Every improvement scientist will face situations in which failure creates frustration and disappointment. Setbacks from tests of change (PDSA) arise when the test fails to yield according to our prediction. Do you go back to the proverbial drawing board to modify a failed change? What do you learn from your observation of the failure? How do you modify your theory; your prediction about what effect a change will have? (You do have a theory don't you?)
In this magazine article Jonah Lehrer cites the work of Kevin Dunbar and others who study how scientists study things - how they fail and succeed. As we work to raise safety and quality improvement work to scientific standards, we might do well to understand what he has learned and how it could be applied to sharpen our improvement acumen. This article is worth reading - I think you will easily see some possible pitfalls of improvement as with science. From the pitfalls come some simple messages about learning from failed improvement, modified from Lehrer's summary:
- Check your assumptions. Does the result you observe contradict your
theory? How might you change your hypothesis?
- Seek out the ignorant. Ask someone who is unfamiliar with your improvement what think - explaining it to them will help you see it in a different light.
- Encourage diversity. Form a diverse team around quality improvement work and value all input. Include family and non-clinical team members.
- Beware of failure-blindness. Be careful that you do not filter the result you see with bias and preconception.