The Great Divide

What is the great divide between “the art of management” and “the science of management”? We get a clue in the December 10, 2007 issue of The New Yorker. In The Checklist, Atul Gawande explains how one doctor is radically changing medicine by improving the processes that doctors, nurses and specialists are engaged in everyday. For example, a checklist used in ICU reduced line infection rates from eleven percent to zero. Think zero defects in manufacturing. Part of a study done in ICUs found that an average of 178 procedures are completed on a patient. Inserting a line is only one of those steps. What else could go wrong?

Read the entire article and get it in the hands of others. It is compelling. It also helps quell the riot of that standard work stuff doesn’t work here mantra. If standard work can be effective in hospitals where an ICU team will face 1 over 32,000 possible combinations of procedures for every patient with on average of 178 steps for each combinations, then it can standard work will work for us in manufacturing.

This article reads like it was plucked from the newest lean manufacturing book. Take for example the quote from the subject of the article, Peter Pronovost,

“The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is insuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government and academia. It’s viewed as the art of medicine. That’s a mistake, a huge mistake.”

How many people out there think that what they do is more art than science? The fact is, it just feels like an art when everything works well. We just don’t see the pattern of repeatability in what we do. Whether it is the nurse feeling for a vein, an artist feeling the correct brush stroke, an mechanic setting the right torque, or an operator lifting something safely, there is definite and correct technique that produces a unique result.

In management, how often have you heard that management is an art, not a science? Isn’t it time we put that old horse to rest? Is the great divide between art and science then the concept of process improvement thinking?

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