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Viewpoint: Should we all be looking for marginal gains?

Chris Hoy about to take gold 2012 Image copyright Getty Images

The concept of marginal gains has revolutionised some sports. Could the same approach also change important areas of everyday life, asks Matthew Syed.

The doctrine of marginal gains is all about small incremental improvements in any process adding up to a significant improvement when they are all added together.

It is perhaps most easy to understand by considering the approach of Sir Dave Brailsford. When he became performance director of British Cycling, he set about breaking down the objective of winning races into its component parts.

Brailsford believed that if it was possible to make a 1% improvement in a whole host of areas, the cumulative gains would end up being hugely significant.

He was on the look-out for all the weaknesses in the team's assumptions, all the latent problems, so he could improve on each of them.

By experimenting in a wind tunnel, he noted that the bike was not sufficiently aerodynamic. By analysing the mechanics area in the team truck, he discovered that dust was accumulating on the floor, undermining bike maintenance. So he had the floor painted pristine white, in order to spot any impurities.

Each weakness was not a threat, but an opportunity to make adaptations, and create marginal gains. Rapidly, they began to accumulate.

He went further. The team started to use antibacterial hand gel to cut down on infections. When he became general manager of Team Sky, he redesigned the team bus to improve comfort and recuperation. They started to probe deeper into untested assumptions, such as the dynamic relationship between the intensity of the warm-down and speed of recovery. As they learned more, they created further marginal gains.

Team GB used to be also-rans in world cycling. Indeed, one pundit described the operation as "a laughing stock". But in the last two Olympics, Team GB has captured 16 gold medals and British riders have won the Tour De France three times in the last four years. This is the power of a questioning mindset and a commitment to continuous improvement.

But if this approach can have such dramatic results in sport, what could it do beyond sport?

Healthcare

Preventable medical error is one of the biggest killers in the UK. It kills more people than traffic accidents. The key word here is "preventable". These mistakes shouldn't happen, but they do, over and over again.

Why? One key reason is that some doctors struggle to admit to their mistakes and weaknesses, because they worry about the effect on reputation and possible litigation. But imagine a different approach, where doctors were up-front, open and on constant look-out for marginal gains.

In fact, this kind of system was adopted at Virginia Mason, a hospital in Seattle. Staff were encouraged to file reports if anything went wrong, like accidentally prescribing the wrong medicine. That gave the hospital an opportunity to make small changes, such as altering the labelling on drugs so that they could be easily identified under pressure of time.

This commitment to continuous improvement also led to the discovery that a newly admitted patient had received a colour-coded wristband signifying "Do Not Resuscitate" instead of one indicating drug allergies (as a result of a nurse being colour blind). So, text was added to the wristbands. It was another marginal gain.

But this was just the start. They started to use checklists in the operating theatre, to alter the ergonomic design of surgical equipment, to systematically improve clinical hygiene. Each improvement seemed small, but they rapidly accumulated.

What happened? Since the new approach was taken, Virginia Mason has overseen an astonishing 74% reduction in liability insurance premiums. It is now regarded as one of the safest hospitals in the world. That is the power of marginal gains.

Image copyright Getty Images
Image caption Takeru Kobayashi in action

Speed eating

For something less serious, but equally revealing, consider speed eating. This is now a big "sport" with sizeable prize money. The largest competition is the annual Nathan's Hot Dog Eating Contest in New York. You have to eat as many hot dogs as you can in 12 minutes, which most people do by stuffing their mouths as greedily as possible.

But in 2001, Takeru Kobayashi, a Japanese student, approached the contest with a marginal-gains mindset. Instead of eating the hot dog whole, he tried breaking it in half. He found that it gave him more options for chewing, and freed his hands to improve loading. It was a marginal gain. Then he experimented with eating the dog and bread separately.

Then he experimented by dipping the rolls in water, then water sprinkled with vegetable oil, then he videotaped his training sessions, and tested different ways of chewing, swallowing and "wriggles" that manipulated the space in his stomach in order to avoid vomiting.

When he arrived in New York, he was a rank outsider. He was slight and short, unlike his supersized competitors. But he smashed the competition, eating an incredible 50 hot dogs, almost doubling the world record.

Image copyright Getty Images
Image caption Slight tweaks to the B-17 improved safety

Aviation

Aviation is an industry with a marginal gains approach. It is always looking for improvements, however small, to drive safety.

For example, in the 1940s, there were a series of inexplicable accidents involving B-17 bombers. The industry commissioned a psychologist to conduct an investigation. He found that the switches controlling the flaps in B-17s were identical to those controlling the landing gear, and were placed side by side. Under the pressure of a difficult landing, pilots were making a mistake.

A quick fix was required, so a small rubber wheel was attached to the landing-gear switch and a small flap shape to the flaps control. The buttons now had an intuitive meaning, easily identified under pressure. This was a tiny change, a marginal adjustment to the design of the cockpit, but it had dramatic results. Accidents of this kind disappeared overnight.

This approach has now been applied to airlines for many decades with remarkable effects. In 1912, eight of 14 US Army pilots died in crashes - more than half. In 2014, the accident rate for major airlines had dropped to just one crash for every 8.3 million take-offs.

Image copyright Thinkstock

Life

Exams: There are many important aspects to success in exams, most crucially knowledge of the subject, but think of the marginal improvements that could be driven by analysing past papers (to predict what questions are likely to come up) and of taking into the exam room a water bottle (to sustain hydration), a banana (to sustain blood sugar levels) and ear plugs (to reduce distraction).

Business: Many of the most innovative companies are now using a marginal gains approach. Google, for example, runs 12,000 data-driven experiments annually in order to discover small weaknesses and, thus, small improvements. One such experiment found that by tweaking the shade of the Google toolbar from a darker to a lighter blue, it increased the number of click-throughs. This marginal change increased revenue dramatically.

Children: Children are often taught to think that mistakes are bad. They get red lines in their books when they mess up. This is why they fear to put their hands up in class and struggle to take risks. But in an experiment where children were taught to think of weaknesses not as embarrassing, but as opportunities to learn, they became more inquisitive and resilient. They also performed better.

That is the power of the mindset that underpins marginal gains. It might just change the world.

Matthew Syed is the author of Black Box Thinking: The Surprising Truth About Success


Dave Brailsford and marginal gains

Image copyright Getty Images

Dave Brailsford explains the idea of marginal gains to the BBC in 2012:

"The whole principle came from the idea that if you broke down everything you could think of that goes into riding a bike, and then improved it by 1%, you will get a significant increase when you put them all together.

"There's fitness and conditioning, of course, but there are other things that might seem on the periphery, like sleeping in the right position, having the same pillow when you are away and training in different places.

"Do you really know how to clean your hands? Without leaving the bits between your fingers?

"If you do things like that properly, you will get ill a little bit less.

"They're tiny things but if you clump them together it makes a big difference."

Olympics cycling: Marginal gains underpin Team GB dominance


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