An Entish Life, by Peter Augelli

An Entish Life

(or, an application of Lean Theory to Government Legislation)

 

By Peter Augelli

 

Humans seem to have the uncanny ability to think we know the answer without actually understanding the issue.  We do this in business, we do this in our daily lives, and sadly we do this in government. I do not expect this to be a revelation to people. Most would probably agree with what I just said. However, the tragedy comes in our failure to apply that knowledge. Especially in critical situations like legislation.

 

The way we legislate today starts with an assumption: if a problem exists in society, let’s use college tuition for example, it is the government’s role to solve it. Now some of you may think that is not an assumption! It is a fact. But is it? By saying the government must solve for an issue means our solution must include the government and most likely some law or policy.

Thank you captain obvious that’s why we need government paid tuition!

 

I have my reservations about that conclusion, but let me not be hasty- though neither should you.

At my last job I was responsible for overseeing the installation of medical software at hospitals. This required months of project management, with hours of intense conversation regarding the best ways to configure the software for the hospitals use. These conversations often focused on: What is the hospital’s current process, how do we configure the software to best assist in them carrying out their current work? Doesn’t seem unreasonable, and honestly that question drove many successful install. But was it the best question? Was it always the right question? Definitely not. There were many instances where we either used the software for things that might have been best left on another system or on paper, or times where we configured the system in a way so opposite its original intent it produced confusion and errors.

At one hospital they wanted to put a multi signature protocol for nurses in the system. A functionality that did not exist at the time and which they had a perfectly effective paper tracking sheet for. This lead to a cumbersome workflow that wasted time and was prone to error (not that the nurses failed to execute the protocol, they just failed to document it in the system. Employees generally do the right thing if enabled to). We found ourselves in these situations during the install because we didn’t start by understanding the problem and the question. By first understanding the problem, we could have formulated the correct question and thus gotten the right answer.

 

When installing our software, the problem statement for the project is roughly this: we need to install an EMR system to reduce patient safety concerns, increase revenue, and capture data. Great! Accept really the problem is: we need to reduce patient safety concerns, increase revenue, and capture data. We should take out the first clause because it assumes the EMR is necessary. What does that allow us to do? It allows us to take each issue and examine many different ways to solve for them. Some of which may be the software, but maybe not. Instead of our original question we instead ask: what is the hospital's current process? What should it be? Can an EMR help get them there? It opens many other possibilities, ones that may work even better than the EMR.

 

Circling back to college tuition. What is the problem? We need the government to help people afford college? What about we need to allow people to pursue the career they want?  I think the latter is the more useful question. Why do we get a college degree? For fun? That’s an expensive hobby. Most of us have a career in mind when we apply for college or we think it’s necessary to be successful, to get where we want in life. The first question limits our potential solutions. The problem must be solved by the government, and we assume we need the institution. Why assume we need the institution or the government to begin with? Why shouldn’t I be able to write a dissertation and be awarded a PhD without going to a university? Why if I have a great idea that could further a field, do I even need a PhD?

 

What about bachelor degrees? Why do organizations want you to have them? They don’t care that you went to a university; they care that you are coming equipped with certain knowledge and can problem solve. Do we need college to do that? Imagine a system where I could get a college degree with nothing more than a public library card, and an internship. There is no reason, I shouldn’t be able to check out a college textbook and learn on my own.

 

By asking the right question, maximizing our possibilities, we might realize that the government isn’t part of the solution at all. Unfortunately, politicians need to sell themselves as people with solutions. Like sales men they must sell their product: themselves; their party; and their employer. It is only natural that they will convince us that government is the answer. It’s in their best interest. But is it yours? we as a population should expect more from our officials. We should expect more from ourselves. The next time we hear an issue do not ask yourself what the government can do to solve it. Ask what can be done and is the government the best solution. Go ahead pick an issue. What do you think? I have some ideas. Do you?