Unappetizing Spaghetti Diagrams

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A Spaghetti Diagram is a simple visual tool to demonstrate the flow of material, flow of information, and flow of money in a process. The word “spaghetti” is descriptive because it describes flow that is not easily understood, can’t easily be followed, or if the flow is literally all over the place.  Indeed, a Spaghetti Diagram represents a point-of-departure: what does the current state look like and what are the exact improvements we need to make?

Put another way, a Spaghetti Diagram is a visual representation of how bad things really are and are used to expose Waste and Opportunity.

How Bad are Things, Really?

Sometimes, through poor thinking and poor choices, Spaghetti Diagrams aren’t just representations of how things are, but they can be representations of what we have created: sometimes, we turn our processes into Spaghetti Diagrams; this is precisely the case with the U.S. Government and the current Healthcare Debate.

The Democratic Party’s proposed Healthcare scheme is below ¹:

This map begs several questions:

• Where does it start?
• Where does it end?
• Are all motions equally important?
• What are the value-added steps?
• What are the steps we can do without?
• Can a 15 year old understand what is happening on this map?

It is safe to conclude that the map above is clearly bloated — complexity at its worst.

For me, I have a question that drives clarity and honesty in my thinking:

Can a 15 year old understand this?

If the answer is “No”, then I need to work harder to make my idea clearer and simpler.  Using that question as a litmus test for the Healthcare Scheme above, I believe the answer would be a clear “No.”  In other words, the Map above is a starting point, not an ending point: there is much to improve.

One area not exposed by either of the above maps is, perhaps, the most insidious of all: amidst all the confusion and motion are people that could potentially be harmed.  The patient is the true casualty in either of the above maps: she gets lost in it — indeed, we forget that at the center of Healthcare is the patient.  Broken processes enable our forgetfulness of people.

Broken process unfortunately helps us to forget people

Another map worthy of Spaghetti-like accolades is below ²:

Again, the presence of many squiggly lines means one thing: OPPORTUNITY for improvement.  This is clearly a starting point, not and ending point.  There is so much to improve.

To be fair, creating a future-state of the above is not trivial, underscoring the fact that Healthcare is clearly complex.  One thing is clear, if anything needs and begs improving, it is Healthcare where the biggest opportunities lie ³.

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