Book Review: Rippling; how social entrepreneurs spread innovation throughout the world. Beverley Schwartz 2012

Social entrepreneurs work on societal problems; they push against the norms of societies, governments and organisations. They develop unique solutions because they have to. Social entrepreneurs are not the stuff of organisational employees. These are very focused individuals who operate outside of regular structures to make change happen. They speak up, point out and are unafraid to plough, what at times is, a lonely furrow.

This book is about large scale change and transformation. It's neither an academic review nor a pop-science polemic. Instead it covers the stories of real social entrepreneurs as they create and implement systems changing innovations.

The book provides a number of case studies and draws out some guiding principles and lessons.

Advice on being a social entrepreneur includes:

• "Take responsibility for your life"; this is about getting out there and up there with what you believe in. It's about taking your ideas and working full out to find sponsorship and to convince others. It's not about "selling" a corporate idea within the corporation, although the way social entrepreneurs influence provides useful lessons.
• "Remain objective". This sounds really odd but the essence is to avoid falling on love with your idea so much taht you're unable to see it's faults and end up defending it when others try to improve it. It is about focusing on the benefits to others - note: to others, not to yourself or your organisation.
• "Do something"; social entrepreneurs are not thought leaders or academics. They are people who get things done and they do this by marshalling their own resources (internal and external) and expending personal energy on keeping the action going. They are in for the long term and demonstrate remarkable consistency of purpose. They are 'doe-ers'.
• "Solution"; They are entirely solution focused. They constantly work to find a solutions to keep their work moving forward. They tend not to use the language of "problems" or consider problems as barriers - instead they are the opportunities to improve and speed up implementation. Sounds a bit obvious and trite - but the case studies in this book demonstrate this.

Schwartz identifies four characteristics of social entrepreneurs:

1. Purpose
2. Passion
3. Pattern
4. Participation

To some extent these seem the same characteristics that are used to define good leadership or those who foster social movements. From reading her book, I think Schwartz is positing that its the amount of each of these characteristics that matters: amount and strength. Social entrepreneurs are not spending time on office gossip, annual planning away days, business planning processes - they are putting the maximum amount of energy into their fundamental beliefs, and taking them to action.

Great book. 

Book Review: Arbesman - The Half Life of Facts: why everything we know has an expiration date

I don't why I never thought of knowledge as decaying over time. Especially when knowledge acquisition and transfer / spread is my specialist topic. Arbesman provides excellent examples and a logical argument to support his hypothesis that facts die out at a predictable rate. This is a fascinating thoguht, especially as in healthcare we believe that we constantly press against "old" facts which are stuck in the system. A reframing to think about what their "half-life" might be, is a useful and inspiring one.

Arbesman has come up with new vignettes rather than trotting out the old favourites. This is not a new take on an old subject, but rather a new subject requiring some disconfirming thinking.

Book Review: Crucial Conversations by Patterson, Grenny, Mcmillan & Switzler

This book has the subtitle "Tools for talking when the stakes are high" and I found there was not a single page that disappointed me. Part way reading through the book I thought this is all common sense, and of course a lot of it is. However, the authors are showing and telling in an extremely compelling manner that you just can't help going "aha", oh-yes", "of course" every few minutes. My copy is full of notes, highlighter marks and pages turned over.

So what's the meat in the book?

At its heart is a dialogue model which is about me and the other and how we each act, feel, tell a story and see/hear. In our dialgue we are aiming to create a pool of shared meaning and there are a number of factors that impact this, such as safety, and silence (withdrawing, avoiding, masking) and violence (controlling, attacking, labelling). All this sounds cold in this description, what brings this book alive is the way the authors develop the model with the use of various tools and stories. It's impossible to read it anot feel connected yet at the same time feel empowered to do something about your next high stakes conversation.


You can download book chapters and sample MP3 audio from http://www.vitalsmarts.com/books_more.aspx . There is also the stress test to discover your style under stress.

Book Review: Time Traps by Todd Duncan

You can't manage time but you can manage your thoughts, actions and tasks - that is the underlying premise of this powerful book. I read the book a couple of years ago and in a rare moment, I decided to read it again as I found I was often using the mantra of its premise and was seeking to find more ways to satisfy my desire to get a grip on the slippery slope of the balance between time and tasks.

The book is written with sales in mind though I didn't find this detracted at all from my personal context and I expect anyone who deals with many interactions with others will find it helpful.

The author talks the reader through a number of traps. The first is the identity trap. This is how when time is monopolised by our work we become our work - and thus how important it is to rethink time, to rebalance as part of regaining our personal identity. Secondly there is the organisation trap where the author suggests that most sales people are disorganised, out of control and say they lack the time to catch up. Well, that sound like a lot of the stories I hear from many people! And what I say sometimes as well!!! He suggests learning to stop all unnecessary tasks before they steal time, admit legitimate tasks onto your list of things to do, and make sure you know the difference between necessary and productive tasks. Then take action and assess how you're doing.

He also talks about the Yes trap, and then how to say No, or sacrifice more sales for the benefit of others. He has some interesting things to describe on the value of saying no. Then there is the Control Trap and the issues of letting go and learning to delegate. The technology trap should be familiar to those caught by their email, and for sale people he discusses the Quota trap. And if you're not trapped out yet, there is also the Failure Trap and the Party Trap.

I know this book changed how I felt about time and the management of it the first time I read it and certainly, the second time around, I was reminded to take some more detailed action steps.

Go to here http://www.timetrapsbook.com/ to download a chapter or to carry out the self assessment on the eight traps.

Book Review: NO! How one simple word can transform your life, by Jana Kemp

This makes a change from all the "Yes, you can" books! It's basically about getting over the fear of saying now and taking control of any circumstance without negative consequences. A critical aspect as you might imagine is tone of voice and the author words hard to ensure we understand that it's critical we get this right - not too fast, too harsh and to make sure we choos the right words when we do mean it. It is also key to stick to your decision when you've make it.

Kemp has a model called the POWER of No which has an acronym from POWER: Purpose, options, when, emotional ties and rights/responsibilities. She suggests that using this acronym will help us to make a yes / no decision based on the right issues at the time. For me I find it a lot to think about when considering a yes/ no response online, though I suppose you get better at it with practice.

In essence the decision prcess goes like this
- think about the purpose and context of the decision
- what option do you have? What resources are available?
- when is it due? What is the deadline and can you meet it?
- be realistic about the emotional ties
- consider your rights and responsibilities

I'll be trying out some "No's"....

Book Review: New Age of Innovation; Prahalad & Krishnan

If you're interested in large scale change and innovation then you'll find this book fascinating. On the one hand it felt like there was nothing startlingly new to me yet on the other it was neatly put together in a readable way that made sense.

A key premise is the current trend of personalisation and how value is based on the unique experience we all want. The authors refer to this as N=1. Current technology drives this, social networking, web 2.0 etc. How can we co-create value with our users and consumers? What are the challenges with managing who owns the knowledge? All good questions. They also suggest we need to make the most of collaborative networks, electronic and face-to-face, be flexible and ensure scalability. I liked the section on scalability and in my mind there is more in here than what they covered. This is a key element and is also linked to their second premise.

The 2nd key premise is the one that resources need to be global and they use another little formaula: R=G. Here they suggest the issue is that access to resources is more importnat than providing products; namely it is the solutions that matter rather than the kit or pieces. I think I agree with this. Again, scalability comes up.

They mention social movements and how they figure in the process as well as organisational transformation. There was nothing much new in the organisational process other than the context of the infomrational technology infrastructure - well, that is rather new and for some people rather perplexing.

If you've not yet engaged with Web 2.0 and new technology then this is definitely worth a read.

Book Review: The Art of Changing the Brain by James Zull

I was recommended this book by Paul Batalden and he was right - it is excellent.

The subtitle is "Enriching the practice of teaching by exploring the biology of the brain". The author manages to integrate biology and neuroscience with educational and learning tactics. For me the book brought to light the process of learning in the sense of how the structure of the brain influences the process.

Zull explains the natural relationship between the structure of the brain and learning, how brain connections change data into knowledge, the way that evolution of the brain is linked to how we are motivated in our learning, and the importance of emotions in the learning process.

While the book covers some breadth of biology at no time was it too complex to follow for someone like me who has limited knowledge of the subject. I think, if you did know more about biology, then you would possibly get more out of the book than me.

Parts I really like was when Zull got practical and linked the discussion to how teacher can then use this knowledge to provide better learning experiences. Having made the links to brain structure it really made sense. I have been testing out some of the ideas and techniques and they do seem to work for me and for those with whom I work.

If you're a fan of PDSA cycles then on reading this you will probably have a major "Aha" moment as you figure out just how they work!

Book Review: Groundswell by Charlene Li & Josh Bernoff

The authors define a groundswell as “…a social trend in which people use technologies to get the things they need from each other, rather than from traditional institutions”. mmm that sounds like an important thing to know about if you think you're a traditional institution, or if you think you're breaking new ground, or if you're a consumer wondering why you're starting to feel left out the loop.

What I liked about the book was the examples and case studies. Usually I skip these, however, I foudn these ones riveting reading. Who needs thriller novels when the business world presents us with such chaotic and roller coaster events. Fabulous.

I also found the way the book was constructed and organised to be very helpful, especially when faced with a disconcerting topic. Far from being disorganised, the underlying structure helped get the message through.

Read this book and it will move you on from thinking about "all we need to do is have the odd blog and a fancy web 2.0 website" and get you into strategising about your social media presence. I have always been convinced that social media is not just for the youngesters and this book has all the examples and conceptuals models to help you create some of your own thinking for your business to prove it is for everyone.

The book has, as you would expect, a great website. http://www.forrester.com/Groundswell/index.html It is good to see them practising what they preach. They have a blog and there is also a social media profiling tool you can download and use.

I'm not one for giving 5 stars to a book, but this one deserves it. I might just read it a second time.

Book Review: Overtreated by Shannon Brownlee

The subtiutle of this book is "Why too much medicine is making us sicker and poorer". This book was quite shocking. I know there is a lot of what goes on in healthcare that is unnecessary yet to find a huge amount of detail and information in one place really put the issue into perspective. It is focused mainly on the USA though there are many parallels with other health systems.

Throughout the book, the author provides stories and examples to illustrate the data and statistics that without the stories would appear cold and less shocking.

As I read through the book, particularly in the early chapters I found myself going "I know him/her"! Shannon Brownlee hooks a fair amount of the debate onto the actions of some of the current health leaders in the USA (you might like to read the book to see if you are mentioned...!) There is an excellent chapter on the VA Healthcare systems, how it has improved and in many cases how it is an example of how healthcare in the USA could look and feel.

Chapters include:

• Too much medicine: complelling arguments as to why population based healthcare would be a real improvement
• The most dangerous place: beware the hospital and what might happen
• Your local hospital: how uncoordinated care and overtreatment results in poor outcomes
• Broken hearts: how the latest fad takes root, based on economics
• The desperate cure: an argument for evidence based care if there ever was one
• The limits of seeing: an expose on the limits to radiology tests
• The persuaders: mmm who is influencing whom, and why?
• Money, drugs and lies: why not to believe everything published in journals
• The doctor isn't in: all about managed care
• When less is more: some ideas to cope with over-capacity and overtreatment in the USA

This book is a must for every health care improver who believes their own project is making a difference... The strategic and tactical issues raised in it really provide a new perspective.

Book Review: Tribes: we need you to lead us; by Seth Godin

All of Seth Godin's books are amongst my favourites - sometimes you just resonate with an author. I like the way he speaks his mind and is unafraid to test out new thoughts and ideas.

He explains a tribe is nothing ore than a group of people connected to an idea, a leader and one another. His point is that with the web as it is developing we have more ways to find people of similar ilk and to join the "tribe". However, not all of these groups are fruitful and they need leaders and facilitation in order for them to be productive and constructive. This leadership angle is important.

Seth Godin's thoughts as I connected to them in this book is that being a leader of a tribe is tough and demanding. Often tribal leaders are accused of being outside the norm - a bit of a heretic. He believes that the leaders who are perceived as such and who stick to their views will win out in the end.

What does the author suggest we do to grow these tribal social movements?
1. Publish a manifesto; state who you are and what you are about
2. Others need to find and connect to you - make this as easy as possible
3. Keep the financial stuff in the background
4. Publicly track your movement's momentum and growth
mmm easy on paper though I wonder just how easy it is to do these things.


As good as his books, I also recommend Seth's Blog http://sethgodin.typepad.com/ and you can find out more about him and his books at http://www.sethgodin.com

Book Review: Sustaining lean healthcare programme; a practical survival guide - Eaton & Phillip

Different book styles appeal differently, to different people. This one appealed to me because it is relatively short (94 pages plus appendices), well organised, uses bullet points and lists, checklists, diagrams and has some short examples to illustrate points.

Contents include:

1. Where are you on your journey
2. Why do only 24% succeed?
3. Going Lean
4. The top ten signs of a failing programme
5. Creating a lean healthcare organisation
6. Four key checklists
7. The next eight things to do...

So do only 25% succeed? The authors suggest there are 8 critical success categories Communications. resources, involvement, training, implementation, compass, achievement and leadership (yes, these do spell "critical"). If you like wordplay then read the book and discover PRISM, CAD, VSE, RIE, RPE, FIT, FMEA etc. Not as bad as it looks in a list here. I found them a good description, and sometimes reminder, of basic principles.

The chapter on the top 10 signs of a failing program is easily read. For each reason there is an explanation of what you may experience, why it happens and then what you can do about it.

The four checklists you need? One each on people, success, tools and culture. Nothing really new to me, just nicely organised.

I particularly liked the Appendices which included key lean phrases and concepts (worth the price of the book for its organisation and simplicity), audit form, guide to common saying (fabulous!), and then a number of "how to" guides.

I know Mark Eaton has actually implemented lean in healthcare. This book is a demonstration that when written by someone who has got their hands dirty it turns into valuable desktop reference.

Book Review: Spiritual Capital; wealth we can live by. Zohar, Marshall

You know about IQ. Along came EQ. And now we have SQ - Spiritual Capital.

Published in 2004, this book languished on my bookshelf filed somewhere between management books, self-help and fiction. Having read it I will now file it permanently under management texts. Although it is written for an individual to read and contemplate their own SQ, it is framed for wider thinking covering society and organisations.

The authors provide explanation of the different type of Capital:
IQ: Material Capital, rational intelligence - What I think
EQ: Social Capital, emotional intelligence - What I feel
SQ: Spiritual Capital, spiritual intelligence - What I am

SQ is defined at what a community or organisation exists for, aspires to, takes responsibility for. These combine to provide a moral and motivation framework for existing. "Spiritual" is described as human beings asking why we are doing what we are doing and suggest we seek a better way of doing it. It is not, as the authors state, about shrines in hallways or calling employees to prayer.

SQ links to corporate social responsibility (CSR). When I read this I wondered how much public sector organisations monitored their CSR - being funded byt he taxpayer does not automatically create CSR.

The authors spend a few chapters unpicking various theories of motivation. Nothing new in here if you've covered this before, however, I liked the way they framed their discussion and the use of their motivation scale.

They suggest twelve principles of transformation. These alone are worth the read. So much of the change management and improvement work I am involved in is focused on transformation. These authors provide a thought-provoking, simple yet rich framework for conceiving of and applying transformation.

The book ends with a chapter on corporate spiritualism and asking the question "Is it still capitalism".

If you are trying to figure out your own meaning at work, leading others through change processes or concerned about your organisation's "soul", then this book will provide you with some language and structure to frame your thoughts.

Book Review: The ABCs of Evaluation - Boulmetis & Dutwin

I've rediscovered another older book (2005) on the bookshelf. I was browsing round the home library searching for inspiration in developing an evaluation for a leadership development program. I remembered what I liked about this book the first time round.


The authors have produced a book which is set out logically. It covers the choices you have and steps to take to carry out an evaluation. I found the section describing different evaluation models and which one to choose was just what I was looking for:
1. Discrepancy Model: use when the program is so interwoven within the organisational context it is difficult to discover freestanding changes
2. The Goal Free model focuses on the participants needs and is independent of the organisation's needs.
3. The transactional model is similar to the goal free model with the exception that the evaluator plays a more active role in the evaluation process.
4. The decision makingg model focuses less on the success of the program and more on the longer term sustainability
5. The most popular model is the goal-based where the outcomes are assessed against the organisation's objectives (or program objectives)
The authors do also list other evaluation models and I would be interested in using systems analysis with my healthcare programs. The version using art criticism where you bring in an expert in the field to review progress is an interesting one I had never thought of. The adversary model where participants present their views and a "jury" hears their evidence might be useful for the rapid assessments we sometimes need to make.

The evaluator's role is covered as a continuum from the start of the program through to the end as well as the level of active participation in the evaluation process.

I was interested in what an evaluation is supposed to measure. Having got used to most healthcare evaluations answering "has the program delivered its objectives" it was good to see that "was the program efficient in terms of cost and staff time - was the expense worthwhile?". What we often mean when we say sustainability, the authors use impact. I like this as it covers not just the sustainability of the results but also the magnitude of the results as contributing to the organisation's long term objectives.

The book also includes the types of data, how to present it and the process of writing up your report.

I'd recommend this book if you're starting out in evaluation or need a refresher. If you're a seasoned program evaluator I suspect you will find other books go to more depth.

Book Review: Performance Drivers by Olve, Roy & Wetter

Performance Drivers by Olve, Roy & Wetter
John Wiley & Sons, 1999
Purchased from Amazon



On the one hand the topic of this book seemed old and faded - there must be 10 new methods for change and improvement being issued every day - yet on the other hand, it seemed fresh and comforting, like a newly washed pair of favourite socks. It was comforting because it answered the questions I had in a way which build on my existing knowledge, and fresh because it left me with new ideas and measurement strategies.

Part I covers the reasoning behind the need for a Balanced Scorecard and how it is effective for strategic control. I liked the way the authors explained how the dynamic between measures is so important. I think so often this interdependence is lost, with the result that we have undesirable knock on consequences in our systems or we miss valuable opportunities for improvement.

Part II takes you through the process of building a Balanced Scorecard. The cases from different industries illustrate the diverse ways you can do this. There is more detail in here about understanding and using causal relationships between measures.

Implementing a Scorecard is discussed separately to building and designing one. This section, Part III, covers IT systems that help as well as the facilitation process to ensure the scorecard is used to develop a learning culture rather than performance management straight jacket.

Part IV explains how you can use Scorecards to inform parties outside the organisation and there is also a chapter on their use in the Public Sector. If you are working in the Public Sector you may like to start with this chapter.

Finally, Part V has hints, tips and advice on making the scorecard process a success. If it were me I would have put these notes earlier in the book as they are important.

If you are bereft of any ideas on what measures to use then the authors have helpfully compiled a "starter for 10" list in a useful Appendix.

I recommend this as a handbook for those who are searching for ways to measure the dynamic variables in a system or organisation, with the aim of learning from the output.

The Intelligence of crowds

It is difficult to subvert the ego of the individual and go with the average of the crowd - yet when the crowd's results outperform those of individuals it may be time to do some creative thinking about how we make chnages in healthcare - or anywhere else.  A classic example of the wisdom of the crowds is the "how many marbles in a bottle" challenge. With a decent sample, the average of the crowd is usually very close to the actual number. In comparison, individual's results are varied, the range is big and there are few that are close to the target.

NPR has interviewed the author of a book on the subject.


In his book The Perfect Swarm, Len Fisher talks about swarm intelligence -- where the collective ideas of a group add up to better solutions than any individual could have dreamed up, including an example of how UPS reorganized its driving routes using the logic of an ant colony.

You can listen to the interview (17 mins) or read a transcript.

Listen out for the way in which UPS redesigned their routes using swarm logic.  Do you think the same is possible for the redesign of patient pathways?

Groundswell; social media works

I couldn't help but do some cross pollinating for once (or is it cross blogginating). I've just read and reviewed "Groundswell" by Li & Bernoff.

The book is about how people use social media to buck the trend of how they get information - namely using technology rather than the traditional methods from traditional instititions. This has significant implications for how we go about encouraging the spread of good practice.

Read the book review and get more infomration at www.mybookblurb.blogspot.com