How do we stop creating problems that feed the DMAIC Lean Six Sigma (LSS)problem-solving machines we have rightly created? If we teach everybody how to effectively solve problems, will some transformation begin that slowly wakes everybody up so that we can actually measure the rate of change of problem creation to problem prevention? For example, consider 3M. They trained about 55,000 DMAIC LSS green belts. What happened to their rate of problem creation? Nobody really knows because that was not a measure of success. As an analogy, our emergency medical system has a lesson for us in this context.
 
Let's say we train large numbers of EMT's (emergency medical technicians) and emergency room trauma teams. What is likely to happen to the rate of emergencies? The time it takes to react to an emergency will probably be reduced and the effectiveness of the corrective medical treatment will probably increase, but the number of incoming emergencies probably won't be affected. The problem solving DMAIC LSS process can be compared to the emergency medicine process. At an accident scene, the EMT defines the victim's general problem, measures the victim's vital signs, analyzes the data and identifies the root causes of the damage, then they make decisions on improving the victim's state and control the victim's condition as they transport them to the hospital. When they get to the emergency room, the process is essentially repeated by the medical doctors and emergency room workers. Our current medical emergency process does double-DMAIC! Even so, emergency services continue to be in very high demand. Recently, a presidential candidate noted that poor and uninsured people are using our emergency rooms for non-emergency care because they will not be turned away in most cases. They may have to wait quite a while but they will be attended to. His next point was that we need to transform our health care system into a wellness system. We cannot afford to sink more resources into expensive reaction at the rate we are headed - we have to change and focus our investment on prevention and avoidance of health problems in the first place. Without making a political judgment on this point, it is exactly the same paradigm we face with DMAIC LSS transforming to FutureSigma, a preventive approach. We'll still need our problem solving/emergency medicine approach, but it would be needed much less.
 
There will always be a need for DMAIC LSS "belt" training and programs to fix problems in our organizations. By itself, however, DMAIC LSS does not stem the flow of problems to be solved as new DMAIC projects. It is not a transformative way to switch over to problem prevention. If it was, we would be measuring and watching the rate of new DMAIC LSS projects going down and staying down, and we would be focused on that outcome. I just don't see this in the organizations I visit and I don't hear of it out in the world at large.
 
We have to define specific mechanisms that enable us to change over to problem prevention in some practical way. There are two mechanisms to be concerned with; the first helps us transition, and the second is what to do on a daily basis to sustain the new behavior once we have made the switchover. For this article, we will discuss the transition mechanism.
 
Employing Change Agents to Start the Transition
 
As another analogy, consider the case of smoking versus quitting for health reasons. In the short-term, a person can use nicotine gum to help them stop smoking, until their habit can be replaced with healthy lifestyle behavior once they have stopped smoking. First, a chemical is used to displace the root cause of the addiction. Then, with the cycle of addiction disrupted, systemic daily life style changes are gradually adopted.
 
Our organizations may try to initiate a similar type of behavior change (and some changes are as difficult as quitting smoking!) by employing an external consultant who is an expert in the desired change, or use an internal change agent with similar capabilities. This is much like a chemical that intermixes with the current flow of behavioral mechanisms and forces change. It's often slow and painful because people don't like to change much.
 
The following table illustrates pros and cons for some alternatives for a short-term change agent role.
 

Change Agent	Pros	Cons
External Consultant who specializes in problem prevention process deployment from a LSS experience base	·         Have a process & plan to follow based upon specific mechanisms to transition from reaction to prevention dynamics & behaviors ·         Already motivated to drive the transition from a Prevention inertia perspective	·         New offering to the Lean Six Sigma market, ·         People are not used to their unique model, tools, methods & best practices ·         Possess a relatively untested change model in the LSS environment
External Consultant who specializes in problem prevention process deployment with little or no LSS experience base	·         Extensive experience in business process design ·         May bring fresh perspective that is proactive in nature ·         No LSS process or deployment experience	·         Weak on transforming a LSS (reaction) process to a FutureSigma (prevention) process ·         Little or no experience in LSS or its alternatives that reverse the paradigm to prevention
External Consultant who specializes in general change mechanics	·         Extensive experience in generic change management process, mechanisms & projects	·         Little or no experience in LSS or its alternatives that reverse the paradigm to prevention
Internal Change Agent for problem prevention	·         Extensive experience with internal culture, process & vocabulary ·         Well established internal infrastructure to train & control	·         Imbedded LSS problem solving paradigm, process, training & deployment mechanisms. ·         LSS process inertia, lack of the LSS project & deployment network urgency & behavior motivation to transition to prevention