Hospitals have to constantly adapt to rapid change. High reliability, however, assumes that teams can rely upon rules and protocols. In uncertain environments and novel situations, a different type of approach may be beneficial. Specifically, an agile or test-and-learn management approach allows teams to test new processes and protocols.
The management model called test and learn has been around for a couple of decades and its methodology came out of complex adaptive systems. Complex adaptive systems think about problems from the spectrum of either known or unknown problems. Known problems typically are addressed simply by applying rules. However, there are two kinds of unknown problems: one is the known unknown, usually a forecasting or a predictive problem, and then, there’s the unknown unknown, where the best management approach is a test-and-learn approach. When the organization doesn’t have a historical understanding of the system to model, it can introduce something new into the system to see the response, and then change. What has been driving the most recent conversations is the rapid introduction of technology and AI into healthcare. Work experiences where a human and a technology work together are emerging. The technology is taking over services that don’t need the judgment of the human being. The challenge is that this technology is, by its nature, not static. It keeps changing over time.