Steven KellyBy Steven J. Kelly, ISPI International Director

As an expatriate living overseas, I do not view much American television. Recently a relative sent us a “care package” containing, among other goodies, a package of DVDs of a recommended show, entitled House. The fast-paced drama focuses on a weekly life-and-death race for medical diagnosis and treatment before the patient succumbs to disease. The show is all about performance assessment, of a radical variety–with life and death always a commercial break away. The show’s protagonist–Greg House, M.D.–is an ornery technician who practices “streaming diagnosis.” By this, I mean real-time performance assessments under stress unlike most in our traditional organization performance world.

Since the client is usually dying mysteriously and quickly, often the diagnosis can only be confirmed by trial application of interventions. Decisions are based on data collection and continually monitored indicators. Mistakes are made. Assumptions based on sets of symptoms that seem observable and rational turn out in error. Intervention treatments are selected based on well-founded evidence, peer-reviewed studies, and often the immediate best judgment of the diagnostic team. As this is prime-time TV, usually patients are saved within the hour portrayal. But, sometimes the human performance system is overwhelmed by factors, and the “client” dies.

Is House portraying the realistic world of hospital medicine? Highly unlikely. Cost seems no issue. All resources are available and accessible. Unfortunately, like most of life, diagnosis and especially execution of performance interventions (even most biological ones) are slow, plodding, and uncertain. But, what the series highlights is the critical role of diagnosis before intervention, even when the symptoms seem common sense and almost intuitive for action. The details, it seems, are critical. And even more important, once the diagnosis is hypothesized, the effect of the applied intervention must be monitored directly using ongoing sensory data indicators. If results are not as expected, the intervention is revised or stopped. The data is reevaluated. This approach is critical for the success of all performance interventions–whether medical or other.

As performance improvement experts, many of us yearn for organization environments that allow for such client attention, clear data for problem assessment, and the ability to conduct “streaming performance assessment.” That is, the resources to continually collect and monitor progress of solution sets toward defined results in real time. But, despite these real-life limitations of project resources, attention, time, and clarity, our human performance technology profession still provides outstanding contributions to our clients. And these contributions are always created through rigorous up-front diagnoses, with close analysis of underlying causes of performance gaps, prior to designing and executing solutions.

One of the ways we celebrate ISPI members’ illustrative achievements is through the Society’s annual Awards of Excellence. Accessible to all members, the awards are designed to highlight people, chapters, organizations, products, and innovations representing excellence within the performance improvement field. Review the criteria here now, and consider sharing your successes with the broader membership. Obtain recognition for these achievements and become a role model for your peers.