Navigating the Rapids: What Paddling Taught Me About the PDSA Cycle
*This is part of a series of blogs which start off as a narrative retelling of a kayak adventure and later link that experience to a specific leadership/ organizational principle. Feel free to jump ahead to “Applying these Lessons Ashore” if you’d like to skip the narrative portion.
The river was swollen from an early spring melt. I could hardly hear through the roar of the falls and hardly see through the mist, and yet I felt calm with my kayak, Cedar Courage, in hand. The river ahead was a complex network of currents, eddies, rocks, and fallen trees. Choosing the right line was crucial, but I had done my homework. I had waded upstream chest-high in the freezing water while being buffeted by the crushing current only an hour before, this was truly type-A fun. But from this perspective, closest to the action, I could evaluate the twists and turns of the river, looking for every hint of a hidden rock or tree, trying to plan against every eventuality as I knew I’d soon be rushing down this same river in a moments time. Now, standing at the bank, I was calm and ready. I had spent weeks planning, talking with locals and reviewing resources online, I had also spent years honing the skills that I would need to pull this off!
Setting off, I felt the immediate rush of cold water and adrenaline. The first rock was upon me in seconds. Committing to my chosen line, I paddled vigorously to the right, through the center of the V-like channel, steering the kayak as best I could. I did not hit the line perfectly, it was in-fact pretty ugly, but I made it through. It was harder to fight the current than I expected, but I got past the first hurdle and needed to immediately shift my focus to the next challenge – looking back and reveling in success wasn’t an option, that could come at the end. I noted the stronger than expected current and navigated the next few sections a bit better. As I came around a large bend, I saw something I had missed on my journey up! On the far-left bank hidden in the trees was a discarded and crushed canoe. I was still moving fast, and had chosen to stay along the right bank, but as I kept paddling the eddies kept forcing me off course. I was drawn towards the enormous standing wave on the left and realized that if I did not act quickly, my boat would end up next to the canoe. I paddled hard, but as I careened sideways I realized I could not out-paddle this wave - I could however meet it head on. I felt more like a surfer at Big Sur than a Kayaker as I crashed into that 14-foot wave (ok it was probably 4 feet at most but in that moment it felt all-consuming). I came out the other side waterlogged but alive and invigorated. The water calmed and I paddled over to shore to empty my water-filled boat and reflect on the descent.
I don’t just paddle for the physical challenge or thrill, but for the mental one. Each decision, each stroke of the paddle, is a lesson in planning, commitment, analysis, and adaptability. The river has also taught me a lot about humility and failure. Mother nature remains undefeated. Even with the best planning and execution, the unexpected can happen. Sometimes in the moment you can’t fight the flow of the river and need to embrace it. But that doesn’t mean next time you can’t apply what you’ve learned, adapt, and find a new way through. I made the run a second time, this time I was able to slow down, tack further right, and evade a second Big Sur moment! Failure is an opportunity to learn, and one failure does not mean success is impossible but that you need to study and adapt your chosen “line”.
After my second run, I set up a picnic (licorice, re-hydrated chili, and hot chocolate) in a nearby clearing. I sat back and reflected about how much paddling and organizational leadership in human services have in common. The skills I was learning and practicing were critical for navigating any complex, dynamic environment, especially ones where the pace is fast, change is constant, and the risks are real!
Applying these Lessons Ashore
The same adrenaline is felt by leaders as they navigate the real-world rapids of our human services systems. System as big and complex as healthcare for example has that same intangible power and ability to sweep us along in its wake. If we haven’t adequately planned staff or patients may end up feeling like our blue canoe. There exist a number of systems and frameworks to help navigate these complex changing environments. At the Healthcare Lean Greenbelt program at McGill’s Executive Institute, they pointed us towards the PDSA cycle. This cycle - Plan-Do-Study-Act (PDSA) - is a fundamental framework for implementing change, and it could have been written by a kayaker!
The first steps are to ground yourself with three key questions: What are we trying to accomplish? How will we know that a change is an improvement? And what changes can we make that will result in improvement? Once you’ve done this, it’s all about monitoring and controlling the outcome through the Plan, Do, Study, and Act phases. If done well, and with the buy-in of the frontline teams it is an incredibly powerful framework to drive improvement.
Plan: Just like choosing the right line down the river, the initial phase of designing a new program workflow begins with a thorough analysis. Get as close as you can to the action/problem, seek input from everyone with skin in the game, think about risks and opportunities the change may create.
Do: Have courage and commit! Knowing it may not go perfectly to plan, but also that staying on the sidelines is not an option. Commit long enough that you make it to the end of a cycle of your workflow, you may be tempted to pull the plug at the first bump along the road, but growing pains are natural in any change process. This is where commitment and buy-in will be tested, but keep reminding the team that a certain degree of failure is expected and ok, they will not be punished. Reminding of shared team goals like improving client experience or program accessibility can help keep the team morale high doing this first iteration.
Study: A moment of calm always follows a set of rapids, this is an opportunity to reflect, learn, and ideate to improve your next run. Similarly, in the PDSA cycle, the Study phase involved evaluating the outcomes of the new changes or workflow adaptations. Collect data, hold focus groups or share surveys. This evaluation is a crucial step to find flaws, celebrate successes, and understand the impact of the interventions.
Act: A river is a living system, and each run will require adaptations and sometimes a complete change in strategy. The Act phase in the PDSA cycle is designed to adjust your approach based on the Study phase. This could mean revising the workflow, introducing additional training, or even redefining the goals.
Repeat: The cycle is iterative and transformative. It may take many runs down the river before you no longer capsize, but usually each run improves progressively. Most importantly, do not give up.
