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

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.

Well, OF COURSE no one trusts management…..

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

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.

 

Managing the complex organization

Traffic Pro

Traffic Pro by marie carrion

A great read popped up over at inc.com this week.  The author, Ilyz Pozin, is a successful entrepreneur with several successful companies under his belt.  The article, entitled, “Want Happier Employees? Get Rid of the Bosses” describes his foray into the world of innovative management practices.  Along the way, he learns something about mentoring vs. directing, allowing teams to self-manage, the elimination of hierarchies based on titles, eliminating worry over salaries and incomes, and rewarding people for performance instead of activity.Those things are, in a nutshell, at the core of every bit of innovation in management writing over the last 30-40 years or so.  Which doesn’t make any of it a bad thing – it’s just a reminder that these ideas have been around for a very long time, and maybe we’re finally starting to see some of them come into fruition.

Unfortunately, despite all the cries to the contrary (including those coming from yours truly) – management is still, and always will be, quite necessary.

For instance, Pozin tells us that his innovative approach to managing his company – where people are organized into self-directed teams, has been going on for just 3 months. That is hardly long enough to declare sustainability to the approach.  He also declares, “Individuals need to be managed, but teams manage themselves.”  That statement, I believe, is wrong.  Or, at the very least, it’s mostly wrong…and it is mostly wrong due to a chronic misunderstanding and misapplication of what management is and should be.

Teams in simple environments are more able to “manage” themselves – which means they are able to organize their own activities and determine how to go about their work, assigning tasks to each person within the team.  Disputes are resolved, ideas are discussed, actions are taken.  All of which is to say that these teams, perhaps, don’t “manage” themselves – but, rather, that they lead themselves.  Managing is, of necessity, a bureaucratic and dogmatic process.  Coordinating the activities of a group of teams, especially as an organization grows increasingly complex, requires someone to help all those teams get organized.  In other words, someone must manage the interactions.Managing becomes necessary the more complex the organization becomes. Not “leading” or “coaching” or “mentoring” –  but “managing.”  Groups  of teams need coordination – Not in the childish way we push people around and call it “management” or bastardize such things into calling them “leadership,” but management – the coordinating of activities and the people who are going to perform them.

Someone needs to ensure the free flow of work throughout the organization.  Even the highest performing teams will need to have administrative things taken care of for them – facilities to work in, team members recruited, retained and substituted, legalities administered, etc.  Which, and especially in a highly complex organization, will require someone to coordinate the effort between teams and to identify and remove the roadblocks.  This means management.

The key is to make that management valuable and prevent it from becoming the hierarchical enigma we’ve all come to know – one whose only purpose is to maintain the hierarchy for its own sake regardless of the quality of work the teams that depend upon that management produce.  Management, when viewed as something that exists only to facilitate and enable the performance of work, becomes an important, vital and valuable function within the workplace.  When it exists to provide a layer of blind enforcement, unnecessary political and procedural activity, and as a salary enhancement vehicle for the technically proficient – its value diminishes to the point of being worthless.

Perseverance, intelligence and flexibility – 3 things that will never get you past HR

The Processor

The Processor by monkehranch on deviantart.com

A great, and yet depressing, article appeared on wsj.com last week.  Authored by David Wessel and entitled “Software Screening Rejects Job Seekers” the article references a forthcoming book from  Peter Capelli, “Why Good People Can’t Get Jobs.”

The focus of the article is “the now-ubiquitous use of software to screen applicants” in hiring practices and a downward spiral stemming from the use of software applications in order to handle the volume of resumes companies received.  Software made it both less necessary to employ a large number of recruiters and HR pros, as well as possible to receive a larger number of resumes, and those resumes came in droves.  The volume became impossible to handle, so more software support was needed, and the filtering of resumes has become so exact that a whole new skill – tricking the filtering software – has emerged.

All of which, in my humble opinion, is just another example of how the workplace culture inside of most companies has completely gone astray.  Although individuals are touted as “the greatest asset” by many companies, the emphasis placed on truly dealing with those individuals is becoming less and less.  Hiring is based on nothing more than technical skills, and even within that, the keywords describing those skills must match exactly to what the person who wrote the req thought of when they were writing it.

Since we all know that establishing supportive, long-term relationships are the key to enjoying work, getting the most out of people, fostering creativity and innovation – what sense does it make to put such a heavy over-emphasis on skill sets and key words?  If culture is the king that eats strategy for breakfast, shouldn’t the effort be expended on identifying people who fit within the company?  Personality, after all, is something that is innate – and doesn’t change.  Skills, however, can be learned.

The keyword – based paradigm is born from a belief that managers don’t really ever have to engage their employees.  The belief, instead, is that by finding someone who already knows how to do that job, that the person can be plugged into a role and left alone, forever.  Like buying a new gear for a machine – simply insert the right part correctly and it will run all by itself.

Unfortunately, humans don’t operate that way, and the “soft skills” that are fundamental to personality – things like perseverance, intelligence, flexibility, and other intangibles are what makes a person enjoyable to work with….or not.  Those are also things that need to be fed and cared for in order to grow – unlike skills, which can be learned through a training class, a book, a PowerPoint presentation or CBT module.

In spite of the teaching of many management thinkers from gurus such as Deming and Scholtes, to more recent works from Pink and Sinek, to the innovative discussions of “Maangement 2.0” taking place at the Mix, over the past 30 years the fundamental mindset of management has not changed.  What is needed, instead of “Managers” –  is a caste of teachers and mentors who aggressively look for raw material they can shape and inspire into becoming the workers and leaders that companies need.

Unfortunately, we may never get it, because anyone who had ever wished to rise through the ranks learned to do so not by developing and inspiring others, but by figuring out the keywords to make it look like they did.