One change at a time

In the NIATx model of process improvement, change teams use rapid-cycle testing to test and measure one small change at a time.

If you make multiple changes at once, you won’t know which one worked, so you’ll be wasting time and effort doing two things differently instead of one. When you analyze the results of the test period, you want to know for sure that any improvement (or deterioration) from baseline is almost certainly due to the single change you were testing. For example, let’s say that you are ready to start rapid-cycle testing changes that you hope will reduce waiting time. You come up with two changes that seem promising: double-booking appointments and allowing walk-ins. During the first test, you decide to institute both these new changes for a couple days. The problem here is that whatever the outcome, positive, negative, or neutral, you won’t know which factor is responsible. On the other hand, if you give each of these two changes its own separate test period, you’ll know for sure whether each one helps or hinders your cause. You need to do this for each change, even if you are testing a promising practice, because what worked for someone else may not work for your organization.

Essentially, the key here is patience. Even if you’re sure that all of your ideas for change will yield great results, test them individually. Then you can start a new test cycle in which you test the successful changes together and make sure that the improvement sticks. When you keep you change cycles short, you’ll get to all your ideas within a brief time.

From The NIATx Model: Process Improvement in Behavioral Health (2011)