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Abstract
Problem-solving in organizational contexts occurs on two levels. In first-order problem-solving, problem solvers address the immediate problem at hand; while in second-order problem-solving, they seek the problem's root cause to prevent recurrence. Research in organizational problem-solving has found that second-order problem-solving is quite rare in practice. As part of an action research project in a mid-sized hospital, we introduced a problem-solving metaroutine (called the "A3 Process") to aid second-order problem-solving. Data are presented that demonstrate a significant increase in problem-solving effectiveness when all steps of the metaroutine were followed versus when one or more steps were skipped.
Keywords
Organizational problem-solving, metaroutines, healthcare.
1. Introduction
A good deal of research has addressed the topic of how to deal with process-related problems to produce sustainable change. For years scholars have asserted that effectiveness improves dramatically when organizational members go beyond short-term measures to resolve a problem, and to investigate the process critically and jointly to find and address the root causes [1]. Yet, Feigenbaum [2] reports rarity in applying the second step, and it appears that the trend persists even today [3] [4]. Organizations, therefore, continue to find sustainable change of work systems a significant challenge. The healthcare sector in particular continues to grapple with such systemic issues [5].
The organizational routines that result in short-term fixes to operational problems have been termed "first-order problem solving." For example, a nurse who detects a shortage of a medical supply in the supplies closet may enact any number of routines - asking others, looking in other places or borrowing from another department - to minimize the interruption in patient care. If the nurse stops there, the immediate crisis may be resolved, but the same scenario will likely recur because the root cause(s) to the problem have not been addressed. If, on the other hand, the nurse/nursing team investigates why the stock out occurred and implements countermeasures to prevent recurrence, the result would be a more long-term solution to the problem (i.e., a sustainable change) that improves operational performance. Researchers term the organizational routines that produce these higher levels of insight, and thus sustainable improvement, as "second-order problem solving."
We argue that effective metaroutines can facilitate second-order problem solving to produce sustainable change and therefore continuous improvement within...