No Quick Fixes for Complex Problems
By Mark Graban
An editorial written by an American Airlines pilot in the Fort Worth Star-Telegram caught my attention ("Unintended consequences of the Passenger Bill of Rights"). The pilot makes the case that Congress's actions to prevent multi-hour passenger delays on the tarmac give the airlines incentive to proactively cancel flights 
rather than face the risk of million-dollar fines for a single flight. The result is that, rather than simply being delayed, passengers end up stranded, often not able to book another flight until the following day.
The pilot writes:
"The Passenger Bill of Rights is the wrong answer to the right question that demonstrates two important points. First, a simplistic legislative solution is completely inadequate to a complex problem like tarmac delays.
And second, for all who lobbied for this legislation based on a handful of overpublicized and anecdotally enlarged tarmac tales, when you're in line waiting to rebook your travel, remember that you got what you asked for: You're not waiting on the tarmac. You're simply not going anywhere."
Well-intended actions often lead to unintended consequences. This is a core lesson of the system dynamics field popularized by Peter Senge in his book The Fifth Discipline: The Art & Practice of the Learning Organization. I was fortunate to take a course on this topic during my graduate studies at MIT. We learned many lessons of simple actions that, while locally helpful, made the system worse.
One classic example was towns along the Mississippi River that built levees to keep flood waters back. As our professor said, your town's levee only had to be an inch taller than the levee of the town across the river. This led to a levee arms race that inevitably pushed flooding further upstream. The further upstream, the worse the flooding. Locally brilliant, globally suboptimal.
In the case of the airlines, policy makers framed the problem as "passengers shouldn't have to wait without food, water, or working toilets." At the time, the airlines couldn't create a compelling and workable plan either for providing water, food, and toilets or for calling a plane back to the gate temporarily, so Congress stepped in with a "solution" that sounded great as a sound bite. But now you might be more likely to miss the start of a vacation altogether instead of being delayed for three hours.
We can see similar overly simplistic thinking in healthcare. In the United Kingdom, the problem was seen as patients waiting too long in the "Accident & Emergency" department. So the government set an arbitrary target of a 4-hour limit for waiting in A&E.
Hospitals responded in many cases with dysfunctional behavior--unintended consequences. Ambulances were kept parked just outside the door with the patient still inside so that, by a technicality, the 4-hour clock was not yet ticking. Or, patients were admitted unnecessarily, even if they still hadn't seen a doctor, tying up a bed that might have been needed by another patient who hadn't yet hit the 4-hour limit. Instead of improving the overall flow, a simple "solution" was created that didn't take the whole system into account.
Whether it's an airline, factory, or hospital, we need to combine lean with a system dynamics view of our work and value streams. Instead of local solutions that harm the whole, we need to avoid the "quick fix" and the "easy answer" that might cause more harm than good.
As we move forward with the Passengers' Bill of Rights, here's a chance to see if the government practices PDCA (Plan-Do-Check-Act). If the law isn't working (or the unintended consequences are worse than the benefit), Congress should kill the law. Now I'm being overly simplistic, eh?
Mark Graban is a senior fellow at the Lean Enterprise Institute and is the author of the book Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction, winner of a 2009 Shingo Research and Professional Publication Award. Mark is the founder and lead contributor of LeanBlog.org, where a longer version of this post originally appeared.