Accelerating improvement means acting quickly. Most improvement efforts fail because so much time is spent considering, studying and meeting that nothing ever changes. Organizations that want to improve can simply begin small-scale tests right away - today even!

Improvement teams should ask, "What is the largest, informative change we can make by next Tuesday?" This will not be the only change a team should make, and probably will not be the most important one, either. But by making an informative change "by next Tuesday," teams can break the inertia that keeps many improvement efforts from getting off the ground.

It is easy to become comfortable with the status quo and the easy path. When we demonstrate in small ways that another approach can work better, we make accepted practices suddenly appear archaic.

Running small-scale tests sooner leads to improvement much more surely and quickly than does running large-scale cycles later. Even an ambitious and innovative change can be tested first on a small scale -- for example, with only one or two physicians, with the next five patients, for the next three days. In general, make the strongest change that the team can do quickly, on the smallest sample that will be informative.

When a team can show improvement, then expanding the scope will be much easier. Each test, properly done, provides valuable information and forms the basis for further improvement. If a change works on a small scale and is improved in successive tests, it can then be implemented with assurance on a larger scale.

Testing changes is an iterative process: the completion of each test rolls directly into the start of the next test. A team learns from the test (What worked and what didn’t work? What should be kept, changed, or abandoned?) and uses the new knowledge to plan the next one. When the team continues linking tests in this way, it can refine the change until it is ready for broader implementation, thus helping to overcome an organization’s natural resistance to change.

So, remember to always ask, "What Can We Do by Next Tuesday?"