How a Fishbone Can Help You Eat Your Veggies

By Ulfat Shaikh, MD

Originally posted on February 1, 2014

February is here and it is possible that a few of you, like me, are already rethinking your new year’s resolutions. What seemed a month ago like a sure-fire plan to lose 10 pounds, exercise more, eat healthier, or manage ones finances, now seems a little more suspect. Let’s view this bump in the road, not as a reason for despair, but an opportunity for improvement.

I teach a class on health care quality called “Personal Quality Improvement”. The class incorporates process improvement techniques to handle exactly these sorts of relapses.

Students come into class with a personal lifestyle aim. They share their aims with the group and then work together to make the aim SMART (Specific, Measurable, Achievable, Realistic, and Time-bound), or SMARTer. They select metrics to help them measure their baseline performance and to track how they are doing. Students select a small handful of changes they want to make over the next 6 months. And then they plan a couple of Plan-Do-Study-Act cycles.

Along the way students learn about fun quality improvement tools on the job – whether it is a flow diagram to help them figure out why they are late for work every day, a root cause analysis using a fishbone diagram to understand the reasons for their not exercising, or a run chart to help them track how many fruits and vegetables they eat every day.

Process improvement geek heaven, I know!

Over the years, quite a few people have written about the concept of using quality management to help solve all sorts of life’s little issues. In their 1993 book, Quality Is Personal: A Foundation for Total Quality Management, Roberts and Sergesketter look at how Total Quality Management principles apply to individual self-improvement and reduce waste and non-value added activities at work.

My own go-to resource, The Improvement Guide: A Practical Approach to Enhancing Organizational Performance, elegantly demonstrates how quality improvement tools can be used to start and end meetings on time. And I have personally used these principles to respond in a timelier manner to e-mails, although I do unfortunately still experience frequent lapses and a full in-box. In The Personal Continuous Quality Improvement Work Book, Neuhauser and his colleagues walk learners through quality tools to improve aspects of their lives, be it watching less television or enhancing study habits.

So the next time you see an infomercial that claims to help you lose weight fast, sleep better or change your life, you might want to consider holding on to your money and trying some of these performance improvement techniques for free.

ShaikhUlfat Shaikh, MD, MPH, MS is director of health care quality at the University of California Davis School of Medicine. She blogs about health care quality improvement at Pulse.

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