David Norris, MD, MBA

Ask These Seven Questions When Tackling Process Improvement

Sometimes systems or processes break or begin to fail. If they break suddenly, you're lucky – a sudden break makes it easier to find the root cause. When a system slowly fails, it can be very frustrating because finding the source for the failure can be challenging. Part of keeping a process or system in good working order is to monitor and maintain it consistently. If you're a leader of an OR, you know that nothing ever stays the same. If you want to lead successfully, you understand that maintenance is crucial.

Good change leaders ask good questions. They are always asking questions that will help them implement change or process improvement effectively. They do this so they can gain understanding and help those they lead understand the change, as well.

process improvement

Seven Questions to Ask When Tackling Process Improvement

If you've identified a broken or failing process in your organization, fixing it can be easier if you start with the right questions. Here are a few questions I ask as I approach any process improvement plan.

  1. Does this process support the mission and purpose of the organization?
  2. This is the first question I ask about any process improvement initiative. The question assumes, however, that you know and understand the mission and purpose of the organization. Understanding the mission and purpose will guide your decision-making; it's the organization's what and the why. It's what you do and why you do it. Once you have firmly established the mission and purpose, you can evaluate the process concerning the company's what and why. Does this process help move the company closer to achieving its mission and purpose? If so, how? If not, why? How well does it support the mission and purpose? Is this process required? Why are you using the process in question if the answer is no? Should you eliminate it? Always eliminate any process that does not support the mission and purpose of the company in some form or fashion.

  3. Does this process add value?
  4. If the process supports the mission and purpose, does it make a meaningful contribution to the company? If it's required, then how might you make it more meaningful? What is the value of the process to the company? This question focuses on the degree to which the process supports the company. The greater the support, the greater should be the effort invested in maintaining and improving the process.

  5. Is this process in control?
  6. Hopefully, any time a process is established, somebody has designated quality metrics that can gauge its success. If not, you've got your work cut out for you. How are you monitoring this process? What are your acceptable limits and tolerances? How did you establish those limits? How are you collecting the data about the process? Sometimes the process supports the organization and adds value but isn't in control. Errors and omissions occur, and things slip through the cracks. It is crucial, therefore, to determine the acceptable limits of your process and how you will monitor it. A sure way to make a process more valuable is to have it under control and within limits.

  7. Who owns this process?
  8. Who is responsible for it? Is it a single person or a group of people? If someone is responsible, how much control does that person have in determining how the process is implemented and improved? Nothing is more frustrating than using a process over which you have no control. Look for ways to give those people involved in and using the process some ownership and control over the process. Identify those who will own the process and define what they are responsible for. Make certain they understand their responsibilities and how they will be held accountable. Getting their buy-in will go a long way towards implementing your desired change.

  9. How visible does this process need to be?
  10. Is this a customer-facing process or a back-office process? Which would provide greater efficiency? Which would offer more significant customer satisfaction? Let's face it; there are some processes the customer doesn't want or need to see. Hot dogs can be delicious, but the customer doesn't need to see how they are made. Similarly, patients and surgeons don’t care how the surgical supplies get to the hospital. They just want those supplies to be ready and available for their procedures. Many times, our processes aren't designed with the customer in mind. Plan out which processes the customer should witness and which should be tucked away in the back. Which of your processes should be visible to the customer, and which don't they need to see?

  11. How efficient is this process?
  12. How well does the process do what it is intended to do? How simple can you make it? What steps can you remove? The less complex a process is, the easier it will be for your people to use it. Simplifying a process will help reduce errors and make it easier for you and those responsible for it to manage it.

  13. How can we improve this process?
  14. What steps can you remove, add, or modify to improve this process? Continuous improvement should be your goal. How can you make this process better? And as you begin to improve the process, start with the very first question above and begin all over again.

Always ask questions to ensure you make the most effective and consequential changes to a process in your organization. Never assume you know all the answers, and always ask good questions. Involve those individuals who are using the process you're trying to fix. Use the questions outlined above to make your process improvement and change management jobs easier.

About the Author

David Norris, MD, MBA is a practicing anesthesiologist who is dedicated to improving the business intelligence of all healthcare providers. As an author, speaker, and teacher, he helps other providers develop the practice they desire. And as someone who is passionate about enabling physicians to deliver quality care in an efficient manner, David is proud to serve on PrefTech's board of advisors. You can learn more about David at