Most Popular Posts on the Curious Cat Management Comments Blog

The most popular posts on this blog (10 May 2010 through today - the data I have doesn't let me just look at data for 2015):

1. Profit = Market Price - Actual Cost or Price = Cost + Desired Profit (2012)
2. Mistake Proofing and Mistake Making Less Easy (2013)
3. Performance without Appraisal (2005) - which was my 100th post
4. Cease Mass Inspection for Quality (2006)
5. 14 Plus Potentially 14 More Years for Copyrights Has Become 120 Years (2013)
6. Sustaining Management Improvement Through Personnel Changes (2014)
7. Causes of the Health Care Crisis (2011)
8. Global Manufacturing Data by Country (2006)
9. Data Must be Understood to Intelligently Use Evidence Based Thinking (2014)
10. Deming and Toyota (2006)
11. The Failure of Hero Worship Thinking at JC Penney (2013)
12. Customer Focus is Central to Lean Thinking (2012)

Breakdown of popular posts by year: 2014 - 2, 2013 - 3, 2012 - 2, 2011 - 1, 2006 - 3, 2005 - 1.

I started this blog over 10 years ago. After I figured out that I thought blogging would work for me I created a self hosted blog (the Curious Cat Management Improvement Blog) and moved the content to that blog. But I kept up the post here since web pages should live forever. For several years (about 2005 to 2011), I posted occasionally to this blog, sometimes the posts were comments made on other blogs.

In 2011 I started to use this blog a bit more consistently to collect the management and leadership related comments I made on other blogs here (when they seemed to say something useful or interesting that were worth posting on this blog - often things I wanted to be able to find later).

Related: Most Popular Posts on the Curious Cat Management Comments Blog (2014 edition) - 10 Most Popular Posts on the Curious Cat Management Blog in 2014 - 20 Most Popular Posts on the Curious Cat Management Blog in 2015 - 10 Most Popular Post on The W. Edwards Deming Institute Blog (2015)

The Importance of a Work Culture That Values and Supports Critical Thinking

Critical thinking is tremendously important. I have come to think it might be the most important precursor to management improvement (evidence based management, continual improvement...).

One of the big issues is for people to understand thinking critically about ideas isn't an insult to whoever came up with the idea being discussed. This isn't something I would have thought of as important until seeing so many cases where people are not comfortable discussing ideas (and weaknesses in those ideas) in the workplace.

Comments prompted by: thinking critically

Related: A Good Management Culture Encourages the Debate of Ideas - Respect for People Doesn’t Mean Avoiding Any Hint of Criticism - Dangers of Forgetting the Proxy Nature of Data

Quality Digest: How to Create a Culture of Continuous Improvement

Quality Digest published my article: How to Create a Culture of Continuous Improvement

Related: Change and the Management System - John Hunter online - Lowering Expectations Isn't Showing Respect

Root Cause - Addressing Systemic Causes Not Symptoms

Comment on Just Ask Why Five Times? Effective Problem Solving for #Lean or #LeanStartup Doesn’t Start or End There

> Would you agree that complex systems rarely have a single root cause?

Yes. And also "root cause" is a neat concept but in reality it is not usually "true" but an a sensible acceptance of a cause that is systemic enough and addressable enough to consider "root." It isn't that there is this "true root cause" that created the current problem. There is a way to look at the issue and find a deeper cause that will allow you to address it and improve the future performance of the system.

Depending on how you look at the problem there can be many different "root causes" that are sensible from their different perspectives. The important thing is by aiming to fix root/systemic problems you will not just treat the current symptom you are dealing with today but eliminate future problems from occurring. If you are doing that, you are doing well.

If you start noticing that you are addressing problems that could have been addressed in previous attempts to address root causes, you can exploring whether going further in each attempt makes sense. It isn't as simple as this but if you notice you addressed a systemic problem at the "branch" level effectively for example. So if you had 3 fixes that did stop future problems on each of the branches but on the fourth fix you looked and said hey all 4 of these connect to this larger branch (or tree trunk - which is connected to a real "root") I would say asking if you should have addressed the "next why" may well make sense.

Related: Root Cause, Interactions, Robustness and Design of Experiments - Address the Root Cause Instead of Finding the Person to Blame - Poor Results Should be Addressed by Improving the System Not Blaming Individuals - Firing Workers Isn’t Fixing Problems - Examine the System, Don't Look to Blame a Person - Why Do You Ask Why?

How Badly Are Companies Treating You?

Comment on: How well does your organization treat clients or customers?

Our reader poll today asks: How well does your organization treat clients or customers?

– Extremely well — we take great care of them: 35.17%
– Very well — we treat them better than most other companies: 34.88%
– Well — we do a decent job but could improve a bit: 25%
– Not well — we could treat them much better: 3.49%
– Poorly — I’m surprised we even still have customers: 1.45%
...
Do you agree

No I don't agree; maybe I just have the lousy sample of companies I interact with. Truthfully I don't deal with companies that treat me poorly unless I don't have a choice - but that is not uncommon at at (ISP, airlines, electric company, mortgage company...).

The survey results don't surprise me, given how out of touch executives and managers are about what their customers must put up with.

I intentionally pick companies that are good, but for example with a mortgage it is then sold and I am forced to deal with a bad company...

I am thrilled when a company treats me well (because my expectations have been so beaten down that just not being treated as a huge bother is a rare), but it is rare. Trader Joe's does consistently. My credit union does. In general restaurants do.

What I have found is that if the executives are paid more than $1,000,000 the company probably treats me very poorly. I don't think is a cause, but I do think it is correlated. The executives seem to always have room to pay themselves huge salaries but are loath to provide the customers someone that answers the phone or email without wasting tons of the customers time.

Upon my return to the USA after 4 years overseas the biggest annoyance has been dealing with these companies I am forced to deal with that treat me with complete distain. They see no problem wasting my time or forcing me to follow some idiotic processes that make life easy for them.

Related: Customers Get Dissed and Tell (2008) - Is Poor Service the Industry Standard (HP in 2006)? - Don’t Ignore Customer Complaints (2014) - Customer Service is Important (2006)

Spend More Time Doing What You Do Well

Comment on: Is it Better to Work on Strengths or Weaknesses?

As you say to the extent your weaknesses are things you have to do spending time improving them usually makes sense. I think often the most productive thing is to spend time working on the system to maximize the use of people's strengths and minimize the use of their weaknesses. This often has a big impact without much effort.

And when you do that it is often the magnitude of strengths that makes a big difference. So you can avoid dealing with much of the weaknesses in the team and focus most effort on the strengths. And when you do that my getting even better at x allows the improvement not to just be x * 1.1 but (x * 1.1) + (y * 1.3) + (z * 1.4) - (if say I am now 30% "better" than y at the task and 40% better than z. Obviously it doesn't work so cleanly in the real world but that concept that you can get way more improvement normally by adjusting the way work is done than just by having everyone get less bad at the stuff they really should avoid doing most of the time.

You do also have to pay attention to the long term, so if someone wants to move into supervision but has some weaknesses they need to address and strengths to improve working on that makes sense.

Related: Take Advantage of the Strengths Each Person Brings to Work - Helping Employees Improve
- Many Good Employees Want to Continue to Do Their Current Job Well - Lessons for Managers from Wisconsin and Duke Basketball

Change and the Management System

comments on: Better Change Leadership as a Countermeasure to “Resistance to Lean”

I agree, the problem isn't change but the process for change. There are many smart things to do to help the process work better.

The most important thing though is the entire management culture. Tactics can help change efforts be more successful. But if the culture is hostile to continual improvement (fear based, performance appraisal based, target based, blame based, imposing from on high...) the tactics are working in a difficult situation. Still a good idea, but no matter what tactics are used it will be a challenge.

When the culture has the right environment (PDSA, seek to continually improve the system, respect for people, support for innovation, understanding of variation in results, seek process weakness to improve not people to blame, provide training...) change is set in a system where resistance is much lower (and in very highly functioning systems it is encouraged not resisted).

Change tactics are still sensible but often they are baked into how things are done. As you grow more toward becoming such an organization change tactics fade into the normal process and the resistance fades too.

Related: Communicating Change - People Take Time to Believe Claims of Changed Management Practices - Encourage Improvement Action by Everyone

Pretending to Listen to Customers Rather Than Actually Doing So

Comment on Are You Really Listening to Your Customer or Just Going Through the Motions?

I find myself very frustrated at how incredible poor and superficial "listening to our customers" is at nearly all companies I have to deal with. It is atrocious, often beyond the superficialness of any concern is creating hoops to waste customers time who even deign to raise an issue of persistent failures by the company (I have had this with Amazon for the last 2 months - it is amazing how they expect you to repeatedly jump through hopes while they ignore you over and over). I would have dumped them for this horrible service but I can't get them to refund my sizable balance because it isn't their "policy" to bother to refund money in your balance.

A method to get useful feedback I learned maybe 20 years ago at a quality conference, it is really simple, why nearly no companies do it is a sign how little they actually care about customer service and improvement. Just ask "customers, what one thing could we do to improve?"

Then you also need systems in place to use what you learn to improve, of course.

Related: Delighting Customers - Simple Customer Care: Communicate - Poor Customer Service: Discover Card - What Job Does Your Product Do?

The Use and Misuse of Technical Jargon

Comments on: You want muda? Let’s talk about muda!

Essentially the terms are precise technical jargon. As with nearly all technical jargon it is very useful for experts and confusing (and, to many, off-putting) to people that are not experts.

You are exactly right, overwhelming people with jargon when trying to introduce new ideas is not usually helpful. Using a couple pieces of jargon can be helpful as it reinforces the idea that this is new stuff and can make people tie the new ideas to new terms.

When some people are learning it is easier to think of muda than "waste." They have an understanding of "waste" and it may well not include what is meant to be included in a lean context. They can rearrange in their head that in the context of lean "waste" is different - we do this all the time.

For some people using muda to think differently is helpful, for others it is not and often creates resistance.

English has many words we understand differently depending on the context (for example, "lean"). It works remarkably well but especially when people are learning it is easy to miss special "lean" meaning when using common words. Technical jargon is helpful with experts being able to quickly communicate unambiguous (well less ambiguous) specific meaning which is why jargon usually exists - to allow for communication to be more effective.

Certainly at times jargon is also used by experts to baffle or impress non-experts rather than to help communication. Reducing this use of jargon would be a good thing.

Related: Learning, Systems and Improvement - Open Source Management Terms - Getting Known Good Ideas Adopted

Customer Service is Often More Like a Mugging Than Service

It is so frustrating to deal with most companies with monopolistic positions in the USA (which is a lot of them).

I find dealing with those companies a matter of being confronted by someone trying to pick your pocket while they both ignore and insult you and give you orders about what hoops you have to jump through if you want to stop one of the things they are doing to harm you.

Some are not that bad, I get water and garbage from the local county, they are actually the best service I get from a monopolistic provider. The electricity provider is just designed mainly to make their lives easy but they don't make it horrible to deal with them.

Getting broadband (Verizon and Comcast where I am) is horrible - dealing with them is exactly what I wrote above. Health insurance (and I don't even make any claims) is bad, and if I actually got any service I imagine it would be horrible dealing with the service providers seeking to rip you off and the paperwork being a nightmare.

I avoid dealing with the monopolistic providers as much as possible but you often are stuck. For example, I can (and have) only use sensible providers to get my mortgage, but then they are sold to service companies that are horrible and I have no say in the matter.

Much more than the costs taken by companies when they can buy politicians in order to allow the abuse of the market by dominant providers I abhor the pain of dealing with these companies as a customer and the constant vigilance required to protect yourself from them ripping you off. It is like being forced to commute in a packed subway with bought off police that allow pickpocket teams to work without interference.

Related: Worst Business Practices, Fees to Pay Your Bills - Customers Get Dissed and Tell - Incredibly Bad Customer Service from Discover Card - Don’t Let the Credit Card Companies Play You for a Fool

Learning From Process Improvement Efforts

Comment on: How to Improve (at just about anything)

1. The classic way:

Do – make an improvement
Do – change a process
Do – implement some training
Do – install a system

When you have been through the 4 do’s keep right on doing.
2. The recommended way:

Plan – develop an idea or innovation, work out how you will implement it.
Do – carry out the plan on a small-scale, test it to see if it works.
Check – study what happened, did the plan work? If not why not? What can you change?
Act – adopt the change and roll it out, abandon it or learn from it and adapt it.

Another huge benefit to the PDSA cycle in my experience is to learn. I can't remember how many times I would see in the do-do-do-do organization that

do#1 was x
do#2 was y
do#3 was x again
do#4 was z
do#5 was y again

Um, ok, yeah why are we trying things we already know don't work (they are presented as fixes not, as well this old way wasn't great but jeez it was much less bad than the mess we have now so lets go back). Why are we thinking x is going to work when we just dumped x because it wasn't working? PDSA makes you think about the process, study the historical data and document your predictions. The learning will

Related: How to Improve - Document Your Decisions to Learn More Effectively - Learn by Seeking Knowledge, Not Just from Mistakes - Write it Down

Businesses Need to Capture Potential Information and Use the Creativity of Employees

Comments on: Asking the Employees

The problem I see is that management systems can't be seen as independent from the specific tactic in some area (for example getting employees to share ideas). So the effectiveness of soliciting ideas from employees varies mostly by the overall management system unrelated to the specific tactics of the attempt to get ideas from employees. The specific tactics matter but less than the management system (which is often a mess and something no one wants to address).

My father wrote an article a long time ago on how to use ~"two resources, largely untapped in American organizations: potential information and employee creativity."

I think it provides worthwhile ideas.

Related: Trust Your Staff to Make Decisions - Leading Improvement and Enjoying the Rewards - Do What You Say You Will

Deming Wanted Managers to Understand the Systems They Managed and to Visit Where the Work was Done

Comments on Deming wasn’t a fan of Management by Walking Around

Deming’s view is entrenched in Lean management practice in the form of “Genchi Genbutsu”, literally “go and see” at the “real place”. Where practitioners of Management by Walking Around merely visit the workers for a chat, practitioners of Genchi Genbutsu stay with the workers to understanding what is going on.

True, and the details you provide are important. It wasn't managers going to the gemba Deming was against. What mattered is the system. Some people did Management by Walking Around (MBWA), even decades ago, in a useful way - with understanding. But most did not.

Gemba walks are much more likely to be useful (because the expectations are for a more engaged leader) but there are plenty of times those are not done well, and are no better than bad MBWA. Jim Womack has a book out on Gemba Walks which provides good details to managers on what they should do (and what Deming wanted them to do).

Related: Out of Touch Executives Damage Companies, Go to the Gemba - Leadership and Management - Jeff Bezos Spends a Week Working in Amazon’s Kentucky Distribution Center (2009) - Customer Gemba

What is a Lean Program, Deming Program?

Thoughts in response to: Dr. Deming’s Last Interview & Jack Welch’s Thoughts on Him by Mark Graban.

Deming sure provided some great quotes in that interview; those you listed above and more (in fact I posted about one this week in To Achieve Success Focus on Improving the System Not On Individual Performance). From Mark's post:

I’m not sure what 'a Deming program' is anymore than I know what 'a Lean program' is sometimes.

This is so true. Basically organizations can be making good progress but essentially none that *have* a Deming or lean program. Toyota is sensible to consider the closest - I mean lean after all originally was just documenting Toyota and calling it lean instead of Toyota management or whatever. But Toyota does plenty of things that are not what even Toyota says how things should be done.

And beyond that lean has evolved away, IMO, from just being able to say anything Toyota does is by definition lean. Lean and Deming are more about a philosophy of managing - continual improvement, respect for people, etc. than prescriptions. So you can't really have a checklist and say that if your org can check off all these things they are lean or Deming.

The fact that the management systems can't be reduced to a checklist is a necessary given the long lasting power they offer. When you reduce the ideas for management that far (so you have a checklist of exactly what to do) you get a stupid system that can't be used for managing large systems of people. Organizations doing the best job of being worth of claims of being true to the management systems are likely to have the widest understanding of all the ways in which they are failing to live up to that vision.

I continue to think Toyota is doing a very good job. But they also have plenty of room to improve. And they continue to be tempted by becoming more like other companies instead of recommitting to the principles of lean and Deming.

Related: Rethinking or Moving Beyond Deming Often Just Means Applying More of What Dr. Deming Actually Said - Long Term Thinking with Respect for People - Deming and Software Development

Building a System to Reduce Interruptions for Software Developers

I feel strongly about the damage done by interruption to maker's focus. My appreciation for this damage to system performance was greatly enhanced as I became a software developer.

In my work prior to software development I could see that interruptions were not ideal but they were not so damaging to my work and they do also have value. But work that requires extra focus, and software development sure did for me, the damage increasing greatly.

Over 20 years ago at the Madison Area Quality Improvement Network they had a simple visual management sign at everyones office and cube. You could dial between various settings - GREEN available (free to interrupt)... RED busy, don't interrupt... There were 3 to 5 settings. It worked very well for them.

Of course such a system is highly dependent on the overall management system. Just putting that up in most offices would likely fail. MAQIN was an organization that embodied modern management practices (Deming, lean, respect for people, organization as system, etc.). It worked very well for them.

When building a software development team I tried to protect developers from interruption while having very open communication between developers and program managers (product owners). As is often the case, the real roles didn't line up exactly. In our organization, the people that needed us to develop software (to varying levels) didn't want to take on the responsibilities that agile would suggest (setting priorities etc.). Nor did the that organization want to deal with the conflicting priorities of the various people in their organization had for software development. As part of making things work, I took on a bit of the priority setting roles.

One of the things I did was explain to those that had us do software development was why it was critical to allow software developers to have uninterrupted time to focus. I shared various articles and reports over time and would talk about this as I interacted with them. I encouraged people to talk to me first (at that time I had transitioned from developer/software-development-program-manager to nearly entirely a program manager role).

We also had weekly meetings (when it made sense) with the "product owners", me and the developers working on the software. We scheduled additional meetings when necessary.

I also encouraged people to use email when possible to just check on things, ask simple questions, ask to meet. Again I explained how just going up to talk to the developer could impose significantly higher costs to them being able to focus of their work than there were for interrupting my work or others that had work that could more easily be interrupted with lower consequences.

When there were very important deadlines I would increase these instructions not to interrupt the software developers. And I would talk to the developers about how things were going and if the developers wanted help pushing back a bit I would then do so - mainly by trying to work on the system (provide a set time to allow needed discussions, coach the "product owners" on the difficulty caused by interruptions etc.).

As you might expect this worked better with some people than others. It made a significant difference though. And in our organization it was actually a bit less effective because the software developers were all so nice. They could say how interruptions damaged what they could do systemically but were always super friendly whenever they were interrupted. I was by far the most willing to actually disappoint people face to face in the name of improving overall performance.

It is very hard to overestimate the systemic nature of all of this. By delivering great results we were able to reinforce that if we followed the modified Deming/agile methods we were using were important. Those needing work from us ranged from very skeptical to accepting of those ideas but our performance (both in meeting their desires for software and for interpersonal interactions) made them willing to go along with the methods we said were important.

Related: Deming and Software Development - Mistake Proofing Deployment of Software Code - Creating a Culture that Values Continual Improvement

A College Degree Isn't an Acceptable Hiring Screen

Comment on: Do You Need a Degree to be Hired to Develop Software?

In all the time I hired developers (about 10 years), I never made a college degree a requirement.

The best developer (who was also much more - designer, coach, architect, program manager...) I ever helped hire didn't have a college degree.

Our company had just hired a new HR person that started "showing their worth" with new rules such as the dictate that all hires must have a college degree. Thankfully our team agreed to hiring him was wise and the CIO decided that dictate was nonsense and we hired the applicant.

I have written about what a great software development team we created.

In addition to a college degree being a lousy hiring screen, so are most of the automated screen poorly designed HR departments use. Years of experience, experience with a list of specific software, keywords listed, etc. are just lazy and poor criteria to use to reject applicants.

Related: Dee Hock on Hiring (2010) - Hiring – Does College Matter? (2007) - Google’s Answer to Filling Jobs Is an Algorithm (but yours shouldn't be) - The Illusion of Knowledge - Working as a Software Developer

Did Deming and Drucker Agree on Important Management Practices?

Response to, Help needed fleshing out differences between Drucker & Deming? on The W. Edwards Deming Institute LinkedIn group.

Here are some links about the topic

• video of Drucker discussing Juran, Deming and himself
• Driving Out Fear and Other Similarities Between Drucker and Deming by Kelly Allan
• Podcast with Kevin Cahill and Joyce Orsini where they discuss the interaction between Deming and Drucker and their ideas

There were cases where Deming and Drucker disagreed but in many ways the ideas they proposed were compatible.

Drucker did propose MBO, his version was not the same thing we criticize. Drucker did criticize how it was being implemented. I think you can argue even with the way Drucker wanted it done, but that way isn't nearly as bad as the way it was done in practice (so don't think Drucker was promoting managing in the way MBO has often been practiced).

And also don't tie Drucker to just MBO, he had lots of ideas over a very long career and many work fine with a Deming management system. I think in many ways Drucker's stuff can be more easily molded to whatever someone wants it to be - this is one reason I think you see Drucker taught in business school. They can claim Drucker wouldn't object to many things, even though, really I think he would - I am not sure Drucker spoke out so directly (especially compared to Deming).

But Drucker was direct on some things, like how bad excessive taking of company's money by executives was. And MBA programs seem perfectly fine ignore this, even though what Drucker found horrible has become mathematically 10 times worse than it was.

I think Drucker was ahead of Deming on this. I don't know that Deming ever was clear on how bad this practice was, but I think he would be clear about it today (though that is just my guess, I could be wrong). I think Dr. Deming would add that to the list of deadly diseases. Remember the original list was 5 before he added 2, to make it 7.

Related: Deming's Point 11.b of 14 - Deming versus Drucker - Why There's No Right Way to Do MBO - 3 Deming-Based Alternatives to Management by Objective

The Value of Putting Pen to Paper

Comments on Learning by Writing… by Hand

The psychology behind the learning advantage of handwriting is starting to be understood... [Carol Holstead] "It turned out my theory was right and now is supported by research. A study published last year in Psychological Science showed that students who write out notes longhand remember conceptual information better than those who take notes on a computer."

I am also a fan of technology. And also a fan of learning and paying attention to research. Pen on paper has advantages for learning that technology has yet to equal. At the same time technology has many advantages also.

We seem to understand the advantages of using technology fairly well but under-appreciate the advantages of pen on paper. To make sure we don't lose out due to this bias we should think before we accept that pen on paper isn't worthwhile.

From a post I wrote in 2005, Measurement and Data Collection

I believe, it is better to focus on less data, really focus on it. My father, Bill Hunter, and Brain Joiner, believed in the value of actually plotting the data yourself by hand. In this day and age that is almost never done (especially in an office environment). I think doing so does add value. For one thing, it makes you select the vital few important measures to your job.

Lots of data will be kept in computers and that makes sense. But putting pen to paper has value that we too quickly dismiss.

Related: Experience Teaches Nothing Without Theory - The Illusion of Knowledge - Write it Down to Improve Learning (Ackoff)

Learning Can't Take Place Without Theory

Response to: The Secrets of Lean

I think you make good points, but I think you make a mistake stating:

"This system of learning has come from experience, not theory."

For some reason, culturally, we created this idea that theory was about disengaged people (away from the gemba) thinking in a way disconnected from practice. But this is not what theory is.

Learning can't take place without theory. Experience doesn't lead to learning. Experience with a theory and an informed observer that questions what they see can lead to learning.

It seems to me accept theory that is separated from the gemba as what theory is and then say theory is not useful, experience is. But we are making a mistake when we think this way. The problem we see in theory being used disconnected from feedback from the gemba is a bad use of theory. But the problem is not that theory needs to be eliminated, but that theory disconnected from the gemba is not useful in learning about systems and improving our organizations.

Related: Experimentation is an iterative process - Effort Without the Right Knowledge and Strategy is Often Wasted

Lowering Expectations Isn't Respect

My comments on good post by Michael Ballé - How demanding can a lean leader be while remaining respectful of staff?

Being respectful means first not dismissing people’s difficulties but making the utmost effort to figure out the problems they mention and their origins.

...

Being demanding is a large part of lean leadership and, to be honest, in most cases, all goes well and people respond... there’s always one in ten who throws up a fuss, makes tantrum and will accuse you of being disrespectful in your very requests.

...

Being respectful means making sure people can succeed to the fullest of their abilities.

...

as a leader, your first job is to teach people to change.

A big problem we have (at least in the USA) is the opinion some people develop that respect has to do with not making anyone uncomfortable. That isn't respect, that is creating a dysfunctional mindset.

Fear driven culture that give mouth service to "respect" often create a climate in which managers find themselves fearful of being blamed for "disrespecting people" (which often means making someone uncomfortable). If they truly are being dis-respectful their boss needs to be dealing with that and helping them improve (which their boss should know because they are actually involved in management - but in many organization, probably most, the their boss would be clueless).

These management system concepts are all connected - weaknesses in critical areas create huge problems. If management doesn't know what is going on in the gemba they are suppose to manage, problems are very likely. Sadly this is often the case.

What you say is well put. We need to have high expectations and expect that people will rise to the challenge. And if people can't (with help and good systems) we need to find them a new position at which they can excel. Babying people isn't respectful to them or everyone else.

Helping people be as contribute is respectful. While ignoring poor performance is often easier for the manager than addressing the issue and helping the person improve doing the difficult task is what managers need to do if they respect people. And likely managers should be spending a lot more time doing this and eliminating other things taking up their time (unless they are in an amazing organization where coaching is a huge part of the managers job - in which case, wonderful).

I have written about this several times: Practical Ways to Respect People - A Good Management Culture Encourages the Debate of Ideas - Respect for People Doesn’t Mean Avoiding Any Hint of Criticism

Patient Centered Doesn't Mean Patient Directed

One thing I find annoying is when people talk about patient "choice" as if that is the fundamental principle in health care. We often try to simplify things so much that they are untrue. Health care is complex and trying to point to pithy sayings does more harm than good I think.

Patient focus matters but there are conflicts between what is the best care and what patients want. And there are conflicts between what those paying for care want and drug companies want and hospitals want and doctors want. These require difficult choices and in order to optimize results we need very well designed systems that take these issues into account.

Sadly I think the USA generally has very bad systems in place. The rest of the world isn't that great either, but by and large is better than the USA and much cheaper. Most health care providers care about patient care and often make heroic efforts to provide it. But the systems are just lousy.

Those systems that seem the most lousy to me around extracting cash from payers - it is absolutely horrible in so many ways in the USA. Sadly this creates hugh waste in the USA that is ripe for improvement (and has been for at least 30 years). Patient care also has plenty of room for improvement, but thankfully it isn't as messed up as the whole payment system is.

One of the things people ignore is that we are not talking about GM in the 1980s being pitiful compared to Toyota. When we look at how poorly the USA health care system does it is in comparison to other rich countries it isn't a comparison to "Toyota." It is more like being pitiful compared to 1980s Fiat or something. When you are twice as expensive with no better results than Toyota that is somewhat lame. When you twice as expensive as not very well run systems with no better results that is super lame. And then add on the top of it that you bankrupt hundreds of thousands of people a year, force people to avoid health care so they don't go bankrupt...

We need to have systems that are patient focused but that doesn’t mean patients dictate treatment. And we need to see a much wider system than we normally do. We need to be focused on healthy living not just disease treatment. And given the mess that is the USA health care system we need to focus on reducing the burden of coping with the horrible USA health system bureaucracy - that system does great damage to those having to deal with it (and it is nearly all waste that shouldn't be creating such hardship).

Response to: A Story About a Hospital Putting Safety First Over Patient Satisfaction

Related: USA Health Expenditures Reached $2.8 trillion in 2012: $8,915 per person and 17.2% of GDP - Our Failed Health-care System - Overview of 5 Nations Health Care Systems

Influential Women in the Field of Quality Management

My response, off the top of my head (there are plenty of others to include) to Who Has Inspired You About Quality? by Nicole Radziwill.

I searched online and found a nice “List of Gurus” that someone put together that includes my extra picks! But!! There’s a problem with it. Where area the women? The one woman in this list is someone I’ve never heard of, which is odd, since I’ve read papers by (or about!) all of the other people referenced in the list. Which brings me back to my original point: Where are all the women quality gurus? It’s time to start celebrating their emerging legacy. If you are a woman who has made significant contributions to our understanding and/or practice of quality and improvement, Please contact me. I’d like to write an article soon.

Joyce Orsini and Gipsie Ranney have done lots of good stuff. So has Clare Crawford Mason.

Gertrude Mary Cox isn't known so much for "quality" as statistics but she was an impressive person and a generation or two ahead of others (and it really is related to quality).

Mary Poppendieck has really good stuff at the intersection of quality and software development.

Meg Wheatley was really popular in the 1990s in the systems thinking area of quality. I thought her stuff was good, but wasn't as impressed with it as many people - I haven't seen her stuff in a long time.

There are a couple recent podcasts from the Deming Institute with Paula Marshall, Andrea Gabor and Monta Akin (as well as others listed above).

Most, or all, of those could be good articles.

Related: My post on Who Inspires Your Management Thinking and Action? - women in science and engineering

A Good Management Culture Encourages the Debate of Ideas

my comments on Political Correctness Comes To Lean

Criticism is one of the ways in which knowledge advances. It is a type of thoughtful feedback (and subsequent dialogue) that helps expose blind spots, identify misunderstandings, provide alternate explanations, or uncover errors that others cannot see or are unwilling to acknowledge.

...

Without criticism from others, we are unlikely to challenge our own thinking or escape the comfort of self-satisfaction. We fall prey to the confirmation bias and accept information that confirms one’s views and reject all information that does not. We also develop a love for the status quo. Criticism is rejected without consideration and attributed to people who are simply uninformed or who suffer from professional jealousies.

The outcome is blocked information flow, which is the opposite of what we seek to achieve in Lean management.

I agree with you. I put much of the blame on insecurity and mistaking respect for people with not making anyone uncomfortable. When people are insecure or unconfident they often take criticisms of ideas, plans, results, etc. as personal attacks. Then misunderstanding of don't be "dis-respectful" to people comes into play.

I have written about this several times

Respect for People Doesn’t Mean Avoiding Any Hint of Criticism

Building a Great Software Development Team, a significant part of which was hiring people that would debate ideas without becoming overly personally defensive.

And those posts link to more related posts. The retreat into criticism of ideas is dis-respectful is a real problem for management improvement. Usually there are plenty of other more severe problems, but if you are doing well and getting rid of common failures to manage the organization as a system, experiment and base decisions on data (in many ways) you are likely to reach a point where the fear of debating ideas common in the USA becomes a serious problem.

Related: What Does Respect for People Actually Mean? - Disrespecting most people in order to avoid confronting one person is not good management (or respect for people)

Most Popular Posts on the Curious Cat Management Comments Blog

The most popular posts on this blog:

• Profit = Market Price - Actual Cost or Price = Cost + Desired Profit (2012)
• Mistake Proofing and Mistake Making Less Easy (2013)
• Cease Mass Inspection for Quality (2006)
• 14 Plus Potentially 14 More Years for Copyrights Has Become 120 Years (2013)
• Sustaining Management Improvement Through Personnel Changes (2014)
• Causes of the Health Care Crisis (2011)
• Performance without Appraisal (2005)
• Boston Lean? (2013)
• Data Must be Understood to Intelligently Use Evidence Based Thinking (2014)
• The Failure of Hero Worship Thinking at JC Penney (2013)
• Customer Focus is Central to Lean Thinking (2012)

I started this blog over 10 years ago. After I figured out I thought blogging would work for me I created a self hosted blog and moved the content to that blog. But I kept up the post here since web pages should live forever. For several years (about 2005 to 2011), I posted occasionally to this blog, sometimes the posts were comments made on other blogs.

In 2011 I started to use this blog a bit more consistently to collect the management and leadership related comments I made on other blogs here (when they seemed to say something useful or interesting that were worth posting on this blog).

Related: 10 Most Popular Posts on the Curious Cat Management Blog in 2014 - 20 Most Popular Post on Curious Cat Science and Engineering Blog in 2014