Friday, 29 October 2010

Productivity 5: What do we mean by "Productive"?

This is the fifth in the Productivity Series by Sarah Fraser. If you want to sign up to receive updates in your email inbox or your Reader (your choice) then go to the Blog and click on the Subscribe button.

So what do we mean when we say we want to be productive or we want our services to be productive? This is something we think we know but until we articulate exactly what we mean, the term is uncertain and ambiguous. What one person understands as productivity may not be the same meaning that another has.

The online dictionary provides a number of definitions and I liked the way it provides similar, related and dissimilar words.

ThesaurusLegend:  Synonyms Related Words Antonyms
Adj.1.productive - producing or capable of producing (especially abundantly); "productive farmland"; "his productive years"; "a productive collaboration"
creativeoriginative - having the ability or power to create; "a creative imagination"
fertile - capable of reproducing
fruitful - productive or conducive to producing in abundance; "be fruitful and multiply"
profitable - yielding material gain or profit; "profitable speculation on the stock market"
successful - having succeeded or being marked by a favorable outcome; "a successful architect"; "a successful business venture"
unproductive - not producing or capable of producing; "elimination of high-cost or unproductive industries"
2.productive - having the ability to produce or originate; "generative power"; "generative forces"
3.productive - yielding positive results
successful - having succeeded or being marked by a favorable outcome; "a successful architect"; "a successful business venture"
4.productive - marked by great fruitfulness; "fertile farmland"; "a fat land"; "a productive vineyard"; "rich soil"
fruitful - productive or conducive to producing in abundance; "be fruitful and multiply"
Based on WordNet 3.0, Farlex clipart collection. © 2003-2008 Princeton University, Farlex Inc.

Using the above I came up with a number of questions to ask myself and others who claim to be working on increasing productivity:

  1. If being productive can be defined as the capability to reproduce I wonder what productive spread is? I think it is about how efficiently we adopt and implement best practises, but that may not be the all of it.
  2. If being productive is about abundance, how can we shift our mindset to one where we aim to use and create abundance rather than to streamline, cut and destroy services? How much impact can a mindset shift make?
  3. If being productive is about yielding positive results, I wonder for whom these results are? How do we manage the differing expectations of different stakeholders?
How do you define "productive"?

Thursday, 28 October 2010

Productivity 4: Leaders need to be productive

This is the fourth in the Productivity series by Sarah Fraser. Is is possible to have a productive organisation if the leader is not productive?

This short video by Patrick Collins focuses on how leaders can use the 80:20 rule to ensure they focus on what matters and what provides the value you provide as a leader.

If you think you know the 80:20 rule, then I challenge you to watch this video and test whether you put it into action.

Tuesday, 26 October 2010

Productivity 3: Productivity is more than a process

This the the third in a series of Productivity notes by Sarah Fraser. Productivity is more than a process.

New and improved policies can impact the design and implementation of efficiencies. For example, new recruitment, pension, appraisal and similar policy changes can impact processes not only in the short term but also long term. I do think that policy improvements are a necessary condition for many other efficiencies to be put into place.

Clinical productivity is often conceived as as "how hard are we sweating out clinical assets". Another way of looking at this is to see clinical productivity as the most up to date and best practice clinical methods being used. For example, continuing to carry our surgical procedures that are no longer proven to be effective is not productive.

Process productivity is the most familiar aspect of efficiency chasing in healthcare. Largely based on the principles of Lean (or reduced and less focused use of Lean) it is helpful but not enough to meet the healthcare challenges for the next 2 - 5 years.

Monday, 25 October 2010

Productivity 2: Reduced variation is not enough

This is the second in a series of productivity notes. Reducing variation is only part of the productivity process.

Reorganising processes so they are precise and prediction is helpful but not enough. In the diagram, the red dots are hitting the target in a predictable way. However, while they may be precise, they are not accurate. The green dots, with less precision, are more accurately placed around the bulls eye.

What I learn from this is the need to

  • know the definition and position of the bullseye (what is the purpose of the process being improved)
  • measure for accuracy as well as measuring variation
  • fix accuracy first, then go for reduced variation

Sunday, 24 October 2010

Productivity 1: Operational Efficiencies are not enough

This is a the first in a series of Productivity notes from Sarah Fraser.  Are your productivity projects innovative enough?

Organisations, like the NHS, will need to do more than streamline some processes as part of their cost saving initiatives. Many projects underway are badged as productivity improvement yet mostly they are about basic good management. For example, reducing DNAs (Did Not Attends), improving the Discharge Process, holding less meetings, carrying less stock etc. These are important and help to provide a good base form which to develop more innovative approaches, however, I am concerned few organisations considering gains in productivity through redesign and reconception of processes.

Many managers may feel like they are standing in the equivalent of the Victorian cotton mill with a clipboard in one hand and a stop watch in the other. Yes, it is possible to gain more efficiency from a process. I argue, however, that the leaps in efficiency come from reconceptualising what is being delivered. For example, in many countries for at least a decade, group appointments are available for patients with long term conditions. This is one small example of how rethinking a process can create both an efficiency and an improved patient experience.

Friday, 15 October 2010

Gartner's Hype Cycle is more useful than the Rogers' Diffusion of Innovation Curve

The classic Diffusion of Innovation curve was created by Everett Rogers back in the 60's, before many improvement facilitators were born.The terms, early adopter, majority, laggard etc have survived because they provide an explanation for something that is often difficult to fathom - how different groups of people respond differently to the same innovation. I have written at length (see previous posts and books) about the limitations of this theory and it inability to predict or provide guidance about what to do next.

Gartner introduced a theory in 1995 designed to explain what happens when a product or innovation is hyped, and then goes through various stages to acceptance. I like this theory because it steps away from the position of blaming people for not doing something and focuses more on the intrinsic value of the innovation or product.
Image from Wikipedia: Hype Cycle
The Trigger is the first breakthrough event that starts the interest in the product/innovation. This is followed by the peak of inflated expectations where the optimism for application outweighs the difficulties. The focus is on the possibility of the product/innovation. The trough of disillusionment comes when the failures start stacking up, expectations are not met, or something new comes along and this idea is no longer fashionable.  The slope of enlightenment may turn up years later when the original idea is tweaked and adapted and made more applicable. The plateau of productivity is reached when the product/innovation becomes mainstream due to its stability and usefulness.

Obviously, this curve will have different shapes for different products. Here are a couple of exercises:

  1. Take one product/innovation which you believe to be at the Plateau of Productivity, and track back, seeing how the curve shapes with regards time and visibility (visibility = talked about, in the press, on agendas etc)
  2. Map your current products, innovations and ideas on the cycle and see what you learn. Are they grouped in one area? What might you need to do to manage the transition to the next phase?

Let me know how you do by filling in the comments section below.

Saturday, 9 October 2010

Scheming Virtuously; A Handbook for Public Servants

Nick Charney (Canada) has written a brief e-guide on how to get things done in the Public Sector, perhaps innovatively, whilst keeping our sanity, job and relationships.

Highly commended and you can download Scheming Virtuously; A Handbook for Public Servants as a pdf from the davepress blog (which is worth subscribing to

Tuesday, 5 October 2010

4 resources why PowerPoint is not a good format for influencing others

PowerPoint has its place. As a method of influence it is limited, however, it has become pervasive in corporate life to the extent it is used beyond its purpose.

1. Life after death by PowerPoint 2010
This video by Comedian Don Mcquillan says it all.

2. Do my slides suck? test
This "Stop your presentation before it kills again" blogpost provides a compelling arguement to ditch your slides, or at least do some self analysis to discover the reason why you are using PowerPoint.

3. 11 ways to images poorly in slides
This blogpost covers 11 ways in how using images in PowerPoint can detract from your message. It is a compelling argument to beware the selftrained designer...

4. Dodging bullets in presentations
An excellent slideset which not only highlights the problems with using bullet points but also shows how to move to something better and more effective

Oh dear, I see I wrote this blog in bullet points. Deary me.

Monday, 4 October 2010

When stories and Powerpoint clash

A mantra I keep hearing is "we need to tell stories to influence change." I agree with this, however, I do have a few provisio's

  • if the story has no relevance to your message then why are you telling it?
  • if you provide a personal story to illustrate your values then please make sure it connects with the audience at the time (please update and avoid repeating)
  • when you use PowerPoint to tell your story there seems to be a dissonance - the method is not matching the intent
As a method of influence, especially for large scale change, stories work well because they contain the emotive meme that a PowerPoint presentation usually lacks.  So let's use stories, but let's use them advisedly and with care.

Saturday, 2 October 2010

7 Resources about Social Enterprise

With the decimation of the quangos in the NHS in England there will no doubt be a rush to create a variety of social enterprises to fill the gaps and maintain employment. I have been on a mission to try and understand a bit more about social enterprises and here are a number of links and resources that I found useful.

  1. Social Enterprise Coalition (UK) is a good place to start. It is fairly comprehensive and I learnt a lot about what is going on, right now, with regards social enterprise. There is a Health & Social Care forum.
  2. If your interest in Social Enterprise is beyond the shores of the UK then Wikipedia has an overview of what it means in different countries.
  3. Business Link (UK) has the how to steps if you want to set up a Social Enterprise in the UK
  4. Social Enterprise Live is a useful magazine, giving news, resources, blogs and comments on the topic. There is a recent post on how the organisational from will suit the NHS.
  5. The Department of Health has a fairly comprehensive guide on social enterprises and health
  6. If you are up and running as a Social Enterprise and need support and resources then an excellent place to start is with Social Enterprise Works.
  7. The most inspiring, for me, website on Social Enterprise is SE London. Lots of resources, videos and success stories.

Overcoming resistance to change - isn't it obvious

How to overcome resistance to change is one of the most common questions I am asked. The dominant mindset I encounter is that the person who does not want to change (aka doesn't want to do what they are told to do) is resistant and therefore wrong.  There is as many answers to this issue as there are management consultants. An interesting approach is the animated video with a script by Eliyahu Goldratt of "The Goal" fame. Despite the video being largely a promotion for his new book, it does have some useful content and ideas.

Friday, 1 October 2010

Different types of practice; good, best, novel, emergent

The definition of good practice has always been contested and maybe the use of the phrase "spread good practice" is part of the problem as to why adoption of existing practice is so difficult.  The Synefin model provides us with four categories of practice:

  1. Best Practice (simple systems where the idea is obvious to all and obvious to adopt)
  2. Good Practice (complicated systems where the relationship between cause and effect is less obvious, some investigation is needed and usually adaptation in order to solve the problem
  3. Emergent practice (this occurs in complex systems where you only figure out in hindsight how something happened, how the results occurred - and this analysis is not necessarily predictive.
  4. Novel Practice from chaordic systems where there is no relationship between cause and effect

If the goal of a large scale program is to spread the use of methods or techniques that deliver improvement then I think it is important to be able to diagnose what type of practice is being touted. Often novel or emergent practices are praised as the solutions to problems, putting the pressure on other individuals, teams and organisations to do something similar - and when they don't they are castigated for not trying.

The devil in the diagnosis of type of practice. Do you have any examples of the different types of practice?

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