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  • Susan Snedaker

Small Changes Make a Big Difference

I was talking with my colleague and Lean expert, Ron Bercaw, recently. He told me a story about working with a primary care provider who complained that he never had enough time, he was spending too much time after hours finishing up paperwork and he was burned out.


Ron suggested a few small changes to this physician’s practice patterns. After just a week or two of trying out these minor changes, the physician called Ron exclaiming that for the first time in years, he had gone home on time and not had work to do in the evening.

As Ron told me the story, I thought about a parallel story in my career when I was a new director and was struggling to manage an employee. This employee was smart, dedicated and had been newly promoted and he was failing miserably. Everything I was doing was failing to make any difference.


A consultant, Lorraine Gutsche, asked me if I would be willing to make a few minor changes to the way I managed this employee. Fearing it might be a trick, I hedged and said “maybe.” After she suggested the small changes, I committed to modifying these few minor behaviors (of mine). Within weeks, this failing employee was headed in the right direction and ended up becoming one of my star employees.


In thinking about these scenarios recently, I was reminded of the power of small change.

Anyone embarking on a lifestyle change (stop smoking, eat better, exercise more….) knows that the greatest success comes from making the smallest changes and sustaining them. Why it’s easier to form bad habits than good I’ll never know, but the reality is that good habits can be built by incrementally small changes sustained over time.

That brings me back to healthcare IT.


It’s tempting to "swing for the fences", to try to drive change that will “move the dial” or “change the game”. We sometimes find success in these big efforts. However, these moments don’t frequently come around, but we have the opportunity in a daily, even hourly, basis to make small improvements.

So, the challenge is to look with a new perspective at the work we do and find opportunities for small, continuous improvement. To use a phrase I heard some years back while attending a workshop at Canyon Ranch (thank you, Gary!), make the change “laughably small” – so small that if you were to tell someone the change you were making, they would laugh.


Want to improve the quality of your testing process? Create one testing script. Laughably small.

Want to improve the server hardening process? Create one checklist. Laughably small.

Take a look at your world and see where you might make small adjustments for big improvements. Ultimately, these are more sustainable and far less taxing to implement and sustain.

The power of small, sustained change is often underestimated ,and certainly undervalued, because it lacks the power of "wow".

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