IKEA effect for improvement projects

The IKEA effect is the tendency for people to place a disproportionately high value on objects that they assembled themselves, such as furniture from IKEA, regardless of the quality of the end result (Wikipedia definition).

Unfortunately the same effect appears in many improvement projects I encounter, no doubt due to the same issues. After the investment of over coming the complexities of getting the thing working, the emotions involved, the panics, the restarts, etc etc, it's inconceivable there could be anything better. It's also inconceivable to throw it away and start again or replace it within living memory.

If the project has a great result, then that's just perfect. However, where the result is less than good, it's this IKEA effect that comes into play and makes the problem difficult to resolve. It's also known as inventoritis - when we fall in love with our inventions and lose the ability to customise them on the basis of feedback.

Do check your improvement work today. IKEA effect?

Business learning from walking: 7. What to do when you reach your goal

Every project needs a plan of what to do when the project reaches its goal.

When I've finished a 14 mile walk I need to know how and where I'm going to rest my feet, dry off or warm up depending on the weather, going to get a meal etc.  The end of the walk is the not the end of the entire process. Just as I'm unlikely to organise a dinner party for the evening of a long walk, I'd like to know when I end a project that there's going to be a time of rest, recuperation and celebration.

Business learning from walking: 3. Never fear turning back or retracing your steps

I learnt an important lesson last week when walking on the Isle of Wight. Well, I learnt many lessons, but one of them was that sometimes it's easier to turn back and retrace your steps, than to go into unplanned territory.

We'd walked for a hour or so, it was hilly and we'd just headed down a steep hill that was so steep in places there were steps. Popping out between the hedges we realised something was wrong. After much deliberating and map checking, we had two options:( a) take a new, unplanned path that would get us back to where we wanted to be that was longer, less scenic and involved riskier road walking, or (b) hike the half mile back to the last decision point, even if it mean a steep 200ft climb back up the hill. After some whimpering and puffing from me, we got back on our planned track.

All change projects reach dead ends or go off track - often due to enthusiasm for trying new ideas. It's important to keep the goals in  mind and to assess any difficult situations. In my experience we tend not to have the courage to go back a few project steps and start again. Instead we blunder on and end up taking a longer and more tortuous route to get to where we need to be.  In future, I'll be asking more questions and keeping in mind the possibility of going backwards to go forwards.

Part of knowing when to turn back and when to go on is an important skill, and this is covered in the next post in this series.

Paper: Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

Ah, context. Context matters in healthcare interventions and so many improvement projects and similar interventions ignore context. This paper,  Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments, is important because it attempts to discover measures that influence interventions into account. The results are mixed.

"We identified 186 potentially relevant instruments, 152 of which were analysed to develop the taxonomy. Eighty-four instruments measured constructs relevant to primary care, with content measuring CQI implementation and use (19 instruments), organizational context (51 instruments), and individual factors (21 instruments). Forty-one instruments were included for full review. Development methods were often pragmatic, rather than systematic and theory-based, and evidence supporting measurement properties was limited."

Implementation Science 2012, 7:121