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The 5 Why Technique and Healthcare Technology

Businesses in every field are constantly coming across problems that need to be solved and solved quickly. Unsolved issues typically grow into larger problems quite quickly and getting to the root of an issue can be the difference between making a profit or reporting a loss in a quarter.  Systems, hospitals, and practices that continue to grow and operate at a high-level understand how to solve problems effectively and efficiently.

Incorrectly identifying the root of the problem is almost worse than not addressing the problem at all.

In order to solve a problem, its root cause must be identified so that the right plan is set in place.  Typically, identifying the root cause is where organizations struggle. This mistake results in continually unsolved problems, wasted efforts, and untold hours of frustration.  Shortly stated, incorrectly identifying the root of the problem is almost worse than not addressing the problem at all. When thinking of the size and scale of your healthcare technology program, you likely already know the magnitude these impacts can have. One simple question can make a huge difference in helping your technology team dig deeper.  “Why?”

The 5 Why Technique is a process improvement technique leveraged by manufacturing firms. Within these process driven companies, this technique is proven to help drill down to the root cause of an issue so that the proper solution, or countermeasures, can be identified and implemented.  So, what is this technique?

With each reason provided, asking another ‘Why?’ searches for another explanation…

This technique, invented by the founder of Toyota, helps you hone down to the real reason a problem is occurring by simply asking “Why?” until no further explanation can be given.  Answering a why question requires great thought to identify the correct reason for the occurrence.  With each reason provided, asking another ‘Why?’ searches for another explanation, i.e. the cause of the cause.  Continuing to iterate through this reason cycle eventually leads to the issues causing the problems in the first place. In healthcare terms, it’s treating the disease not the symptoms.

The independent cause is the one that is not the effect of a preceding cause and is, thus, the root cause.  You will know when the root cause has been found when there are no further reasons that can be given to the ‘Why?’.  This root cause is where you should begin to implement an appropriate countermeasure.  Starting here will begin to work from the bottom up as the effects of the root cause will begin to disappear until the initial problem, which started this investigation, has been fixed as well.

Use Case

At this point, you may be wondering how the 5 Why Technique can be applied to a healthcare technology organization. Here’s an example from a real Golden Source Consultants client. The technology leader initially shared a list of issues that business users had compiled when closing out a development phase. The issues included everything from requirements documentation, PMO processes, reporting, and, of course, issues with the software itself. The tension between the technology team and business team was high early in the project and success depended on both sides getting to the bottom of issues and working together to find solutions.

Golden Source Consultants assisted the client in performing a 5 Why Review. Taking the list of issues submitted to the technology team, a list of eight common issues was identified. This took the list of complaints from hundreds of individual lines and synthesized the feedback for a realistic starting place.

Next, GSC simply asked “Why?” the prescribed five times. An example looked something like this:

  • Issue: “I attempted to submit the form and it took at least one hour from start to finish to load all my requirements.”
  • Why #1: You can only submit one form at a time, even though each stakeholder has as many as 200 requirements. 
  • Why #2: The system was set up to show the form as an easy one time fill in and hide the bulk submission button.
  • Why #3: The leadership team initially thought the form view would be easier for stakeholders to understand.
  • Why #4: The bulk submission option has multiple steps and a complicated grid view which the business users are not currently trained to use. 
  • Why #5: The business users have only recently been added to the development management software for this program.
  • Root Cause: Training for business users on the development management software and its advanced functionality.
  • Solution: Three 1-hour Lunch & Learns scheduled and recorded to demo the software and advanced features including bulk upload.

One by one each issue was reviewed identifying the root cause. Sometimes the answer was revealed within only three or four steps, other times the questioning went as far as seven steps. As the 5 Why analysis was reviewed with both the technology and business teams, real discussions occurred. Blame was avoided and both sides worked through and agreed to mutually beneficial solutions. When the 5 Why Review Session was complete, clients on both sides expressed their gratitude and appreciation for thoroughly addressing each item.

Reasons Why the 5 Why Method is Effective in Healthcare Technology

If you’re still not convinced, here are five reasons why you should consider trying the 5 Why technique.

Thorough By repeatedly asking why, you peel back the problem and causes layer by layer.  Rather than staying at the symptoms of the problem, you can drill down to what is causing the overall disruption and you uncover the whole picture.
Explorative Like the above, asking why repeatedly gives you the opportunity to explore if there are several ways to improve solve the issues you’re encountering. Sometimes the earlier “Why’s” identify simple tweaks that can further improve your outcomes and amplify your solution to the root cause. 
Persuasive Working with experts in their fields of science and medicine means that your stakeholders require your solutions to follow rigorous investigation and rational backing. The 5 Why technique is invaluable in persuading hard to convince stakeholders.  Remember a solution that doesn’t yield buy-in is a solution that fails.
Easy To implement this methodology correctly, you do not need to attend a 6-month course or a weekend seminar.  You just need to have the inquisitiveness of a five-year-old.  Asking why is all that is required.  If something does not make sense, ask why again and, eventually, the confusion will clear up.
No Blame The goal of the 5 Why technique is not to find out who made the mistake or how a problem occurred.  The 5 Why technique acknowledges that knowing who to blame doesn’t solve the problem.  Instead, this method focuses your time and resources on getting to the root cause to solve the issue. This saves your time, money, and relationships.

Stop trying to fix the symptoms. Your short-term fixes only spend more time and money to cover the issues. Instead, find the disease and issue the right technology prescription to create a lasting cure.

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