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

I Don't Take "Better Management" for Granted

My response to a post on Management Innovation is at the Top of the Innovation Stack [the broken link was removed] and the authors reply to my first comment:

JD Meier: "I think we are so used to 'better management' now that we take it for granted."

You are much luckier than I (both as an employee and customer). I find very few companies show evidence of practicing what Deming, Drucker, Ackoff etc. talked about many decades ago. Better management is still a distant hope for most organizations in my opinion.

I do think Hamel talks about lots of good stuff. I admit my study of his is not extensive, but from what I remember he does tend to (as do nearly all these people trying to sell their ideas) make more of what he is saying than is merited.

It reminds me of college when about 50% of my professors in the first lecture had some version of: In [this class] we are studying the true core of knowledge, everything else is just a different take on what we will study here. If it was physics then chemistry, biology... are really sub-disciplines of physics. If it was philosophy everything else was a sub-discipline of philosophy. I thought it was pretty funny. And that passion likely made them great professors, even if I think they lost perspective on reality.

I think even many fairly good management thinkers get hung up on the wonderfulness of their thoughts and how critical their details are. I do still I do like Hamel but I think he is too caught up with his ideas and thinking what he has been looking at is more important than it really is.

My first comment:

I agree with what I think is the premise - that better management is critical for the ability for an organization to successfully innovate. And that bad management can kill otherwise excellent innovation in the other domains you list.

I think calling it management innovation however is misleading. It is true management at very valuable companies (and less valuable ones) needs a great deal of improvement. But it is mainly adopting good management practices people like Deming, Ackoff and Drucker talked about many decades ago.

Related: The Need to Improve Management While Building Organizations Fit For Human Beings - Quality and Innovation - New? Different? How About Better?

Niche Markets

One of the things I find amazing is how focused niche markets are. I noticed this as a kid collecting baseball cards and then paying attention to all the very focused niche markets I saw. When people find it surprising that people actual focus on that I don't really find it surprising but I do still find it interesting.

Here is a good example of what I mean, a business focused on manufacturing bottle caps specifically for use in craft and jewelry projects. That is not a market I think most people think of and say wow if only I could build a business in that market I would be set.

But by focusing on customers and building your business to give customers what they want you can build a good business. That is how the Bottle Cap Company built itself. It started out selling on bottle cap products at local farmer's markets and then ended up with an extra supply and sold that on eBay. And based on that response they saw a larger global market and expanded. And now they ship products and supplies daily all over the world from their warehouse located in Nampa, Idaho.

The success of companies like Google and Apple and Tesla are interesting. But far more success is gained in small companies providing needs to niche markets. I wrote about recent lean startup weekend in Johor Bahru, Malaysia recently along the lines of providing products and services to meet customers needs and not needing to try and become the next Twitter. Sure making billions sounds nice but that is extremely unlikely. However building a successful small business is possible by managing the business well and applying good customer focus principles.

Related: What Works for One Business May Not Work For Others - Pilot on a Small Scale First, Good Advice We Often Ignore - The Customer Knows Best?

It isn't Fair to be Judged for Performance Outside Your Control

My response to Simon Guilfoyle post

It’s also necessary to acknowledge that multiple variables affect crime rates; factors such as economic cycles, substance abuse, the weather, societal influences, changes in legislation, and so on. None of these are directly within the gift of the police to influence. Also, what about where the police cause an increase in reported crime by having the temerity to find someone carrying a weapon? Surely proactive problem-solving should not be discouraged on the basis that finding hitherto unreported criminal offences is incongruous with an over-simplified crime reduction narrative...

I would say many of the examples are outcome measures of the system - which is a better measure than is often used.

However, they are often beyond the control of individuals and even police departments overall (many other factors play a part - economic development, social services system, education system...).

Likely more directly relevant the measurement error is often so high that the figures have more to do with measurement than the actual outcome. And when the figures are being used to blame then it dramatically increases the likelihood the figures will be a poor representation of outcomes.

I would rather see more focus on outcome measures. We should also reduce incentives to misreport data (often blame related).

I think the issues you raise about the system being larger than the police can tackle alone should be a reason to INCREASE the view of the SYSTEM. The important system is LARGER than the police department. When we have institutional walls that break up the system we need to find ways to knock down those walls so the system can work together. Granted this seems nearly impossible given how much difficulty we have even just breaking down barriers inside tiny pieces of our organizations.

Nevertheless that is where the focus should be. We shouldn't decide the outcome measures are not fair given where we put organizational barriers. We should decide that we need to realize when we cut funding for x it drives bad results in section a. And when we allow y to retain fitfully outdated management practices that doesn't just impact their ability to succeed it likely creates lots of other problems all over the place.

Related: Be Careful What You Measure - Millennium Development Goals

Sustaining Management Improvement Through Personnel Changes

My reply to a comment on Reddit about my interview: Leadership While Viewing the Organization as a System.

So if a new manager is able to mess it up, the system was necessarily weak? Not sure I agree.

Looking at the context the interviewer asked about a new CIO coming in a gutting the management system. I said if they have a strong management system that can't happen. Executives can't just have whims (usually driven by a desire to "make their mark") that throw out the principles used to manage the company if there is actually a strong management system.

Most organizations just float with whatever fads are going on, so in most they can flip flop as new executives come into place.

On the question of new managers making mistakes. Yes, I agree they can. Once again good management systems make a significant effort to bring new managers up to speed. Those management systems reduce the likelihood of failures created by new managers making mistakes. Again, most organizations do a poor job of brining new managers up to speed: Toyota does a good job, the USA military does also, Costco does a good job, I think P&G does (but my information could be outdated). Many others do this well, but the majority of companies do this extremely poorly. That is a serious failure of a management system and I would put more of the blame for those failures on the poor management system, that the managers making mistakes when they were put in a position they shouldn't have been (being made responsible without proper preparation).

Related: Poor Results Should be Addressed by Improving the System Not Blaming Individuals - Management Training Program (2005 Curious Cat post) - Curious Cat Management Improvement Dictionary

Data Must be Understood to Intelligently Use Evidence Based Thinking

All metrics are wrong, but some are useful

Metrics might tell you something about the world in a quantified way, but for the how and why we need models and theories … metrics are generated must be open and transparent to make gaming of the system more difficult, and to expose the biases that are inherent in humanly created data

True, understanding the proxy nature of data (and how well or questionably the proxy fits) is important.

Data can't lie but we often make it easy for others to mislead us when we don't understand (or question) what the data really means (what operational definitions were used in the collection, etc.).

Related: Operational Definitions and Data Collection - Actionable Metrics

How to Deal with Motivation Problems.

Comment on, The Great Addiction to Motivation

By saying that we lack the motivation, it gives us another excuse to procrastinate.

...

Have any tips for getting your motivation back? I’d love to hear them.

I think we misidentify the issue when we claim it is motivation (as you allude to). As to why we don't take action, I believe it is more about habit than motivation. As to what to do, make habits of what you care about.

Our organizations often demotivate us. We don't need pep talks and reward/carrots to get over the de-motivation. We need the practices that de-motivate us (Dilbert does a good job highlighting many of these) to cease. In this sense what is needed to motivate us is to remove those things that are de-motiving us. Leaving those in place and relying on pep talk and such gimmicks is a losing strategy.

Words about how employees should be all motivated about work while the organization beats out the intrinsic motivation people have at ever turn only drives de-motivation to higher levels. Instead, build an organization where intrinsic motivation flourishes.

For more ideas see the Curious Cat Management Improvement blog posts on motivation.

Data on Medical Errors

How Many Die From Medical Mistakes in U.S. Hospitals?

In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

I wish these reports would provide some detail on what these really mean. Is it 250,000 people that were completely healthy coming in for a physical and they die when they would have been healthy if the medical system didn't exist? I doubt it. Is it 2,000 completely healthy people and 248,000 people that were under intensive medical care for years keeping them alive and now we slipped up and they died? Probably not, again, but my guess is it is closer to the second.

Preventing errors is obviously important. And in health care it is very important, of course. But just because you use data doesn't mean it isn't misleading. Medical errors leading to death is just too big an operational definition to be very meaningful in my opinion. For these numbers to provide much insight I really think they need to be segmented more:

• perfectly health person that was going to be perfectly healthy for decades but were killed by medical error.
• person that needed life saving care of they were going to die that month and we routinely should be able to provide the very easy care to make them perfectly healthy again but they were killed.
• etc…
• person that was extremely sick with many problems for years and was saved with medical care over and over again. Complex care was needed and much of it was done well but in the very challenging situation there was a mistake and that mistake is the proximate cause of death.

We should be working on making everything better and eliminating medical errors that cause damage and death. But there are huge differences between a medical error conditions that caused death and to me those differences are so huge lumping them together is hardly useful.

My understanding is we do use risk based assessment to compare things like survival rates or operations at different hospitals. A figure of survival rates comparing two hospitals when one was the hospital where all the most difficult case for the Western USA were sent to a local hospital that dealt with the easy operations for that health issue would not be very useful. So they try to adjust for the severity of the problem (as I understand it). It would seem to me a similar thing would be much more useful for medical error death rates. Was the person in such a risky state that the tiniest misstep (error or whatever else) would kill them or was it someone who is perfectly health and dies immediately due to an error.

Related: Errors in Thinking - Epidemic of Diagnoses - Health Care Crisis - Great Visual Instruction Example (taking pills)

Response to comment on my comment

Right, l think the thing I am getting at is there is a big difference between making a mistake while you are in a complex situation where any of 30 bad decisions in a pressure situation could result in death (and where doing nothing results in death) versus a situation where there is no risk of death until you do an absolutely idiotic thing that turns my visit to get a physical into death.

Everything should be constantly improved and made safer with mistake-proofing thinking... And healthcare needs this more than most everything due to the dangers and consequences involved.

When there are headlines like 100,000 deaths due to medical error every year that reads to me like John was walking along the street and boom a medical-error/piano dropped on his head and killed him. But I don't believe that is true. I bet it is true that are lots of deaths due to just unforgivable errors - someone is given a drug which was indicated in numerous sensible ways would kill them due an allergy but they were given it anyway and died.

But I don't trust how much of the deaths attributed to error are really 20% error, 19% cancer, 18% diabetes, 17% cardio-vascular disease, 16% long term high level use of powerful drugs ravaging the body, 10% car accident (which also someone else might say is 5% error, 30% cancer, 25%...). The error is still bad, and the system needs to be improved to reduce the frequency and consequences of errors. But I just don't know how to take the error to death data without much more explanation.

In reading more details on the studies they comprehend this issue with the data but I haven't found where they provide more meaningful data. What I read just talks about the contributing nature of "blame" on medical error etc..