Synopses & Reviews
The Improvement Guide
In today's tumultuous global marketplace, making effective changes in how organizations are run has become more important than ever. Performance improvement continues to be a key focus for leaders in business, healthcare, education, and government concerned with long-term success and sustainability. Executives, managers, and workers need practical methods and techniques that produce lasting results.
This second edition of the best-selling book, The Improvement Guide, offers an integrated approach to learning and improvement, one that is designed to deliver quick and substantial results. Using straightforward stories to illustrate core ideas, the expert authors introduce a flexible model for improving quality and productivity in diverse settings. They draw from research conducted in a variety of areas—manufacturing, healthcare, government, and schools—to present a practical tool kit of ideas, examples, and applications.
Since the book was first published more than a decade ago, the authors have expanded the use of their Model for Improvement¿through work on improvement efforts at multinational companies as well as in different industries such as healthcare and public agencies. This thoroughly revised and updated edition includes new information that shows how to accelerate improvement by spreading changes across multiple sites—for example, spreading improvements in cardiac care across multiple hospitals; spreading set-up efficiencies across multiple manufacturing sites; or spreading approaches to reducing homelessness across multiple cities.¿In addition, the book contains an explanation of how other approaches such as Six Sigma and Lean production are related to the Model for Improvement framework.
Designed to be highly approachable, the book's Resource Guide to Change Concepts is updated so that even beginners can utilize the tested techniques of some of the world's most experienced practitioners. Like the first, this second edition offers a practical tool kit filled with dynamic ideas, illustrative examples, and useful applications.
This new edition of this bestselling guide offers an integrated approach to process improvement that delivers quick and substantial results in quality and productivity in diverse settings. The authors explore their Model for Improvement that worked with international improvement efforts at multinational companies as well as in different industries such as healthcare and public agencies. This edition includes new information that shows how to accelerate improvement by spreading changes across multiple sites. The book presents a practical tool kit of ideas, examples, and applications.
Praise for The Improvement Guide
"Managers will profit enormously from studying this unique publication, which presents a very practical, readily implementable way to improve the performance of any organization. Utilizing this approach over the last fifteen years, under the guidance of a co-author, has been a major key to the success of our company."
—David R. Harvey, chairman and former CEO, Sigma-Aldrich Corporation
"The updated edition of The Improvement Guide builds on API's practical approach to improvement, providing even more great examples, and expands into methods for large system change and spreading improvement quickly. This is an outstanding reference book for anyone leading improvement."
—Bruce Boles, master black belt, Hewlett-Packard
"The Model for Improvement developed by the authors and presented in this book is remarkably simple and profound. The first edition is a classic. The second edition retains the best features of the original and incorporates twelve years of experience of many organizations around the world that have been using its contents. It is a valuable reference for anyone working with improvement. We have been using The Improvement Guide in the Continuous Education Program on Improvement at the University since 2000, with outstanding results."
—Ademir J. Petenate, professor of statistics at University of Campinas (Brazil) and director of ANOVA—Methods for Improvement
"If you are involved in organizational improvement efforts, this book is an invaluable asset and guide to learning. The detailed explanations of theory, principles, and tools, along with pragmatic real-world examples of successful project execution, allow an improvement team to understand organizational complexity, then break improvement efforts into simpler components, yielding dramatic insights and results."
—Jerry W. Jackson, MD, Nephrology Associates, PC; improvement advisor, Institute for Healthcare Improvement
About the Author
Gerald J. Langley
is a statistician, author, and consultant, and co-founder of Associates in Process Improvement (API), a consulting firm that specializes in the improvement of quality and productivity.
Ronald D. Moen is a statistician, consultant, and teacher to industry, government, and education. He is co-founder of API.
Kevin M. Nolan is a statistician, author, and consultant at API, where he focuses on developing methods and assisting organizations to accelerate their rate of improvement in quality and productivity.
Dr. Thomas W. Nolan is a statistician, author, and consultant, and¿co-founder of API.
Clifford L. Norman is a consultant with API whose work has emphasized the psychology of change.
Lloyd P. Provost is a statistician who advises to organizations as an API associate.
Table of Contents
Introduction: The Improvement Guide, Second Edition.
PART ONE: INTRODUCTION TO IMPROVEMENT.
Chapter One: Changes That Result in Improvement.
Principles of Improvement.
The Model for Improvement.
Key Points from Chapter One.
Chapter Two: Skills to Support Improvement.
Supporting Change with Data.
Developing a Change.
Testing a Change.
Implementing a Change.
The Human Side of Change.
Key Points from Chapter Two.
Chapter Three: Improvement Case Studies.
Case Study 1: Improving the Morning Meeting.
Case Study 2: Improving Service in a Dental Offi ce.
Case Study 3: Improving Methods for Teaching Biology.
Case Study 4: Contamination in Shipping Drums.
Case Study 5: Reducing Energy Use in School.
Key Points from Chapter Three.
PART TWO: METHODS FOR IMPROVEMENT.
Chapter Four: The Science of Improvement.
Milestones in the Development of Profound Knowledge.
Key Points from Chapter Four.
Chapter Five: Using the Model for Improvement.
What Are We Trying to Accomplish?
How Will We Know That a Change Is an Improvement?
What Changes Can We Make That Will Result in Improvement?
The Plan-Do-Study-Act Cycle.
Using the Cycle to Build Knowledge.
Key Points from Chapter Five.
Chapter Six: Developing a Change.
Some Typical Problems in Developing Changes.
Reactive Versus Fundamental Change.
Theory for Change.
Methods for Developing Fundamental Change.
Key Points from Chapter Six.
Chapter Seven: Testing a Change.
Applying the Science of Improvement to Testing.
Principles for Testing a Change.
Designs for Testing a Change.
Strategies for Testing.
Key Points from Chapter Seven.
Chapter Eight: Implementing a Change.
Testing a Change.
Implementing a Change.
Implementation as a Series of Cycles.
Implementing Changes to Achieve and Maintain Improvement.
The Social Aspects of Implementing a Change.
Key Points from Chapter Eight.
Chapter Nine: Spreading Improvements.
A Framework for Spread.
Phase for Organizational Readiness for Spread.
Phase for Developing an Initial Spread Plan.
Phase for Executing and Refi ning the Spread Plan.
Key Points from Chapter Nine.
Chapter Ten: Integrating Methods for the Improvement of Value.
Eliminating Quality Problems.
Reducing Costs While Maintaining or Improving Quality.
Expanding the Expectations of Customers to Increase Demand.
Developing an Environment Conducive to the Improvement of Value.
Key Points from Chapter Ten.
Chapter Eleven: Improving Large or Complex Systems.
Project Setup and Management.
Understanding the System and Developing High-Impact Changes.
Testing and Learning Systems.
Key Points from Chapter Eleven.
Chapter Twelve: Case Studies of Improvement Efforts.
Case Study 1: Reducing the Occurrence of No-Fault-Found Components.
Case Study 2: Improving the Drill Process.
Case Study 3: Reducing Infection and Mortality Rates in a Pediatric Intensive Care Unit.
Case Study 4: Improving Safety at a Manufacturing Plant.
Case Study 5: Improving the Credentialing Process at CareOregon.
Case Study 6: Improving Sales at a Specialty Chemical Company.
Key Points from Chapter Twelve.
PART THREE: IMPROVING VALUE AS A BUSINESS STRATEGY.
Chapter Thirteen: Making the Improvement of Value a Business Strategy.
Building the System of Improvement.
Key Points from Chapter Thirteen.
Chapter Fourteen: Developing Improvement Capability.
Developing Improvement Capability in the Workforce.
Organization to Support the Focus on Improvement.
Development of Other Capabilities.
Key Points from Chapter Fourteen.
Sample Agendas for Getting Started, Sponsors, and Improvement Advisors.
Development of Internal Improvement Advisors: Topical Agenda.
Appendix A: A Resource Guide to Change Concepts.
How to Use Change Concepts.
The Change Concepts.
Appendix B: Tools and Methods to Support Improvement.
Methods and Tools for Viewing Systems and Processes.
Methods and Tools for Gathering Information.
Methods and Tools for Organizing Information.
Methods and Tools for Understanding Variation.
Methods and Tools for Understanding Relationships.
Methods and Tools for Project Management.
Standard Forms for Improvement Projects.
Appendix C: The Model for Improvement and Other Roadmaps.
Fundamental Questions for Improvement.
Alternative Roadmaps for Improvement Projects.