The 5 Stages of Data Denial
Your next data driven discovery will be challenged.
In 2009 I attended a session on healthcare intelligence titled, "Health Data, Indicators and Rankings: What do they matter, what do they measure?" The title itself is catchy - and the content proved quite valuable (and also entertaining at times).
Dr. Brian Postl, CEO of the Winnipeg Regional Health Authority spoke on Winnipeg's approach to leveraging data and driving change. Brain shares, you can't improve unless you change. I would also add that without the data it's awfully difficult to determine that direction for positive change.
Most of the data is used for mythbusting (yes, you can think of it like the MythBusters show on Discovery Channel). In the public sector (healthcare, education etc.) there are endless opinions on performance efficiency - but the cold hard data can settle the debate, right? Data cannot be refuted? Wrong. As I've learned, very wrong. Take a deep breath.
Users love data that supports what they are already doing. So give them some encouraging data they can hug and share. Build their love and trust for your intelligence. The challenge is to leverage data on areas that can be improved - and this is where your results will be challenged. Change often costs money, change is hard, change sometimes means admitting mistakes. In early BI scoping studies I find most departments claim they are the best at what they are doing - especially if funding is driven by performance and there is no intelligence to say otherwise... why not claim you're the best?
Anyone who works with data must understand the following: The use of data can be very devastating for the organization and the community to absorb, especially in a political context. Unfortunately, the only thing reported my media is those ranking below average. "No one shakes your hand for the 80% positive performance, but instead publicize the other 20%," says Brain. I believe data (accurate data) is truth, but do tread lightly and understand the implications of what you discover. Don't be surprised if you're the only one celebrating your find.
In healthcare, data is used for clinical and management accountability. Some nurses love data, they can't get enough of it. Most clinicians are analytically minded. Brain focuses on management accountability, saying they have the greatest ability to influence change in the system - and this is a key application of the data.
Over the past 20 years, every time the Winnipeg Health Region uses data for anything major they go through what Brian calls the 'stages of mourning' (which could be quite funny if it wasn't so damn painful, he noted). I have always remembered the 5 stages of data denial and believe they especially ring true in public sectors where comparisons, rankings, and growing data transparency is open for media and public scrutiny. Here they are!
The first response will be, 'Your data must be wrong, that doesn't reflect our performance. There must be a mistake here'. Instead of dissecting and justifying every data element, just ask, 'Is it at least in the ballpark?'. Recognizing the data is never precise enough, there may be something here that everyone can accept - enough motivation to take action and investigate further.
A classic response again. It may not include that last 5 minutes of operational performance, but honestly, how new does it have to be? Ask that question. In the public sector often the data collection itself takes time. Brain mentions that Winnipeg is now close to real-time data, but this question still comes up. Working with real-time data is necessary for true agile intelligence, but may not be necessary for high level trending.
3. We have already changed
That's great news! Now, can we at least demonstrate we've made the changes? At least at this point the organization has acknowledged there was a problem (maybe the data isn't far off after all) and they're trying to improve. Ask what changes have you made? How can we expect to see this reflected in the data? How are we measuring the effectiveness of these changes. All very valid questions to ask when you encounter this 3rd stage of data denial.
4. This is a different place
No one likes being challenged with comparison to a better performing organizing. In my healthcare experience I've learned never to deliver recommendations coupled with comparisons to other health regions without a clear understanding of how the characteristics of each region align. Very often one region will have a different demographic, and this needs to be taken into account.
With that said, how different are they? Help the organization find commonalities that support sharing and application of best practice. Claiming this a different place should not get them off the hook every time.
Many nurses, clinicians, teachers and other staff have been asked to change so many times they fear this is just another 'flavor of the month'. It can be hard to convince an organization to try changing, again, to improve performance after their last attempt was unsuccessful. The data might be able to help. With great depth to your intelligence there may be opportunities that were not recognized prior. This a perfect area to leverage a platform like QlikView to dig and explore the data.
Through this process you need patience, compromise and perhaps most of all, champions! Start with a small change, something you can measure, share and celebrate the success.
So next time you encounter a hurdles along the way, expect the 5 Stages of Data Denial. Plan for them and help everyone through each stage before the real change can begin.
Please leave comments below, share your opinions, your experience, your stories.
You can also connect with me on twitter @dHolowack. (see the Contact page link above)