Davis Balestracci, president of Harmony Consulting in Portland, Maine, and an authority on quality improvement and the use of statistics, understands that raising quality in long-term care would be easier if it weren’t for “those darn humans.” In his keynote address at Long Term Care Medicine – 2012, he talked about how to make meetings more productive, communicate successfully at all levels, and effect constructive and lasting change. A starting point in quality improvement is to realize that “all work is a process,” Mr. Balestracci said. “Your processes are perfectly designed to get the results you are getting.” He then noted that the “process” in many organizations is a convoluted mess fraught with confusion, conflict, complexity, and chaos. Making work more predictable by reducing variations is a key to effective and lasting quality improvement, he observed. “You want to reduce inappropriate and unintended variations” that push quality improvement and positive change off track. Mr. Balestracci noted that facility team leaders waste significant time reviewing data and tossing around numbers. He suggested that data charts often are misleading and confusing. “In 30 years, I’ve never seen an appropriate use of trend data,” he said. “I hate bar graphs and trend lines.” Bar graphs “enable and encourage 500 interpretations [of the data presented] by any 500 people.” Meetings are a common source of misdirected data analysis and wasted time, Mr. Balestracci said. Instead of identifying useful information that can encourage positive change, meeting participants indulge in “data torturing” and second guessing. Like it or not, he added, “this is what you’re doing in meetings.” Leaders often use data merely to call for better numbers (fewer falls or better pain management, for example). A better way to approach data analysis is to use what Mr. Balestracci called the run chart. This is a time-ordered data plot with a median as reference. He observed that this tool is more illuminating because it makes shifts in a parameter over time more obvious.