Root Cause of the Outlier

Impossible goals are fun, aren’t they?

Yes.  About as fun as unclogging a toilet. With your bare hands. In a public restroom.  At the Texas State Fair. 

Yet, organizations thrive on stretch goals.  Without them, we would consistently settle for mediocrity.  If you are tasked with achieving a metric that seems as far-flung as a manned mission to Neptune, allow me to share an example from a client.

The client, a provider of health care services, was feeling pressure from the market to evaluate and treat patients in a timelier manner.  To meet demand, their front line health care staff would have to increase their average daily productivity by 400%!  That’s an enormous problem solving challenge for any organization.

At first, nurses and nurse practitioners thought the goal to be impossible.  They saw no way to solve the problem without a huge increase in manpower.  Still, through innovation and teamwork they identified efficiencies in their process that allowed them to double their productivity.  Many in the administrative ranks thought they had come as close to solving the problem as they could, and seemed content with the gains they had made.

Until one day someone said, “Are there any individuals in our organization who are producing at a level that is 400% more than the others?”

That’s when they found Charles.  Charles was the outlier – the one guy, in one region, who was evaluating and treating roughly four times as many patients as the others. Not surprisingly, they investigated Charles’ workflow to identify what he was doing that was distinctive from everyone else.  It didn’t take them long to identify the root cause of his superior performance.  As soon as Charles finished treating his first patient, he went to his computer and opened a special software program.

A program no one had authorized.  A program no one else had.

This software program had features to automate many of the routine reporting tasks.  When they asked Charles about the software, he simply responded, “Yes.  I bought it and installed it on my own.  There is no way I could hit the goal without it.”

As a result, the firm invested funds to make this software available to every nurse and nurse practitioner and they quickly saw the productivity increase across the organization.  Their success is a lesson for anyone seeking to hit a goal that has never been achieved by using a root cause analysis process that we call Distinction Analysis and requires just a few simple steps:

  1. Validate the expected level of performance– Identify the one person, department, or system who is hitting the goal you are trying to achieve. Sometimes this requires benchmarking in another industry.
  2. Draw distinctions – Identify what is the same AND what is distinctive between your organization and the successful one.
  3. Identify the most impactful changes – Don’t make all changes at once. Rather, identify the top 1-3 that have the greatest potential to make a significant positive impact, and track how each one directly impacts performance.  No need to change things that have no significant benefit.

While there will be situations where you are unable to identify a valid group for comparison (we’ll talk about them in another newsletter), it’s important to recognize that we often have all the data we need, we simply haven’t taken the time to mine it.

At Action Management, we have been helping clients meet their stretch goals for nearly forty years. If you would like to find your own “Charles”, give us a call at 800-386-5611.  We would love to help!























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