The trouble with targets

1136281264582304The front page article on the Press for Friday 7th November 2014 says “Patients ‘forgotten’ in wait for surgery”.

It goes on to say that research published in the NZ medical journal suggests that:

“One in three people requiring elective surgery are being turned away from waiting lists to meet Government targets.”

It should be no surprise to any of us that if a numeric target is imposed on a system then the process performers will do what they can to achieve it, even when their actions are detrimental to the actual purpose of the system. The controlling influence of the targets will be even greater if contingent financial implications are involved (carrots or sticks).

If we viewed a league table of (say) hospitals and wait times, what would this tell us? Would it tell us which:

  • has the best current method as judged against the purpose of the system; or
  • is best at managing the system against the numeric targets?

…and what about quality?

This NZ research is not an isolated or even new incident. John Seddon has been following, and challenging the fallout from target setters for many years, across the whole range of UK public sector services. Many of his findings are comedy and yet scary at the same time.

Any target-setter should have no surprise by the resultant behaviours of process performers and their managers, such as to:

  • Avoid, or pass on difficult work;
  • Attempt to restrict work in the process, by:
    • making it hard to get into the process; or
    • throwing them back out (‘they didn’t do it correctly’); or
    • inventing new ‘outside the target’ queues earlier in the process
  • Applying the ‘completed’ stamp as soon as possible, and often before the customer has reached the end from their point of view;
  • Earn easy points, by doing things anyway when not strictly necessary…because it will count towards the target

The target-setter has created a ‘survival game’ of ‘how can we make the target’ which replaces ‘serve customer’.

So what to do? How about adding on layers of compliance reporting and inspections to police the process, to spot them doing ‘naughty things’ to meet target and punish bad behaviour…that should work, shouldn’t it?

Thus the battle lines are drawn, with the customer suffering in the cross fire.

Of note, the Press article goes on to explain that the Government target of 6 months is soon to be reduced to 5 and then 4….because, obviously, adding more pressure on them will motivate them to improve!???

What about if we replace numeric targets with capability measures (which measure the capability of the process against the purpose of the system)….and then used these measures to help us improve.

We can laugh (or cry) at the public sector comedy…but let’s not forget what we do with targets in our own organisations.

Stating the obvious!

Copy-of-dumb_blondeIt is really easy for any leader to say “I want…

  • Continuous Improvement;
  • Removal of waste;
  • Reduction in failure demand*.”

(* explained in my earlier marbles post here)

All are sensible, in fact obvious! But it’s a bit like a financial advisor telling you to ‘buy low and sell high’…what have you actually learned that you didn’t already know, and how does this help?

It’s much harder to understand the system conditions (structures, policies, procedures, measurement, IT), and underlying management thinking (beliefs and behaviours) that protect the status quo, create the waste and cause the failure demand….because you have to change your thinking!

“We cannot solve our problems with the same thinking we used when we created them.” (attributed to Einstein)

If you:

  • set numeric activity targets to make improvements…
  • …and offer rewards for their achievement…
  • …and rate (and rank) people’s performance against them…

…then you haven’t understood (or accepted) about systems, measurement and motivation.

To quote from John Seddon:

“Treating improvement as merely process improvements is folly; if the system conditions that caused the waste are not removed, any improvements will be marginal and unsustainable.

The original marbles

blue_marble_closeup_sjpg1676For those of you who have attended a particular course that I run, I hope you remember the marbles!

For those of you who haven’t (yet) attended, then this post should cover the point nicely.

I try to be mindful of the source of everything that I use (no, really, I’m not making it all up…I am trying to stand on the shoulders of giants) and, with this in mind, I wanted to share with you the link from which the marbles presentation comes from…it is well worth a quick read!

Now, before you go there, it’s worth bearing in mind that the blogger (ThinkPurpose) has a particular ‘mess with your head’ style of writing (which I really like…you’ll see what I mean the more posts you read!).

…so, here it is: post.

If you look at each marble that is being listened to, you can see that they can easily be converted to the same/ similar types of demand we receive in our organisation.

Now, ThinkPurpose is him/herself (?) standing on the shoulders of John Seddon and his original definition of:

Failure demand is demand caused by a failure to do something or do something right for the customer…which is created by the organisation not working properly…which is under the organisation’s control.”

“…in service organisations, failure demand is often the greatest source of waste.”

Going forward I’d love to hear about people seeing, studying, and talking about their marbles!!!

Finally, it was recently put to me that ‘isn’t failure demand just another way of explaining the waste of re-work?’. My response is ‘no, but there may very well be a relationship between the two’. My explanation to show they are different is as follows:

On the one hand: You might spot an error, perform some re-work to correct it and do this without the customer’s knowledge/ attention…and thus avoid failure demand (the customer contacting you).

On the other: You might receive failure demand without this requiring re-work of what’s already been done:

  1. ‘where is my claim’: doesn’t mean that there is necessarily anything wrong with the work that has been done so far…it just might be ‘stuck’. To handle this failure demand requires new yet avoidable work to:
  • handle the customer’s request (e.g. the phone call), look up the claim details, make enquiries, work out what is happening;
  • expedite the claim so as to be seen to be ‘doing something’ for the customer
  • get back to the customer with well thought through and carefully crafted explanations and ‘platitudes’
  1. ‘why haven’t you done this to my claim’: doesn’t necessarily mean that previous work has to be re-worked. It requires new yet avoidable work to:
  • handle the customer’s request as per the above; and
  • perform further actions that:
    • should have been done, but weren’t; or worse
    • are now required but wouldn’t have been if it had been done right in the first place.

Either of these examples of failure demand might prompt an element of re-work, but they will always require new work.

Shonky experiments

chemikWhat’s the definition of an experiment? The Oxford English dictionary provides the following:

  • A scientific procedure undertaken to make a discovery, test a hypothesis, or demonstrate a known fact
  • A course of action tentatively adopted without being sure of the outcome

So an experiment can be about testing a hypothesis (i.e. you are predicting the outcome), and it can be about studying a ‘what if’ scenario where you don’t have a specific expectation of what the result will be. Further, some philosophers of science hold that an experiment can never prove a hypothesis, it can only add support.

To be valid, the experimenter must:

  • have a meaningful and robust method of ‘before’ and ‘after’ measurement: you need to be able to objectively study the outcome;
  • have a valid method of isolating the variable(s) being considered: there’s not a lot of point testing something whilst there are lots of other changes going on as well;
  • neutralise any potential biases: you need a truly open mind…bear in mind that the human being irrationally looks for evidence that supports its current view and, conversely, ignores evidence that does not.

Okay, so how is this relevant to an organisation trying to improve?

You are not performing a valid ‘experiment’ if you are simply ‘testing’ how to implement something you have already decided, and then ‘learning’ how to adjust its implementation so as to roll it out more efficiently.

The ‘Act’ within Plan-Do-Study-Act does not mean Implement…it means take the relevant actions that arise from your scientific study of the outcome of your well planned and executed experiment.

‘Act’ might mean:

  • adopt the change; or
  • abandon the change (e.g. reverse it to arrive back at the original condition), or
  • adapt the test (because you learned something important that needs adjusting); or
  • expand the size of the test (because you need more evidence to conclude)

A reminder of a quote by some dude called R Buckminster Fuller (nice name!):

“There’s no such thing as a failed experiment, only experiments with unexpected outcomes.”

Remember that the PDSA ball should be continually rolling. It isn’t about one grand experiment that purportedly ‘solves all our problems’ by transforming us to a new state. It is about constant experimentation by the joint efforts of those charged with managing a process and those who perform it.

As a closing comment: Why might people be keen to jump to conclusions rather than have an open mind? It might be worth considering the management instruments which are being used upon them (M.B.O, targets, contingent rewards, the rating and ranking of people’s performance).

Don’t feed the animals

dont feedWe’ve all seen the signs in zoos, domains, at car parks in our national parks…and we understand the point, even if we haven’t considered it deeply.

So…let’s consider: why shouldn’t we feed the animals?

  • We stop them thinking for themselves: they become fat and idle, expecting the food and gorging on it as and when it is delivered. They come to expect it, even knowing when the feeding times begin;
  • We alter, and harm, their natural abilities:
    • they lose their motivation of solving their feeding needs for themselves and of real satisfaction with their successes
    • even worse, they now take on new behaviours
  • They become dependent on us: once reliant on us, if we take the food away there will be a period of confusion and likely pain;
  • We create un-natural competition in what used to be a structured independent community: we witness the fighting at the artificial food source;
  • Often, the food we give them isn’t healthy for them and certainly not as healthy as what they get in the wild…we try our best to imitate it but it’s never the same thing;

…we become their keeper, they lose their instinctive capabilities. We no longer witness all the wonderful things that they are capable of. They submit to our control.

I am really using an analogy for contingent rewards: the offering of something on a contingent basis in order to (attempt to) control how someone acts…which makes these rewards extrinsic by definition.

What do we try to do instead?

  • We attempt to safeguard, or provide (if it has already been destroyed) a natural environment in which the animals can thrive!

So how do we treat people in our organisations? Now, to be very clear, I am not putting you or I ‘above’ anyone by writing this post. I am but one of the animals in an organisational system, just like you or anyone else.

If contingent rewards are being used then the Board determine how to feed the Executives at the top, whilst managers handle the feeding of the process performers at the customer interface.

The point is that contingent rewards will have highly undesirable effects!

It’s worth noting that animals can be successfully introduced back into the wild, to become amazing again! Whether this is successful will depend upon how severe the dependence has become and the effort (both time and expertise) put into undoing this.

The analogy is not perfect but I hope you see the point. Clearly, animals in the wild are dependent on their natural habitat for survival and nature isn’t always kind. Consider that our natural food of choice is to be intrinsically motivated in what we do…and, given the right habitat we can thrive!

Change – just suck it up!

dui-law-changesBeing a pom, I hadn’t heard the ‘suck it up’ phrase until I came to New Zealand. I find it quite amusing…I particularly like some of its derivatives like ‘harden up’ and ‘take a concrete pill’.

Obviously it isn’t always appropriately used but it reflects an attitude of ‘stop whinging, it is what it is – just get on with it’.

So, when I hear the oft quoted remark that ‘change is the only constant’ (or such like), I note that this is used (in various guises) by ‘leaders’ to basically say ‘just suck it up’. A re-organisation is a classic example when it is brought out of the ‘communication’ drawer.

Consider the opposite though, that human beings are creatures of habit and resist change. Professor Rosabeth Moss Kanter sets out reasons for why this is so, and I pull out/shape some of these below:

  • Loss of control: interfering with our desire for autonomy
  • Excessive uncertainty: major change feels like walking off a cliff blindfolded
  • Sudden surprise: no time to consider (where a short ‘consultation’ period does not count as time)
  • Loss of face: we are likely to have a lot emotionally invested in the current state…we might even have designed parts of it!
  • More work: having to deal with the change (and it’s inevitable glitches because the new ‘grand plan’ can never be 100% thought through) on top of the real work
  • Upsetting the system: the change is likely to have knock on effects, disrupting other parts of the whole which could not have been foreseen.

So there is clearly a paradox, a herculean rub here: We are being told to constantly change, yet we don’t like change!

Now, the command-and-control response is typically to introduce a ‘Change Manager’ to the mix to grease the change through the lumps and bumps in the way.

But what if the combined ‘manager – process performer team’s constant state was of one in which their job was to continually change the system they work in, for the good of the customer…rather than having this done to them.

Mike Rother, in his excellent book Toyota Kata contrasts two types of management thinking in respect to making improvements:

  1. normal daily management + improvement (where process improvement is a separate add-on activity, often wrapped up into projects to be carried out by other teams and then ‘rolled out’ to the process…often requiring significant ‘change management’)
  2. normal daily management = process improvement (where improving and managing are one and the same, where the changes are identified, tested and then ‘rolled in’ within the system…which virtually strangles the need for ‘change management’)

For us to crush the ‘change’ paradox, we need to move from a command-and-control environment in which the change is dictated to the system to a systems-thinking environment in which the changes come from within the system.

If we re-examine the reasons for fearing change, we can see that most dissolve away when:

  • the ‘manager- process performer team’ are in control of improving the process;
  • …which means we have replaced excessive uncertainty with controlled sequential experiments;
  • …with no surprise as to what is coming (they, after all, are masters of this);
  • …meaning that they own how they build upon what they have already done, for the good of the customer;
  • …such that these improvements are part of the work, not extras imposed upon them;
  • …with all experimental results studied to learn their effect on the system BEFORE action is taken.

How do we successfully do this? To start, we need to critically examine our management thinking.

IT and Improvement

Bruce_the_Shark_by_hayn“Asking a consultant if you should….put in a new computer system is like asking a hungry Great White Shark if the water is warm and you should go for a swim.” (Seddon quoting Craig, D and Brooks, R)

We all know about the wonders that can be achieved through technology…we also know the massive pain that we can suffer from trying to jump on/ implement the next ‘big thing’.

Another quote that fits well in this space:

“IT marketing is more hyped than next season’s fashion colours and the MTV awards combined.” (Unsourced)

John Seddon contends that the problem with IT is with the way we approach it, this being something like:

  • We see some potential ‘holy grail’ dangled in front of us that seems to play to our symptoms;
  • We write some specification of what we think we need/ how we might use the ‘shiny new thing’;
  • The IT provider then takes this, re-writes it in their own version (a straight jacket if you will) and then delivers against this;
  • …which then fails to deliver against our actual reality (which only now we begin to properly understand…but this is now too late);
  • …so the supplier blames our original specification;
  • …and succeeds in selling more ‘implementation consultancy’ to ostensibly ‘put matters right’ or, at the risk of being cynical, ties us further into the abyss of their technology.

Seddon proposes that our approach should be to “understand and improve – then ask if IT can further improve.”

  • Understand: Ignore IT. Do not even assume the problem, or solution, has anything to do with IT. Instead, work first to understand the ‘what’ and ‘why’ of current performance as a system…which means learning about demand, capability, flow, waste…and the underlying causes of waste;
  • Improve: Improve performance without using IT to do so. If you currently use IT, either leave it in place or work without it. Now, improve doesn’t just mean the process…it very often means the management system surrounding it;
  • Ask ‘can IT further improve this system?’: It is only now that you can address the benefits that potential IT counter-measures can bring because you are asking from a true position of knowledge about the work. This is IT being ‘pulled’ into the work rather than dictating the method (“the way the work works”).

And, throughout all of the above, we should be measuring the capability of the system against its purpose (from the customers’ point of view) and can then consider whether each change in method (including the use of IT) has in fact been an improvement.

Now, an obvious chicken-and-egg question arises here: ‘…but don’t I first need IT to measure capability?’. A couple of thoughts in reply:

  • You don’t need IT to capture the demand trigger point and its satisfaction point….though it is likely to make it much easier – the same ‘understand, improve and then ask if IT can further improve’ applies to IT reporting. Before touching IT for reporting, you need to understand what you should be measuring. I have seen most IT implementations deliver a suite of out-of-the box reports that do not measure capability;
  • Even if your IT ‘solution’ delivers you such measures, you need to understand whether they are being distorted by the process performers due to the effects of the management system on their behaviours? …perhaps this needs focus first?