Business in the rear-view mirror

Would you drive your car, whilst looking only in the rear-view mirror?
I thought not…yet this is common practice in business, education, and government, where historic performance data such as quarterly reports and comparisons with ‘this month last year’ are widely held to be meaningful.

The noted US engineer and scholar Dr Myron Tribus famously wrote of this as: ‘-like trying to drive a car by watching the yellow line in the rear-view mirror.’
And I for one would not wish to be a passenger in a car driven that way!

My attention was drawn here by a Tweet: > @kvistgaard RT @tetradian: RT @jdevoo: Walking in Allende’s Footsteps: Cameron’s No. 10 Dashboard nyti.ms/UfOwnv #cybernetics #entarch #vsm

< A recent Civil Service article expresses pride in the achievements of a young fast-track officer, who had created a ‘dashboard’ application for the PM’s iPad.
‘One of her recent projects…was designed to give the Prime Minister, other Ministers, and senior Whitehall officials an at-a-glance overview of everything that’s happening in government and elsewhere…with a few taps or swipes of his fingers, he can see very quickly what important new information has come to light, how certain government services are performing, and a selection of relevant and important news reports.’

I accept that in politics a craving for sound-bite sized facts is a cultural constant, and may be an itch that highly visible leaders cannot leave un-scratched. My complaint lies not with the politicians, but the shallow presentation of data. I’m pleased that intelligent politicians want to track data, but concerned that this format invites incorrect interpretations.

Look at an example: http://publications.cabinetoffice.gov.uk/assets/images/strategy/case-studies/fast-stream/Alice–GDP-ret.png -look solely at the last 5 points in a hopeful frame of mind and you might see a strong rise; but search for an overall trend and do you see an upward shift? This really is just a pretty picture, since no matter how many points of that wiggly line are drawn it provides no explanation.

Since the diagram does not explain WHY things happened, this trace is not helpful to PREDICT what may happen in the near future -which is the main route for those seeking to understand and improve performance.

Without using theory “Perhaps it is a 70-year cycle?” to link events with causes, these snapshots and zig-zag plots cannot tell us any more than that the situation is volatile.
We need users to ask “What happens next?” shifting the emphasis from home-spun guesswork “Yes Sir Humphrey, figures do seem to be rising” –but are they really? –can we tell whether this really is a normal swing, or a fluke? –and does the cause lie inside the work, or is it driven from outside?

Thus an emphasis on prediction has to become a key task for management. Sadly this dashboard is not about prediction –and as a passenger in the car, I’m becoming worried…

Why targets are not helping the NHS to improve

An event by the Deming Alliance - Monday 11 April 2016   09.30 – 16.15

The Round, Nettle Hill, Brinklow Road, Ansty, Coventry CV7 9JL

www.nettlehill.co.uk   Google map http://glurl.co/jTl    Rail: 15 minutes taxi from Nuneaton or Coventry

 

OUR FOCUS will be on the management of healthcare in general and the NHS in particular, drawing analogies and comparisons with the ex-Soviet system of healthcare management.

Topics include:

  • Current healthcare management thinking vs. ex-Soviet healthcare thinking
  • The use of numerical targets (including deadlines) as a method to increase performance
  • Interpreting indicators (especially flowcharts)
  • Managing and understanding hospital (NHS) budgets
  • Procurement and contracting

THE PARTICIPANTS

Do you work in healthcare or the NHS in the UK?     Are you interested or involved in performance improvement? Are you concerned by the need to improve quality while under pressure of resources?

The seminar will be particularly valuable if you are a junior doctor, a departmental head, a Trust Board member, a CCG lead or an advocate of patient healthcare rights.

There will be contributions from other Deming Alliance members, followed by a discussion on the way forward for the NHS, developing a strategy and identifying concrete next steps.

Alliance host for the day: John Morgan

ATTENDANCE FEE   £45 includes tea & coffee breaks, and buffet lunch.

To book email Secretary, Brian Leeming  brianwleeming@gmail.com

 

THE CONTEXT

Healthcare organisations around the world set their focus on improving the patient experience, and the use of targets has become the normal way to approach this (eg introduction of business plans, Quality & Outcomes Framework for primary health care, cancer waiting times etc).

Logically, it seems to make sense. People know what to aim at; objectives can be measured to show progress and achievement (“if you can’t measure it, you can’t improve it”); and healthcare workers can be held accountable to increase their performance and productivity; and to maximise cost-efficiency.

But have you ever felt that this way of working isn’t working, results are not real, and everyone is chasing their tails?

We stretch to meet the latest set of evidence-based targets, while previous versions become neglected.

Managers incentivise staff to perform, one group distrusts the other, and care levels and cost-savings don’t improve overall.

In a participatory way, the speaker will share and discuss lessons he has learned on improving the performance of health organisations & projects.

THE MAIN SPEAKER

Peter Campbell, a British GP by background, now works as a Consultant in International Public Health Management.

He has 20 years experience working to design, implement and evaluate small and medium scale health projects in developing countries. These include (alphabetically) Albania, Bangladesh, Ethiopia, Indonesia, Kazakhstan, Kosovo, Malawi, Mongolia, Morocco, Tajikistan, Turkmenistan and, particularly, Uzbekistan where he lived for 8 years.

In 2009 he completed a full-time Masters (MSc) in International Health at Heidelberg University, Germany. Since then, in addition to his consultancies, he is lecturing to Master and PhD level students at Heidelberg University, and runs his own courses in Project Design and Health Financing at the Charité Medical University, Berlin.

Peter is also the Team Leader of a €27 million project to develop 16 hospitals in Uzbekistan on behalf of the German KfW Bank.

-ends-

 

 

 

What are Managers for? (one more time)

Despite the ongoing professionalisation of ‘management’ as a distinct line of work, some questions remain too often unanswered.

A key one is ‘What IS the main task for any manager?’

If we wind back the clock to the 1950′s and 60′s we find that a wealth of research was going on to answer this problem, even though American industry and society appeared to still be riding the crest of a wave. Amongst the researchers was William B. Given, who was President of American Brake Shoe Corporation.  Note that Given was not simply a practitioner, but also a graduate of Yale and MIT.

Given’s book Bottom-up Management: People Working Together published in 1949, was well ahead of its time.  Peter Drucker cited Given’s book in his The Practice of Management (1954). And it was following a visit to American Brake Shoe that a business school student championed the refreshingly pointed term ‘Bottom-up Management’ to a wider audience.

According to Given, a good manager had to be a team player; yet like the captain of a sports team -not necessarily the best player-  he had to be a leader; and also to exert a moral influence.  Beyond the formal delegation of authority that was normal in the 40′s, he argued that each manager should deliberately pass elements of his own responsibility for decision-making down the chain, calling it ‘progressive decentralization’.

In both practice and in print Given pressed for personal freedom to be passed on to superintendent staff, ‘-to venture along new and untried paths; freedom to fight back if their ideas or plans are attacked by superirors; freedom to take calculated risks; freedom to fail’ - and according to the brothers Hopper (in their brilliant book ‘The Puritan Gift’ detailing the rise, and decline of Puritan values in North American enterprise) this is the genesis in print of ‘Bottom-up’ which today is a term given (sic) too little credit.

Oh how I wish more of today’s business school teachings took account of this strand of thinking…yet the concept that ‘Managers know what is to be done; and how’ persists in splendid isolation, and so is well beyond its use-by date.  Of course the two are polar, and the truth in any situation will lie in experimentation and establishing a reasonable balance between the two.

Hence my plea to managers, their directors and (long-suffering) staffs, to practice both top-down and bottom-up patterns, according to what works well.  A little open-minded experimentation will quickly prove the worth of the blend, and results will follow.

 

I bet you want your people to innovate…

You want your people to innovate, don’t you? Of course you do; yet is it easy for them?
# I bet your corporate values include something like ‘Our people are our greatest asset’.
# Ever paid a consultant for new ideas? -and do you invest to capitalise on insiders’ suggestions? (yet I’ll wager you have spent more $ on the external, than on those staff ideas…)
# Think back to the last appraisal round: how many ideas were held up as successful? -and what proportion of your staff were offering up ideas?
# And maybe you ask them to ‘Do it Right First Time’? –OK.
# Ever put up a Staff Suggestion Box? -and did you get the response you dreamed of? No…

I want you to see, that there is a strong link between employees’ concerns over have over ‘getting things wrong’ -especially when those things are the ones counted in their performance, pay and bonuses; and the level of real freedom staff have to come up with radical ideas, to develop & trial them.
Even if we count the adoption separately, its common to find that the part of working life where we place most value on ideas is as a slogan, but much less as real support for doing things differently.

OK, how many of us learnt to ride a bicycle on the first attempt? Come on now, you can’t really expect staff to take risks with an important part of their futures unless you actively support them, by making it OK to admit ‘failures’, and to share mistakes; and you’ll need to cover some loss in pay.
But consider the rewards! –once the folk who live every day with problems see that you really do want suggestions, they will flow freely. When workers own and promote their own ideas, (not via the cheesy Suggestion Box) adoption of the early offers will encourage others.
Then the organization begins internal learning (which is cheaper!) -and managers will learn much more of where to study and improve the annoying problems that are holding you all back.
Sustainable innovation begins -

    inside your organization!

Creating buy-in

In talking this week with Debra, one of my new American friends, about leaders creating ‘Followship’ the subject of ‘Employee Engagement’ (EE) came up. Although EE is widely practiced in projects to bridge a void in the contract between staff and leaders, I had not thought much about what it represents.

Referring to a military example of strong employee buy-in, Debra suggested that it is often better to build employee support for a vision without all the funding in place; than to merely accept a funding stream and then change the direction of teams to follow it. I readily agreed with this emphasis on followship, saying “Right -you can’t buy buy-in.”

What I came away with was a thought that whilst Employee Engagement may be just another fad, it fails to answer an underlying problem; no, not the nuts and bolts of creating buy-in, but asking ‘Why don’t our organisations naturally allow staff pride in work, and grow joy and ownership that render EE unnecessary?’

I’m pretty sure that the problem is the way we run organisations, split along functional lines that do not relate to the real work, as top-down hierarchies with multiple purposes that divide staff, and involving staff downstream of decision-making instead of pulling in their expertise up front.

Hotel IT system

This week I asked a hotel Receptionist “Can you help me, please?; I can’t get into my room.” She apologised, saying that they had major problems with the room access system, one of the 30 or so computerised systems that the chain replaces under a global ICT programme. In this case 29 of the 30 had been installed and wrestled into shape; but this one was taking a little longer to patch up.

With little prompting she also explained that corporate policy was to change all these systems on a 4-year cycle. And the more experienced staff who have seen scheduled disaster before can reasonably predict the ensuing chaos. It became clear that local staff were powerless to affect this policy, and dug in each time to minimise the effects on customers and operations.

I can see that a corporation working a highly competitive market needs to attract and retain highly mobile customers, and so will wish to acquire the best customer activity information – so replacing tired software makes sense. However I struggle with three aspects:
firstly how can a global HQ knowingly inflict such damage, albeit temporary, on its revenue-producing operations?;
second that it does not allow its operations staff -who would have more current knowledge? no influence over how the changes are implemented; and
third that in a dynamic market it fixes a 4-yearly schedule -whatever happened to ‘If it ain’t broke, don’t fix it?’

Of these three points, the first two appear to reflect assumptions at HQ that do not favour front-line staff, and they certainly offer room for improvement to be gained and to better use the knowledge of staff; however the third has a different character, as this 4-year cycle feels to be arbitrary. This third may present a different scope for better work and as a consequence, reduced costs.

I think I shall write to the chain, and see how many bounces the letter takes before reaching someone who will properly answer. Watch this space, but don’t hold your breath!

Whistleblowing ain’t easy

I’ve been reading an example in today’s ‘USA Today’ newspaper of how difficult it is to go against a damaging culture, in this case alleged serious fraud in US government property arm, the General Services Agency.

Many of us know at an intuitive level when things are very wrong. Elaine Johnson says: “Moral behaviour is hard-wired into the human brain.” -however the rub for the would-be whistle blower is that acting on what we know to be right is tougher when the consequences for one’s employment are severe.

Reports to federal committee hearings say that an executive had fostered a culture of ‘putting people down’ who objected to his spending decisions. Apparently the official’s spending habits extended to taking a nine-day visit to Hawaii to attend a one-hour ribbon cutting. One employee told the Inspector General ‘he squashed someone like a bug’ for speaking out.

However oversight since the inspector’s report of May 2011 suggests the matter is a deeper problem than one person’s bad behaviour, with evidence to federal committees suggesting that lavish spending after the release of the inspector general’s report points to a ‘-culture we are going to get to the bottom of…a culture of fraud’

And once the behaviour has spread widely, being a whistle blower is a whole lot harder again. Dr Deming wrote: ‘Fear invites wrong figures. Bearers of bad news fare badly. To keep his job, anyone may present to his boss only good news.’

Beyond the alleged fraud, such a climate of fear damages the lives of all people it touches. There lie hidden and possibly greater costs than those exorbitant purchases, because they are largely external to the organisation, and not costed to the accounts.