- Make the work problem-specific and user-centered.
It starts with a single question: “What specifically is the problem we are trying to solve?” It enlivens a co-development orientation: engage key participants early and often.
- Variation in performance is the core problem to address.
The critical issue is not what works, but rather what works, for whom and under what set of conditions. Aim to advance efficacy reliably at scale.
- See the system that produces the current outcomes.
It is hard to improve what you do not fully understand. Go and see how local conditions shape work processes. Make your hypotheses for change public and clear.
- We cannot improve at scale what we cannot measure.
Embed measures of key outcomes and processes to track if change is an improvement. We intervene in complex organizations. Anticipate unintended consequences and measure these too.
- Anchor practice improvement in disciplined inquiry.
Engage rapid cycles of Plan, Do, Study, Act (PDSA) to learn fast, fail fast, and improve quickly. That failures may occur is not the problem; that we fail to learn from them is.
- Accelerate improvements through networked communities.
Embrace the wisdom of crowds. We can accomplish more together than even the best of us can accomplish alone.