Going Through the Motions: An Empirical Test of Management Involvement in Process Improvement
Executive Summary — How can managers better lead their organizations to improve work processes? Describing their study of hospitals over an 18-month period, HBS professor Anita L. Tucker and Harvard School of Public Health professor Sara J. Singer detail how and why managers' taking action was more effective than their communicating about actions taken. Findings suggest, first, that taking action on known problems in specific work areas on at least a quarterly basis may improve the organizational climate for improvement. Second, the study indicates that managers would be well advised to take action-preferably substantive and intense action-in response to frontline workers' communications about problems. Overall, the research provides insight for senior managers who want to improve their organization's climate for process improvement. Key concepts include:
- Resolving a small number of problems is better than collecting data about many problems.
- Giving feedback to employees about actions taken can worsen their perceptions of the climate for improvement if the actions were superficial or punitive. In other words, managers do not fool frontline workers by going through the motions of process improvement.
- The risk of surfacing a large number of problems is twofold: (1) identifying many problems simultaneously may overwhelm people with a new awareness of the full extent of problems within the organization, complicating and slowing decision processes and spreading already-stretched resources, and (2) it may reinforce cynicism among frontline workers that managers are uncommitted to improving the organizations' work systems.
Managers play a critical role in process improvement. However, research has found that many improvement efforts fail due to insufficient management involvement. Less is known, however, about mechanisms to foster managers' involvement and their impact on organizational climate, which predicts successful outcomes. We addressed this gap with a field experiment suggested by Toyota's problem-solving process. We tested three related process improvement activities: (1) interacting with workers to learn about problems, (2) ensuring that action is taken to address the problems, and (3) communicating about actions taken. Sixty-nine randomly selected hospitals, 20 of which were randomly selected to engage in the three activities for 18-months, participated in the experiment. Survey results showed that identifying problems had a negative impact on organizational climate while taking action had a positive impact. Results suggest that solving problems as they arise (e.g. Toyota's approach) with intense and substantive actions is more productive than gathering information about large numbers of potential problems to solve (e.g. incident reporting systems). Providing feedback about actions taken negatively impacted frontline workers' perceptions. Qualitative results suggest that communication can backfire when managers go through the motions of process improvement activities without making a sincere effort to resolve staff concerns. Keywords: process improvement, hospitals, Toyota Production System, management, field experiment, safety. 35 pages.