The stakes are high for this program. As any physician will tell you, physician burden and frustration levels are real. Programs designed to improve often distract. Done poorly, measures are divorced from how physicians practice and add to the cynicism that people who build these programs just don’t get it. Over the next several months, we will be rolling out details, but for now a couple of themes. At its core, we need to simplify. We have the opportunity to sunset three old programs and align them together in a single new program. That program needs to be streamlined and simple to use so physicians can focus where they need to – on their patients. Comments of CMS Acting Administrator Andy Slavitt at the J.P. Morgan Annual Health Care Conference, Jan. 11, 2016.

Does this sound familiar?  After 20+ years in government and another 10+ years in industry it sure does.  We try so hard to improve things but we almost always make the same mistakes when doing it.  Then when it doesn’t work, when we finally admit it doesn’t work, we go back and do it again, using the same old approach that took us to this failure in the first place.

How do we break the cycle?  Do we again go about “rolling out detail over the next several months”?  How about “aligning them together in a single new program?”  None of these strike me as a way we ever fixed problems like this.  Later on in the talk it says they are talking to the physicians so they’ll finally get it all right.  They didn’t talk to the physicians originally?  Probably they did.  So what is going to happen differently this time?

More on how to break the cycle Seven Ways To Make That “Silver Bullet” Work

Every time we’ve broken the cycle and finally successfully launched a program or improved an organization it was from the inside out.  It was never directed and fixed from the top down.  It almost always leveraged something that was already going on within the organization, usually by a small group of people — that were not part of some inner or privileged circle of people (such as those that cluster around senior managers).

Also see The Leap From Mediocrity To The Exceptional Is Shorter Than We Think

One of the most satisfying approaches was when we took our “top down” authority and instead of telling everyone what to do and how to do it we simply implemented a service where we would help people to improve towards the existing goals.  Three years of failing, where we restarted the effort every six months, including using one million dollar a year consultants,  was pretty much solved in just nine months.

For details see Don’t Project Manage Change — Provide A Service!

When we find ourselves constantly trying and constantly not succeeding we need to look hard at doing something different.  Really different.   Really different means that it will often be uncomfortable and often appear career limiting.  The good news is or at least the humorous part is that when we finally succeed we’ll hear people say that what we did was the obvious thing to do.  

For examples see Disrupt The Project To Make The Big Improvements and Success Is Often Counter To What Everyone Else Is Doing

What are you doing in your project that will really make a difference this time and not just be another distraction?