Root Cause, Interactions, Robustness and Design of Experiments

Eric Budd asked on The W. Edwards Deming Institute group (LinkedIn broke the link with a register wall so I removed the link):

If observed performance/behavior in a system is a result of the interactions between components–and variation exists in those components–the best root cause explanation we might hope for is a description of the interactions and variation at a moment in time. How can we make such an explanation useful?

A single root cause is rare. Normally you can look at the question a bit differently see the scope a bit differently and get a different “root cause.” In my opinion “root cause” is more a decision about what is an effective way to improve the system right now rather than finding a scientifically valid “root cause.”

Sometimes it might be obvious combination which is an issue so must be prevented. In such a case I don’t think interaction root cause is hard – just list out the conditions and then design something to prevent that in the future.

Often I think you may find that the results are not very robust and this time we caught the failure because of u = 11, x = 3, y = 4 and z =1. But those knowledge working on the process can tell the results are not reliable unless x = 5 or 6. And if z is under 3 things are likely to go wrong. and if u is above 8 and x is below 5 and y is below 5 things are in trouble…

To me this often amounts to designing systems to be robust and able to perform with the variation that is likely to happen. And for those areas where the system can’t be made robust for some variation then designing things so that variation doesn’t happen to the system (mistake proofing processes, for example).

In order to deal with interaction, learn about interaction and optimize results possible due to interactions I believe the best method is to use design of experiments (DoE) – factorial experiments.

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George Box Webcast on Statistical Design in Quality Improvement

George Box lecture on Statistical Design in Quality Improvement at the Second International Tampere Conference in Statistics, University of Tampere, Finland (1987).

Early on he shows a graph showing the problems with American cars steady over a 10 years period. Then he overlays the results for Japanese cars which show a steady and significant decline of the same period.

Those who didn’t get to see presentations before power point also get a chance to see old school, hand drawn, overhead slides.

He discusses how to improve the pace of improvement. To start with informative events (events we can learn from) have to be brought to the attention of informed observers. Otherwise only when those events happen to catch the attention of the right observer will we capture knowledge we can use to improve. This results in slow improvement.

A control chart is an example of highlighting that something worth studying happened. The chart will indicate when to pay attention. And we can then improve the pace of improvement.

Next we want to encourage directed experimentation. We intentionally induce informative events and pay close attention while doing so in order to learn.

Every process generates information that can be used to improve it.

He emphasizes the point that this isn’t about only manufacturing but it true of any process (drafting, invoicing, computer service, checking into a hospital, booking an airline ticket etc.).

He then discussed an example from a class my father taught and where the students all when to a TV plant outside Chicago to visit. The plant had been run by Motorola. It was sold to a Japanese company that found there was a 146% defect rate (which meant most TVs were taken off the line to be fixed at least once and many twice) – this is just the defect rate before then even get off the line. After 5 years the same plant, with the same American workers but a Japanese management system had reduced the defect rate to 2%. Everyone, including managers, were from the USA they were just using quality improvement methods. We may forget now, but one of the many objections managers gave for why quality improvement wouldn’t work in their company was due to their bad workers (it might work in Japan but not here).

He references how Deming’s 14 points will get management to allow quality improvement to be done by the workforce. Because without management support quality improvement processes can’t be used.

With experimentation we are looking to find clues for what to experiment with next. Experimentation is an iterative process. This is very much the mindset of fast iteration and minimal viable product (say minimal viable experimentation as voiced in 1987).

There is great value in creating iterative processes with fast feedback to those attempting to design and improve. Box and Deming (with rapid turns of the PDSA cycle) and others promoted this 20, 30 and 40 years ago and now we get the same ideas tweaked for startups. The lean startup stuff is as closely related to Box’s ideas of experimentation as an iterative process as it is to anything else.

Related: Ishikawa’s seven quality control tools

He also provided a bit of history that I was not aware of saying the first application of orthogonal arrays (fractional factorial designs) in industry was by Tippett in 1933. And he then mentioned work by Finney in 1945, Plackett and Burman in 1946 and Rao in 1947.

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The Education System

The current topic for ASQ Influential Voices to address is the importance of the education system and the impact on the capability of employees.

The education system is important and not very good in my opinion. As a kid I found it boring and constraining and a system designed more to extinguish my quest for knowledge than increase my desire to learn. As a kid I was told by adults that adults knew better and I shouldn’t complain.

I was told “don’t you realize you are in one of the best school systems in the USA?” With a bit of data I was convinced that seemed likely. To me this seemed like an even more ominous sign. If the best was this bad what was everything else like?

The argument that made the most sense to me (for why I should be happy with, or at least accept, the lousy system I was stuck in) was that as a kid I probably just didn’t understand why this environment that seemed to bore not just me, but most all the kids around me and this system that crushed our desire to learn must somehow be working otherwise the adults would certainly fix it.

As an adult what I find is my thoughts as a kid were essentially completely correct (except that last one that adults wouldn’t stick with some pitiful system without good reason) and plenty of education experts had been saying the same things. Adults seem perfectly fine not adopting proven better education practices just as they are fine not adopting proven better management practices.

When Dr. Deming was asked what to do instead of performance appraisal, when he railed against performance appraisal, he said do “whatever Peter Scholtes says.” To the question of what we should we do about the education system I say do whatever David Langford and Alife Kohn say.

I know more about the specifics of what educational systems following David Langford’s idea are like, and all I can say is they are wonderful. If I had kids I would definitely consider moving somewhere that had such a system (like Leander, Texas where they have been moving down that path for 20 years). They focus on helping student learn in a way that is so much more sensible than the one I had to sit through and most everyone reading this had to sit through.

The percentage of students that graduate with a desire to keep learning from an educational system like Leander is much greater than the traditional path. My high school had more National merit scholars than any public high school in the USA the year I graduated (some prep schools beat us, but only a few – partially because we were so large and they are often small). We had many students that were smart, dedicated and capable of succeeding at prestigious universities. Of course with tons of University of Wisconsin faculty as parents this is not a very surprising result.

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Practicing Mistake-Promoting Instead of Mistake-Proofing at Apple

Mistake proofing is a wonderful management concept. Design systems not just to be effective when everything goes right but designing them so mistakes are prevented.

I have had several bad customer experiences in the short time I have had my iPad mini. One of the most pitiful is caused by mistake-promoting process design. As the name implies that isn’t a good idea. Mistake-proofing processes is a good practice to strive for; processes that create extra opportunities for failure impacting customers negatively are a bad idea.

My experience below is but one mistake-promoting practice that has caught me in its grips in the short time I have owned my iPad mini. I want to view books on the mini but can’t find any book reader. So I decide, fine I’ll just install the Kindle reader app.

I go to do so (run into additional issues but get through them) and then Apple decides for this free app, on an iPad I just bought with my credit card a week ago, to block me from getting what I need and force me to revalidate my credit card. This is lame enough, but I am used to companies not caring about the customer experience, so fine, what hoops does Apple want to force me through?

But guess what, the unnecessary steps Apple decided to force me through are broken so I can’t just waste my time to make them happy. No. They have created a failure point where they never should have forced the customer in the first place.

So they not only didn’t mistake-proof the process they mistake-promoted the process by creating a unnecessary step that created an error that could have been avoided if they cared about mistake proofing. But instead they use a mistake-promoting process. As a consumer it is annoying enough to cope with the failures companies force me through due to bad management systems that don’t mistake proof processes.

Companies creating extra opportunities to foist mistakes onto customers is really something we shouldn’t have to put up with. And when they then provide lousy and then even incomprehensible “support” such the “change your name” vision Apple decided to provide me now it is time to move on.

After 5 years of buying every computing device from Apple, they have lost my entire good will in one week of mess ups one after the other. I knew the reason I moved to Apple, the exceptional Macbook Air, was no longer the unmatched hardware it once was; but I was satisfied and was willing to pay a huge iPad premium to avoid the typical junk most companies foist on you. But with Apple choosing to make the process as bad as everyone else there isn’t a decent reason to pay them a huge premium.

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Toyota Posts Record Profit: Splits $15 million in Pay and Bonus for top 21 Executives

After posting record profits of $17.9 billion Toyota proposes to increase the pay and bonus for the top 21 executives to $14.9 million. That is not as you might expect just the increase in the bonus to the CEO. That is the entire pay and bonus for the top 21 executives. That places all 21 together below the top 50 CEO paydays in the USA.

Toyota’s net income for the year surged 89.5%. While the profits are partially due to good management at Toyota the decline in value of the yen also greatly aided results.

Management Pockets A 19% Raise As Toyota Racks Up Records Profits

Toyota proposed 1.52 billion yen ($14.9 million) in combined compensation and bonuses to 21 directors, including President Akio Toyoda, in a notice to shareholders Tuesday. The Toyota City, Japan-based company paid 1.28 billion yen the previous fiscal year.

By comparison, total pay for union workers increased 8.2 percent [this was linked to an article as a source but the link was broken, so I removed it] on average from last fiscal year. The carmaker granted the union’s request for workers’ average bonus to rise to 2.44 million yen, the equivalent of 6.8 months of salary.

The company forecasts a 2% slip in net profit to $17.5 billion for 2015.

Toyota continues to generate cash flow extremely well and has over $20 billion in cash at the end of their 2014 FY. They are also increasing the dividend to stockholders and buying back more stock.

Less than a handful of USA CEOs that is took more from their companies treasuries than all 21 off the Toyota leaders take together led their company to greater earnings than Toyota (only a few companies earned more: Apple, Google, Exxon…). The thievery practiced by senior executives in the USA is immoral and incredibly disrespectful to the other workers at the company and the stockholders.

ExxonMobil did earn more and their CEO took $28.1 million. I think Chevron and Wells Fargo may have earned more than Toyota with a CEOs taking $20.2 and $19.3 million respectively.

Alan Mulally, Ford CEO, took $23.2 million while the company earned $7 billion. If you can ignore his massive and disrespectful taking what he doesn’t deserve he has been an acceptable CEO in other ways.

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Building a Great Software Development Team

twitter screen shot of the quoted conversation

Elliot: I worked with some of the best programmers I’ve ever known at the tiny, obscure ASEE

Adam Solove: Why do you think that happened? They hired for passion, rather than experience?

If I had to pick one thing, passion would likely be it but really it is a complex assortment of things. Passion for the right things, based on what we aimed to be, mattered a great deal. That took the form of being passionate about the user experience, being passionate about good software development practices, being passionate about good software itself, being passionate about treating each other with respect, being passionate about learning and improving.

I think there were several other important factors, such as: the skill to turn a passion for good software into actual good software. This required intelligence, interest and knowledge about software development but didn’t require specific experience (computer science degree, 2 years of Ruby on Rails development, certification or any such thing). Hiring based on experience is a big mistake. In my opinion hiring based on capability and potential (which is based partially on experience) is wise.

Another factor is that we had people (those first few hires were critical) that were really knowledgable about programing good software and that became a self reinforcing process. The gaps one person’s ability and knowledge could be filled by someone else helping them understand and get better.

The expectation was that we found great solutions. If we didn’t we kept looking and asked each other for help (another factor in creating a great team). We didn’t just accept that we were confident the solution wasn’t very good but couldn’t find any better options so I guess this is the best we can do.

We were interested enough in good results that we would push for better options instead of just accepting something that was kind of ok. This shouldn’t be such a big deal; but in practice it is huge. So many places just end up avoiding conflict to the extent that it is a huge detriment to results.

Without confidence, honest debate about ideas is suppressed as people are constantly taking things personally instead of trying to find the best ideas (and if doing so means my idea is criticized that is ok). Our group was great at this. It is something I find it a bit silly to say a workplace was “great” at but in most places I find the fear of someone being concerned stifles discussion to an unbelievable extent.

This is also one of many areas where the culture within the team was self reinforcing. As new people came on they understood this practice. They saw it in practice. They could see it was about finding good ideas and if their idea was attacked they didn’t take it nearly as personally as most people do in most places. I sought to understand if people we looked at hiring would be comfortable in such an environment.

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Cognition: How Your Mind Can Amaze and Betray You

The webcast above is from the excellent folks at Crash Course. This webcast provides another view into the area of Deming’s management system on the theory of knowledge (the one most people forget), how we know what we know and how that belief isn’t always right.

Two of the four components of Dr. Deming’s management system were about our brains (psychology is the other) which makes a great deal of sense when you think about how focused he was on the human element in our organizations (and the others are viewed significantly by how they interact with our brains – how we view variation, how we often fail to look at the whole system when drawing conclusions, etc.).

I believe most people don’t give nearly enough attention to theory of knowledge especially and also psychology within the context of an organization. They are a bit messy and vague and dependent and not easy to create simple cut and paste instructions for how to manage. This webcast takes a different look at it without connections back to management but I think most people need to spend more time thinking about these ideas. This video can help you do that.

If you are constantly (multiple times a minute in this video) seeing the connections with Deming and how the points relates to management that is a good sign. If not, that probably means you should spend more time reading and thinking about the theory of knowledge and psychology (see managing people posts).

Related: Customers Are Often IrrationalRevealed preference versus stated preferenceHow We Know What We KnowThe Neuroscience of DemingIllusions: Optical and Other

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A Good Management System is Robust and Continually Improving

Imagine a big clock, the big and little and sweeping second hands moving with absolute accuracy for years and years. Then, imagine various people working within it, somehow swapping out gears and cogs without the clock stopping or slowing down even a little.

This is a fairly good quote on a good management system. Some people might not like the mechanistic model – comparing an organization to a clock, and I agree that isn’t the right model, but even so it is a good quote.

The quote, from a story about the San Antonio Spurs captures what should happen with a good management system. Things just keep running well as inevitable changes take place (and keep getting better in the case of a management system).

A good management system doesn’t rely on heroic efforts to save the day. The organization is designed to succeed. It is robust. It will succeed with all the variation thrown at it by the outside world. A good management system takes advantage of the contributions people offer, but it will not perform poorly when others are relied on.

A well run organization has graceful degradation (when one component fails or one person is missing the performance doesn’t suffer, bad results are avoided).

With software for example, a decently created web sites may use javascript to enhance the user experience but if javascript is unavailable the site works fine (just missing some neat features that are nice but don’t prevent users from getting what they need). Poorly designed software has critical dependencies on conditions that cannot be guaranteed to be present for end users and the software just fails to work when those conditions are not met. Ungraceful degradation is too common in software. It is also too common in our management systems.

An organization succeeds because of the efforts of many great people. But the management system has to be created for an organization to prosper as what we all know will happen, happens: people will leave and need to be replaced. And the people that stay will need to adjust to new conditions inside the organization and in response to external forces. A good management system is constantly improving performance, innovating, increasing the robustness of systems and increasing the capability of people.

Related: Bad Weather is Part of the Transportation SystemHow to Sustain Long Term Enterprise ExcellencePerformance dependent on specific individuals is not robust and not capable of continuous high quality performanceEuropean Blackout: Human Error-Not

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Your Purpose Must Be About You

Guest post by Jurgen Appelo

I’m a writer. It’s the one thing that I intend to do for the rest of my life. That means, when I focus on writing, I cannot focus on knitting. Somebody else will have to do the knitting, so I can focus on the writing. And maybe later, I can trade my wonderful book for someone’s beautiful sweater. This concept applies to all other professionals too. Everyone is entangled in a web of economic dependencies, and therefore, the purpose you choose for yourself should somehow generate value for the others around you. Or else nobody will give you a knitted sweater.

This all makes perfect sense to complexity scientists, who have known for a while that complex adaptive systems find a global optimum through local optimizations and interdependencies. (At Home in the Universe by Stuart Kauffman) The parts in a complex system all try to optimize performance for themselves, but their efforts depend on the dependencies imposed on them by the parts around them. With a mix of competition and collaboration, the parts interact with each other without any focus on a global purpose. Nevertheless, the end result is often an optimized system. Biologists call it an ecosystem. Economists call it an economy. I call it common sense.

Putting the “Why” in Your Mission Statement

Most management scholars and experts have ignored the insights from the complexity sciences (or are unaware of them) and some have suggested goals for teams, and purposes for businesses, that are too narrow. There are many corporate mission statements in the world expressing ideas such as, “Make money for shareholders”, “Put customers first”, and “Achieve superior financial results” (The Leader’s Guide to Radical Management by Stephen Denning). In each of these cases, the purpose of the organization is (too) narrowly defined as providing value to one type of client or stakeholder.

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George Box Articles Available for a Short Time

A collection of George Box articles have been selected for a virtual George Box issue by David M. Steinberg and made available online.

George E. P. Box died in March 2013. He was a remarkably creative scientist and his celebrated professional career in statistics was always at the interface of science and statistics. George Box, J. Stuart Hunter and Cuthbert Daniel were instrumental in launching Technometrics in 1959, with Stu Hunter as the initial editor. Many of his articles were published in the journal. Therefore we think it is especially fitting that Technometrics should host this on-line collection with some of his most memorable and influential articles.

They also include articles from Journal of the American Statistical Association and Quality Engineering. Taylor & Francis is offering these articles freely in honor of George Box until December 31st, 2014. It is very sad that closed science and engineering journals block access to the great work created by scientists and engineers and most often paid for by government (while working for state government universities and with grants organizations like the National Science Foundation[NSF]). At least they are making a minor exception to provide the public (that should be unlimited access to these works) a limited access to these articles this year. These scientists and engineers dedicated their careers to using knowledge to improve society not to hide knowledge from society.

Some of the excellent articles make available for a short time:

The “virtual issue” includes many more articles.

Related: Design of Experiments: The Process of Discovery is IterativeQuotes by George E.P. BoxThe Art of DiscoveryAn Accidental Statistician: The Life and Memories of George E. P. Box

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