The height of disrespect for people: A UK Healthcare nightmare

The_Doctor_will_SEE_you_now_by_DaYDid
The_Doctor_will_SEE_you_now_by_DaYDid

The Doctor will SEE you now by DaYDid

I came across this lengthy article from The UK’s Daily Mail detailing the nightmarish conditions at Staffordshire Hospital, where it is reported that between 2005 and 2008 as many as 1,200 patients died needlessly due to appalling conditions and neglect.

Keep those dates in mind – this is current.  The events described in the article did not happen in some long-forgotten past or in a third-world hell hole.  This scandal is unfolding, right now, in one of the most developed nations on earth.  If you want to know just how far an organization can stray from the Respect for People ideal that lies at the root of Lean and Operational Excellence, forget Foxconn and look at the UK’s NHS.

There are a host of other articles on the Daily Mail site.  This article shares stories from the families of victims of the hospital’s abuses, where people were so thirsty they drank water from dirty vases and patients were often left to soak in their own urine for days.

Of course, the man at the head of it all refuses to accept responsibility, blaming ‘the system’ for the problem.  I know Lean typically advocates looking at the system for the root of the problem and not blaming the individual, but this seems like a bit of a bastardization of that concept.

The scandal runs wide and deep, and would be shocking if it wasn’t so utterly disgusting.  The Guardian has published a guide to the scandal, demonstrating just how far-reaching this is that it requires a guide.

Amazing that, in an era where Lean Healthcare is gaining more and more momentum, a situation like this exists.

In the age of engagement, you can’t thwart ambition

ambition_by_tja88

ambition by tja88

There are more articles, books and posting out there on engagement, creating engagement, the benefits of creating engagement, and so on than I can count.  So, of course, I’m going to write a post about engagement (Once in a while, I do like to suppress my contrarian urges and go along with the crowd).  Instead of yet another voice telling you how to generate engagement, however, here’s a tale of how to make sure it gets utterly destroyed:

A friend recently told me that, at the employer she has been with for years, and after having recently completed a graduate degree that the company funded, during her Annual Review (a practice that, all by itself, tends to smother engagement anyway.  Click here for good reading on the subject) she was penalized….yes, actually penalized, for seeking other opportunities within the company.  “Clearly, you’re not happy here,” she was told.  “Everyone else is doing good work because they are committed to their position.”  and, with that, she received a less-than-stellar review that impacted her income, of course.  During the course of the year other people had transitioned to new roles both into and out of that department, leaving her flabbergasted at the comments in the appraisal.

My poor friend’s predicament left me wondering how, in an era where engagement is so widely and openly discussed, any employer can seek to crush its people’s ambitions?  Clearly, this person was not disloyal – after receiving advanced education she was looking to return that value to the company by applying it internally (something she had limited opportunities to do in her current role).  Nonetheless, she was chastised and punished for trying to bring greater value to the company and create her own sense of engagement by taking on a more challenging position (because, obviously, no one was much interested in creating that sort of engagement for her).

I heard this story right on the heels of a great Fast Company article describing how many employees are now forced into faking enthusiasm.  Clearly, as both the article and my friend’s experience demonstrate, the situation with regard to engagement is getting worse instead of better.   Also, if you want people to be dedicated, celebrate their ambitions.  Chris Seper recently placed a very popular article on LinkedIn speaking to the situation directly: “Why I celebrate when my employees leave”

Here’s a tip for those who are still struggling with the concept:  Engagement….or passion…or loyalty…or whatever word you want …. is not about appearances.   Nor is it something that you should rely on people creating for themselves, because such things are not brought about through the perserverance, discipline and dedication of employees.  Perserverance, discipline and dedication are the results of employee engagement, not the inputs.

Follow up: Why Lunch & Learn is not for everyone

lonely_lady_loves_lunch_by_emohoc
lonely_lady_loves_lunch_by_emohoc

lonely lady loves lunch by emohoc

Last time out, my post on why I dislike the practice of Lunch & Learns drew quite a few visitors to the site, and a small handful of comments on reddit.

One comment, in particular, stuck out in my mind.  Reddit user: “CivilDiscussions” wrote:

You sound like quite the slacker. In the real world, we have lunch meetings all the time. Lunch isn’t guaranteed to be “your time”

Now THAT is a fascinating take – that wanting to have a break with which to recharge, or to avoid yet another mindless, unproductive meeting, is associated with slacking.  The only thing this makes me believe is that people with this mindset have not yet adopted the principles of productivity or efficiency.  Instead, they value activity over accomplishment and, therefore, believe attendance at lunchtime working sessions is useful, which is just plain silly.

After reading the comments on reddit, however, i recalled Susan Cain’s book, Quiet, and her Ted talk on The Power of Introverts.  The assumption that people are “slackers” simply for their preference to be alone for awhile, especially mid-day after 4-5 hours of listening to other people’s incessant yammering, chatter, shifting, shuffling and noise, is certainly ignorant.  For those like me who crave that 30 or 60 minutes of isolation to block out the world and spend a little time doing something that either interests us intently, and/or relaxes us significantly – being chastised for doing what helps us to work seems like something that would cause a loss productivity.

Given that such a significant portion of the population is, in fact, introverted – that only makes the practice of Lunch & Learns that much more difficult to understand.  Consider what we know:

  • Trying to divide a person’s attention is counter-productive.  Eating and working at the same time guarantees a loss of efficiency in both activities and, since time is limited, makes both less effective, too.
  • The majority of people out there don’t like their jobs.  Throwing more information and activity at them in the same amount of time & space is mind numbing.  This either breeds resentment, fatigue resulting in a loss of creativity, or both.
  • A very large percentage of people function poorly when they don’t have a chance to “switch off” and re-charge.  Once they can do that, however, they are remarkably productive and creative.

Lunch & learn sessions fill what seems like non-productive time with something that feels more useful.  What gets missed, however, is the longer-term affects of allowing people to relax, unwind or to even have some time to think about the issues of the day without interruption.  Eliminating this time in favor of the vain belief that if people are doing something that feels like work, they must be doing something productive, is simply ignorant and condescending.

 

Well, OF COURSE no one trusts management…..

Backstabber_by_bat_bat
Backstabber_by_bat_bat

Backstabber by bat bat

In a conversation with a seasoned manager who asked me why I believed morale was so poor in his organization, I stated that the thing most often heard wafting through the cubicles was that people simply don’t trust the management here. “Well, that’s universal.” he stated, and quickly dismissed the concerns people were uttering as just usual, typical, workplace angst. 

And so, improving the situation quickly became impossible or, at the very least, set back for quite a while. 

Now, it would be easy to point out the ignorance of this approach, or how such thinking leads to long-term disengagement, to how the failure to put aside personal perceptions and attempt to understand a situation before launching into a solution is a far more optimal approach, etc, etc, etc.  Certainly, all of these things were my first, immediate, and emotional reactions. Upon reflection, however, I realized that this problem  was born from different perspectives on management’s role among the age groups in the organization.

Those who felt that the staff was – for lack of a better term – whining, were all north of 55 years of age, and most of those were north of 60.  Their expectation was that managers were tough, not very understanding, at that the entire management rank of the organization was something for everyone else to contend with and develop mechanisms around. 

The folks on the other end of the spectrum were all 30-40 years old, and had an expectation that, while management needed to be stood up to at times, its primary function was to enable workers as much as possible.  Managers, from their point of view, needed to make adjustments in their own behavior when confronted so that the organization as a whole, as well as the people within it, could thrive. 

Younger still, and with a very different perspective, were those who were 20-30 years old, who believed they shouldn’t even have to confront management and let them know where the problems were.  They expected management to be involved, engaged, and have a deep understanding o the work such that problems were prevented, not simply addressed when they arose. 

 Some of this difference in perspective has to do with simple matters of maturity.  s you get older, you get a little more grizzled, tougher, and less likely to expect that someone else is going to take care of you.  Some of it, however, is also generational – my belief is that those folks who are in their 20s now will be more likely to look for collaborative and trustworthy management styles when they are in their 60s, as well as be more likely to create a sense of trust in the organization as they rise through the ranks. 

They will not achieve it 100%, of course, since having to bend the young whelps into shape is a part of maturing and becoming a leader.  There are clear differences in the expectations that generations have of the role of management, however, and not all of those expectations will erode over time. 

For the highest ranks of management, this is an important element of team dynamics to understand.  There are going to be conflicts arising from role expectations, management styles, personality types and even just work habits.  But what is driving those attributes?  The root cause may be something so simple as understanding when a person was born.

My best advice to anyone, regardless of age group, is simple:  Seek understanding and reflect before speaking.  Every opinion is a valid one, and you will understand it better if you first learn to understand the premise with which it was made.  This will provide you with an opportunity to examine your own opinions and behaviors and then decide if you are the one who needs to grow up a little, or regain a little of your lost youthful optimism.

 

Stump the Chump, and the Steve Jobs Paradox?

Paradox
Paradox

iTime paradox by IlookingYou

Two weeks ago, I delivered the presentation that’s been adorning the home page to a monthly meeting of the New Hampshire chapter of the project management institute.  That presentation was drawn from a series I put on the blog just a little over a year and a half ago, where I made a connection between common, sub-optimal activities that are found in project environments and Lean’s 7 wastes.

I thoroughly enjoyed the chance to stand up and speak about how Lean is not a set of cost reduction techniques nor a quality assurance program, but a philosophy of how organizations work, how people work, and of how people within organizations work.  While several in the audience were expecting a discussion of Agile software development when they heard the topic would be about Lean in Project Management, I think my focus on understanding environments and behaviors resonated with a few of the audience members.  Many asked if they could obtain a copy of the presentation, which I took to be quite the complement, also.

If the Q&A that followed, however, I was asked a question that – as I put it, “Stumped the Chump.”  One gentleman asked, in response to the portions of my presentation that focused on the Respect for People foundation of Lean and, in particular, the Shingo model, how I would characterize Steve Jobs and Apple’s success, given that Jobs was a well-known egomaniac and had a reputation for being quite stern and non-compromising.

While some members of the audience offered their take on what might have happened at Apple as others took up the cause of Respect for People and the “appropriate” management styles, in an effort to help me out as I stated that the question would require some thought, I thought up my response.  I briefly recounted my understanding of the work Steve Jobs did at Pixar, and the interpersonal dynamics he created within the hallways of Pixar (quite literally) that fostered collaboration and creativity – including several dynamics for idea sharing and generation that were drawn from – you guessed it – the Toyota Production System.

While this answer satisfied the gentleman asking the question, it has stuck with me for the past couple of weeks, as I felt the need to contemplate the question a bit further.  What I may have come to realize, is that there is something of a Paradox involved when a true visionary ascends to the position of influence within an organization.  These situations are remarkably rare, I believe, which is why they are so disruptive, revolutionary, and highly successful.  It is dependent as much upon the circumstances as the traits of the individuals involved, but it is clear to me that the person(s) who creates a whole new paradigm for conducting the work of an organization very often must embrace what I will call the “Jobsian Paradox.”

Clearly, the stories of the founders of the Toyota Production System are not that far from what we hear of Jobs doing at Apple.  The outcomes are revered by many, studied and copied by others, and delved into by an army of commentators looking for the secret to the success these visionaries bring about.  What they have in common, however, is something that is, indeed, contrary to the tenets of creativity and innovation in both project and process.  That is, that at the beginning – when people’s mindsets need to be calibrated towards a new understanding and  that understanding needs to translate into action, someone authoritative, demanding, relentless personality must be at the forefront of creating and driving the system under which change will occur.

From those personalities come systems, and from that relentless focus on driving people to the correct behaviors comes guiding them to possibilities, and from satisfactory mediocre comes the expectation of greatness.  It must begin, however, with unique individuals willing to drive others to the point of aggravation in order to be achieved, which is something of a paradox in the realm of thinking that believes people are intrinsically motivated and that all a brutish task master can do is to de-motivate them.

This is, in many ways, akin to the concept of a Level 5 Leader that Jim Collins discusses.  To foster change, unique, rare, visionary people are needed.  In order to turn their vision into reality, however, a certain drive is required that leads the people with that vision to adopt behaviors we tend to believe, at least in the short term, are counterproductive and entirely suboptimal.

To wrap it up, the Jobs-ian paradox is this:  For true visionaries with the ability to persevere, many of the management practices and behaviors that we associate with high levels of creativity  and innovation among the workforce, are ignored or simply not practiced in order to bring the organization, as a whole, to high levels of creativity and and innovation.