PRE103 MGMA 2015 Data Sanity: The Leadership Catalyst for Organizational
Excellence Preconference
Davis Balestracci
www.davisdatasanity.com
1
Supplement for Davis Balestracci’s 10/10 Seminar
Part 1: Transitioning your role to get the respect you deserve: a practical, realistic introduction to
cultural resistance / psychology for BOTH leaders and practitioners
Rationale
 Overall rationale framing today’s Minicourse
 Matthew E. May’s Seven Unshakable Truths about Projects
 Suggested reading (brief articles): Framing the day and its content
pp. 1-3
p. 3
p. 4
[live links]
Part 1: “Those darn humans!”






Three KEY Concepts
What am I going to “Stop…Start…Continue?”
What are you tolerating? – “Perfectly designed” for Dew’s “Root causes?”
Two leadership “wildcards” to create a quid-pro-quo
o Demotivators
o Peter Block’s “Employee Manifesto”
Quotes used during talk
Highly recommended readings: Creating a culture of excellence
Part 2: Data Sanity
p. 5
p. 6
p. 6
pp. 7-9
pp. 9-10
pp. 10-11
pp. 11-16
Guiding Wisdom to Create a Culture of Excellence
STOP TOLERATING!
Any good quality management system is the sum of the decisions made within it…Each time we choose to
sacrifice the good of the system for one person, or allow an ineffective, outdated legacy practice to continue,
we take small steps toward lower and lower standards.
When we have a culture that puts quality and environmental attainment at a lower priority than feelings and
keeping the status quo, slowly we make the hundreds of decisions that eat away at total performance.
Over time, harmless little decisions can derail a quality management system.
-- Jim Verzino
============================================================
ENOUGH!
Enough of attending meetings that lead to building a bridge to nowhere, enough of asking what I'm supposed
to ask rather than what needs to be asked, enough of praising people who are undeserving of praise, enough
of valuing form over substance, enough of accepting good when what is needed is outstanding, enough of
enabling people to act as victims when they need to take personal responsibility.
Inevitably, this kind of shift doesn't happen unless a substantial number of leaders put their collective foot down
and say “Enough!” in unison. - - Mariela Dabbah
=========================================================================
Overall Rationale for Today’s Approach: Excerpts from Introduction to Data Sanity
As so many of us have painfully discovered, true progress can seem virtually glacial. The time has come
for people in improvement roles to be far more pro-active in working cooperatively in true partnership with
boards, executive management, and physician leadership in addition to staff. “Data Sanity” is both a catalyst
and conduit to do this. It demonstrates a new way of thinking via a common organizational language based in
process and understanding variation to motivate more productive daily conversations…for everyone. Most of
you will find this suggested innovative roadmap quite challenging; but the rewards awaiting you are many.
Davis Balestracci
www.davisdatasanity.com
2
DATA INSANITY CONTINUES UNABATED
The rampant waste caused by poor everyday organizational use of data continues. Many high level
executives have no idea of the vast potential that exists to have their organizations take “a quantum leap to
unprecedented results” through the common language alluded to in the last section. I call it “data sanity” –
new, more productive conversations in reaction to the everyday use of data and the resulting meetings and
actions.
In executives’ defense, given their experiences with business school statistics courses and the statistics
taught by the consulting groups many hire, I must say this lack of awareness truly isn’t their fault! It’s time for
people routinely working in improvement to own this, stop the excuses, stop training that is nothing short of
legalized torture, stop tolerating the executive attitude of “give me the 10-minute overview,” and do something
(else) about changing their perceptions of improvement and, especially, statistics.
To be fair, many people in improvement have had the exact same experiences with statistics in required
courses, on-line belt training, and project facilitation training. They are naively passing on the only experience
they know. All of this is the wrong focus – and the wrong material. Implicit in these is an approach that is “bolton” to the current ways of doing work.
Regardlesss, as the minicourse will demonstrate: Whether or not people understand statistics, they
are already using statistics.
According to Mark Graham Brown, proper organizational use of data has the potential to reduce senior
management meeting time by 50 percent and eliminate one hour of a middle manager’s time every day poring
over useless operational data reports (60% of which are waste) – Time that can then be spent on
organizational transformation and generating more time for your front-line to do what it likes best – patient
care.
IT COULDN’T BE SIMPLER: “PLOT THE DOTS” AND WATCH THE CONVERSATIONS CHANGE
Statistical training needs major surgery. It should no longer teach people statistics, but instead teach them
how to solve their problems…and make lasting improvements by thinking critically.
Data Sanity is an intriguing alternative that can be hardwired or “built-in” to your current culture. All it
requires of participants are the abilities to: (1) plot data in its naturally occurring time order, (2) count to eight,
(3) subtract two numbers (this “advanced” technique could involve some borrowing), (4) sort a list of numbers,
(5) use simple multiplication and addition, and, most important, (6) think critically, which is missing in most
training.
It is time for boards, executives, and middle management (and improvement professionals!) to discover
the unknown and untapped power of some basic tools that will cause a profound change in
conversations…and results. One must learn how to stop boring these powerful people to death and, instead,
become willing allies in getting them desired results beyond their wildest dreams.
Leaders can no longer continue to abdicate their responsibility for learning basic methods for routinely
understanding and dealing with variation. And it’s also time for promotions to reflect a person’s willingness to
use them routinely, be successful with them, and teach them to their direct reports.
THERE IS NO “MAGIC BULLET”
Be careful: Books and consultants continue to try their best to seduce you with (ultimately disappointing)
easy answers, templates, and fancy Japanese words. I promise you realistic, practical answers that may not
initially seem easy, but will address deep causes, get your desired results and hold these gains…if you have
the wherewithal to learn and apply a new “belief system” to your daily work..
At this moment, a technique called “rapid cycle PDSA”(Plan-Do-Study-Act) is ubiquitously being touted as
the “cure all” – and it might be…if used in conjunction with good critical thinking skills. If any of you have tried
it and are frustrated, you have good reason – and it’s called “human variation.” It’s also time to take a realistic
view of the “bolt-on” teams using rapid cycle PDSA and their inevitable problems that we’ve all experienced,
both as members and facilitators.
My respected colleague Ron Snee cites six common mistakes continue to be made despite what has
been learned in the last 30 years:
Davis Balestracci
www.davisdatasanity.com
3

Failing to design improvement approaches that require the active involvement of top management

Focusing on training rather than improvement

Failing to use top talent to conduct improvement initiatives

Failing to build the supporting infrastructure, including personnel skilled in improvement and
management systems to guide improvement

Failing to work on the right projects—those that deliver significant bottom-line results

Failing to plan for sustaining the improvements at the beginning of the initiative
I remain more convinced than ever that any solid improvement theory comes from the late W. Edwards
Deming’s teachings. The basic tools and statistical theory underlying them have barely changed since his
death in 1993. If anything, I have made their applications even simpler.
I agree with Snee’s observations on the six mistakes above. My goal is to help you create organizational
cultures where the words “quality” and “statistical” are dropped as adjectives from programs because they are
“givens.” [And, by the way, YOU are the “top talent” to which Snee alludes!]
Improvement methods may come and go, but the need to improve performance and the bottom line never
goes out of style.
MY FINAL CHALLENGE: ARE YOU READY TO SAY “ENOUGH!” TO YOUR STATUS QUO?
The time is now to:
 manifest more effective executive engagement (and development),
 use everyday “data sanity” as a philosophy and conduit for organizational transformation,
 utilize data more deliberately and efficiently in improvement, and
 create an everyday culture of improvement through leadership where key results can be
hardwired and built-in to cultural DNA.
If you have read this far and are still intrigued and interested, then welcome, my newfound companion and
colleague, to a transformational journey. I hope you will respond to and learn from the many challenges that
await.
[Note: Data Sanity is used as a text in the Mayo Clinic improvement curriculum (scroll to 9:00 in the
following): https://www.youtube.com/watch?v=f-FbIA3ezBw&app=desktop ]
From Matthew E. May: Seven seemingly unshakable truths about projects

A major project is never completed on time, within budget, or with the original team, and it never
does exactly what it was supposed to.

Projects progress quickly until they become 85% complete. Then they remain 85% complete
forever - sort of like a home improvement project.

When things appear to be going well, you've overlooked something. When things can't get worse,
they will.

Project teams hate weekly progress reports because they so vividly manifest the lack of progress.

A carelessly planned project will take three times longer to complete than expected. A carefully
planned project will only take twice as long as expected.

The greater the project's technical complexity, the less you need a technician to manage it.

If you have too few people on a project, they can't solve the problems. If you have too many, they
create more problems than they can solve.
Davis Balestracci
www.davisdatasanity.com
4
Framing the day and its content: Creating a culture of excellence
In a nutshell, the three articles below frame my approach to improvement:

“Has the Pareto Principle Come Home to Roost”:
http://www.qualitydigest.com/inside/twitter-ed/pareto-principle-coming-home-roost.html

“The Sobering Reality of Beginner’s Mind” [Why I teach this to MBA students]
http://www.qualitydigest.com/inside/quality-insider-column/sobering-reality-beginner-s-mind.html

“Are You Becoming a ‘Qualicrat’?”
http://www.qualitydigest.com/inside/twitter-ed/are-you-becoming-qualicrat.html
Bottom line: Could what happened below still happen today at your organization? If so, what’s truly
changed? Addressing these types of issues is truly integrating improvement into organizational DNA:

Hacquebord, H. (1994). Health care from the perspective of a patient: Theories for improvement.
Quality Management in Health Care, 2(2)2, 68-75. [live link directly below] Note: 20 years old!
https://www.qualitydigest.com/IQedit/Images/Articles_and_Columns/December_2011/Special_Health/Heero_back
_surgery.pdf [actual article]
Back surgery experience insightfully observed entirely through the lens of improvement theory (specifically
Deming). Addressing the issues in this article would be true “improvement as DNA”!
http://archive.aweber.com/davis_book/K.sWM/h/From_Davis_Balestracci_Be.htm [Davis’s comments]
 A new definition of “personal accountability” (for culture…and us)
John Miller ( www.qbq.com ): QBQ: the Question Behind the Question
[Can be read < 1 hour. I use it as pre-reading for retreats]
Content overview (a HOOT!): http://www.youtube.com/watch?v=bdBwkOgww_Y
 Spitzer, D (1995). SuperMotivation. (AMACOM)
Summary plus link to survey:
http://www.qualitydigest.com/inside/quality-insider-column/another-deeply-hidden-lurking-cost.html
Hard reality of projects and teams…and PDSA [Are you in denial?]:

Activity is Not Necessarily Impact: FOCUS! [Work on “5-Star” projects]
[Wisdom of Matthew E. May]
http://archive.aweber.com/davis_book/EDHNT/h/From_Davis_Balestracci_.htm

“Quality Turf wars”: http://www.qualitydigest.com/oct97/html/cover.html [from 1997: still true? (YES!)]]
Davis has done extensive publishing of many “one-pager” and “one-to-two pager” articles on key concepts.
They are listed in this document on pages 15, 20 and 21 with “live” links directly to most articles.

I feel that follow-up reading using these BRIEF explanations of key concepts – written in the
conversational style in which I teach – will be more valuable.
Davis Balestracci
www.davisdatasanity.com
5
Three KEY Concepts
1. Improvement “Pyramid”
2. A-B-C Model for Human (AND
Organizational) Behavior
Most organizations are stuck here because
they think “logic” will be enough:
Engines need Fuel:
3. John Miller’s QBQ
Davis Balestracci
www.davisdatasanity.com
6
Davis Balestracci
www.davisdatasanity.com
7
“How are my B1 beliefs about my role challenged by this process?”
What are you Tolerating? Can you develop ZERO tolerance for these?
John Dew’s Seven True Root Causes(?)
•
Placing budgetary considerations ahead of quality,
o A1? Tolerating “Costs” vs. “the four Cs”
•
Placing schedule considerations ahead of quality,
o A1? Tolerating arbitrary goals and deadlines
•
Placing political considerations ahead of quality,
o A1? Tolerating manipulation for personal gain
•
[A1? Tolerating] Management A1 resulting from
(unintentional?) ignorance and/or arrogance
o Management C1:
 “Give me the 5-minute overview.”
 “All I need is ‘red…yellow…green’ ”
[Is this your Leadership B1: “I have nothing to learn”]
•
[A1? Tolerating] Lack of fundamental knowledge, research or
education,
o C1: Blind benchmarking and copying (alleged) solutions
o Vague problems/solutions/meetings/results
•
[A1? Tolerating] a pervasive belief in entitlement
(management, culture, and MD),
•
[A1? Tolerating] C1 autocratic leadership behaviors, resulting
in "endullment” rather than empowerment.
o Cultural B1? “Learned helplessness”
Davis Balestracci
www.davisdatasanity.com
8
“If we are unhappy with the behavior of people on our team or in our organization, we need to take a
closer look at the system and structure they're working in. If they behave like bureaucrats, they're likely
working in a bureaucracy. If they're not customer focused, they're probably using systems and working in
structure that wasn't designed to serve the servers and/or customers. If they're not innovative, they're likely
working in a controlled and inflexible organization. If they resist change, they're probably not working in a
learning organization that values growth and development. If they're not good team players, they're likely
working in an organization designed for individual performance. Good performers, in a poorly designed
structure, will take on the shape of the structure.” [Davis’s emphases]
-- Jim Clemmer
Use these as a quid-pro-quo in line with the Block article on the next page:
Turnabout Is Fair Play – Peter Block
I don’t quite know what is happening to me, but I am beginning to feel some empathy for managers. In our
efforts to create accountable, high performing and satisfying workplaces, we most often think that if the
management would change, the institution would change. So we train them, write books for them, consult to
them.
I have felt for some time that the problem with our leaders is not so much their behavior but the depth and
intensity of our expectations of them. We persistently want our boss to be our mentor, we want them to take
responsibility for our development. We get upset when they do not act with integrity or work well together
articulate a clear vision, or serve as a powerful advocate for our unit with those even higher in the institution.
It is disturbing that we expect so much of our managers. For a shift in culture, something more is required of
the employees. Perhaps workers are the cause and management is the effect. Our frequent feelings of futility
and frustration may be from putting our eyes on the wrong prize. Here are some wishes of myself and other
employees that would balance the equation and support the transformation many of us seek.
Davis Balestracci
www.davisdatasanity.com
9
Employee Manifesto
1. Care for the success and well being of the whole institution regardless of how it is managed. Stop thinking
that the organization has to earn loyalty. Commit to its purpose and its customers even if management no
longer is so committed to us.
2. Mentor ourselves. Find our own teachers and support, don’t expect it from the boss or from human
resources. Be willing to pay for our own learning, recruit our own coaches, plan our own continuing education.
Stop thinking the organization is responsible for our development.
3. View our boss as a struggling human being, no more able to walk their talk than we are able to walk ours.
Have some empathy for anyone who would have to endure the reality of having us as their subordinates.
Besides, most bosses are more worried about their bosses than they are about us. Why would they be any
different than us?
4. Learn how to run the business. Become economically literate. Know the budget-cost-revenue connection of
everything we touch. Learn as many jobs as possible, figure out what clients and customers want and how to
give it to them. And do it even if the pay system is irrational and indifferent to anything that matters.
5. Be accountable for the success of our peers. Decide to support their learning and focus on their strengths,
rather than criticize their shortcomings. Be their mentor, see their weaknesses as an opportunity to learn
forgiveness and tolerance. And there is a battle with them over territory or budget, give it away.
6. Accept the unpredictability of the situation we are in. The future of the organization is a mystery and no one
knows how long these conditions will exist. Outsource our fortune teller, and stop asking where we are headed.
Today is where we are headed and that is enough.
7. Forget our ambition to get “ahead.” Ahead of whom? Why not stop competing with those around us? Maybe
we are not going to get promoted and our salary grade is essentially peaking right now. The only hope we have
for more prosperity is if the institution really grows and even then we will never get our fair share of the
rewards. Besides, if we do get promoted, who is to say we will be any happier? My observation is that the
higher you go in the organization, the more depressed people become.
8. View meetings and conversations as an investment in relationship. Value a human relationship over an
electronic one. Assume we come together to make contact with each other and any decisions we make are
simply a bonus. Agree to end one meeting this week without a list or action plan. Besides, most of our best
plans get changed five minutes after we leave the room and the lists are mostly a reminder of those things we
do not really want to do.
9. Deliver on our promises and stop focusing on the actions of others. The clarity and integrity of my actions
will change the world. Stop thinking and talking about the behavior of others. Let go of disappointment in them
and how they were too little and too late. Maybe they had something more important to do than meet our
requirements. Similarly, no one else is going to change. They are good the way they are.
10. If change is going to happen, it will be us. Ghandi said that “if blood be shed, let it be ours.” We need to
blink first. Shift our own thinking and do it for our own sake, not as a hidden bargain designed to control the
actions of others.
11. Accept that most important human problems have no permanent solution. No new policy, structure,
legislation or management declaration is going to fix much. The struggle is the solution. Justice and progress
will always happen locally, on our watch, in our unit, only as a result of our actions with those in the immediate
vicinity.
12. Stop asking “how?” We now have all the skills, the methods, the tools, the capacity and the freedom to do
whatever is required. All that is needed is the will and courage to choose to move on, and to endure the
uncontrollability of events.
13. Finally, stop seeking hope in the eyes and words of people in power. Hope is for us to offer, not request.
Whatever we seek from our leaders can ultimately only be found in the mirror. And that is not so bad.
Davis Balestracci
www.davisdatasanity.com
10
The Point
The point is to confront the passivity, isolation and complaints that flood our workplaces. Employees are
powerful players in creating culture and we ignore this when we act as if managers are the primary agents of
change. Managers and leaders are not off the hook for how their power makes a difference. It is just that the
hook has room for many players—us included.
These guidelines could easily be translated into ways to handle the difficulties of marriage or ways for
citizens to rebuild the qualities of their community. They may seem to carry a strain of cynicism, but they are
more a witness of faith. I have long felt that what we seek looking up in our organizations are expectations and
dependency that is better directed at God rather than at a second level supervisor.
Also, I write these with full knowledge that they are rules I fall short of fulfilling. Perhaps if I could act on what
I know to be true, I could stop writing, you could stop reading and we could both seek in real literature, music
and art what we now seek on bookshelves filled with answer manuals. We could stop going to consultants and
therapists and force them into real work. We could turn in our degrees in engineering, technology, finance and
administration for ones in philosophy and religion. And this would be the most practical thing we could do.
===================================================
Quotes Used During Talk
When we are dealing with people, let us remember we are not dealing with creatures of logic. We are dealing
with creatures of emotion, creatures bustling with prejudices and motivated by pride and vanity.
— Dale Carnegie, personal effectiveness pioneer and author
Laminate the following and hand it out liberally: ZERO tolerance for blame!
Only about 15 percent of [problems] can be traced to someone who didn’t care or wasn’t
conscientious enough. But the last person to touch the process, pass the product, or deliver the
service may have been burned out by ceaseless [problem-solving]; overwhelmed with the volume of
work or problems; turned off by a “snoopervising” manager; out of touch with who his or her team’s
customers are and what they value; unrewarded and unrecognized for efforts to improve things;
poorly trained; given shoddy material, tools, or information to work with; not given feedback on
when and how products or services went wrong; measured (and rewarded or punished) by
management for results conflicting with his or her immediate customer’s needs; unsure of how to
resolve issues and jointly fix a process with other functions; trying to protect himself or herself or the
team from searches for the guilty; unaware of where to go for help. All this lies within the system,
processes, structure, or practices of the organization…
--Jim Clemmer Firing on All Cylinders
Jim Clemmer: Why most training fails
“Too often, companies rely on lectures ('spray and pray'), inspirational speeches or videos, discussion groups
and simulation exercises. While these methods may get high marks from participants, research (ignored by
many training professionals) shows they rarely change behavior on the job. Knowing isn't the same as doing;
good intentions are too easily crushed by old habits. Theoretical or inspirational training approaches are where
the rubber meets the sky.”
Davis Balestracci
-- Jim Clemmer
www.davisdatasanity.com
11
Jim Clemmer: The Behavior-shaping role of structures and systems
“It's like the strange pumpkin I once saw at a county fair. It had been grown in a four-cornered Mason jar. The
jar had since been broken and removed. The remaining pumpkin was shaped exactly like a small Mason jar.
Beside it was a pumpkin from the same batch of seeds that was allowed to grow without constraints. It was
about five times bigger. Organization structures and systems have the same affect on the people in them. They
either limit or liberate their performance potential. Many organizations induce learned helplessness.”
-- Jim Clemmer [ www.jimclemmer.com ]
Highly Recommended Useful References (articles designed as ‘5-minute reads’)
**The BASIC behavior model (human and organizational) introduced in my talk:

http://www.qualitydigest.com/inside/quality-insider-column/frustrated-glacial-improvement-progress.html

http://www.qualitydigest.com/inside/quality-insider-column/frustrated-glacial-improvement-progress-part-two.html

http://archive.aweber.com/davis-newslettr/OgmhH/h/From_Davis_Balestracci_.htm
A universal statement from good improvement practitioners: A transforming organization is going to need
a culture of feedback and coaching – and LOTS of it.

The absolute best resource for the type of coaching needed is The Heart of Coaching by Thomas
Crane.
o
Download the first three chapters FREE at: www.craneconsulting.com .
Good basic material

Balestracci, D (2015). Data Sanity: a quantum leap to unprecedented results. Englewood, CO:
Medical Group Management Association. [New edition, including e-edition, to be released in March
2015. Write me for copies of Preface and Introduction where I explain rationale and structure]
If you liked my lecture, you will like this. I “write like I talk.” I also address the “cultural” issues you will face as
you try to implement changes. [e-mail me for Chapter summaries – davis@davisdatasanity.com ]
 Spitzer, D (1995). SuperMotivation. (AMACOM)
Summary plus link to survey:
http://www.qualitydigest.com/inside/quality-insider-column/another-deeply-hidden-lurking-cost.html

Studer, Q (2004). Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference
http://www.amazon.com/Hardwiring-Excellence-Purpose-WorthwhileDifference/dp/0974998605/ref=sr_1_1?ie=UTF8&qid=1440079179&sr=81&keywords=quint+studer+hardwiring+excellence

Davis’s Quality Digest articles – cover all aspects of improvement, including culture. These are
more like 2-pagers:
Link to the archive (many articles listed, with live links to individual articles):
http://www.qualitydigest.com/read/content_by_author/11300
Davis Balestracci
www.davisdatasanity.com
12
Are you “doing” TQM / CQI / Six Sigma / Lean / Lean Six Sigma / Toyota Production System or
trying to transform and create a culture of excellence?

When Transformation is Involved, “Just DO it!” WON’T do it!
http://archive.aweber.com/davis_book/5PKtM/h/From_Davis_Balestracci_When.htm

Root Cause Analysis? Be Careful! (contains a very insightful explanation from an American Society
for Quality member) – many times, the “root cause” is ‘culture,’ as in “perfectly designed”:
http://archive.aweber.com/davis-newslettr/CFmRX/h/From_Davis_Balestracci_.htm
Part 2: Data Sanity

Three KEY concepts of the day
p. 12
Transforming from Data INsanity to Data Sanity
 Key example: Important display and calculation
 Article links to the PT cancellation, budget, and overtime scenarios
 Seven Everyday Statistical Traps
p. 13
p. 14
p. 14
Post-seminar highly recommended readings, references and “nuggets”
 Start here: good BASIC reading
 ‘5-minute reads’ on various statistical / data topics covered
p. 15
p. 16
Davis Balestracci
www.davisdatasanity.com
[live links]
[live links]
13
1. EVERYTHING
is a process
Unless your improvement process is
consciously based on this framework, you
will not be solving the “deeper” problems of
which no one is aware.
Focus on reducing the “four Cs” of
confusion, conflict, complexity, and chaos
and the “other C” – costs – will go down.
Focusing solely on costs will increase
confusion, conflict, complexity, and chaos –
AND costs!
2. Why “traditional” statistics courses don’t work in the real world

A visual of why the statistics you are taught in a
“basic” academic course are many times NOT
APPLICABLE in the real world – NO concept of either
“process” or HUMAN variation.

Unfortunately, the computer will do anything you
want.

The more you know what is wrong with your data
(“human variation”) the more useful it becomes.
The following brief newsletter explains things further
and shows the example I did during the seminar
comparing three hospitals: http://archive.aweber.com/davis_book/52KHQ/h/From_Davis_Balestracci_Old.htm
3. Brian Joiner’s “Levels of Fix” [from Fourth Generation Management]
Push for “deep level” fixes:
Davis Balestracci
www.davisdatasanity.com
14
http://archive.aweber.com/davis_book/ADapE/h/From_Davis_Balestracci_.htm
Davis Balestracci
www.davisdatasanity.com
15
Elegantly Simple Example: “After that downward trend, why did we go back up?”
(Actually, you didn’t.
Despite 150 root cause
analyses, nothing has
changed… over FIVE
years.)
Bacteraemias
[TIME order]
10
7
3
10
10
8
12
8
6
7
13
6
9
3
10
2
9
12
5
Sorted Order
2
3
3
5
6
6
7
7
8
Moving
Range
*
ABS (7-10) = 3
ABS (3-7) = 4
7
0
2
4
4
2
8 Median: 10
TH
9 [9 smaller, 9 larger]
9
10
10
10
10
12
12
13
ABS (5-12) =
1
6
7
3
6
7
8
7
3
7
Sorted
Moving Range
0
1
2
2
3
3
3
4
4
4
6
6
7
7
7
7
7
8
MRmed: Avg. of
9th and 10th = 4
[KEY to process variation]
MRmed = 4
MRmax = 4 x 3.865* ~ 15
Process common cause:
8 + (4 x 3.14*) ~ [0– 20]
* From theory:
Always used with MRmed
Davis Balestracci
www.davisdatasanity.com
16
Physical therapy cancellations scenario – Putting traffic lights and arbitrary goals to rest once and for
all:
http://archive.aweber.com/davis-newslettr/C5qT1/h/From_Davis_Balestracci_.htm
Budget and overtime scenarios:
2007 Resolutions: Weight and… Budget?—Parts 1 & 2) (January/February 2007)
http://www.qualitydigest.com/jan07/departments/spc_guide.shtml
http://www.qualitydigest.com/feb07/departments/spc_guide.shtml
Seven Everyday Statistical Traps
1. Treating all observed variation in a time series data sequence as special cause
2. Treating things that “shouldn’t” happen as special cause
3. Fitting inappropriate “trend” lines to a time series data sequence.

What part of “NEVER!” don’t you understand?
4. Unnecessary obsession with and incorrect application of the Normal distribution

How often did I mention it?
5. Choosing arbitrary cutoffs for “above” average and “below” average

The process WILL tell you
6. Improving processes through the use of arbitrary numerical goals and standards

Goal = “Fact of life”
 Is it a “would be nice to achieve” target (arbitrary) or a “We don’t attain this, we don’t
survive” target (fact-of-life)?

“Is the ‘gap’ from the goal common or special cause?”
7. The use of rolling or moving averages

These create a deceptive picture and actually invalidate commonly used statistical methods

Can easily create the appearance of special causes when only common cause is present
Davis Balestracci
www.davisdatasanity.com
17
Highly Recommended Useful Follow-up References
Good basic material [Start here! – note that one outstanding articles is free (**)]

Balestracci, D (2015). Data Sanity: a quantum leap to unprecedented results. Englewood, CO:
Medical Group Management Association.
If you liked my lecture, you will like this. I “write like I talk.” Chapters 1-4 are designed specifically for leaders
[e-mail me for Chapter summaries – davis@davisdatasanity.com ]

Joiner, BL (1993). Fourth generation management: the new business consciousness. McGraw-Hill.
http://www.amazon.com/Fourth-Generation-Management-BrianJoiner/dp/0071735860/ref=sr_1_2?ie=UTF8&qid=1358526612&sr=8-2&keywords=brian+joiner+fourth
Outstanding overview of a sound everyday quality perspective with which to approach all work. I use this as a
text for an MBA course I teach and the students love it!

**Nolan, T and Provost, L (1990, May). Understanding variation. Quality Progress. Retrieved from
http://ww.apiweb.org/UnderstandingVariation.pdf [Direct link to a free .pdf copy of the article]
This article was seminal in my understanding of process thinking and common vs. special cause
Davis Balestracci
www.davisdatasanity.com
18
BRIEF (easily read in 5 minutes) articles by Davis that cover key data concepts from this seminar
Data INsanity and Data Sanity
1-2 page “Statistical Corner” articles by Davis for Quality Digest covering main topics of today:

TQM, Six Sigma, Lean and…Data? [Trust me: they’re all the SAME!]
http://www.qualitydigest.com/july06/departments/spc_guide.shtml

Dialogue between Davis and World Quality Leader [Why leaders must understand variation!]
o People LOVE Rankings -- http://www.qualitydigest.com/sept06/departments/spc_guide.shtml
o
I Now Understand Why Deming Was Such a Curmudgeon
http://www.qualitydigest.com/oct06/departments/spc_guide.shtml

Why avoid commonly used bar graphs? – easy: most of them are worthless!
http://www.qualitydigest.com/june06/departments/spc_guide.shtml

Sick of Boring Meetings that Waste Your Time? [Beware of trend lines and direct two-point
comparisons]
http://www.qualitydigest.com/sept05/departments/spc_guide.shtml

A Common Cause Strategy for Count Data [Pareto matrix concept: uses data from article
above]
http://www.qualitydigest.com/oct05/departments/spc_guide.shtml

Statistical Stratification: Part 2 (p-charts)
http://archive.aweber.com/davis-newslettr/7E07T/h/From_Davis_Balestracci_.htm

The Wisdom of David Kerridge: Statistics and reality--Part 1 [dealing with “clinical trial” mindset of
physicians, which is NOT RELEVANT to real, everyday world]
http://www.qualitydigest.com/dec07/departments/spc_guide.shtml

The Wisdom of David Kerridge: Statistics and reality--Part 2
http://www.qualitydigest.com/jan08/departments/spc_guide.shtml

It’s Time to Ignore the Traffic Lights (Example shown in minicourse)
http://www.qualitydigest.com/july05/departments/spc_guide.shtml


The first two common cause strategies:
o
http://www.qualitydigest.com/inside/quality-insider-article/wasting-time-vague-solutions-part-1.html
o
http://www.qualitydigest.com/inside/quality-insider-column/wasting-time-vague-solutions-part-2.html
Are You Using SWAGs? [Important article: shows a common WRONG analysis that I suspect will
be very common to determine “pay for performance”]
http://www.qualitydigest.com/jan06/departments/spc_guide.shtml

Think you Know Balanced Scorecards? Think again… [your “Homework” scenario]
http://www.qualitydigest.com/sept07/departments/spc_guide.shtml

Root Cause Analysis? Be Careful!:
http://archive.aweber.com/davis-newslettr/CFmRX/h/From_Davis_Balestracci_.htm
Davis Balestracci
www.davisdatasanity.com
19