Five Questions with Eric Dickson, M.D.

Eric Dickson Headshot High Rez
Eric Dickson, M.D.

Eric Dickson was an emergency room physician and administrator when he first hit on the unlikely idea of using a children’s toy to teach key principles of teamwork, leadership and process improvement. Here he explains how the exercise helps the 1,125-bed UMass Memorial Health Care system, which he now leads, implement thousands of employee-generated quality and safety ideas each year.

1. Betsy Lehman Center: How did the Potato Head exercise get started?

Dr. Dickson: Back in around 2008, I was teaching the “lean” system of process improvement at the Harvard T.H. Chan School of Public Health, and people just weren’t getting it. Because I’m an emergency room doc and deal with trauma, I wanted an exercise that would show how, even if patients arrive in a mess, you can use process improvement to do a better job of putting them back together without doing any harm. Our three children were still pretty young in those days, and we happened to have a big box of Hasbro's Mr. Potato Head parts at home. So my kids built the original Mr. Potato Head models that served as the ‘patients.’ Using those, we took the exercise into class and everyone liked it so much that I kept getting requests to do it again and again at other places.

2. Betsy Lehman Center: During the exercise, you ask groups of people to take a bag full of parts and assemble from nine to 14 unique Potato Heads that exactly match a series of photographic models. Why is that so hard?

Dr. Dickson: Everybody laughs when they first get their bags. But then they get started and make a bunch of mistakes and the quality is not good. Each group has an inspector who rejects any Potatoes that don’t match their picture, and it takes forever to fix the errors. So at that point, when they realize how difficult this really is, we bring in a coach to help the teams get organized.

3. Betsy Lehman Center: What does the coach tell them?

Dr. Dickson: First, she suggests that each team choose a leader. Then she tells the leader, ‘Have the team talk about why they failed and how to do it differently. But don’t offer your own ideas. Only implement ideas the other team members come up with.’ That’s important because when the people doing the work feel they own the process, they will be motivated to invent even smarter ideas in the future. They will also start working together better, which prevents a lot of rework and potential harm to the Potato. Each team has up to eight minutes to assemble the toys. On the first trial, almost none of them finish. But by the third trial many get it down to five minutes or even four.

Umass Idea System 1
An idea board from a unit for general medicine patients on the University Campus of UMass Memorial Medical Center in Worcester.

4. Betsy Lehman Center: How does that tie in to process improvement at UMass Memorial?

Dr. Dickson: We require it for every new employee at UMass Memorial Health Care during their introduction to the system-wide continuous improvement program we call the “Idea System.” The aim is to get everyone engaged every day in making things better for our patients. We have 400 business units and every one of them does regular huddles to seek new ideas. Each also has an idea board that lists the latest proposals and progress toward them (see photo at left). So in the emergency room, for example, one problem was we never had enough pillows because we were constantly sending patients up to the hospital and they took their pillows with them. So the solution was to send a tech around each morning on ‘pillow rounds.’ This person goes to every floor and finds the closets that are stuffed with pillows and brings some back. And we tracked how well that was working.

5. Betsy Lehman Center: Has the “Idea System” been successful?

Dr. Dickson: Every manager has a portion of their compensation at risk based on how many of their reports’ ideas they implement. And last year, we implemented over 15,000 ideas from our 13,000 employees. We are fundamentally trying to go from being a culture of problem identifiers to one of problem solvers—and that’s when we will have achieved our goal. The Potato Head exercise helps introduce people to that. When I first dreamed this up, I thought we’d use it once or twice and then forget it. Instead [he says with a sigh], Potato Heads will probably be my legacy.

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