Løs problemerne før de opstår

How to get out of the cycle of reacting to problems, so you can go upstream to fix the systemic issues that beget them?

Af Simon Tulloch, psykolog, chefkonsulent, Dansk Selskab for Patientsikkerhed

Have you ever heard the quote by Paul Batalden: “Every system is perfectly designed to get the results it get”, and thought, that’s nice, but how can I apply that maxim to my team, department or organisation? Perhaps the latest book by Dan Heath called ‘Upstream; the quest to solve problems before they happen’ may be for you.

Gratis webinar med Dan Heath

The book takes the reader on a ‘user friendly’ journey through examples and evidence of how one can overcome the challenges in your system by exploring and understanding the factors that led to these challenges.

Heath uses the parable of children drowning in a river to unfold the key message, i.e. two campers jump into a river to save a drowning child…only to see another struggling child drift by….and then another.  One of the campers starts to walk away when the remaining camper demands to know where he is going.  The answer: “I’m going upstream to tackle the guy who is throwing all these kids in the water.” Heath states that this is the spirit of the book. Is it possible to get out of the cycle of constantly reacting to problems, and go upstream to fix the systemic issues that beget them?

Mere om bogen på Heath Brothers hjemmeside

In the book, Heath explores some of the psychological factors that push us downstream, such as ‘Problem Blindness’, ‘Lack of Ownership’ and ‘Tunneling’ (which relates to resource scarcity or ‘limited mental bandwidth’), and sets-out seven questions to help us move upstream:

  1. How will you unite the right people?
  • Maintain a ‘big tent’ and surround the problem with the right people.
  • Use data for learning: “Grounding an effort in concrete data is the only way to unlock a solution to a major problem.”
  1. How will you change the system?
  • Remember – ‘Every system is perfectly designed to get the results it gets’
  • “Upstream work is about reducing the probability that problems will happen, and for that reason, the work must culminate in systems change.”
  1. Where can you find a point of leverage?
  • To get systems to change, you must start somewhere. So, find a point of leverage by immersing yourself in the problem and look at all the factors.
  • Chances are you can target a small population, event, data set.
  1. How will you get early warning of the problem?
  • Look for historical patterns to inform your predictions so you have more room to fix it.
  1. How will you know that you’re succeeding?
  • Beware of “ghost victories” or those who try to game the system.
  • Short term measures must be appropriate steps towards the long-term goal.
  1. How will you avoid doing harm?
  • Look beyond the immediate win; you’re in the long game.
  • Create closed feedback loops to continuously improve.
  1. Who will pay for what does not happen?
  • Where are the costly problems?
  • Who is in the best position to prevent these problems?
  • How do you create incentives for them to do so?

As with all Heath Brothers material, there are resources to accompany the book on their website https://heathbrothers.com/books/upstream/ and Dan Heath is delivering a free online webinar and Q&A session on October 20 (sign up here: webinar)


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5. oktober 2020

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