Nice work in bringing to mind the notions of “Lean”,

 Nice work in bringing to mind the notions of “Lean”, “Six Sigma” and “Kaizen” methods of thinking to the evaluation of our healthcare learning communication processes to promote project success:

“I also need to be competent in informatics so that I will be able to recognize and use nursing data to improve performance and quality of care. Informatics skills will also enable me to develop flow charts that represent clinical processes and be able to analyze these charts to inform decisions.”

Your overall goals made me think of the Ishikawa (fishbone) process, whereby several categories of causes are analyzed whenever there is a problematic outcome; the vital issues to address typically involve the team members who are actively involved in the work flow, and who need constant communication and information-sharing to achieve project outcomes, as well as departmental and organizational goals.

As Suarez-Barraza and Rodriguez-Gonzalez (2019) point out, Ishikawa’s logical “fishbone” process can be utilized to determine if/how any of our organizational processes may actually be the “root cause” of errors in communication and productivity in healthcare. As the authors share, “Exploring this questioning can shed light on the first indications to ratify the arguments of Ishikawa and Deming, that the main problems of companies are found in their processes and perhaps, in a deep way, in some of these cornerstone root causes that have to do with the way organizations are managed” ((Suarez-Barraza and Rodriguez-Gonzalez, 2019, p. 302).

1- What do you think of this notion that the way organizations are managed informs if/how communications happen in an organization, as well as what specifically is communicated by leadership at any given time?

In addition, the authors discovered that there were at least seven typical patterns that show the first signs of cornerstone root causes in organizations. These typical, problematic patterns are listed in the table below (Suarez-Barraza and Rodriguez-Gonzalez, 2019):

Synthesis of Common Patterns 

Common patterns (Level 2 causes)

Common patterns (Level 3 causes)


Lack of staff training

Errors caused by lack of technical training of staff in performing their duties

Poorly trained employees at the technical level

Lack of employee motivation

Unmotivated and frustrated employees

Unmotivated and frustrated employees

Problems in processes execution

Failures in sequence, flows, delivery times and process standards

Deficient processes or with flaws in their operation

Coordination problems between functional departments

Coordination and organization failures in the company

Failures in the design of the organizational structure


Inefficient information flow

Inefficient information flow

Side and vertical communication problems

Poor communication channels

Failures in communication channels

Problems with final good

Quality Errors in Product Manufacturing

Products with quality problems

Ineffective leadership


Inefficient leadership of middle and top managers

Stressful work environment


High pressure and stressful work environment

Failure in resource management (materials, machinery/equipment, financial)


Inefficient resource management

Problems with service quality

Failures in the quality of the service provided

Problems with service quality

2- What do you think of these research findings related to everything you have learned at the doctoral level thus far?

Great food for thought!


Suárez-Barraza, & Rodríguez-González, F. G. (2019). Cornerstone root causes through the analysis of the Ishikawa diagram, is it possible to find them?: A first research approach. International Journal of Quality and Service Sciences11(2), 302–316.

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