Tomorrow
When my oldest was little, his concept of time was simple. The past was always "last night," and the future was always "when I wake up again." Focused on the here and now, he seemed perfectly aware of many good things to come. To him, "tomorrow" was something he couldn't wait to experience.
We adults could learn something from this. Recently I was at a meeting with other ancillary department and nursing managers discussing order entry. Our time was spent "mapping" the current process to decide what we liked, what we didn't like, and what we needed to fix. It struck me that we were talking about today when we should have been talking about tomorrow.
I didn't dare say anything – the participants were too intent on deciding how to fix the present – but later I wondered if it was a little like trying to drive somewhere by staring at the floor of the car instead of the road. We hadn't discussed a different process, only tweaks to an inevitable future. Our "plan" was grease and duct tape, not a new car.
This happens so many times we never question its validity. We form committees, work teams, and discussion groups to describe today. We flowchart, narrate, and analyze to fix what doesn't work. But we improve instead of design. We recycle instead of replace. We fall short of describing tomorrow by extending today.
A better approach to process design might be to scrap everything. Start fresh and pretend we know nothing about what we think will or won't work. Really try to see things for the first time, from a different angle, or with new knowledge. Once we've figured out our future – what it looks like, how it works, what it costs – getting there is surprisingly easy.
Once we're moving in a new direction we can always figure out what doesn't work today. My guess is we won't want to, once we wake up again.