A. Moralizing for Pain Relief
In great pain from his right molar, a person comes to his dentist. The doctor sits him down on the treatment chair, pulls out a set of illustrations of proper brushing and pictures of foods that can damage our teeth, and begins to lecture the patient about the poor dental hygiene that led to the pain he is suffering.
It doesn’t work that way, does it? At that moment, the patient needs rapid treatment of the infection, along with pain killers. All those unnecessary recriminations won’t even be heard.
B. A Problem – And its Causes
A problem is an abnormal gap between the current and the desired situation. For example: a deviation breaking the standard. Usually, this will be accompanied by a sense of distress or urgency, as in the story about the dentist. Only the pain and the sense of urgency brought the patient to the doctor, although it would appear that he should have come earlier. At that moment, it’s clear to both of them that the pain must be alleviated immediately. Yet, a good doctor would not be satisfied with antibiotics, and would treat the infection in the tooth, which is the source of the pain. Moreover, it is also clear that the treatment of the problem should not end there and that if the patient does not change his behavior, the problem is likely to recur, perhaps even more severely. The same is true for the detection of cancer: by the time the symptoms appear, the disease is already in an advanced stage.
Deviations, abnormalities, mishaps, crises, and surprises are an inseparable part of the work in any organization. They are rarely discovered deliberately, as in, for example, a quality control procedure designed to examine the gap between the current and the desired situations and to lead to improvement. More often, they are discovered only when it hurts – when something isn’t working, or if there is a crisis between the organization and its customers or between management and the employees, and so on. Usually, in these situations, there are different levels of treatment of the problem – from first aid to alleviate the symptoms (the pain) and bring the situation back to its basic stability, to an analysis of the root sources of the problem and their treatment, to generating a change in the organizational culture and the modes of thinking that led to the root sources that created the symptomatic pain.
C. Kata – A Concept from the Field of Martial Arts
In the first stage, the concept of Kata may help identify and deal with the problem. This term, taken from the field of martial arts, refers to a mode of activity composed of a set sequence of movements that should be executed in a given situation. With repeated practice of these movements, it is possible to execute them automatically and quickly and identify the skills needed for self-defense in an emergency situation. Acute medical situations, of course, also require such skills, and this is why medical protocols can be life-saving. I remember only too well how, in the 1973 Yom Kippur War, when the Syrians “were at our gates,” the young conscripts performed the well trained practices that helped to break the Syrian advance.
In situations of crises and stress, Kata can appear in many different forms, but all have one purpose: to identify the gap from the desired situation and to quickly deal with the symptoms of a specific problem. This is what must be done when a dissatisfied customer turns to a service representative, and, if necessary, through Kata and practice, find a solution for a lecture when the power point doesn’t work.
In terms of its character, Kata is similar to Daniel Kahneman’s “Thinking Fast & Slow” (2011) description of the First System Response; that is, it is a fast, instinctive, and autonomous response.
D. The Five-Question Kata to Cope with a Problem
In developing line people’s problem-solving skills, a “Kata” of five questions should be practiced as the basis for analytic thinking – a tool that will improve intuition even under pressure:
- What is the current situation?
- Where to you want to go (diagnosis of the gap = the problem)?
- What is causing the gap? What is the obstacle?
- How will you try to overcome the obstacle?
- How will you evaluate your success at solving the problem, or at the least, in understanding its root sources?
The fifth stage opens a round of study and learning through new attempts. This type of learning is especially critical when dealing with complex or repeated problems, when it is clear that an immediate fix is not enough and that an in-depth investigation is necessary. This requires a different form of attention, which works out of the Second Thinking system (following Kahneman), which primarily involves conducting an in-depth analysis of the problem and the root sources that created it and establishing work methods that will lead in-depth change through transformation of the organizational culture.
From Practicing Kata to an A3 in a Hospital
Once it has become habit, the Kata also becomes the basis for integration of the A3 methodology. When you add the description of the background to the problem at the beginning, and the conclusions and future plans in the conclusion, the five questions form the structure of the process of the A3 methodology: definition of the background, the current situation, and the future situation; understanding the root problems for the gap (the obstacle); Plan-Do-Check-Act (PDCA) cycles; examination of the results of the experiment; and beginning another cycle for further learning.
Coping with backlog in emergency rooms and urgent medical care hospital facilities provides an example of both the use of Kata thinking at the most urgent level and of A3 methodology for in-depth treatment. For example: in response to lack of space in the department of internal medicine for a complicated patient, the staff executes a rapid Kata procedure and decides to leave the patient in the ER. Several hours later (sometimes, even a day later), a bed has still not become available in the internal medicine department, so the patient is transferred to the hallway. When there are no more beds available in the hallways of the internal medicine departments, the ER is closed. Recurring closure of the ER due to lack of beds requires the application of the A3 method for an in-depth examination of crowding in hospitals, which could lead to far-reaching insights, including insights regarding the percentage of chronic patients who are unnecessarily taking up beds in hospitals.
Breakthroughs, innovation and organization change are often the result of exceptions, deviations, surprises and accidents. Kata is an effective methodology for transforming problems and mishaps into opportunities for learning and improvement.
Boaz Tamir, ILE.
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