1. What change can we make that will lead to improvement?
Change Concept: General notion or approach to change that has been found to be useful in developing specific ideas for changes that lead to improvement.
Go over what is a change concept
Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs 29

2. A Resource Guide to Change Concepts
Grouping:
A. Eliminate Waste
B. Improve Work Flow
C. Optimize Inventory
D. Change the Work Environment
E. Enhance the Producer/Customer Relationship
F. Manage Time
G. Manage Variation
H. Design Systems to Avoid Mistakes
I. Focus on a Product/Service
# of Concepts 11 4 8 5
Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs

3. Complete List of Change Concepts
Manage Variation
Standardization (Create a Formal Process)
Stop tampering
Develop operation definitions
Improve predictions
Develop contingency plans
Sort product into grades
Desensitize
Exploit variation
Design Systems to avoid mistakes
Use reminders
Use differentiation
Use constraints
Use affordances
Focus on the product or service
Mass customize
Offer product/service anytime
Offer product/service anyplace
Emphasize intangibles
Influence or take advantage of fashion trends
Reduce the number of components
Disguise defects or problems
Differentiate product using quality dimensions
Added for 2nd Edition
71. Change the order of process steps
72. Manage Uncertainty, Not Tasks
Eliminate Waste
Eliminate things that are not used
Eliminate multiple entry
Reduce or eliminate overkill
Reduce controls on the system
Recycle or reuse
Use substitution
Reduce classifications
Remove intermediaries
Match the amount to the need
Use Sampling
Change targets or set points
Improve Work Flow
Synchronize
Schedule into multiple processes
Minimize handoffs
Move steps in the process close together
Find and remove bottlenecks
Us automation
Smooth workflow
Do tasks in parallel
Consider people as in the same system
Use multiple processing units
Adjust to peak demand
Optimize Inventory
Match inventory to predicted demand
Use pull systems
Reduce choice of features
Reduce multiple brands of the same item
Change the Work Environment
Give people access to information
Use Proper Measurements
Take Care of basics
Reduce de-motivating aspects of pay system
Conduct training
Implement cross-training
Invest more resources in improvement
Focus on core process and purpose
Share risks
Emphasize natural and logical consequences
Develop alliances/cooperative relationships
Enhance the Producer/customer relationship
Listen to customers
Coach customer to use product/service
Focus on the outcome to a customer
Use a coordinator
Reach agreement on expectations
Outsource for “Free”
Optimize level of inspection
Work with suppliers
Manage Time
Reduce setup or startup time
Set up timing to use discounts
Optimize maintenance
Extend specialist’s time
Reduce wait time
Instructions (continued)
Fill in these fields:
Questions
Predictions
Change or Test
Data Collection
Use additional paper if needed.
Guidelines 
How frequently does each cause occur?
How seriously does each cause affect the process? 
Discussion 
As time permits, discuss what you might do in the Do, Study, and Act phases of this PSDA cycle.
Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs

4. Using Change Concepts
Vague, strategic, Improve process to reduce anxiety
creative
Give patients and families access to information #27
Use beepers for family and friends waiting
Specific, actionable, Make beepers available to
Results families of all surgery patients next week.
Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs