HDG #004: Forget the 5 Why’s and do this instead
Read time: 6 minutes
Today I'm talking about why we should throw the 5 Why's Method out when it comes to analytics. Just don't tell the process improvement peeps, or they'll come at me on Linkedin.
If you're not familiar with the 5 Why's Method, I'll break it down:
5 Whys is the practice of asking why repeatedly (5 times, in fact) whenever a problem is encountered. You do this in order to get beyond the obvious symptoms and discover the root cause.
It's a popular tool for root cause analysis. And it works remarkably well.
CMS even turned up with a guide on how to facilitate a 5 Why exercise.
Here's how the 5 Why’s work, courtesy of CMS:
The issue we're solving for: a resident suffered a serious injury during his transfer from a wheelchair back to his bed.
We ask why 5 times:
Why? CNAs didn't have the equipment needed to care for the resident.
Why? The needed equipment is sometimes hard to find.
Why? Not enough specialized equipment to care for residents with unique needs.
Why? The anticipated number of residents with unique needs and their equipment requirements are not known.
Why? The strategic planning and budgeting process does not include projections for equipment needs based on the anticipated volume of residents with unique needs.
This questioning process is continued until all the root causes are found. It is common to find the same root cause for two or more contributing factors.
If we're lucky, we may even have data we can use to understand or identify some of these hidden Why's.
I came out of the womb asking "why," so I naturally gravitate towards it. But…
5 Why's are great for pinpointing root causes, but not so great for thinking more broadly.
We do a lot of root cause analysis in healthcare and community equity analytics. We can certainly use the 5 Why method on challenges like these.
For instance:
We noticed a certain area of the state tends to be more susceptible to having different (poorer) outcomes than other rural areas.
We noticed our monthly costs have increased.
We noticed some patients have a higher acquired infection rate than others.
But the 5 Why method only tells us one thing: why.
It doesn't necessarily tell us what to do about it.
It is not actionable.
Use the 5W1H method instead.
I like this method because it helps me think more broadly when I'm analyzing an issue. And it's just as easy to remember. It goes:
Who? What? Where? When? Why? How?
It is a more flexible approach for analysis because the questions you ask will be largely dependent on what you're analyzing, what problem you're trying to solve, or what goal you have.
Let's use an example from above: We noticed a certain area of the state tends to be more susceptible to having different (poorer) outcomes than other rural areas.
Who? Who is being most impacted? Who is unexpectedly falling through the cracks?
What? What are the unstated assumptions we’re using while analyzing this problem? What is the thing they all have in common/or don’t?
Where? Where do we need to target our efforts? Where are we likely to have the most success? The least?
When? When or under what circumstances is this most likely to happen? When does it tend to occur more? Less?
Why? Why are the people/things/processes acting/behaving/turning out the way they are?
How? How can we address this? How will we measure the progress or outcomes?
P.S. This is also called the Kipling method.
Ultimately, there is no one way to do analysis and design programs that will have a tangible impact. These two methods are very complementary, and many more are out there. But having a handy framework to keep in mind can help guide you and remind you to think a bit more broadly.
Actionable Idea of the Week:
The next time you're starting an analysis or planning a new strategy, keep this framework in mind.
If you hit a creative roadblock, you can also reach into my Guide where I've compiled a starter bank of questions you can use within this framework as you’re doing an analysis or starting to think about designing a new strategy.
What other frameworks have you used? Hit reply and let me know your thoughts.
See you next week!
-Stefany
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