All posts by Simon Black

Change Principles, Culture, Excellence, Professionalism, Service

Lessons from Florence Nightingale 200 years on…

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Contribution by Kent alumna Dr Rachel Black     (SSPSSR 2011)
Chief Executive at the Orpheus Centre

12 May 2020 marks 200 years since the birth of Florence Nightingale, pioneering nurse, researcher and social reformer.

 

Florence Nightingale combined phenomenal caring skills with brilliant intelligence. She was a fan of data and used it to change practices and improve people’s health outcomes. During the Crimean War, many more men died of infection than of war wounds. Florence Nightingale radically reduced mortality rates by delivering outstanding infection control and nursing care to those people.

The Covid 19 pandemic is also being managed in large part through rigorous infection prevention and control to prevent people needing to be hospitalised. People are washing their hands frequently, staying at home, practicing social distancing, and self-isolating if required. We have all radically changed our lives to accommodate such changes.

I have been a nurse for my whole adult life, starting my training when I was just 18 years old. In some ways my role as CEO at Orpheus has felt like the furthest move from clinical practice I have ever made. Not anymore! With Covid 19, I am absorbed in physical and mental health risk assessments, designing and implementing practices to control and prevent infection, reviewing presentation of symptoms and deciding on courses of action. All of my accumulated nursing knowledge and skills are being utilised.

I hold the following words of Florence Nightingale in esteem:

“Let whoever is in charge keep this simple question in her head:
not, how can I always do this right thing myself, but how can I provide for this right thing to be always done?”

(Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not).

In keeping our services running, I am always aiming for the Orpheus Centre and all our workforce, volunteer and paid, to do the right thing: to keep our students safe and well above all, to maintain their care, to promote their independence, and to keep them learning. I am of course prepared to step in anywhere, but I need to ensure the workforce and families have the resources and support to play their parts excellently. It is a tribute to our wonderful donors and funders that we continue to have those resources available and we are forever grateful.

The Domiciliary Care Team at Orpheus are not registered nurses, but they do nursing care. They develop supportive and trusting relationships, they enable students to feel confident when they are most vulnerable, and, in partnership with other professionals, they tend to the needs of students when they are at physical or mental low ebbs. Like many care services, the range and complexity of skills they are expected to practice is ever growing and increasingly complex, particularly at this time. Our Domiciliary Care Team is brilliant. In the world’s hour of need, it is the traditionally under-valued, customer-facing job roles which have kept people safe and even alive. During the Covid-19 lock-down we clap for carers on Thursdays and put up our rainbow posters. It should not have taken a pandemic to see how the world needs these people. We must not lose sight of their importance in the months and years to come.

Florence Nightingale also said:
“Were there none who were discontented with what they have, the world would never reach anything better.”

Faced with the unknown of a pandemic, all the Orpheus Centre students, parents, volunteers and staff have made tremendous changes to their personal and working lives to make the world better by keep themselves and each other safe. People have been amazingly flexible and good-natured in really trying circumstances. They find themselves undertaking tasks they do not usually do and, frankly, may prefer not to do. Above all, people have been hugely kind and so very patient.

Dr Rachel Black, CEO, the Orpheus Centre

I think Florence Nightingale would look on the Orpheus Centre with approval. She would see a large team of students, parents, volunteers and staff who are all working for the good of the students and each other. She would see a team of staff who are always empathising, prioritising the wellbeing of students and parents, looking out for each other’s needs, and, essentially, keeping the working space and their hands so very clean.

I am in awe of Florence, but I am also in awe of the Orpheus Family and so very proud to be in it.

 

Reading:

Nightingale, F. (1992). Notes on nursing: What it is, and what it is not. Lippincott Williams & Wilkins.

Orpheus (2020) About us https://www.orpheus.org.uk/about-us

 

CLASSIC POSTS REVISITED (new twists on old themes)

Change can’t be planned – it emerges

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An earlier version of this was first posted on June 15th 2017

Traditional change management follows a linear approach, defining a goal, identifying a plan and delivering to that plan. The process is logical and surely unquestionable. The approach to setting targets for change and measuring progress has now been given its own name ‘deliver-ology’. However a sexy new name does not mean there has been a revolutionary change from traditional linear thinking – in fact it is the same old bad thinking in new clothing.

The problem is that organisations do not act in a linear fashion, they are much more complex systems. This means that if you change one thing then something unexpected is likely to happen somewhere else – and what you had intended may or may not happen.

Of course understanding systems can be a difficult thing to do. Instead managers either resort to ‘giving their view’ on things, or setting success measures, kpi’s and so on, based on those views. Having a view on why things are a problem is one thing, but  for John Seddon, it is better to get knowledge by collecting data.

He suggests that it is better to define the following:

  • Purpose is the definition of why we are here, best understood from the customer (or user’s) perspective.
  • Measures allow us to understand what is likely to happen going forward if the systems doesn’t change.
  • Method – can be addressed when we understand the data derived from our measures.

Systems Theory tells us that Purpose Measures and Method are fundamentally linked – it is a systemic relationship. This systemic relationship can either work for you or against you depending on how you set things up.

If you impose arbitrary measures then you create a de facto purpose, which is the one that the workforce will follow. This will constrain method. It will prevent people from improving the work.

On the other hand if you derive measures from the users point of view (e.g. customers)  and then put those measures in the hands of people doing the work you and enable people to improve method so that measurable improvements can be pursued, then you can systematically deliver success.

The paradox is that in this system, change requires no plan. For Seddon, change is simply an emergent property. Innovation can only occur if you set things up that enable people to innovate in response to the real system of customers and organisation – what happens.

Any attempt to plan change otherwise is fiction, even if people suggest it is rational and logical. Remember logic arises from understanding the inter-connected nature of the system, and not from an accumulation of assumptions.

Instead Seddon suggests that you need to see your organisation as it really behaves – how things work relative to your purpose ‘warts and all’ – because then at least you will know. Once you know that you can respond by innovating – enable people to innovate and oversee the changes that need to happen and you will improve morale.

Reading:

Seddon, J. (2003). Freedom from Command and Control. Buckingham: Vanguard Press.

CLASSIC POSTS REVISITED (new twists on old themes)

Targets only motivate people to meet the target (not to do good work)

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An earlier version of this was first posted on 14th January 2014

The reasons for employing people are:

1) to do the work (produce output, product, service), and

2) to improve the work.

Additional to this is the social benefir of haveing people involved, sharing ideas and creativity and social bonding, raised morale and a sense of teamwork, but these are largely side-effects form allowing them to carry out 1 and 2 above (if done correctly!).

If the person is clear about the purpose of their work, then 1 and 2 should be easy to deliver if they have the right resources, skills, and understanding of users’ (e.g. customers) needs.

But managers rarely leave it at that…

Traditionally, managers get people to do ‘better’ in their work by what John Seddon tags as ‘sweating the labour’ – getting the people to work harder or faster. The idea is that you get more output for the same hours work – essentially more for the cost (efficiency).

Of course the idea of the sweatshop is morally uncomfortable – exploitation to achieve a profit motive. Yet we still stick to the idea by setting targets: ‘You produced 100 widgets last month, let’s have you aim for 110 widgets this month‘.

It seems plausible – motivational even! What possibly could be the harm in setting a target?

Well, the widgets are being created for a purpose – presumably the purpose for which the customer buys them. And that purpose is associated with the design and quality if production in the widget that is produced.

If you create arbitrary targets (and measures of performance) you will create a de facto purpose in people’s mind which is to deliver those targets. This is different from actually delivering the purpose of the work.

Your worker will work to produce 110 widgets BUT not necessarily a widget that meets the customer needs, nor a widget that could be produced faster or at lower cost whilst still meeting the customers needs, other than by cutting corners (lowering quality or increasing risk). The worker is busy but has got his eye off the ball. This produces errors and lowers the quality of work – which will probably have to be redone – at greater cost.

Targets are not motivational. They might make people move, but that is not motivation. A dog that moves is just one looking to avoid the next kick. It is not a motivated, free thinking, creative, proactive animal. Why would we exect people to operate any differently?

Reading

Herzberg, F. (1968) “One more time: how do you motivate employees?”, Harvard Business Review, vol. 46, iss. 1, pp. 53–62

Seddon, J. (2005) Freedom from Command and Control, Vanguard Press, Buckingham, UK.

Change Principles, Learning & Teaching, Updates

Things will always go wrong…better to look at what is predictable

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Ed Deming used to say that ‘things will always go wrong’. This is true in the complex work and business environments that are encountered day-to-day.

We can be victims to this, much as we would be for unforeseen natural disasters: hurricanes, tsunamis, volcanic eruptions. Alternatively we can prepare for a likely disaster and have plans in place to mitigate its effects: bunkers, safe havens, evacuation plans.

Better is for us to be able to predict these occurrences. This is true for natural disasters, but for most of us are not obviously threatened by such calamity (which is why we probably fuss more with the trivia of the world of work!). So lets talk work – the importance of prediction is true in how we handle day-to-day ‘disasters’.

Things go wrong for two reasons – (1) underlying problems in the way things are set up we means we have cycles of good days and bad days, and (2) problems caused by an assignable factor. Deming called the first ‘common causes’ and the second ‘special causes’. the importance of this differentiation is n what we do in response to those issues. Things will always go wrong.

If performance is below the level we need on a predictable basis then we have an underlying set of ‘common causes’ which are built into the system of work – its design, the training of people, the job design, raw materials, plans. This takes a lot of effort to test new methods, monitor progress and change and embed new approaches. No quick fix.

If a one off problem occurs think – do we know the cause? Is it a one-off? Can we mitigate for that cause? What would we do if it occurs again? Fr this situation never go through redesign of the system – that will only make things worse and put what was under control, to now spin out of control. However if you find the cause then stop and think – does knowing this fact give us a clue to future fundamental improvements?

Deming W.E. (1982) Out of the Crisis, MIT CAES, Cambridge MA.

Deming W.E. (1993) The New Economics, MIT CAES, Cambridge MA.

Change Principles, Excellence, Process Improvement

Systems ignorance and unintended damage

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Cause and Effect Analysis is often considered a comprehensive approach to addressing problems and identifying solutions. This approach is true in closed systems where linear cause-effect relationships typically occur. Many areas of manufacturing and assembly would fit into this model.

Most work situations do not occur in a closed system but instead are in open systems where many factors affect an outcome.

Ishikawa recognised this in his ‘fishbone analysis’ approach to problems. He recognised that many causes, and layers of causes  can affect an outcome. He also advocated for the collection of data on causes and outcomes before relying on an intervention to have a desired affect.

If we ignore this advice we will implement actions which will have unintended consequences. Send a ‘communication’ and it is interpreted as a threat. Give a pay-rise to one person and it is seen as a betrayal of trust by a dozen other people. Instigate an inspection system and it generates a new industry (and associated cost) to the sector. Seek to drive down costs by reducing resources and it will increase costs by causing repeated failures.

If you have a lunchtime to spare it is worth listening to Peter Senge’s discussion about systems in organisations:

Peter Senge’s keynote speech “Systems Thinking for a Better World” at the 30th Anniversary Seminar of the Systems Analysis Laboratory “Being Better in the World of Systems” at Aalto University, 20 November 2014.

Change Principles, Professionalism

The myth of restructuring

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Re-structuring and re-organising is probably the most common change management method used in organisations. It is the organisational equivalent of management accounting – moving things to make an impression that things have changed.

managers like to make an impression, and many are prepared to even if it involves complete illusion. The problem with restructuring is twofold.

First organisational structure has much less influence on organisation performance than does organisational culture. uit is the behaviour of

The phenomenon is not new. In the magazine article “Merrill’s Marauders” (Harper’s Magazine, 1957)  Charlton Ogburn described his experiences in the british Army during the  Burma Campaign of World War II thus:

“We trained hard, but it seemed that every time we were beginning to form up into teams we would be reorganized. Presumably the plans for our employment were being changed. I was to learn later in life that, perhaps because we are so good at organizing, we tend [as a nation] to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency and demoralization.”

If you want to look busy spend your time, and other people’s time doing a restructure. Aside form wasting time and resources (including redundancies, pay rises, consultants fees, etc) it will have the added benefit of making things worse.

On the other hand act professionally, use knowledge accrued by organisation development over 50 years and consider the overall system of work, what is affecting people’s effectiveness and work with them to make things better. It involves everyone, fixes the problems which people are actually experiencing, and is a lot cheaper.

Reading:

Beckhard, R. (1972) Optimizing Team Building Effort, J. Contemporary Business.  1:3,  pp.23-32

MacDonald, J. (1998) Calling a Halt to Mindless Change, Amacom, UK

 

CLASSIC POSTS REVISITED (new twists on old themes)

Still no ‘instant pudding’

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An earlier version of this was first posted on 3rd June 2013

When we consider change in the workplace we should “see things as a human system: people, the work that we do, the interactions we have with each other, the physical environment that we create and use. These

Don't go for the "quick mix-quick fix"
Don’t hope for the “quick mix – quick fix”

are the routes to change.”

This is great because as humans we have the privilege of choice; we can be proactive and make things happen.

The down side of this is that this situation is by its nature complex – other people might not feel the same as us and may put up barriers or counter-proposals.

As a consequence, to make things change, we need to encourage people to change – or at least the people who have an impact on outcomes (note: trying to change people who cannot affect change is a sure-fire route to getting unpopular AND will fail to have impact in any event – so don’t make people the problem).

To encourage people to change we need to change their thinking, how they value people, how they understand why results occur, how systems work (or don’t work), how to distinguish between ups and downs, between real improvements and one-off blips in performance.

Some people may have an epiphany and see new ways to operate, whilst other people may more gradually understand the need for a new perspective. Either way new thinking has to be embedded in our habits and ways of working and this usually takes practice.

This is consistent with Herrero’s (2006) suggestion that new behaviours are needed FIRST  to support proposed changes in processes and systems.

Quoting his mentor Deming, Donald Wheeler tells us  that “The [new] way of thinking – has to be cultivated. This will take both time and practice. There is no instant pudding. There is no shortcut.”

To effect change is to do it… and to keep doing it. To be the change … and sticking to it.

As Wheeler says “There’s nothing to it but to do it.”

Further Reading:

Herrero, L. (2006) Viral Change, meetingminds, UK.

Wheeler D.J. (2000) Understanding Variation: the Key to Managing Chaos, SPC Press, Knoxville, TE

CLASSIC POSTS REVISITED (new twists on old themes)

Tell me – what’s your purpose?

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An earlier version of this was first posted on 2nd May 2013

sub purposeTo be clear about our work – namely, who we are serving, how to do the work, how to change, what is ‘good’, how to measure results, and what improvement looks like – we must be clear about one thing:

WHAT IS OUR PURPOSE?

Peter Scholtes was one of the clearest writers on this concept. For him, like Deming before, everything starts with purpose;  “Without a purpose there is no system”.

Until we have clarity of purpose, all we are doing is completing sets of tasks. ‘Purpose’ should be embedded in our thinking about work, people and organisations.

Scholtes offers an example to illustrate the importance of purpose:

“Cleaning a table cannot be a system until the purpose of the clean table is made clear. A table clean enough to eat on requires one system of cleaning. Clean enough to dance on requires another. Clean enough to perform surgery on requires yet another. Everything starts with purpose.

‘What is your purpose?’ is the most useful question one can be asked.” 

When thinking this way, work is transformed from being seen as tasks to carry out, to become a complelling reason to do something; a framework for making decisions and seeking ways to improve.

Read more:

Deming, W. E. (1993) The New Economics for Industry, Government, Education, second edition. MIT CAES, Cambridge MA.

Scholtes, P. R. (1998) The Leader’s Handbook: A guide to inspiring your people and managing the daily workflow, New York: McGraw-Hill

Scholtes P.R. (1999) The New Competencies of Leadership, Total Quality Management, 10: 4&5, S704-S710.

Change Principles, Excellence, Leadership, Process Improvement

Leadership lessons from Deming

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It is 90 years this month since Ed Deming completed his PhD in Physics, but it is his work with statistical understanding of processes and performance of organisations, and its impact on human behaviour and leadership which is his lasting legacy. Deming was alays open to learning new things, up to the end of his life at the age of 93 – a lesson for us all.

A few important concepts which he identified for leaders include:

  • 90% of problems are cause by the system – and the system belongs to management
  • Banish any form of individual ranking or reward because 90% of variation is due to the system and not individual performance.
  • There is no substitute for knowledge. Seek knowledge not opinion or assumption.
  • Engage people in change. From day-to-day activity they know the problems and issues of work better than managers. Give them the measures to understand the activity and they can better make efforts to improve it.
  • Best efforts tend to cause problems. If we just ‘try harder’ it is likely to make things worse, unless we change the system of work
  • Drive out fear. Innovation, ideas, creativity enable high work performance. Fear crushes all of these things.

Reading:

Deming W.E. (1982) Out of the Crisis, MIT CAES, Cambridge MA.

Deming W.E. (1993) The New Economics, MIT CAES, Cambridge MA.

Voehl, F. (1995) Deming the way we knew him. St Lucie Press, FLA

 

Excellence, Leadership, Process Improvement, Service

Costs are found in flow – not within activities

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 flow2To reduce costs, the expectation is that we must ‘gain efficiency’. This means speeding up the activities which we carry out or reducing the amount of money spent each time we do it. To understand the speed of activities, we should (surely!) count those activities or their cost – and perhaps see how quickly they are repeated or how much cost they accrue. Does this make sense so far?  If it does, then you have been led down the garden path.

Meaningful change should relate to the purpose of the team (essentially their focus on the work), and the team’s purpose should fit with the wider organisation’s purpose. Efficiency gains mean nothing if purpose is compromised. Even cost savings to save a business must be purposeful (and related to core business) if that business is to have any chance to succeed in the long term – otherwise it is just giving respite to an essentially lost cause.

Next consider whether your change is going to impact/intervene with the task (work), the team, or a particular individual (or individuals).

  • With task changes you are interested in both the value of the task (output quality as assessed by the user) and the flow of the activities (timeliness and waste/repetition/failure recovery etc).
  • With team you are looking at effectiveness of contribution and team energy, morale, sharing, learning, synergy and interactions.
  • With individuals it is about their contribution, development and commitment.

If people have been brought along with the change, the reasons, how it fits with team purpose and how it improves output for users at less effort for us (or at least, less wasted effort), then you are much more likely to avoid problems with ‘team’ and ‘individual’. So in a roundabout way a holistic view is important. But it is important at the outset  – during the design of your intended change (when you consider what /where/when) and how you design the ways in which  to get people on board in that design.

The reason people get bothered by change is either:

1) because they know the work and can see the pitfalls and would prefer to implement changes that would make a real difference (potential positive constructive contributors), or

2) they know the pitfalls and want to hide them because they should have raised those problems themselves, so feel a bit exposed (likely negative grumblers).

The ‘1’s will be in the majority – you need to make sure those people don’t become grumblers because their input has not been sought or valued!

 

Reading:

Adair, J. E. (1973). Action-centred leadership. McGraw-Hill.

Seddon, J. (2003). Freedom from Command and Control. Buckingham: Vanguard Press.