First 100 Days

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Recently,  I went over the steps I took as I started my job at Chubb Insurance.  I was brought in by senior IT leadership to address challenges of transformation and change using tools, techniques and practices derived from Knowledge Management.

I quickly realized on my first day that I would need a consistent approach to gather information, listen, learn, think, engage and share with peers, team members and leadership.

Mark Friedman is an Executive Coach and Leadership Development expert.   I worked with Mark all through the hiring process and I asked him if he had advice for my first few weeks on the floor at Chubb.   He helped me think through a comprehensive approach and provided some tools to use.

There are many things to do on the first 100 days but I found a few simple steps most helpful.   I was able to determine quickly who would help me and where there would be some challenges.   I modified the worksheet that Mark provided to me for my own use.  I simply started at the top and worked my way down.


 100-day checklist

Stakeholders:

Up: _____________

Across: _________

Down: __________

Discovery:

Personal set up:_______________

Meet live:   ____________________

Phone calls: ___________________

 

Info/Documents: _____________________

Day One:  ______________________________

First Week(s): __________________________

 

Strategic Capacity

Mission / Vision / Scope and Organizational| Business objectives

Tactical Capacity

Building Blocks:

 

How:

BURNING IMPERATIVE in place (by day 30): _____________

MILESTONES set (by day 45): _____________________________

Team ROLES assessed & aligned (by day 70): _____________

Team CULTURE/Communication steps: ___________________

 


I wrote up an interview template and set up introductory meetings that were designed for 15-20 minutes.

My biggest advocate and supporter was the Global CIO.  I sought advice as I ran into challenges and started developing a map related to the questions of the first 100 days.

Organization


There were many opportunities created through this activity.   Building relationships and listening were key factors.

The first 100 days helped me understand where I fit in the organization and the challenges I faced.   This activity helped me determine where I needed to start and it was a driver for me to make the phone calls and sit with people all across the company.   Most of the best information and guidance came from the Executive Assistants.

If you have questions, or want to see more of the tools I used and examples of products I produced, please let me know.

100-DAYS-WHITE-PAPER (Here is another useful guide from intelligent executive.com)

Why Every Leader Should Build a RetroPi

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It is estimated that the number of mobile phone users in the world is expected to pass the five billion mark by 2019.   The level of interaction with technology creates an illusion of understanding.   Expert users are not expert technologists.

Many senior leaders don’t claim to be expert technologists but when it comes to technology decisions it has become much easier to have an informed opinion on technology whether for design or desired outcome.   This has put a great strain on IT because technology while magical is not magic.   It takes hard work,  a great deal of thought and planning.   Even if agile methodologies are applied,  requirements matter.

In this world of 140 characters or less,  it is safe to say that some folks reading this blog if uninterested would have disengaged about eight sentences ago.    The expectation today is that everything will happen quickly and it will be exactly what was expected or we disengage and find something else.   This is one of many reasons that IT is suffering in large companies today.  CIO’s are fighting subscription or licensed services for solution delivery.   It is true that cloud services and licensed subscription models have great benefit but acquisition of these services still require strategic thinking.

A simple exercise in building a small and usable gaming system will demonstrate end to end implementation of easy to acquire technology and show how important strategic planning and understanding of technology is relative to projects small, medium or large.

Many leaders in industry are walking away from IT and looking to make IT decisions on their own.   They can use their own budget and solve their own problem without IT.  In some instances where risk is low, they can do this with very little impact.  In most cases, they find a need to bring IT in at either the end of the purchase or when they need to actually implement.  This creates contention and can impact their ability to get the software or services they wanted in the first place.   The underlying question is “Why can’t I do here what I do at home”?   Anyone feel free to comment on this .. but the various reasons should be addressed in another blog at some point.   

If industry  / business leaders want to make decisions in technology, they should become familiar with what it takes to compose and implement solutions.  I am not saying they should become IT experts but my contention is leaders should know their desired outcome relative to the environment they are in.    An info-graphic on AI can drive me to put Alexa in my home but this is very different from me deploying Alexa in my company.   As a leader, I need to understand the differences to make an informed and economically sound and viable decision.

Making it Real

The Raspberry Pi is a small computer that you can purchase for as low as $10.00.

The Raspberry Pi has free open source operating systems that you can download for many uses.   One of the operating systems available has software called RetroPi.  With RetroPi you can build a system that plays thousands of games from many of the older popular gaming systems.

You can get as fancy as you like depending on your desired result.

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or you can keep it simple

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Either way,  it is learning experience that incorporates some very basic skills using technology to accomplish a relatively simple goal.

Leadership that seeks to use technologies to enable and grow their business should have a tacit understanding of this kind of project.

Some factors to consider here are

  1. Instructions are readily available both written and video (Build a Pi)
  2. The operating system is no cost and easy to install
  3. The software is pre-configured and highly intuitive
  4. The estimated time to completion is 10 minutes (That’s fast)

Results May Vary

Here we have a simple project that should take 10 minutes to employ.  It will result in countless hours of fun and entertainment for the family and for those who enjoy retro games, it will save hundreds of dollars in purchasing a retro console.  It meets most of the criteria asked from technology companies and IT today.  It has the makings of a perfect simple technology implementation.

Side note, below is my machine that I built..

cogames

Innovation in Iceland

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Geothermal Energy ~ Relaxing Spa

Iceland is powered by an endless supply of heat supplied by geothermal energy by volcanic activity.    It also has a geothermal energy plant with an adjoining resort and spa.

Hidden away across a landscape of lava rock and a sea of smoke billowing up from the ground,  is a geothermal energy facility.   According to Wikipedia “The spa is located in a lava field in Grindavík on the Reykjanes Peninsula, southwestern Iceland. Bláa lónið is situated approximately 20 km (12 mi) from the Keflavík International Airport and 39 km (24 mi) from the capital city of Reykjavík, roughly a 21-minute drive from the airport and a 50-minute drive from Reykjavík.”

The water is renewed almost every two days and stays between 98-104 degrees Fahrenheit or 37-40 C all year round.

The plant produced “waste water” that appears blue due to the silica and minerals in the water.   At some point between 1976 and 1981, someone decided to go into the waste water and bathe in it.   Most people overlook this fact.   Someone at some point in time traveled to this area literally miles from everything and decided to take a dip in electric blue hot waste water.  

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Perspective

The blue lagoon is so popular today, if you don’t reserve a spot there is a good chance you will not get in.   The prices range from $61.00 to over $500.00 just to get in and have a dip.    The place is jam packed and open until midnight in the summer time.  Since Iceland has perpetual light in the summer time,  it is bright out and inviting through the whole day.

The place is growing as well.  They are building private areas and expanding the hotel and luxury environment.    This has become one of the most popular tourist attractions in the world.

The blue lagoon even has science to back their case the-history-of-blue-lagoon-in-svartsengi

iceland-blue-lagoon-geothermal-spa

  • The electric energy created from the plant is produced through the costs of maintaining systems that capture the heat energy from the ground water.
  • The waste water is discharged into pools that create new revenue by tourism and those seeking the “healing waters” of the silica and minerals produced by the plant.
  • The ecosystem of revenue and commerce this energy plant / spa is producing is limitless.
    • Food and beverage
    • Hotel
    • Car rental
    • Expanded travel

This growth and expansion is based on waste water.   As tourism is increasing in Iceland in ways that their current infrastructure has to grow exponentially to support, there are more demands for energy as well.   This system is feeding itself and growing.   Iceland is becoming a very popular travel destination.

Something to note, at any given time over between 20 and 40% of the people in Iceland are tourists.    Iceland is also getting heavily involved in cloud computing.   Think about it,  low power costs,  low costs for cooling data centers makes for low cost data centers.

Bitcoin farming / mining is cheap and since the infrastructure already exists,  this place is primed for the future.

Icelandic people are also innovating in other ways.   People are starting to use electric cars and they also charging for micro-services including in some places charging for the use of a bathroom.

I think Iceland is country to watch.   I don’t have any predictions but as one European tourist said to me in casual passing “Howie,  we came here because we think this is a great place to go with very little chance of terrorism.”      Seems like Iceland has many appealing qualities including safety, openness for sexuality,  growing infrastructure and they are innovating to make the country perpetually attractive.

Now the only thing left for them to do is keep the ISK in check ..

 

 

 

 

 

 

 

The Value and Practicality of the Narrative

Practical Application of the Narrative

Operational Tacit

My cousin is medical student studying in one of the worlds best medical schools. The time-tested and effective best practice in medicine is to teach students by way of books, labs, peer-to-peer, mentoring, coaching and discovery. Consider that educators are not limited by these mechanisms but these are common tools they leverage. The discovery aspect of the education becomes most important as the students enter their medical residency. The student’s experience and awareness of the realities in medical practice become real at this moment. It is the point in their journey where reality sets in and they are actively gaining a tacit understanding of their world.

As part of this experience, my cousin was sent to an emergency trauma center for a few weeks. The hours were long and erratic. One of her first experiences in the center happened not long after her arrival. As she stood in the hallway with one of her student partners, the doors flung open and medical staff were running down the hallway pushing two gurneys. The staff all the while working as a high performance team yelling to each other and coordinating activities as they ran down the hall. My cousin looked over to her friend and said regarding the two gurneys together “I wonder if that is one person or two”

Beyond those words there lives a rush of adrenaline, fear, hope, wonder and an internal experience that can only be described in such a way that it scrapes at our tacit understanding. We understand the idea of jumping out of an airplane or being in a war like situation but through discovery and our own experience we gain the knowledge that informs our hearts along with our minds.

The Story in the End and the Beginning.

The narrative is the connection of events. The connection of events as spoken or written tells a story but not THE story. The power of the narrative is the contextual explanation of the relationship between things. We understand things as stories and this is how we rationalize our world. The narrative as words spoken or written is an important part of our humanity and our effectiveness in communication.

The Common Threshold

The narrative can be practical, effective and for purpose. Every job role has purpose and this purpose is aligned with a greater vision, objective and scope of activities. The narrative in use can be the starting point for these activities.

Practical Use

For every role or activity the narrative can be the starting point. The starting point is the key to understanding the who, what, when, where and potential for how (over time) at a given period of time.

Narrative Activity

The basis of a high level summary that identifies who, what and why. These are given based on a period of time and understanding of a situation.

Example:

George is part of the cable group, the cable group pulls cable for the cable company. The cable is used to support internal and external customers of the organization (Organization x). Organization x is a media company that is focused on the distribution of video and audio services and channels for millions of customers across region x and around the globe.

Understanding where George fits creates a sense of clear purpose for George but also allows for a value mapping of his role to the greater purpose of the organization.

The cable group is part of the infrastructure team. The infrastructure team manages physical assets based on new cable requirements and operational maintenance considerations.

The cable group enables Organization x to grow and serve new markets by creating the physical channels and conduits of connectivity. The cable group allows Organization x to maintain operational excellence by maintaining the infrastructure and supporting current physical network topologies.

The story of George in scope.

George represents every person in context of their role. This person is a performer and actor, he has value and this value needs to be understood. The role and context of the role is the list of things that George may do.

1)Maintain tools

2)Project Planning

3)Repair, create and install cable and cable channels.

The narrative can help clarify and express with more definition the stories within the activities in the list. The time it takes to capture the story is an investment in the future relative to business and knowledge continuity. The job description is only the list but George is the person and his work is much more than a list or process. It is a composition of these patterns interwoven by relationships to form the story.

At the end of a story we learn through reflection.   Our daily lives are filled with short stories that we don’t have the time or take the time to reflect on under most normal conditions.   Although, there are times that we do but we may not write these down or share them any further.  “Honey, how was your day?”  The end of the day can cap a chapter or maybe it is just a pause.

The point is that people choose to reflect on narratives most often when there is a perception that the story is over.   From a business perspective, we can ask to reflect at any time in the story to understand what is happening and participate as an action agent or actor ourselves.  In a lot of ways there isn’t a need to say everything out loud all the time but if we never ask, we never know.

The proper care and feeding of an organization.

George is set to retire. Over the past 36 years, he worked as a tradesman in Organization x as a “Cable Master” he could have written the book on cable but over the 36 years he never had time. He never had time and most folks didn’t know anything about what George actually did. Human resources had George classified as Senior Lineman Cable Technician. They looked at their records and realized that he was set to retire last year at 35 years of service but due to economic conditions he never put a retirement package in.

George was good an employee, he was effective and impactful in his work. Due to one condition or another, George must retire.

In 3 hours you are to capture 36 years of his work..

Consider the framework of many companies today in terms of employee engagement and understanding.    If Organization x is an average company leadership may have actually engaged with George concerning his performance, activities, role and responsibilities 35 times.     We could say that they had 35 opportunities to capture the narrative or reshape the story.   On most occasions over my career,  I have seen managers / leaders try to find ways to just get the performance assessment over with.  Even in the case where assessments were 360 degrees or converted to an ongoing activity, they are always something to avoid.

Now over the 35 opportunities of the annual assessment process which we could recognize of the story of this year past,  the narrative is left and the story stays with George.  It is interesting to consider that companies always tell stories of their foundation and history but they never attend to that history as it lives.  It is only upon reflection of the leadership of the company.   If these same organizations leveraged the time they have to engage their staff, capture the narratives and share the purpose, imagine how much more rich the organization could be.  Also, if we knew more from George over the past 35+ years, we would know much more about his contribution as a person of value and of what we need to know and do moving ahead to maintain and grow.

 Practical Behavior

We are here for a very short period of time.   That is true of every person everywhere.    Our history and heritage is important and understanding how we connect and relate in a given period of time offers understanding that will help prevent mistakes or benefit us in the future.   We have an opportunity to trade a little time on a daily, monthly, weekly, yearly basis to close chapters and reflect on many stories / narratives in our world.

The explicit capture and collection could lead to codification or an organized understanding of who, what, when, where, why and how an organization functions.   The benefits are endless.

Take a look here https://www.pinterest.com/weareteachers/writing-narrative-storytelling-personal/ a good place to start!

 

Emotional Business in Employee Engagement

qua·le ˈkwälē/  noun a quality or property as perceived or experienced by a person.Link

We are physically blind in each of our eyes, we have a blind spot.

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There’s a way to find your blind spot. Cover your left eye and look at the dot on the left in this image. Be aware of the cross on the right, but don’t look at it – just keep your eye on the dot. Move your face closer to the monitor, and farther away. At some point, you should see the cross disappear. Stay at that point and close your right eye. Stare at the cross, and you should see that the dot has disappeared

Our world is what we perceive it to be but not what it is.

We can demonstrate over and again that things aren’t always what they seem.  We can identify sense gaps and find ways to augment them but it is difficult to identify the emotional gaps and find ways to engage.  If it is dark, I can use a light.  If it is hard to hear, I can use an amplifier.   If I can’t smell something, I can add a smell to it (for detection) like garlic added to acetylene.  When asked in an employee engagement survey a question or a statement it may read.. “On a scale of 1-10, my employer values how I feel.”  No matter what number leadership reads there will be a challenge on how to deal with the results.  Are they a reflection of some common reality or common blindness?  If it is dark for everyone and I turn on a light, everyone can see, but if I take an action to deal with emotions.. results will vary.

How does this translate to business?

In a very literal sense, we are enamored with technology because we can see, feel, hear, touch, smell a change.  We can all share in this idea that together we went from someplace to somewhere using something.

This is one of the reasons why today we have more challenges in human interaction and success in employee engagement.  It impacts everything in business.

Emotional continuity in business is part of business continuity and operational agility. Leaders try to address it with tools.  

…  Company X has a problem transferring knowledge from older workers to incoming 20 somethings.   Company X reduced benefits to cut costs, decreased pay to cut costs, cut jobs, gave all of their senior staff a pay increase, and started to make strategic investments and acquisitions.

Company X created a new internal business capability for communications called “JAM” and they asked all of their employees to use it.   The organization spent $3m dollars on the product in licensing and services, hired the best consultants in the world to advise them on the technology and built a marketing campaign around the capability that included a “Jamboree”

It was new and innovative, built on the best technology that anyone could offer, had the best analytic engine in the business to get all sorts of communication, relationship and sentiment analysis.  It could handle all sorts of communications traffic and it could even make predictions.

Brain Drain

Company X started to look at JAM to see how it was being used and what the adoption rate looked like.   As they got closer to the screen the cross disappeared <— look up at the top if you forgot about the cross.  They are looking at the world with one eye shut.

Due to the new healthcare laws, the cost of working actually went up for the older folks. (Read this for more).  “The costs are going up, the benefits are going down and now you are asking me to train young folks that came into the world with the book knowledge of a billion lives at the tip of their fingers.”    It’s like a reverse shark tank.. they are out.

They didn’t join JAM and they won’t, in fact, they plan on leaving but they are just in the process of questioning themselves on when.

Emotional Business

If you want to reach a person, they must have some trust in what you say.  It isn’t simply that you are a person they like or that you have a great scope of influence, you have to speak with both actions and words.  People will give you a chance to back your words with action but if you fail to do what you say you are going to do, they will leave you.  They will leave you first in emotion and you will be blind to that and they will leave you physically and that you will be aware of because of your focus on the circle.

Leaders wonder why that we have “Crew Change” problems in every industry and every market but there should be very little to wonder.  They are looking to solve the wrong problems with great precision with both good and not- so good intentions.   When you believe your organization would sell your organs to make a buck on you in order for them to spend that same dollar on a bottle of the best rot gut they can find, you will lose your emotional inclination to be loyal to them.

Solutions

When someone in your family is hurt, you engage them. You talk with them and not at them.  You find ways to communicate with them.  If your son is hurt, buying him a watch won’t change his pain.   It is the same thing in an organization.  There are choices made by multiple parties.   People choose to work for the organization and the organization chooses to have these people work for them.   You have to take the blinder off and look through both eyes and at the same time, use all of your emotional understanding as well.  At the end of the day, communities are families of people who are working together for common goals.  If leadership in a community separates itself from the community and creates an (us and them) situation, the community will respond in kind.   If you want to build the best organization to work for, you have to start with building trust.   Trust is not a slippery business word or consultant speak, it is a real thing that is not something we can touch but certainly something we can feel.

Knowledge Management and Healthcare

HealthCareCohenSaving Lives

In that moment when you realize that what you are experiencing is real and you have been shaken into the understanding that you are a human being; frail, fragile and living only for a short time this one moment can define or redefine your whole life.

Most of us live our day-to-day lives in a state of ignorance with regard to our health and our lives until we are faced with our mortality or impacted by someone close to us being sick.   People that work in the healthcare industry especially those on the front lines of medicine know all too well about human mortality.  That being said, it is still easy to get into routines and patterns of operation which create a narrow scope of perspective.  In other words,  being in a medical practice can create an intentional numbness.  Some studies show that doctors may suppress their emotions or their brains may automatically inhibit their ability to be empathetic in a short period of time.  The stress of being a person in an environment constantly being reminded that life is short and constantly fighting battles to save lives takes a lot out of people.  It also impacts their decision-making process.

My personal and professional experience has driven me to question why knowledge management is lacking in the healthcare industry.  This industry isn’t short of information but there are indicators that medical practitioners may not have the right information at the right time.

***Frame***

Chip and Dan Health wrote on KevinMD

The following is an exclusive excerpt adapted from #1 New York Times best-selling authors Chip and Dan Heath’s new book Decisive: How to Make Better Choices in Life and WorkHow a smart process helped Kaiser Permanente save lives, which was released on March 26, 2013.

One of the most fundamental problems of decision-making, according to psychologists, is that people get stuck in a “narrow frame”—they view their decision in an unduly limited way, often missing options that are available to them. To break out of a narrow frame, people need new options, and one of the most basic ways to generate those options is to find someone else who’s solved your problem.

For many health care leaders, this search for new options has become second nature. They’ve long since learned to “benchmark” competitors and absorb industry “best practices.” Sometimes, though, the practices that work for one organization may be incompatible with another, like an organ transplant that is rejected. (Imagine if McDonald’s, inspired by movie theaters, started trying to hawk $12 Cokes.)

That’s why we shouldn’t forget, when hunting for new options, to look inside our own organizations. Sometimes the people who have solved our problems are our own colleagues. That’s what was discovered by the leaders of Kaiser Permanente, one of the largest HMOs in the country with almost 9 million members.

In early 2008, Alan Whippy (her first name is pronounced uh-LANN), the medical director of quality and safety at The Permanente Medical Group in  Northern California, was staring at a set of data that astonished her. To continue pushing their hospitals to get better, Whippy and her team had asked the leaders of the 21 Kaiser Permanente Hospitals in Northern California to do detailed case studies of the last 50 patients who had died at each of their hospitals. One problem their hospitals had addressed aggressively—heart attacks—accounted for 3.5% of the deaths. But almost ten times as many deaths came from another cause that was barely on the radar screen at Kaiser Permanente or most of the other hospitals they knew: sepsis.

Dr. Whippy explained sepsis with an analogy: “If you have an infection on your skin, it gets inflamed–red and hot and swollen. The infection itself doesn’t turn the skin red, that’s the body reacting to the infection.” Sepsis is a similar reaction to an infection in the blood stream. The body’s inflammatory reaction spreads to the whole body, even to parts far away from the infection—a case of pneumonia, for instance, can trigger kidney failure or even brain damage.

What Dr. Whippy and her team realized was that physicians were paying careful attention to the infections, like pneumonia, but they weren’t aggressively treating the associated sepsis, which was often the true cause of a patient’s death.

Freeze there. Whippy had a problem on her hands: She needed options for improving Kaiser Permanente’s treatment of sepsis. Where could she find those options?

She located one critical connection within Kaiser: Dr. Diane Craig, a physician at Kaiser Permanente Santa Clara. Craig and her colleagues had spent several years working on sepsis and had already shown some reduction in their sepsis death rate. They were frustrated that progress was not quicker, though—especially since the “recipe” for managing sepsis was known. In 2002, a provocative article had appeared in the New England Journal of Medicine, showing that patients were substantially less likely to die from sepsis if they received quick and intensive treatment shortly after they were diagnosed.

It was easier said than done, though. As Craig knew from personal experience, the quick and intensive treatment was difficult to implement for two reasons. First, sepsis is hard to detect. A patient might look fine in the morning but plunge into crisis by lunchtime, and by then it was often more difficult to correct the cascade of internal damage.  Second, the protocol recommended by the article for treating sepsis—which involves administering large quantities of antibiotics and fluids to the patient—carries its own risks.

As Craig said, “It takes a while for people to get comfortable saying, ‘This patient looks good but I’m going to put a large central IV catheter in their neck and put them in the ICU and pump them full of liters and liters of fluids. And we’ll do all this even though they look perfectly fine at the moment.’” The research supports this early intervention. The risks are worth it. But it was difficult for doctors, with their “Do No Harm” ethos, to move as quickly and forcefully as the research said they should.

Craig and Whippy realized that, to fight sepsis, they had to overcome these two problems by making sepsis easier to detect and by demonstrating to staff the risk ofinaction.

With Whippy’s support, Craig and her team began to incubate new approaches to the problem at Santa Clara. One idea was simple but powerful: Whenever physicians ordered a blood culture—a sign they were worried about a blood-borne infection—a test for lactic acid was automatically added to their orders. (Lactic acid is a critical indicator of sepsis.) This allowed them to detect sepsis well before it began to influence the patient’s vital signs.

Other changes were intended to make the Santa Clara staff more aware of sepsis. Posters and pocket cards were printed up that highlighted the symptoms of sepsis. A grid on the printed materials showed the mortality risk for different patient circumstances. “People could see that this patient, right in front of me, even though they look good—they have a 20% chance of mortality. It was very powerful,” said Craig.

If the doctors and nurses spotted the symptoms of sepsis, they were asked to call a “sepsis alert,” the equivalent in urgency of the “code blue” called when someone is experiencing a cardiac arrest. The sepsis alert summoned a team that could assess the patient and, if appropriate, begin the intensive sepsis protocol.

These innovative solutions began to work. Sepsis deaths began to decline. Whippy, who’d been following the work, knew that the Santa Clara team was assembling a package of cultural interventions that she could spread to other hospitals.  Meanwhile, other hospitals, who’d been pursuing their own solutions, added other critical pieces of the puzzle, like a “pressure bag” that fit around an IV like a balloon, ensuring that sepsis patients would receive fluids quickly enough.

Within a matter of months, under Whippy’s direction, the sepsis protocol was being actively implemented in other hospitals. By summer 2012, Kaiser Permanente Northern California, composed of 21 hospitals serving 3.3 million people, had driven down risk-adjusted mortality from sepsis to 28 percent below the national average.

This solution has astonishing potential. If all hospitals could match Kaiser Permanente’s 28 percent reduction, it would be the annual equivalent, in lives saved, of saving every single man who dies from prostate cancer and every single woman who dies from breast cancer.

* * *

The leaders of Kaiser make it a priority to study their own internal “bright spots”—the most positive points in a distribution of data. For the treatment of sepsis, for instance, Dr. Craig’s team represented a bright spot, because of its lower death rate.

Bright spots can be much more mundane, though. If you’re trying to stick to a new exercise regimen, then your bright spots might be the four times last month that you made it to the gym. If you take the time to study and understand your bright spots—how exactly did you manage to get yourself to the gym on those four days?—then you can often discover unexpected solutions. Maybe you’d notice that three of the four occasions were during lunch, which tends to be the least complicated time for you. So you might make a point to avoid scheduling things at lunch time, keeping that time free for future workouts.

The wonderful thing about bright spots is that they can’t suffer from the rejected-transplant problem, because they’re native to your situation. It’s your own success you’re seeking to reproduce.

Both bright spots and best practices, then, act as sources of inspiration. If you’ve got a dilemma, and you need new options, you can look for new ideas externally, as with benchmarking and best practices, or internally, like Kaiser’s leaders. What’s critical is that we refuse to get caught in a narrow frame, considering only one or two options, and instead widen our perspective so we can see the full spectrum of options that are available to us.

Chip Heath and Dan Heath are the authors of the new book Decisive: How to Make Better Choices in Life and Work, as well as the previous bestsellers Switch and Made to Stick

 ***

The Basics

In the book Decisive, the authors pointed out something that I found compelling but they glossed over.   The time it took from when the article from  New England Journal of Medicine was published until  Dr. Whippy could get the model into best practice was somewhere between 8-10 years.    Authors: Stephen Boone, MD; Christian Coletti, MD; John Powell, MD state in their quick reference guide on sepsis that:

Severe sepsis affects approximately one million patients and claims more than 250,000 lives each year in the U.S. It is the second leading cause of death in non-cardiac ICU patients. Early and aggressive therapy influences outcomes. Utilizing the Surviving Sepsis Campaign Guidelines improves morbidity and can decrease mortality by 25%.

If I am doing my math correctly, in the US alone healthcare professionals had an opportunity to attack 2.5 million cases of sepsis over the past 10 years and the indication is that most haven’t.   Regardless, this is a best practice that should be addressed.

This is about the right information at the right time.   I have written in the past about how in one hospital the leadership turned to a race team to learn how to perform an effective and efficient shift turn over.   I can’t think of any organization that needs to leverage knowledge management more than healthcare.  This is more than just money, this is about saving lives and wellness.onlinelogomaker-102613-2009

When I walk into the doctor’s office today, he is carrying his iPhone or iPad with him, he is managing his personal knowledge but how is his personal knowledge moving from his device to his team or his colleagues?

How many people do you know that have died or have had complications due to sepsis or septic shock?

This is one area of discussion, how many other opportunities are we missing out on?

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Do you know any healthcare professionals?  If so, forward the sepsis guidelines and best practice guides to them please, you never know you may save a life!

Enterprise KM (Metrics)

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Riding the Bike

As a child learning how to ride a bike I had both my uncle and my grandfather take me out to teach me.

Uncle Mark’s Approach

My uncle took off one training wheel and held the bike from the seat as he walked behind me on the path holding the seat.   He was looking to protect me and make sure that I didn’t fall.  His approach was also very logical.   I am sure that he thought about the process of taking one training wheel off at a time and that one wheel would allow me to learn how to offset the void of the other.   Before we got on the path, he explained to me what I needed to do.  I remember focusing on the pedals and trying to lean on the side that had the training wheel.   I fell and dropped that bike a number of times.   As I recall, it got to the point where he told me to keep practicing and we called it a day.

Grandpa’s Approach

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Now this memory is a killer for me.  Thinking back on this I actually remember how I felt in the moment.  The apartment building I grew up in is on the right.   We walked out the door and he told me to get on the bike. He had already removed both training wheels.  He had his hand on the back of the seat to hold me up and he said “when I push you, just pedal and look at the door in front of you”   In the picture above you see the two buildings almost facing each other.   You can see the entrance door from one building to the other, he was pointing at the door for the building on the left.   

He said “PEDAL”!! and he pushed me.   I looked up at the door, it was where he told me to go and I started to pedal in an instant and I mean an INSTANT, I got it.   I had mastered balance and I was riding.  It was one of those kick pedal bikes where you just push back to brake.  I had hit the brakes and spun the bike around like I knew what I was doing.  I turned the bike around and rode toward him elated.  Both of us were so gleaming and from that point on I knew how to ride.

Outcomes over Activities

Grandpa knew that to get the job done that he had to have me focus on where I was going and that the composition of activities involved were a subtle and covert process.   When I tried to focus on the individual activities of pedaling or taking on training wheels off one at a time, it was more of a distraction than helpful.   The result of having me focus on activities caused me to crash.   When my grandfather relieved me of that burden and helped me focus on the OUTCOME  I was able to learn to ride.    Of course there was room for improvement and there was still a lot for me to learn, but I was able to get where I was going right away.

Measuring the Enterprise

There are activities and business process to measure.   Most organizations aren’t in a position to care or understand the results when it comes to knowledge management.   MOST have yet to deal with the “Eleven Deadliest Sins of Knowledge Management .”

Eleven Deadliest Sins of Knowledge Management:

1. Not developing a working definition of knowledge.
2. Emphasizing knowledge stock to the detriment of knowledge flow.
3. Viewing knowledge as existing predominantly outside the heads of individuals.
4. Not understanding that a fundamental intermediate purpose of managing knowledge is to create shared context.
5. Paying little heed to the role and importance of tacit knowledge.
6. Disentangling knowledge from its uses.
7. Downplaying thinking and reasoning.
8. Focusing on the past and the present and not the future.
9. Failing to recognize the importance of experimentation.
10. Substituting technology contact for human interface.
11. Seeking to develop direct measures of knowledge.

Source: (Fahey & Prusak, 1998).

For some I have realized that no matter what I say, there are two truths.

1)People need to see SHINY OBJECTS —->Tools (i.e. Sharepoint, Wiki, Jive, Confluence etc)

2)People need to measure things GETTING TO THE SPECIFICALLY WRONG ANSWER WITH GREAT PRECISION.

If you are still reading..  and you want to learn more about the measures / metrics and you don’t care about anything else I have said here, you are in luck!

A_Practical_Framework_for_SharePoint_Metrics –Thanks Susan Hanley

KMmetricsguide–Thanks Department of the Navy CIO 2001 !~

Outcome to Measure 

Ok.. now that we have fed that beast..  Really,  you really need to think about a few things for the knowledge ecosystem relative to the business.

How can we Increase Revenue?

How can we Improve Productivity ?

How can we Reduce Costs (overall)?

If you want to break these down to areas like operational resilience and continuity or knowledge transfer or other areas, you can!  The bottom line is how is what you are doing in your knowledge practice going to help your business  / organization.   Even the not for profits have desire their work to be more than naught.

If you find yourself focusing on the tools or the measures / metrics, “results aka (s*&%) happens”