Table 2 Approach to analysis and... | Emerald Publishing

Table 2

Approach to analysis and measurement

	QI	LSS	HFE
Paradigm	Pragmatic Analysis of process to understand how change will affect process	Pragmatic Analysis of process to understand how change will affect process	Scientific Analysis of system elements and system interaction using a wide range of qualitative and quantitative and experimental and observational methods and techniques
Design	Model for Improvement with PDSA cycles	Design, Measure, Analyse, Improve, Control (DMAIC)	Pre-post analysis of outcomes, experiment, action research
Approach	Usually initiated locally by frontline workers Stakeholders (staff and patients) identified and engaged to understand the “as is” situation and to create social capital through co-production Driver Diagram (Theory of Change)	Usually initiated by management and undertaken by trained staff Process Owners and Stakeholders (staff and customers) identified and engaged to understand the “as is” situation Voice of the Customer (VOC) – to understand values of all involved in the improvement process and engage them in developing a vision for the future state	Usually initiated by research collaborations with senior leaders. Often facilitated by HFE professionals (working inside or outside of the organisation) in collaboration with local quality, safety and front-line professionals and management Co-design and co-production are requisite to understand the current system (“as is”) and co-create the desired future state (“to be”)
Methods to understand what is happening before the change	Generation of a SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) Aim Statement Process mapping Observation, “common sense” insights Fishbone, 5 whys, Pareto analysis of causes Hearing the “voice of the process” through active engagement of providers and patients using methods such as Surveys, Story Telling and Liberating Structures “Steal shamelessly” and use tools from other disciplines including LSS and HFE (occasionally reduced to a principle or slogan to simplify the adoption)	Process mapping with team/stakeholders; Fishbone, 5 whys, Pareto analysis of causes, Fault Tree Analysis Gemba Walk (to visit where the process happens, observe and understand it) Risk identification and mitigation – Risk Prioritisation Matrix and Failure Modes and Effects Analysis (FMEA) Toyota Production System (TPS) – 5/6S Sort (Seiri), Set in Order (Seiton), Shine (Seiso), Standardise (Seiketsu), and Sustain (Shitsuke), Safety Concepts of Just in Time (JIT), Point of Use (POU), Right First Time (RFT) Quality Function Deployment (QFD), Critical to Quality metrics, Kano analysis Suppliers, Inputs, Process, Outputs, and Customers (SIPOC) Use of common analysis frameworks like SWOT (strengths, weaknesses, opportunities, and threats) and PESTLE (Political, Economic, Sociological, Technological, Legal and Environmental) Waste analysis, e.g. TIMWOODS/DOWNTIME Sandbox to explore ideas and Rapid Improvement Events	Assessment of Teamwork, leadership, communication, culture, wellbeing, e.g. Interviews, focus groups, surveys, ethnographic observation HFE integration into the physical built environment, the tools and technologies that humans use in their everyday work; impact of new tools and technologies or changes to the built environment How humans in the system carry out their work, e.g. Hierarchical Task Analysis (HTA) how humans in the system think about their work when they are interacting and engaging with tasks and technologies like the Electronic Patient Record, e.g. Cognitive Task Analysis (CTA); Critical Decision Method (CDM); Situational Awareness (SA) Assessment; Human Computer Interaction (HCI) assessments How current processes and systems work-as-done (WAD) and as-imagined (WAI) e.g. Process mapping and analysis; assessments of workload How humans in the system relate to each other, trust each other, work together, e.g. Analysis of social networks and roles how humans in the system share data, information and knowledge in the organisation, e.g. Mapping of information flows How the different elements of the system inter-relate and work together to create a functioning (or not) system, e.g. Socio-Technical System Analysis (STSA) How and where current processes or systems might fail, e.g. FMEA; methods for predicting and understanding how and where errors might happen, e.g. Systematic Human Error Reduction and Prediction Approach (SHERPA) Whether or not it is safe to make changes and any potential knock-on consequences (good or bad) to other parts of the system, e.g. Safety Case
Measurement of change or improvement	Assessment of process and variation over time – Run charts, statistical process control (SPC) charts Process, outcome, balancing measures used Person-centred outcome and experience measures – (PROMS and PREMS)	Use of SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goals and objectives Critical to Quality (CTQ) to define data measurements and translate the VOC into measurable metrics Person-centred outcome and experience measures – (PROMS and PREMS)	Action research or experiment including detailed WAD vs WAI analysis Measure of impact on human wellbeing and overall system performance Ongoing measurement and pre-post analysis of outcomes including process, outcome and balancing measures Person-centred outcome and experience measures – (PROMS and PREMS)

	QI	LSS	HFE
Paradigm	Pragmatic Analysis of process to understand how change will affect process	Pragmatic Analysis of process to understand how change will affect process	Scientific Analysis of system elements and system interaction using a wide range of qualitative and quantitative and experimental and observational methods and techniques
Design	Model for Improvement with PDSA cycles	Design, Measure, Analyse, Improve, Control (DMAIC)	Pre-post analysis of outcomes, experiment, action research
Approach	Usually initiated locally by frontline workers Stakeholders (staff and patients) identified and engaged to understand the “as is” situation and to create social capital through co-production Driver Diagram (Theory of Change)	Usually initiated by management and undertaken by trained staff Process Owners and Stakeholders (staff and customers) identified and engaged to understand the “as is” situation Voice of the Customer (VOC) – to understand values of all involved in the improvement process and engage them in developing a vision for the future state	Usually initiated by research collaborations with senior leaders. Often facilitated by HFE professionals (working inside or outside of the organisation) in collaboration with local quality, safety and front-line professionals and management Co-design and co-production are requisite to understand the current system (“as is”) and co-create the desired future state (“to be”)
Methods to understand what is happening before the change	Generation of a SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) Aim Statement Process mapping Observation, “common sense” insights Fishbone, 5 whys, Pareto analysis of causes Hearing the “voice of the process” through active engagement of providers and patients using methods such as Surveys, Story Telling and Liberating Structures “Steal shamelessly” and use tools from other disciplines including LSS and HFE (occasionally reduced to a principle or slogan to simplify the adoption)	Process mapping with team/stakeholders; Fishbone, 5 whys, Pareto analysis of causes, Fault Tree Analysis Gemba Walk (to visit where the process happens, observe and understand it) Risk identification and mitigation – Risk Prioritisation Matrix and Failure Modes and Effects Analysis (FMEA) Toyota Production System (TPS) – 5/6S Sort (Seiri), Set in Order (Seiton), Shine (Seiso), Standardise (Seiketsu), and Sustain (Shitsuke), Safety Concepts of Just in Time (JIT), Point of Use (POU), Right First Time (RFT) Quality Function Deployment (QFD), Critical to Quality metrics, Kano analysis Suppliers, Inputs, Process, Outputs, and Customers (SIPOC) Use of common analysis frameworks like SWOT (strengths, weaknesses, opportunities, and threats) and PESTLE (Political, Economic, Sociological, Technological, Legal and Environmental) Waste analysis, e.g. TIMWOODS/DOWNTIME Sandbox to explore ideas and Rapid Improvement Events	Assessment of Teamwork, leadership, communication, culture, wellbeing, e.g. Interviews, focus groups, surveys, ethnographic observation HFE integration into the physical built environment, the tools and technologies that humans use in their everyday work; impact of new tools and technologies or changes to the built environment How humans in the system carry out their work, e.g. Hierarchical Task Analysis (HTA) how humans in the system think about their work when they are interacting and engaging with tasks and technologies like the Electronic Patient Record, e.g. Cognitive Task Analysis (CTA); Critical Decision Method (CDM); Situational Awareness (SA) Assessment; Human Computer Interaction (HCI) assessments How current processes and systems work-as-done (WAD) and as-imagined (WAI) e.g. Process mapping and analysis; assessments of workload How humans in the system relate to each other, trust each other, work together, e.g. Analysis of social networks and roles how humans in the system share data, information and knowledge in the organisation, e.g. Mapping of information flows How the different elements of the system inter-relate and work together to create a functioning (or not) system, e.g. Socio-Technical System Analysis (STSA) How and where current processes or systems might fail, e.g. FMEA; methods for predicting and understanding how and where errors might happen, e.g. Systematic Human Error Reduction and Prediction Approach (SHERPA) Whether or not it is safe to make changes and any potential knock-on consequences (good or bad) to other parts of the system, e.g. Safety Case
Measurement of change or improvement	Assessment of process and variation over time – Run charts, statistical process control (SPC) charts Process, outcome, balancing measures used Person-centred outcome and experience measures – (PROMS and PREMS)	Use of SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goals and objectives Critical to Quality (CTQ) to define data measurements and translate the VOC into measurable metrics Person-centred outcome and experience measures – (PROMS and PREMS)	Action research or experiment including detailed WAD vs WAI analysis Measure of impact on human wellbeing and overall system performance Ongoing measurement and pre-post analysis of outcomes including process, outcome and balancing measures Person-centred outcome and experience measures – (PROMS and PREMS)