The Difference Between “Reduce” and “Prevent” When it Comes to Process Thinking

Posted on by Brian Veara

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In many healthcare organizations, you often see lofty strategic initiatives that are listed as reducing harm. For example, these objectives are listed as “Reduce CLABSI by 50%” or “Reduce Unplanned Readmissions by 25%.”

The words used in these statements can often represent an immature process and analytics mindset. In organizations that are more mature in their process thinking, these statements use a different verb than “reduce,” instead they use a verb like “prevent.” 

This subtle distinction is important. The starting point of analysis and process mapping is further upstream when the goal is to “prevent.” Consequently, people start looking for root causes and identifying opportunities in the process to prevent the defect from occurring in the first place. For example, identifying opportunities to adjust care plans to prevent the unplanned readmissions while the patient is still being treated.

Organizations using the verb “prevent” in their strategic goals have a measurement system established that signals when a defect occurs. As an example, these organizations know which patients were readmitted yesterday. They have processes in place to consume and react to the signals. By reducing the awareness time, they have reduced the delay in knowing when the defect occurred and the knowledge that it occurred. Their daily safety huddles have defined what defects are occurring, standardized action processes to get at root causes, and have quick cycles of PDSA to prevent the next one from occurring.

Strategic verbs are important. We recommend you review your strategic objectives. Are you describing what you really want to achieve?


Brian Veara, Program Director


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One Response to The Difference Between “Reduce” and “Prevent” When it Comes to Process Thinking

Mike Spencer says: 11/07/2019 at 9:57 am

I believe that “prevent” & “reduce” each has its place in healthcare goals.
The standard – an ideal condition that may never be sustained for long periods (not necessarily same as a strategic goal) – should be zero preventable harm for patients, or perfect safety for employees. This can energize & align the organization, especially clinicians, & get them engaged in the management system.
But if you believe that short-term, say annual, goals must be achievable, realistic, then a stretch goal like 50% reduction can be a motivating bridge between today’s performance, & a better future.
With the right coaching, & organizational alignment, a goal like 50% reduction in CLABSIs will prompt fundamental value-stream thinking.


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