The missing piece of the improvement loop

Plan, Do, Study, Act is how good organizations learn. Most can plan and do. Study is where the loop breaks: there’s no timely, human-level signal about whether a change helped.

Did it help? Answer arrives years later, if at all guess, then repeat Plan what to change Do try it small Study did it help? Act adopt or drop Residents’ journals consented, aggregated weekly, not yearly Simulations model likely effects before spending money results recalibrate the model