Implementing sweeping changes can be overwhelming. In January, we tend to make our annual laundry lists of resolutions and goals. Then, more than likely we get overwhelmed with the list, we stop and try to prioritize the multitude of changes, and then get frustrated that we are not the Super Domestic Administrator.

I can’t believe it has been this long ago, but seven years ago I participated in a healthcare project of process improvement called Transforming Care at the Bedside (TCAB). TCAB was part of the Institute for Healthcare Improvement’s workforce and patient care improvement initiatives.TCAB utilized a lesser known model of performance improvement called “rapid cycle” process improvement. The concept: Identify a problem, test a solution, one nurse, one change, one patient, one result, one day at a time.

Rather than get bogged down with a detailed, project plan and overanalysis that may delay change, the direct healthcare professional is empowered to make one change on one patient and assess results. Then, try the change on a second patient for a second day, then more patients on a third day, etc. Over time, you would have multiple data points and you also have repetition, practice and refinement of process on the part of the direct patient care professional. If results were positive, then the direct care professional can “spread” the change to the team, the unit and across the organization. The organization then has a best practice.


courtesy of the Colorado Hospital Association Website


I truly liked this idea of small, incremental change having the potential for “spread.” Each of us can apply that same concept to our personal lives and families as well.


One of my changes was to create efficiency in my morning routine with basic household chores such as mopping, sweeping and emptying the garbage cans on garbage day. I know these activities may not sound too glamorous, but I can get in a routine that is not efficient, focused and lead me down the path of distraction. I love getting up in the morning, exercising if it is a scheduled exercise day, having breakfast and coffee, and quickly moving forward using my calendar of activities.

I realized I was wasting time going back through the house after breakfast and collecting the garbage into one larger bag to put out on the curb. I would actually put that activity off to start working. With some conscious effort, I tested getting up, collecting all the garbage in the back of the house before going to the kitchen, adding the kitchen garbage, then adding the cat litter bag and then putting out by the back door for one of us to take to the curb. Our house is not large and this change did not shave off a lot of time during the actual process but it did shave off wasted time due to unforeseen future distractions.

With the same technique, I have moved sweeping and mopping from a morning distraction to to an evening “wrap-up” activity (although last week I swept multiple times during the day due to three feline “mops” tracking in oak pollen.)

Just for Today:

Review your “personal community” domains.

Choose one change to make one domain.

Try the change one time, one day.

Debrief yourself. What worked well? What didn’t work well? What was something positive that resulted from that one activity? What was something that needed improvement? What will you do next time? Over time, who in your family or household could benefit from the change?


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