Online Course Video Transcript: QI 101, Lesson 4

Deming’s System of Profound Knowledge Clip 1

Did you ever come up with a good idea? Or at least an idea you thought was going to be good? That idea was going to improve something. Typically, you have an idea and you think it’s going to make a difference in what we call the dependent variable. The problem is that, all too often, life is not so simple that one variable will change the outcome, even if your idea is very good.

What happens in real life is that you get many variables. Matter of fact, you get variables that happen at time 1, and then you get other variables that happen at time 2. In this way they form a sequence and a collection of variables that affect the dependent variable. And what we see is that there are direct effects between some of the variables and the outcome, and then there are indirect effects, that is X1 in concert with X4 conjointly have an effect on the dependent variable. Similarly, X1 affects X5 and they conjointly influence the outcome. Similarly, every variable can have interactions with other variables in the system. These can interact, this one can interact with that one, and then if you realize that over time these variables happen first, they influence the second set and then collectively the whole system influences the outcome.

This is a very different model than this simple view. The idea remains good, sound, and testable, but in fact, what you’ve missed is the complexity of life. What many would call the messiness of life, and how you actually break down a problem. Well, there is a way that we can help ourselves think about this complexity. It was given to us by Dr. Edwards Deming. Deming argued that for anything that you’re trying to improve, in our case an outcome—let’s say it’s improving hand-washing compliance—there are certain aspects of the system that you need to understand about hand-washing, there are certain aspects of variation, there are certain aspects of theories that people have about hand-washing, and finally there are certain theories about human behavior. So if we think about systems, variation, theories, and human behavior, in light of a complex problem, we will be able to break it down into constituent parts and give ourselves an advantage to not oversimplify the complexity of what we’re trying to do.