The first step in the improvement process is to identify the problem. This is true of any improvement methodology being used, such as Plan, Do, Check, Act; Define, Measure, Analyze, Improve, Control; or others.
The statement must clearly define the problem. It should include:
- A factual, evidence-based problem.
- A concise description of the problem.
- A specific, addressable scope for the problem.
It should not assign fault, assume a root cause, or presume a solution.
Problem statement examples
Let’s look at two examples for an often identified problem — response times.
Problem statement #1
We frequently miss our response time interval because of the inadequate on-scene times provided by dispatch. Additional training is necessary for dispatchers, and in-vehicle computer-aided dispatch data terminals are necessary for all response vehicles.
In this example, the problem statement incorrectly:
- Places blame (on the dispatchers).
- Assumes the root cause (lack of dispatcher training).
- Proposes two solutions (training for dispatchers and purchase of vehicle data terminals).
This example does not provide us with factual information about the frequency of the problem, nor does it address the impacts of the problem.
Problem statement #2
Let’s rewrite the problem statement.
We failed to meet our 7:59 response time interval in 34.5 percent of emergency responses during the last six months. Failure to meet this response time may negatively affect our patients, decrease patient satisfaction, and may lead to a dilution of public confidence in our organization. The root cause of this problem is unknown; therefore, the costs of correction are unknown.
The rewritten problem statement provides a factual, evidence-based problem, includes the frequency of the problem, and identifies potential impacts.
Action step for writing better problem statements
Apply for the NFA course Emergency Medical Services: Quality Management (R0158) to learn more about writing factual, evidence-based problem statements. You will also learn how to create, implement and maintain a Quality Management Program using historical examples, current models, and best practices in quality assurance and improvement, process improvement, and data collection and analysis.
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: Gary Coronado / Los Angeles Times