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Analyst: Analyze Thyself

24 August 2016

Photo credit: Ian ThompsonCC BY-SA 2.0

“It is a well-known axiom that what is not measured can’t be managed” (Kaplan and Porter in the opening of their 2011 Harvard Business Review article “How to solve the cost crisis in health care”). This is well-known all right, and false, not to mention downright silly.

Photo credit: Ian ThompsonCC BY-SA 2.0

“It is a well-known axiom that what is not measured can’t be managed” (Kaplan and Porter in the opening of their 2011 Harvard Business Review article “How to solve the cost crisis in health care”). This is well-known all right, and false, not to mention downright silly.

Who ever successfully measured culture, leadership, even the potential for a truly new product? Can none of these thus be managed? Did Kaplan and Porter measure the effectiveness of their own recommendations? Indeed, who has even tried to measure the performance of measurement itself, aside from assuming that it is marvelous? And how about measuring the performance of management? (Don’t tell me that increase in share price does this for the CEO. See “The tricky task of measuring managers.”) I guess, therefore, measurement and management can’t be managed.

Guess what? They can. We just have to understand that many of the things that matter most in organizations (and in life) cannot be measured, yet they have to be managed, whether personally or organizationally. Certainly we have to measure what we can; we just cannot allow ourselves to be mesmerized by measurement―which we so often are.

In this article, Kaplan and Porter (2011) provide a list of seven steps “to estimate the total costs of treating...patient populations”:

1.    Select the medical condition [specifying the possible “complications and comorbidities"]

2.    Define the care delivery value chain…which charts the principal activities

3.    Develop process maps for each activity

4.    Obtain time estimates for each process

5.    Estimate the cost of supplying patient care resources

6.    Estimate the capacity of each resource and calculate the capacity cost rate

7.    Calculate the total cost of patient care

Don’t look for:

8.    Include the costs of doing all this.

But you can get a sense of it by reading the authors’ example of a knee replacement, for which 77 activities are listed.1 Multiply this by elbows, hips, brains, hearts and minds, etc., factor in the frequency of improvements in these activities, which may come one at a time, and you have to wonder if analysts will soon outnumber clinicians in health care.

But the direct costs of their efforts are not the only costs. How about the costs of the distractions to the clinicians―for example, by having to record so much data―plus the costs of the political battles that ensue over who is measuring what, how, where, when, and for whom. Analysts see measurements as objective; contrast this with the political blood spilled over determining them.

Imagine if analysts put themselves through the same scrutiny as some do everyone else. In other words, imagine if they analyzed themselves. Maybe then, instead, we would get more of the following:

Years ago, the British retailer Marks and Spencer decided it was spending too much money controlling the movement of stock in its stores. So instead of a clerk filling out an order form to replenish a shelf, which was handed to another clerk behind a counter, who went to fetch the items, etc., the company got rid of the whole procedure and simply let the clerks go in the back and scoop up what they needed. The company was able to function with thousands fewer clerks and 26 million fewer cards and papers.

Now that’s truly efficient­­, and a vote of faith in the honesty of the clerks. Health care administrators take note: treated with respect, left to figure out many things for themselves, health care professionals can prove to be at least as trustworthy as store clerks.

© Henry Mintzberg 2016. Excerpted from my new book Managing the Myths of Health Care (forthcoming in 2017).

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1 Not to mention that “Outcomes for any medical condition or patient population should be measured along multiple dimensions, including survival, ability to function, duration of care, discomfort and complications, and the sustainability of recovery” (p. 5).

 

Coalescing around Climate

17 August 2016

(Photo Credit: NOAA Photo Library, CC BY 2.0)

I hate to harp on the same themes, but I do need to to get this right. For some time, I have been blogging about imbalance in society, about climate change, and about the plural sector (civil society) and how to get its collective act together. Last week, after participating in several related activities at the World Social Forum in Montreal, including a panel discussion that gave rise to two insights, these themes began to coalesce into a coherent framework for action. I summarize it here as a work-in-progress:

(Photo Credit: NOAA Photo Library, CC BY 2.0)

I hate to harp on the same themes, but I do need to to get this right. For some time, I have been blogging about imbalance in society, about climate change, and about the plural sector (civil society) and how to get its collective act together. Last week, after participating in several related activities at the World Social Forum in Montreal, including a panel discussion that gave rise to two insights, these themes began to coalesce into a coherent framework for action. I summarize it here as a work-in-progress:

THE ISSUE: The world is dangerously out of balance. The private sector is dominant; much of the public sector is coopted by it; and the plural sector is obscure, marginalized by our obsession with left versus right, namely public sector governments versus private sector markets, with no room for the communities of the plural sector in between.1 Many of the difficulties we face now—for example, income disparities, lop-sided globalization, and global warming (intensified by our relentless production of more and more)—derive from, or are exacerbated by, this imbalance.

THE IMPERATIVE: The plural sector will have to take the lead in restoring the balance. The private sector will not cede its established dominance, nor will the social responsibility of businesses compensate for all the the social irresponsibility we now experience. And how many governments are prepared to challenge the private interests that coopt them domestically alongside the economic forces that overwhelm them globally?  This leaves but one sector to take the lead in driving the radical renewal we require—the plural sector.

THE PROBLEM: The plural sector is too plural, and disorganized, to get its collective act together. This is the sector of NGOs, cooperatives, community groups, social movements, social initiatives, and other associations that are owned neither by the state or by private investors. (They are owned by their members, or else by no-one. Who, for example, owns Greenpeace?) The World Social Forum itself made clear last week how eclectic and vibrant is the plural sector, also how much difficulty it has getting itself organized. (Compare this with the World Economic Forum in Davos, and business lobbying in general. Private sector businesses get their collective act together rather effectively when, for example, they wish to lobby for lower taxes.) Can our future be ceded to whatever force in society happens to be the most organized?

FIRST INSIGHT: The plural sector will have to focus on some central challenge. At a panel we ran at the Forum about the sector getting its act together, someone in the audience made the point that, to make headway at this point, the plural sector will have to focus its energies on one central theme. Rebalancing society is perhaps too broad and abstract a theme, at least for getting started. The obvious theme on which to focus is climate change. Pledges by governments, as at the COP 21 conference in Paris last December, will not deal with it. ( See the TWOG of 12 May, “Saving the planet from governments and markets.”) And business initiatives, however beneficial—for example, related to cap and trade, electric vehicles, and alternate forms of energy—are not going to suffice. (See the TWOG of 22 January 2015, “Can the World Economic Forum deal with the world’s social problems.”) We need 0°, not +2°, and cannot count on government or business alone to get us there. Once we recognize the urgency of stopping global warming, not just slowing it down, we will be able to face the underlying problem of balancing our societies.

SECOND INSIGHT: The plural sector will have to channel the power of its plurality—to make constructive use of its own dis-organization. Alex Megelas of Concordia University made an important point on the same panel: that the strength of the plural sector lies in its plurality, namely its messiness. How then are we to reconcile these concurrent needs for organization and dis-organization at the same time? By organizing around a central theme and then tackling it with a whole host of different efforts. We need to swamp the problem of climate change with all kinds of clever initiatives. So the issue reduces to:

THE QUESTION: How to channel the power of the plural sector, which includes that of ourselves, to move the public and private sectors toward profound action on climate change, and ultimately, on the imbalance we face? We are the plural sector, on the ground: you and I. We create, staff, use, and support its associations, in our communities and beyond. Moreover, we vote, we buy, and we march. Individually, we can refuse, we can reduce, and we can replace. And together, as consumers, citizens, and actors, we can drive our governments and businesses to face their responsibilities, as we must face our own. The plural sector will cease to remain obscure when the good folks of the world come to realize the potential of their power, and become the force needed to address the future of this planet and our progeny. After all, what major social change ever began without a groundswell of concerned human energy?

I want to end this TWOG here. After all, as James Thurber claimed: “It is better to know some of the questions than all of the answers.” Here at least is one of the questions. But can I just stop now, without explaining what has to happen next? This is the question I get every time I push these ideas one step further: “Yea, but what do we do now?” The answer lies in we, beyond me.

Social change in the thirteen American colonies began with a sudden tea party in the Boston harbor. The civil rights movement in the U.S. began with an act of civil disobedience, by a woman who boarded a bus in Montgomery, Alabama. People on the ground take the steps that cause chain reactions to change the world.  As a work-in-progress, this effort has to engage many of us, with a plurality of ideas that can evoke all sorts of determined actions, to overwhelm what now overwhelms us. So let me ask you to suggest what can come next, with the spark of compelling ideas that can take us to a decent climate: on Twitter, LinkedIn, and Facebook.

We don’t have it right yet, but we are getting there!

© Henry Mintzberg 2016. For more on the central theme, please see Rebalancing Society…radical renewal beyond left right and center, available in the usual places, but also for free downloading as a PDF.

Follow this TWOG on Twitter @mintzberg141, or receive the blogs directly in your inbox by subscribing hereTo help disseminate these blogs, we now also have a Facebook page and a LinkedIn page.


1 For an all-too-pointed example of this, see last week’s TWOG on how Montreal’s English-language daily focussed its coverage of the Forum around two Israeli-Palestinian incidents, as if the thousand other activities never took place.

 

Dis-organizing our way to balance

12 August 2016

We are masters at running successful experiments in failed events. On Wednesday, as part of the World Social Forum in Montreal, our event in the McGill University football stadium was entitled “On the earth, for the Earth: acting together for a cool planet.” We had no way to know how many people would attend.1 I predicted between 50 and 5000, which made our organizing rather difficult. Suffice it to say that we did not hit the high side.

We are masters at running successful experiments in failed events. On Wednesday, as part of the World Social Forum in Montreal, our event in the McGill University football stadium was entitled “On the earth, for the Earth: acting together for a cool planet.” We had no way to know how many people would attend.1 I predicted between 50 and 5000, which made our organizing rather difficult. Suffice it to say that we did not hit the high side.

Undeterred, we improvised. We adapted much of our design to the numbers present. It worked, rather well in fact. The intention was to self-organize in small groups, to come up with cool ideas that could be taken home for dealing with climate change. That we did, albeit with few groups, including our super-enthusiastic volunteers. Each focussed on one of four questions:

  • Getting it about climate change doesn’t mean we live it. How can you and I live it?
  • What can we do with food: producing, processing, distributing, consuming, and wasting?
  • How can the plural sector [civil society] get its collective act together?
  • How can we build societies of better and better instead of economies of more and more?

What we lacked in quantity (more and more), we made up in quality (better and better). The discussions were great, and animated: we had to stop them after 90 minutes. I joined the group on getting the plural sector act together, a conversation I have had with many other groups, but never this good. All the groups shared what they found, and everyone seemed to leave on a high.

Was this event a failure? Not for the people who attended, and not if, as an experiment, it leads to something more successful. (One attendee hopes to use the design in an event he is organizing later. And we shall be doing so as well, and capturing the learning, in a forthcoming GROOC—a MOOC for groups—in the Spring, probably under the same title. (Check it out on edX in the new year.) But yes, it was a failure by the standards of more and more.2

So, the next time I consider doing something else unusual, should I be asking myself “Why?” instead “Why not?” Never! We have too many events that succeed in numbers—look at the turnouts Trump in the U.S. and Erdoğan in Turkey have been getting lately. We need many more successful experiments, and thoughtful ideas, to make the world a better place.

Later in the day we held a more conventional event—a panel on how the plural sector can get its collective act together. That succeeded both ways: about 200 people turned out, for 90 minutes in a McGill amphitheater, and the discussion was stimulating and animated. Ian Hamilton, who heads up Equitas, the International Centre for Human Rights Education, explained why the sector often does have its collective act together, while Alex Megelas, of the Office of Community Engagement at Concordia University, claimed that one of the great strengths of the sector is its messiness. The five of us were one about the need for pluralism in the plural sector! Yet we live in a world in which the dominant private sector is highly organized. How can dis-organization correct that? This is our dilemma, all too evident in both these events.

And all too evident as well in the coverage of the Forum by the Gazette, Montreal’s English-language daily. It is part of a chain of most of the country’s dailies that were ordered to run the same editorial in the last federal election, endorsing the Conservative Party. This we call a free press. Aside from an initial article on August 4 (straight reporting, that mentioned our event), the Gazette has run only two pieces on the Forum, both about the same issue.

Yesterday the headline read “Protesters hurl insults outside the World Social Forum in Montreal.” Ten members of the Jewish Defence league were yelled at by a number of pro-Palestinians. So many other events during the day, and this received the only headline. A few days earlier, an opinion piece was headlined “World Social Forum shouldn’t grant a platform to anti-Israeli agitators.” True enough. But hardly true enough was what the piece went on to proclaim: “The tone of the conference is fundamentally at odds with” the WSF’s belief in living together. How did this become the tone of the conference? Thousands of concerned and well-meaning people doing wonderful work to make the world a better and more balanced place all dismissed by the excesses of a few. So much is happening in this Forum: discussing youth inequality in Peru, promoting people’s rights to affordable housing all over the world, facing the problem of climate change and of the demise of democracies, even questioning the Canadian government’s refusal of visas for many people trying to attend the Forum itself.

It’s as if the newspaper was sitting in a tree like a panther, waiting to pounce on some cause célèbre to reinforce its own agenda. The first reader comment on the opinion piece tells it all: “This [Forum] is just a platform for socialist ‘anti-everything’ agitators.” Mission accomplished.

Here we have a perfect reflection of the imbalance we live with every day. In Canada we may get to elect our government, but our corporate press continues to use its power to sway public sentiments in favor of private interests—by what it reports, and especially by what it does not report.

The World Social Forum is eclectic. All kinds of tones and voices are being heard inside of it, a few that I personally don’t care for. Yet all but one of these get ignored by a newspaper acting as a platform for its own agitation—essentially to intensify the existing imbalance. Concerned people will have to learn how to use dis-organization to rebalance a world headed for disaster, environmentally and politically.

© Henry Mintzberg 2016. My thanks to Debbie Hinton, Karla Flores, Laura Cardenas Berdugo, Jessica Xiao, Calolina Cruz-Vinaccia, et al. for so wonderfully organizing our experiment, to Joe Ross and Clelia Cothier for so enthusiastically animating it, and to the Office of McGill’s Vice-Principal External Relations and its Desautels Faculty of Management for their support. 

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1 The Forum keeps track of registrants—there were about 15,000 before the start—but no-one signs up for particular events.

2 Several things can explain the low turnout. The McGill stadium is on the edge of downtown, up a hill, a significant walk to reach. The schedule of 9:15 to 3 in a conference of 90 minute events was probably too ambitious. Our marketing was hardly stellar. And then there is getting that act together: a mistake in the printed program also showed our event taking place in a classroom several kilometers away.