
that you’re going to get an infection
in surgery or the NICU than it is in physical
therapy or admissions, or even administration. So we start to break
down the process and realize that
there is a system, and those systems have
smaller subsystems. And it’s the interaction
of all these systems that drive the outcome. We then need to think
about variation. And that variation is
not only conceptually how people vary
in their behaviors but also statistically. Can we gather data and look
at the percent of compliance with hand hygiene, get
the average compliance, and then be able
to stratify that into the different systems? Then, we’d like to know what
theories people have about hand hygiene. And these are quite varied. Everybody seems to have
different theories. Some people don’t seem to
think that germs really matter anymore, that
because they have good intentions,
in fact, they’re not going to have to
worry about hand hygiene. Everybody has
different theories, what Deming called
views of the world, that you need to
explore and understand why those theories are in
place, because those theories ultimately drive human behavior. This is why people
act as they do. So every time we’re
thinking about trying to get people to wash their
hands in a consistent way, we need to think about how
the system is interacting, the variation, the
theories that we have, and finally, the human behavior. These four components
then create this lens of profound knowledge
that Deming talked about. And if we take this lens and
apply it through these four components, we’ll be able
to understand the dependent variable, or topic of interest,
and be able to break it down into its constituent
parts and have a better chance of success.

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