Dr. Atul Gawande confronts this phenomena in health care delivery, describing the challenges of lowering nosocomial infection rates, a complex problem with a wide variety of potential causes. The problem was eventually addressed (hand washing of all things) not through some large scale randomized control trial or picking a solution from the proverbial hat. No, it was addressed through a short-cycle, iterative study of the problem and its possible solutions.

Short-cycle Conceptually

A short-cycle improvement study can be thought of as a phased emergent analysis of a complex problem (Figure 1). That's a loaded statement, so let's unpack the meaning behind the terms. Phased indicates that it occurs over multiple recursive steps. Emergent refers to the fact that the more we engage with a problem, the more robust our schema for it becomes. And finally, analysis means the deconstruction of a multifaceted construct into constituent elements for the purpose of better understanding it. The process has two distinct but recursive phases: an exploration phase focused on understanding the problem, and a testing phase focused on implementing and testing solutions.