The objective of Mechanism 2 is to optimize the quality and reliability of work while maintaining or improving flow of the development process. Quality and reliability are optimized when all necessary feedback and feedforward loops are included in the development process, without reducing flow, and their thoroughness balances speed and quality in an optimal manner. By simplifying and automating feedback and feedforward loops, flow of the guideline development process can be improved, and recommendations delivered faster.
Simplify and automate feedback & feedforward loops
Below are descriptions of the components of this mechanism.
2.1 Build quality controls and checks into the development process
Framing Question: What controls and checks are necessary to ensure quality and reliability within and across tasks?
Building controls and checks into the development process ensures completed work is high quality and reliable, which is paramount in healthcare guidelines. Work that is not high quality or reliable results in work needing to be redone, which causes disruptions in the flow of all ongoing work. Controls and checks also ensure consistent quality and reliability across work, which improves user experiences over time. By simplifying controls and checks, and automating them as much as possible, flow of the development process can be optimized.
2.2 Push quality checks closer to the source of work
Framing Question: How can the team be responsible for ensuring the quality of their own work, as the work occurs?
Building quality checks as close to the source of work as possible improves flow through the development process. Quality checks that are too far separated from the work can lead to problems being identified after they have spread through multiple steps and compounded. This increases the amount of work that must be redone, exacerbating the interruptions in flow. Quality checks that occur as closely to the source of work as possible help prevent problems from spreading, thereby helping to maintain the flow of work.
2.3 Identify problems as they occur
Framing Question: How long does it take to identify problems after they occur?
Identifying problems that occur in the development process as fast as possible improves flow by ensuring quality and reliability are maintained at all times. When problems are not identified quickly, there is a high likelihood of the problem compounding by spreading through multiple steps in the development process. This results in more work needing to be redone and causes larger disruptions to flow. By identifying problems as they occur in the development process, the amount of work needing to be redone is minimized and flow can be restored as quickly as possible.
2.4 “Swarm” and solve problems; build new knowledge
Framing Question: When a problem occurs, how can the team help solve it and document solutions for future reference?
Collaborating with the team to solve problems as quickly as possible allows progress on all ongoing work to resume quickly and minimize disruptions to flow. When problems are identified, teams should leverage their collective knowledge and perspectives to solve the problem; teams that include diverse perspectives are more likely to discover creative and better solutions to challenging problems. Solving problems in a collaborative manner serves to build new knowledge among the entire team, rather than just the individual(s) involved in the work; this leads to fewer preventable problems occurring in the future and improvements in quality, reliability, and flow.
2.5 Optimize the development process for systemic improvements; avoid localized improvements that reduce flow
Framing Question: Which steps of the development process can be made more efficient, without sacrificing flow?
Efforts to optimize the development process should carefully balance quality, reliability and flow. Improvements made to development steps, such as efficiency improvements and quality controls, should carefully consider how these changes impact flow of work through the entire development process. Improvements that enhance a single step but which result in net reductions in the quality, reliability, or flow of work should be avoided. When improvements made to the development process result in systemic improvements in quality, reliability, and flow, guideline programs are able to make continuous improvements.
Comments