What’s the Secret to Change Implementation?

Lloyd Provost, MS; Statistician, Associates for Process Improvement

I think it’s one of the hardest things in the world to do, to implement a change — to do that in a way that’s going to make it permanent. And what it really reflects is people haven’t really studied implementation and the impacts and what it takes to do that. Chapter 8 of The Improvement Guide is all about that, and the secret in Chapter 8 is you use PDSA.

In the Model for Improvement, we want one improvement team to do that all the way — to do the learning, do the testing, do the implementation into the system. And, so, Chapter 8 of The Improvement Guide is all about PDSAs for implementation. What is the difference in testing? And it’s really a whole different thought process. Testing is all about learning; implementation is about, “How do I turn this idea over to the system and make it permanent and build it into that system?” — what tests do we do, what activities, and so forth?

Whereas the scientific method dominates the model as we’re testing and learning, implementation is more like an engineering model. It becomes like project management maybe comes over and dominates a little bit more to do that. So it’s the same model, but we need to get our learning-scientist’s hat off a little bit and get our operations hat or program management hat on as we move into the implementation cycles. And people sometimes don’t do that transition.