My first exposure to continuous improvement came in Lake Jackson, Texas. The year was 1988. Dow Chemical included our hospital, their second biggest supplier, in their effort. Twenty three years later, the Texas Legislature introduced continuous improvement in HB 3425:
CHAPTER 2116. STATE AGENCY CONTINUOUS IMPROVEMENT PROCESSDr. W. Edwards Deming, the noted quality guru, would consider this definition insufficient, surely suboptimal. It completely misses Deming's theoretical foundation for management transformation, his system of profound knowledge.
Sec. 2116.001. DEFINITION. In this chapter, "continuous improvement process" means a set of practices designed to improve organizational operations and remove deficiencies.
Only hacks would reduce continuous improvement to a set of practices, then impose practices that cause the greatest losses, arbitrary numerical goals, incentive pay, internal competition and fear which causes the distortion of figures..
Why did the Legislature offer a "practices version" of continuous improvement?
Sec. 2116.002. EVALUATION OF A CONTINUOUS IMPROVEMENTIt's cover for budget slashing and burning.
PROCESS. Each agency shall evaluate implementing a continuous improvement process to increase efficiency and cost savings.
Sec.2116.003. IMPLEMENTATION OF A CONTINUOUS IMPROVEMENT
PROCESS. After completing the requirements of section 2116.002, the agency may implement the continuous improvement process.
After which a report must be written.
Sec.2116.004. REPORT. The evaluation and any implementation activities shall be synopsized in the agency’s annual report.Texas is only two years behind Washington, D.C. Dr. Deming frequently asked, "will they ever learn?" Few elected leaders paid attention while Deming lived. They've stolen his signature work and reduced it to practices, an unfortunate sign of our co-opted times.
I can hear Dr. Deming boom, "Substitute leadership!" That's not the trajectory for health care or education.
The words "continuous improvement" and "quality" have no meaning anymore. Texas and D.C. are proof.