Dr. Hinnant-Crawford struck me with her challenge to examine process in a recent episode of the HTH Unboxed podcast,, “...we think about the outcomes of improvement and making sure we have an equity or justice centered outcome. But also, how do we make sure we have an equity and justice centered process?” She reminds us that it might be a lot easier to look at data to discover inequities, whereas looking in the mirror may be more difficult, as one may not want to see how they are perpetuating injustices or oppressions with processes that leave out the voices of others. While looking at data is a key component, only looking at the data omits other variables, including the extreme importance of others’ voices as a critical component in improvement science.

Here is one thing I learned over many years of practice: telling someone how to solve a problem or dilemma means there is a 95% chance that the problem will not be solved and in some cases will get worse. There’s always the 5% of the time that the solution works as envisioned, however that’s not a great return.

In my experience, the conversations that produce the most change in a problem or dilemma are those that follow a conversational sequence designed to open up thinking, not provide a solution or answer. This sequence of questions, developed originally for use in the What? So What? Now What? Protocol, sets up a conversational model that opens up possibilities, supports individual agency, and keeps us working in our realm of influence.