QualiTea: Episode 1 - TRIZ

Join Becca Lunn and Sarah White from Health Innovation West of England's Academy team for the first episode of QualiTea.

So what is QualiTea? Quite simply, it's time for a cup of tea and a useful conversation. Each episode is a short, informal chat between Sarah and Becca, focusing on one simple improvement tool. They'll use relatable examples and talk about how you might actually use it in your day-to-day work to help you think a bit differently about a problem. Not in theory, in real life. 

In this episode, we're looking at TRIZ - one of Sarah's favourite facilitation tools and which, according to Becca, gives you the chance to let your evil genius out of the bag!

So grab a brew, get comfortable, and let's get started.

Programme notes

Watch our video about TRIZ

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Transcript

Becca Hi, I'm Becca, and I'm here with Sarah. Between us, we run a lot of the West of England Academy sessions and programmes around improvement, leadership and change in the NHS. QualiTea is exactly what it sounds like. A cup of tea and a useful conversation. These are short, informal podcasts, around fifteen minutes each, each focusing on one simple improvement tool. We'll use relatable examples and talk about how you might actually use it in your day-to-day work. Not in theory, in real life. Think of it as a calm, practical chat to help you think a bit differently about a problem. So grab a brew, get comfortable, and let's get started.

Sarah And today we're going to be talking about one of my favorite tools in facilitation, and that's TRIZ. Some of you may have heard of and I get asked quite a lot what TRIZ stands for. so it's a Russian acronym Um, I am going to try and give you the Russian though, because people often ask and it is and I apologies to all Russian speakers out there and non-Russian speakers. Actually, it's Teoriya Resheniya Izobretatelskikh Zadatch, or the theory of inventive problem solving.

Becca That was brilliant, Sarah. I'm very impressed. 

Sarah Thank you.

Becca So what is TRIZ? What does it actually do?

Sarah So what it actually does is it's one of the quality improvement tools that we use quite a lot. And it and it does something a bit backwards. So instead of asking how do we fix this, it asks how would you spectacularly break this? And this is really good because if you start by designing from the worst possible version of whatever you're dealing with and come up with the most painful, inefficient, soul destroying version you can possibly imagine, you can start to be quite creative. And then you can look at the list of all the things that could go wrong and say, which bits are we actually already doing? And that's kind of where the magic happens, because once you can see how or where you're accidentally making things harder, improvements become much more obvious and much more practical. And it's crucially not about blaming people. It's really about having a bit of a laugh at the broken systems and then using that to work out what we can do differently and what we can stop doing altogether.

Becca Okay, that sounds really, really good. Can we give an example? So, let's choose meetings.

Sarah Yes.

Becca So how how would we create the world's worst meeting? I mean, I might have actually already been in one this week, but

Sarah Ithink I think we can all relate to this example.

Becca I think we I think we could go further. I think we could make it worse. So let me throw something in. Let's, let's invite too many people and not have a room booked

Sarah Yeah.

Becca and make everyone do it in the the broom cupboard. it.

Sarah Yes. In their pants.

Becca Oh, okay. And you're only allowed to speak Russian, obviously.

Sarah Yes.

Becca Um, because this is TRIZ.

Sarah Andhave it on a Friday afternoon. Um, uh, sort of like maybe school picking up time.

Becca Yeah. Or just fifteen minutes before the end of the working day.

Sarah Oh, I have so many things on the agenda that you can't possibly get through all of them and then spend at least thirty minutes going through the minutes of the last meeting.

Becca Yes. And make sure that that agenda only arrives in people's inboxes two minutes before the meeting starts.

Sarah And don't let anyone make any decisions. Always move that into the next meeting.

Becca Absolutely. Um, I think we could start with a wildly inappropriate icebreaker.

Sarah Ah, yes.

Becca One that makes people feel incredibly uncomfortable.

Sarah Yes, but we could make the meeting inaccessible in lots of ways we could. We've already mentioned having it in a broom cupboard in a different language, but what happens if we did it in the dark as well? And used a lot of sign language?

Becca Yes. And technology should fail so that, you know, that really annoying that microphones can make or the double echo consistently throughout and perhaps the slides sort of strobing.

Sarah But you could do the slides backwards and then in a very sort of Shakespearean accent.

Becca Love that, love that. Um, I think also, if you're going to invite people into talk so experts to talk, um, ideally they should know nothing about the subject matter which they're speaking on. Um, I

Sarah I think

Becca also.

Sarah we've nailed it. I think

Becca No,

Sarah we've made

Becca no,

Sarah the meeting.

Becca No. We need people. Anyone who wants to speak has to do so through the medium of interpretive dance. And the minutes will be recorded as a haiku.

Sarah I like it. I like it a lot. Um, yes. So I that is, I think, possibly one of the worst meetings, uh, that we could possibly imagine. So what happens next with TRIZ? Well, this is the clever bit. So from that big list of things that could make it absolutely awful, you can look at some of the things that you're accidentally doing. Um, so we obviously talked about, uh, you know, holding it in a broom cupboard. Uh, but some issues around accessibility. Are the rooms appropriate? Sometimes when you've been in a, if you go to a very long meeting in a very dark room, it can be really unmotivating. So what you do once you've generated your list of, of ridiculous things is to look at them and say, actually, which parts are we already doing? Um, so it's it's flipping it. It's instead of saying, well, you could have no agenda or an agenda that goes on forever. You can say, well, perhaps the agenda does need to look at is it overburdened? Um, and what that can do is really sort of help people to look at the process rather than look at individuals. So they're looking at the wider pictures.

Becca Yes. And it also feels quite a safe way for a team to maybe slot in amongst those hilarious suggestions. Some of the things that they genuinely feel are annoying them and aren't working. And I like it because as you said, you're not blaming individuals, you're criticizing the process. And I feel like that helps people to step away and not take it as a personal attack.

Sarah I did run this with a group once, and one of the people was saying was saying that, um, what was really good about it was it allowed him to, to, uh, unleash his inner supervillain. And that felt really liberating and almost through that persona, he was able to sort of criticize the process in a really robust way because he was being the supervillain, and that was what was asked of him. And that felt really good. Tris gives people the permission, really, to have a bit of fun, wrap it up in a bit of humour, but actually land the points that need to be landed.

Becca Yeah. And I think it's a really useful tool to use with a team who are perhaps being really negative about a change that you are trying to implement or get them on board with. So if you are faced with a lot of, uh, yeah, we can't do that because. Yeah, but that will never work. This can help people get out all of their negativity and actually help them get to the point where they are able to think about how to make things better.

Sarah And the good thing about TRIZ is that, as you've just seen, you can do it really quickly. It's not something you have to spend a lot of time on. It's a very quick tool that can surface some of those things really, really quickly. and it also stops people jumping straight to the solution. Oh, what we need is it makes them focus on all of the things that that could make a situation really, really bad rather than, than going, well, actually, how we fix this is this way.

Becca We've got an example where we really should have used TRIZ. So it would have been perfect. we were looking at a discharge process from hospital to community. And as part of that, a form had been created that gathered all of the information from the whole of the multidisciplinary team about um patients before they left the hospital.

Sarah remember this one. And that form was, shall we say, ambitious. It was asking for absolutely everything. So it wanted clinical details, social support. It was even down to things like the type of hob that the patient had at home. Every nurse, physio and OT occupational therapist was expected to fill it in even though they hadn't seen the patient, so it was incredibly complex.

Becca I mean, the idea was sensible because they wanted to get adequate information to be able to support that patient having a safe discharge home. But the reality we found out was that the community staff didn't even read the information because it wasn't helpful to them. So all of that effort put put into those long form questions and answers and repeated kind of entries and back and forth. Um, not to mention the terrible formatting was basically a waste of the acute staff's time, and it was building into delays. Um, and a considerable amount of resentment, I seem to remember.

Sarah Yes. And I think you're right. If we'd applied TRIZ at that point, we could have asked, how could we possibly make this this process worse? And how can we make it more painful and more inefficient? and I think that I don't know how they could have got any further than the form they actually used. But I think the idea of flipping it so that they were able to look at, look at the complexity of what they were doing, take it apart and become a little bit ridiculous about it. You know, why are we asking about a patient's hob? Um, you know how many people need to know that? Does it need to be on this form? Um, then if they'd been allowed to sort of do that then and include everybody in that process, and then they would be able to test it, change it, test it again, and really sort of have that rich discussion about what they were doing and how much time they were wasting.

Becca Yeah, absolutely. And I think because it had taken them so much time and effort to finalize that form once it was in place, everybody just used it. Despite all of the frustrations and the delays it caused. Essentially, it was a bit like someone had run a TRIZ exercise without realizing it and then kept the nightmare version.

Sarah Yes. And so the takeaway from this is that TRIZ isn't just a sort of chaos tool for for fun. it can be used in real life situations to really sort of have those difficult conversations and to sort of highlight inefficiencies, and make the right improvements more obvious. And, you know, also the quick wins. We talk about quick wins a lot, but if you can really look at something like that and say, which bits are we already doing, can we stop? That's just about stopping doing something. Um, so used in the right setting and used thoughtfully. TRIZ is a really useful tool. it can save time, and can really help clinical teams.

Becca So if anyone's listening and thinking, oh, I might try this, here's a really simple way to do it. So step one, you just need to name the thing that you want to improve, be it meetings, referrals, whatever. And step two ask that question how could we make this fail spectacularly? And then step three let people's evil geniuses out of the bag. Let them list all of their terrible ideas, get them down on post-its, stick them all down, encourage a little bit of dark humoru, and then step four take a step back. Look at that list and ask yourself really honestly, which of these are we doing? If even if it's just a little bit. And then step five, flip those things into clear practical actions that you can stop or start doing. And that's it. No complicated templates required. Sarah  And so yeah, next time you're stuck, or if your team is going around in endless circles, maybe try a ten minute TRIZ Put the kettle on, pull up a chair and ask them how they would break the system and see what falls out of that conversation. And it might surprise you how quickly some of the issues show up. And if you want more tools like TRIZ, that's exactly the kind of thing that we share through the Academy.

Sarah So look at our website or speak to us directly. And there are also links in the programme notes. Right. Tea's gone cold, which is probably a sign that we should stop talking. Thanks for listening.

Becca Thank you very much everyone and we will see you for our next QualiTea session.