Planning for Planning.

It has become an absolute truth that if a person, organization, business or government starts a new initiative without spending some effective planning time, based largely on measureable evidence, the initiative will likely fail.  The more time that is put into developing the plan, the greater the likelihood of success.  “Shooting from the hip” is rarely (if ever) a good idea.

The concept has its origins in the 20^th century literature tied to the thinking and writings of Walter Shewhart, either in the original (1939) form of Specification – Production – Inspection or the ultimate adapted form by Deming:  Plan – Do – Study – Act.  Reality is that the concept has its true origins much earlier, perhaps to the early introductions of scientific method, but for purposes of modern systems, if you haven’t learn from the lessons of the past 70 years, then adding more historical perspective will contribute nothing.    

The larger question is not so much whether planning is a good idea, but rather are there tools that can help the Quality Team and the organization get to the point of a cohesive designed plan.    And the answer is yes.  Depending on the size of the task, the tools will vary, although the principles remain the same.

For simple measures like planning for an internal audit the process can be pretty straight forward. What is our goal, what instruments do we need to develop.  Who will be involved, who needs to be notified, and can we set a timeline to complete the task; an all internal operation.  

If the goal is to create a new product or service then having discussions with the “customer” is a good place to start.  You likely will want to include the design people to make sure that the organization has the structured and skilled where-with-all to achieve what needs to be achieve.  If the project is about introducing innovation, then sort out that it is an innovation that forks are interested  in having.  

If everyone is clear on what exactly the end-point is supposed to look like, then the process to be travelled has a chance of being accomplished on-time and on-design.

With organizational renewal or restructure, the introspective approach of a SWOT analysis can be helpful.  By collectively putting a critical and objective eye to an organization’s Strengths and Weaknesses, and Opportunities and Threats, an approach to maximize the positives and minimize the negatives can be organized, prioritized, constructed and put into operation.  The process may or may not involve the thoughts, opinions and inputs from folks from outside the operation, but does need a cold look at objective evidence and the ability to acknowledge weakness.  Looking inward will reduce the risk of starting along a path that does not take appropriate advantage of what exists or stumbles over what is missing.

Recently I was introduced to a new planning-for-a-plan tool called a Policy Lens.  While new to me, there is a considerable literature on the concept going back over 40 years.  It may well be the instrument of choice for policy advocates by which I mean folks and organizations that live for the opportunity to establish policy in large structures such as government, international mega-corporations, academia, and industry sectors.  If you do an internet scan on “policy lens” or “conceptual scan” you will understand where this tool gets its most common usage, especially over the last 5 years.

The term “lens” is and example of organizational jargon, and is probably better replaced by terms such as point-of-view or perspective or vision. 

For establishing as trivial example policy to address the creating of a webjournal (blog) on laboratory quality management one could look at the topic from the perspective of (a) writers (b) blog-space providers (c) quality teams, (d) academics, and (e ) laboratorians.  Each group could be asked to consider impacts on (1) TEEM units (2) credibility (3) risks and liabilities and (4) quality improvement, plus issues of (i) continual professional development, and regional autonomy and (ii) international applicability or (iii) short-term or (iv) long-term application.  To the extent possible, options should be supported by objective measure and consensus.  Each step would needs tools such as questionnaire designs to be developed.  And all this would need to go through the steps of priority and consensus.

This is obviously not a short term exercise and one would be strongly cautioned against developing a “lens” infrastructure for a trivial topic such as blog writing.  But it would certainly be a useful approach for establishing health policy or delivery systems.   Done properly with appropriate validations and confirmations and broad based objective recordable and measurable inputs, thia is a major exercise. 

Can you go through this whole exercise and still end up with flawed policy?  Of course you can.  That is why Planning leads to Doing and then Studying and then Acting. 

But if the policy is big enough or important enough, the risks associated with under-Planning or non-Planning are guaranteed to be profound.   

SWOT Priority Table for Medical Laboratories.

So I was thinking about SWOT analysis and came up with some ideas about a tool that one could develop to help the process of translating SWOT analysis information into a priority list to get the important repairative  tasks addressed first.
The attached is based on the following assumptions or principles.

1. Laboratories with more than one area of weakness, or threat, or areas with opportunities may seek help prioritizing tasks.
2. While all Quality procedures are equal, some are more equal than others.  (I can this the Animal Farm principle).  For example, if there are improvements to be made both in Management Review and also in updating the organizational chart, it is more important to focus on management review.
3. If a procedure is at an acceptable level, it does not need any work (other than maintenance), but if there are tasks that need to be done, those at a level of severe deficit (threat) they need to be addressed first.  
4. Those where there are weaknesses or opportunities come next.  

So here is how this works.

• In the left hand column I have listed many of the areas and procedures  that a laboratory doing internal review should evaluate.
• Each area should be considered as either being in a healthy condition (strength) or having a weakness.  The weakness may be bad enough to be a potential liability.  Or there may be resources available to address certain areas (opportunities).  It is conceivable that a area could be both a threat and have an opportunity at the same time.  
• For each procedure I have put a "1" in the Strength column.  If after evaluation you want to change this to any value from 0 to 1 to 1 decimal point.  You can also add a value (0 - 1) in any or all of the other columns.  
• The four columns can add to 1.0 or greater. 
• The more you make the line worth, the greater will be its priority.
• Different procedures have different inherent procedure priority levels (PPV).  The PPVs  are the one’s estimated by me.  If you think different values could or should be used, change them.  Again, the greater the value, the greater will be its priority.

http://dl.dropbox.com/u/173944/SWOT%20PriorityQD-0511.xls
 
Note: I have verified that this file works properly.  
Also note I have not  validated it as giving the best priority for addressing tasks.  
 
Feel free to use it, or experiment with it, or disregard.

Interested in your thoughts.

SWOT

Recently I have been taking a close look at quality standards including ISO9001:2008, ISO15189:2007, and ISO17025:2005.  All of them have a lot in common.  First off, regardless of the decision for certification or accreditation, they are all mostly very useful reference sources for people who organize and operate laboratories.  Implementing quality management is a good thing to do.  Second, all of them recognize the importance of management setting the quality agenda based up information gathered through management review.  And third, all of them are future oriented documents that focus on ensuring the laboratory will be better tomorrow than it is today.  All that goes under the headings of planning, or prevention, or continual improvement.

Along the way, I noticed while all the documents make these points, there is one thing that they all seem to ignore or exclude, they are all weak on providing suggestions or recommendations for actually implementing business quality programs in an active laboratory.
So in that vacuum, I offer up my recommendation for inclusion of an organized look at the organizations Strengths, Weaknesses, Opportunities, and Threats as a powerful planning and improvement program.  Done correctly, SWOT analysis is an extremely useful planning and monitoring tool for laboratory management to apply on a regular basis.  

In CMPT I have taken to doing a formal SWOT every 2 years.  That way I get a chance to see if I am actually making progress or just satisfying immediate concerns.

SWOTs have a lot in common with ROOT Cause analysis.  You can do them both in 5 minutes if you want to.  In both instances you get out what you put in.  A five minute job satisfies the piece of paper and gets a tick on the assessment form.  A more formal open discussion will take a lot longer, but the outcome should be worth it.

There are probably hundreds of ways to work through a SWAO Analysis.  I try to keep it focused on the areas that matter most to me and my operation.  I try to focus on 9 topics: Management, Personnel, Facilities and environment, Quality System, Products and Services and Clients and Satisfaction, Awareness, Competition and Collaborations, and Finances.
For each of those areas I first think about what we have and how it can make us stronger, and if our current action is making us weaker.  Are there new opportunities to make things better, and if I don’t act on those or make the changes that I need, what can cause  jeopardy.  
Once I have created my list, I look at what tasks I have created and then put them in a priority order, recognizing that over 2 years I can work or 5 or 6.  

For  me and my program, the process has worked fairly well.  It has created an organized  structure for me to identify the things that we are working on now which include (a) capitalizing on non-EQA projects to create more diversity and a stronger financial platform, (b) increasing the analytes we provide (c ) aggressively finding a new location and (d) increasing the energy we put into ISO9001:2008 and (e) putting a temporary hold on implementing tje new standard - 17043:2010.  Maybe I would have identified these issues anyways, but the stucture helped make them more obvious.

And then to ensure that I actually do something, I make the whole thing public through my annual meeting and annual report, and put it on the agenda for year-over-year discussion.  I can dodge and weave, but in the process of open forum, I cannot hide.

The process has been 98 percent excellent as a forward driving device, but not 100.  I still have the same weakness and threat that I identified now 5 years ago.  I have no succession plan in place for me, and every year that looms as a greater issue.  More on that another day.

But to bring me back to  where the comment started.  All the quality documents talk about planning and review but do not identify this as a useful, indeed valuable, indeed indispensable tool.  Lots of time wasted space for other tools of dubious value (like uncertainty of measurement), but none for how to make my planning process more effective.

I need to do something about that.