Thursday, March 29, 2012

Heroes in Organizations

In almost every organization there are heroes. Heroes are the people who "go the extra mile." Extending themselves to accomplish seemingly impossible tasks. Everyone either looks up to them or are jealous of them. We hold well known examples up before our children and encourage them to "be like Mike." The heroes often reap great rewards when they succeed and when they fall, suffer great disappointments. It is as though we worship manic depressive behavior.

With our current organizational models, we need heroes to "cut through the red tape" that keeps most people from accomplishing very much in their routine day to day work. The heroes become the heroic leaders in our organizations and are greatly sought out. Or organizations would fall flat without them. In a sense, successful organizations have become addicted to these heroic leaders.

This addictive behavior is a two way street. The heroic leaders cannot be heroes if the organizations were not structured to need them. How can one person standout so much if the organization allows everyone to be effective to their full capacity.

How often have you seen ideas and work by an average employee ignored and belittled when the same idea and work by one of these heroic leaders is readily adopted and heralded as brilliant. If organizations were able to listen to everyone there would still be differences in performance/rewards between people but not to the extremes we see today.

This pushing up the hero and pulling down the average person, creates a self fulfilling feedback loop, pushing the heroic leaders ever higher while demotivating and demoralizing the rest into an ever lower state. Following the basic yin-yang principle of the universe, we see that by needing and creating heroes, in balance, we also create the opposite in everyone else.

With this reinforcing loop in place, it becomes ever more difficult to break free into a more effective overall organization. So heroic leadership and organization need for heroic leadership is a co-dependent relationship.

Lets imagine an organization that did not need or have heroes, what would it look like.

First, everyone would have a voice that would be heard. Everyone would be treated as a valuable sensor of the part of the organization within their scope and have input to organization respected as from that scope. No one would be able to get their way based on ego values, but instead on the effect it would have on the organization to move forward towards meeting its purpose. No longer can an idea from someone be shut down by the fallacious argument of "I don't see it." This collective voice is not one of consensus (everyone agrees that it is good) but of consent (no one can see a definite harm.)

With this lower bar for decision making, it becomes easier to make most decisions. When decisions are easier, the risk and cost is lower to make most decisions. This leads to a feedback loop of making more, smaller decisions rapidly allowing the organization to vault up on the agility scale.

Next we would see that the leadership positions would not be overloaded to funnel more power and decisions into one person, but distributed over each team member and distributed over the entire organization increasing capacity accordingly. Information would not flow up and down at through one individual any point who could alter it or choke it. Direction and motivation would flow down through one person to a sub unit of the organization but feedback and sub unit health needs would flow back up through a different person. This would create a balance between the needs of the higher level to meet its organizational purpose with the needs of the sub unit to maintain a healthy environment to support those needs.

It should be easy to see that changing the basic organizational assumptions like this would reduce the dependence of heroic leadership, self empowering everyone in the organization to be engaged in the purpose of the organization, greatly increasing the capacity and agility of the organization without increasing the staff.

All of this is just a part of a new organizational operating system called Holacracy.

Tuesday, March 20, 2012

Medical Records

As part of being alive, most of us have had some contact with the medical profession and institutions. I have been around long enough to have seen many changes in medical technology. One area that seems to drag slowly behind in the US is electronic standardized medical records. As a long time computer technologist, it seems a natural progression. So why is it taking so long.

I have seen the advantages of electronic records and standardization in the very conservative financial industry. Transactions are defined by an international standard and you can send funds and other financial information almost anywhere in the world very quickly. The process is automated and even has the common term of Straight Through Processing.

Recently, I have experienced the transition from paper records to electronic records in some of my Doctors offices. In one office after about 4 months of pain during the transition, the office went from 45 or more minute waiting time in the reception area to about 5 minutes. All due to gains in efficiency. I have not experienced any loss in quality, in fact the visits seem a bit more relaxed and personal.

So why do some offices show so much resistance. I observe fear. I have talked to some Doctors about it and have seen the fear in their eyes. Fear of change. Fear of the cost to convert and maintain the new system. Fear of the pain during the transition as the staff and patience adjust to the change. Fear of lowering the quality of care. Mostly just a fear of the unknown.

But we do have some real world examples. Back in the late 1990s, Denmark starting converting to an National online medical records system so we have well over a decade of data from it.

The Danish system reports an average of 50 minute a day per Doctor reduction in administrative work. With a population of 5.5 million, it has saved the equivelent of $120 Million a year. Translate those saving to the US population and that is almost $7 billion each year.

We in the US spend a lot of money to provide a high quality of care. Health care in the US costs $7,290 per person (16% of GDP). While in Denmark it is $3,362 per person (9.8% of GDP). But what does that buy us? Life expectancy in the US is 78.1 and in Denmark it is 78.6, not any significant difference.

To get the full value from electronic records, it must be standardized, portable and accessible by appropriate medical providers.

Imagine being unconscious in an ambulance. In the current system, no one know what medications you are on or conditions you have requiring special care, unless you carry that information all the time. How many of us do that. Being able to access your history would allow the best cars in the shortest time.

Imagine the data mining applications to help improve the medical industry once we have built up a few years of records.

I see two points to push for this situation. One, lobby every Doctor office to implement an electronic records system. Two, push for a standard at the National (or even better international) level to allow for seamless exchange.

Monday, March 12, 2012

Innovation not equal Ideas

I have worked in a few large companies over the past few decades. Every so often they each would go on an innovations kick. Every time they would trot out the same old tired pony. The suggestion box.

The first few times in each company that I worked, I would get a bit excited that maybe something would happen with the suggestions. But after many years and a number of innovation initiatives, I guess, I have become a bit skeptical. After all how can I expect the company to do anything I put in the suggestion box when they have effectively ignored most everything I have proposed in my day to day work. I have hundreds of ideas every day, but rarely have the bandwidth to action only a few a year.

I got to the point where if I had an idea, I would jot it down and file it in my filing cabinet. Then, usually 3 to 5 years later, when everyone was in a panic and willing to try almost anything, I would go to my file and pull out an idea that would help solve the problem. Often the idea had been proposed and rejected earlier.

I never used all the ideas in my filing cabinet, but enough were useful to make it worth while to keep putting ideas into it. But it did illustrate that simply more ideas is not innovation. There were a lot of ideas in my filing cabinet, but simply sitting there caused no innovation.

My interpretation of an organization that every time it wants to innovate, the major thrust is to call for ideas is that the organization is simply insane. One of my favorite quotes is from Albert Einstein: "Insanity is doing the same thing over and over expecting different results." So I think that it is organizational insanity that causes this belief that this action of thrashing and rehashing is the same as making effective progress. If an organization cannot make use of the ideas that naturally occur in day to day work, how can it have the bandwidth to handle opening the flood gates by calling for ideas.

One problem, I have seen in some companies, is that the call for innovation is filtered through the requirement that the idea be fully formed, with little or no risk and is a home run of at least a value of 100 million before the company would consider any investment. There are a few companies willing to invest in small or partially formed ideas, 3m a few decades ago and Google recently. But it is a rare attitude.

Let's take a closer look at why so many companies cannot take advantage of the day to day ideas for improvement. 20 years ago a good friend of mine, Jeff Rosenberg, made the observation while we were going through another reorganization to implement the management theory of the day that "organizations do what they do because of the structure of the organization." Recently, I heard Brian Robertson, the founder of Holacracy, say that "organizations are perfectly organized to produce the results that they do." Given the current top down command and control organizational structure, with the decisions made towards the top and actions separated from the decisions and performed at the bottom, we have an organization that perfectly suppresses ideas from the bottom and separates the hands on learning and experience at the bottom from the decision makers at the top. This structure tends to calcify the organization, forcing it to do the same things over and over. To simply say "lets have all your ideas" without addressing this calcification perfectly meets Einstein's definition of insanity.

To be fair, working with in the conventional business framework, the suggestion box seems to be the only (easiest) way to break through these layers of calcification. But it rarely shows any significant results as it does not address the fundamental problem with the distribution of power.

Some of the organizational work at Toyota moved some of the decision making down to the line workers with a great increase in quality and production because some of the innovative ideas of the line workers was not lost through the filters of going up then back down through a fully calcified organization. Agile software development expanded some of these principles into the line level programmers, also with a substantial increase in quality and productivity. Holacracy is the leading edge of this wave, formalizing the ideas of distribution of power and dynamic organizational self modification for any type of organization. Holacracy is now formalized into a constitution that can be legally adopted by an organization.

Of course, full adoption of Holacracy would give the greatest benefit to any organization able to make the transition. However if that is not currently possible, a deep study of Holacracy and understanding its principle can help inform better decisions when there is an opportunity to decide between options when adjusting or working within a traditional organization. I do the latter almost every day.