Microfeedback for Adjusting Behaviors

Previously I’ve talked about defining the values and behavior associated with quality culture. Once you’ve established these behaviors, a key way to make them happen is through microfeedback, a skill each quality professional, supervisor, and leader in your organization should be trained on.

We are all familiar with the traditional feedback loop: you receive feedback, reflect on it, make a plan, and then take action. This means feedback is given after a series of actions have taken place. Feedback addresses a few key observations for future improvements. In a situation when actions and sequences are quite complicated and interdependent, feedback can fail to provide useful insights to improve performance. Micro-feedback potentially can be leveraged to prevent critical mistakes and mitigate risks, which makes it a great way to build culture and drive performance.

Micro-feedback is a specific and just-in-time dose of information or insights that can reduce gaps between the desired behavioral goals and reality. Think of it as a microscope used to evaluate an individuals comprehension and behavior and prescribe micro-interventions to adjust performance and prevent mistakes.

Microfeedback, provided during the activity observed, is a fundamental aspect of the Gemba walk. These small tweaks can be adapted, and utilized to provide timely insights and easy-to-accomplish learning objectives, to drive deep clarity and stay motivated to modify their performance.

Where and when the microfeedback happens is key:

1. Task–based microfeedback focuses corrective or suggestive insights on the content of a task. To provide higher impact focus micro-feedback on the correct actions rather than incorrect performance. For example “Report this issue as an incident…”

2. Process-based micro-feedback focuses on the learning processes and works best to foster critical thinking in a complex environment. For example, “This issue can be further processed based on the decision tree strategies we talked about earlier.”

3. Self-regulation-based micro-feedback focuses on giving suggestive or directive insights helping individuals to better manage and regulate their own learning. For example, “Pause once you have completed the task and ask yourself a set of questions following the 5W2H formula.”

For microfeedback to be truly successful it needs to be in the context of a training program, where clear behavorial goals has been set. This training program should include a specific track for managers that allows them to provide microfeedback to close the gap between where the learner is and where the learner aims to be. This training will provide specific cues or reinforcement toward a well-understood task and focus on levels of task, process, or self-regulation.

During change management, provide positive micro-feedback on correct, rather than incorrect, performance. This can be very valuable as you think about sustainability of the change.

Leveraged sucessful, but well trained observers and peers, microfeedback will provide incremental and timely adjustments to drive behavior.

Is There Equity in Out of Office?

I think many of us are considering what work looks like, grappling with a return to offices, hybrid situations, and being fully remote. I think the media focuses rather extensively on companies like Apple, where a good chunk of the workforce seems to be up-in-arms about a mandatory return to the office.

In the pharma world, things are a little more complicated, especially as it applies to the quality profession.

At the heart sits the question, what sort of labs and manufacturing facilities do you have on site? This physical presence requires that certain employees be on-site. Which in most pharmas makes a bundle of those who must be on-site, and those who do not need to be on-site.

I understand the desire for those who can work remotely to want to work remotely. There are a lot of good reasons for working remotely, and I personally chose a company that was purely remote for a chunk of those.

But, and this is a big but, what does equity look like?

Take for example an average quality department. It is broken down into those who support labs, manufacturing, clinical trials and post-marketing surveillance (for simplicity). You thus have in the same department individuals who must be always on-site; who need to show up a few days a week; and those who can do their job perfectly well remotely. To complicate matters you might even have a big chunk of your partners (all those clinical trial, medical affairs, pharmacovigilance folks) that have no attention of coming back to the office.

So, what does equity look like? How do you treat these three camps? How to you compensate those who come into the office, that have commutes on top of their days that co-workers do not? How do you ensure everyone has equal opportunity to be seen, heard and participate? What does this organization look like?

I thnk this is one of the major challenges for quality organizations moving forward. I do not think there is one size fits all, and there is no easy answer.

Adapting and Experimenting – the Role of a New Quality Leader

I think a common challenge is how do we as a new quality professional joining an organization replicate the same success we have had in past roles

Quality requires a support structure, and I think it is easy to underestimate the impact of the absence, or the lack of, that structure. Just parachuting quality professionals into different organizations where they are left without the scaffolding they’ve implicitly grown to expect and depend on can lead to underperformance. Some adapt, of course, but others flounder, especially when hired with daunting short-term expectations, which can often be the case in organizations looking to remediate gaps in a fast way. I think this is only exacerbated as a result of the pandemic.

Culture can have a steep learning curve and being able to execute requires being very well-versed in the culture of an organization. You have to know how your organization works in order to get it to work diligently like a well-oiled machine to execute the higher-level quality vision.

Learning the culture doesn’t mean simply parroting the oft-repeated mantras received during orientation, but truly internalizing it to an extent where it informs every small decision and discussion. At the best of times, that’s difficult and takes time, particularly as there isn’t usually a single monolithic culture to learn, but myriad microcultures in various different parts of the organization. Doesn’t matter the size, this is a challenge.

In the worst case, where an organization has a culture diametrically opposite to that of the previous workplace, “learning the culture” also requires un-learning almost everything that led people to get to their current level in the first place. The humility to strive to turn themselves into the leader the organization truly needs, rather than the leader they’ve grown to be over the past years, is a hard one for many of us. Especially since we are usually brought on board to build and remediate and address deficiencies.

To be a successful agent of change one has to adapt to the current culture, try experiments to accelerate change, and do all the other aspects of our job.

This is hard stuff, and a part of the job I don’t think gets discussed enough.

Defining Values, with Speaking Out as an example

Which espoused values and desired behaviors will best enable an organization to live its quality purpose? There’s been a lot of writing and thought on this, and for this post, I am going to start with ISO 10018-2020 “Quality management — Guidance for people engagement” and develop an example of a value to build in your organization.

ISO 10018-2020 gives 6 areas:

Context of the organization and quality culture
Leadership
Planning and Strategy
Knowledge and Awareness
Competence
Improvement

This list is pretty well aligned to other models, including the Malcolm Baldrige Excellence Framework (NIST), EFQM Excellence Model, SIQ Model for Performance Excellence, and such tools as the PDA Culture of Quality Assessment.

A concept that we find in ISO 10018-2020 (and everywhere else) is the handling of errors, mistakes, everyday problems and ‘niggles’, near misses, critical incidents, and failures; to ensure they are reported and recorded honestly and transparently. That the time is taken for these to be discussed openly and candidly, viewed as opportunities for learning how to prevent their recurrence by improving systems but also as potentially protective of potentially larger and more consequential failures or errors. The team takes the time and effort to engage in ‘second order’ problem-solving. ‘First order’ problem solving is the quick fixing of issues as they appear so as to stop them disrupting normal workflow. ‘Second order’ problem solving involves identifying the root causes of problems and taking action to address these rather than their signs and symptoms. The team takes ownership of mistakes instead of blaming, accusing, or scapegoating individual team members. The team proactively seeks to identify errors and problems it may have missed in its processes or outputs by seeking feedback and asking for help from external stakeholders, e.g. colleagues in other teams, and customers, and also by engaging in frequent experimentation and testing.

We can tackle this in two ways. The first is to define all the points above as a value. The second would be to look at themes for this and the other aspects of robust quality culture and come up with a set of standard values, for example:

Accountable
Ownership
Action Orientated
Speak up

Don’t be afraid to take a couple of approaches to get values that really sing in your organization.

Values can be easily written in the following format:

Value: A one or two-word title for each value
Definition: A two or three sentence description that clearly states what this value means in your organization
Desired Behaviors: “I statement” behaviors that simply state activities. The behaviors we choose reinforce the values’ definitions by describing exactly how you want members of the organization to interact.
- Is this observable behavior? Can we assess someone’s demonstration of this behavior by watching and/or listening to their interactions? By seeing results?
- Is this behavior measurable? Can we reliably “score” this behavior? Can we rank how individual models or demonstrates this behavior?

For the rest of this post, I am going to focus on how you would write a value statement for Speak Up.

First, ask two questions:

Specific to your organization’s work environment, how would you define “Speak Up.”
What phrase or sentences describe what you mean by “Speak Up.”

Then broaden by considering how fellow leaders and team members would act to demonstrate “Speak Up”, as you defined it.

How would leaders and team members act so that, when you observe them, you would see a demonstration of Speaking Up? Note three or four behaviors that would clearly demonstrate your definition.

Next, answer these questions exclusively from your team member’s perspective:

How would employees define Speaking Out?
How would their definition differ from yours? Why?
What behaviors would employees feel they must model to demonstrate Speaking Out properly?
How would their modeled behaviors differ from yours? Why?

This process allows us to create common alignment based on a shared purpose.

By going through this process we may end up with a Value that looks like this:

Value: Speaking Out
Definition: Problems are reported and recorded honestly and transparently. Employees are not afraid to speak up, identify quality issues, or challenge the status quo for improved quality; they believe management will act on their suggestions.
Desired Behaviors:
- I hold myself accountable for raising problems and issues to my team promptly.
- I attack process and problems, not people.
- I work to anticipate and fend off the possibility of failures occurring.
- I approach admissions of errors and lack of knowledge/skill with support.

Culture of Quality Initiatives

At the heart of culture is a set of behaviors and beliefs, that indicate what is important to the organization and drive all decision-making. Culture, and weaknesses within it, drive the root cause of many problems, and improving quality culture is an essential part of continuous improvement.

Quality Culture is Fundamental to Actually Providing Quality

Culture is often the true reason for the behavior of people within an organization and it can often be deeply unconscious and not rationally recognized by most members. These ideas are so integrated that they can be difficult to confront or debate and thus difficult to change.

A critical part for improving culture is being able to measure the current situation. A great place to start is using a survey-based to gather input from employees on the current culture of quality. Some of the topic areas can include:

Leadership and Vision
Management Practices (Management by Facts, Focus on Results and Creating Value)
Employee Ownership and Engagement
Collaboration
Continuous Improvement, Learning Culture
System Thinking

Some of the feedback methods to utilize once you have a baseline can include:

Feedback Method	When to use
Focus Groups	You want detailed feedback on a number if issues AND employees are generally willing to speak on the record
Short, targeted surveys	You have a number of close-ended findings to test AND your organization is not suffering survey fatigue
Informal conversations	You want to gain context of a few data points AND you have a trusted circle

As you build improvements, you will introduce better metrics of success.

Measuring Training Effectiveness for Organizational Performance

Once you a good set of findings select 2-3 key ones and design experiments.

Pitfalls and Keys to Success for Experiments in Quality Culture

Culture is Complex, Experiment for Success

Experiment for Success