Category: Knowing-doing gap

  • Repairs at the Cleveland Clinic

    Please forgive my vague post a couple weeks back saying that Work Matters would be silent for a few weeks, but I wanted to protect my family's privacy as I had a serious health matter to deal with.  I am glad to say I on the mend and (slowly) getting back to work far more quickly than expected. 

    On April 6th, I had open heart surgery at the renowned Cleveland Clinic to fix a leaky aortic valve.  This problem was detected about five years ago and my doctors have been keeping an eye on it since then.  Essentially, the problem was that my valve was leaking badly enough that about 50% of the blood that it pumped out was leaking back in.  This is probably something I was born with that just got worse over the years.  I was without symptoms, and in fact, until a just a few days before the surgery, was riding my bike through the hills around Stanford for a good 90 minutes at least 5 times a week — in part I kept of the exercise because, as my doctors advised, the better shape I was in going into surgery, the better shape I would be coming out.  It was also crucial to maintaining my mental health. But as there was eventual risk of heart failure, my doctors helped me make the decision to have the surgery before any irreversible damage occurred.  I was also pleased to discover from various other tests that (despite my family history of blocked arteries and an imperfect diet and other health behaviors) my coronary arteries were clear and so there is no indication I will need anything stents or a bypass in the foreseeable future and that the repair should last a long time.

    Patients First logo FINALa I went through a fairly complex decision process with numerous conflicting opinions about whether to do it at Stanford or Cleveland, whether to wait or do it now, and what kind of valve to have (tissue –usually from a cow or pig –or mechanical).   I decided on Cleveland because they do so many more of these surgeries than Stanford and, as I decided on a tissue valve, they especially do far more of those (perhaps 1000 a year) than other places — and volume is among the main predictors of surgical success. I also was impressed by their low mortality and complication rates and that they simply seemed generally more organized than Stanford.  Of course, their are many great places to get heart surgery, and Stanford is one of them. but I was more comfortable with Cleveland.  So, although I never thought of myself as a medical tourist, there I was, fitting the definition perfectly.  Fortunately, my Stanford insurance appears to apply in Cleveland as well as it would in California.  I would describe the Cleveland Clinic as a kind of heart surgery factory. but one where nearly every employee we met, from the people who cleaned the floors and rooms, to the dedicated nurses (especially Amanda, Theresa, and the rather magical Virginia), to the cardiologists and surgeons, where competent and compassionate.  Many employees at the clinic wear buttons (see to the left) that say "Patients First." If my experience is representative, this isn't just hollow talk, that saying guides and reflects how people at the Clinic think and act.

    I am especially grateful to my surgeon, Dr. Gillinov Marc Gillinov (pictured to the left).  Dr. Gillinov is surrounded with a team that worked together to keep track of the big
    picture and little details associated with each patient — which I found most comforting as in too many hospitals information flow is remarkably bad.  Gillinov
    also operated on Robin Williams, doing a very similar operation, cow valve and all.
      Check out this video of Robin Williams on
    Letterman talking joking about the surgery… at one point Robin does an imitation/paradoy of
    Gillinov’s voice that is pretty spot on: 
    http://www.youtube.com/watch?v=6IhaAC4dN2Q  
    Not
    only is Gillinov
    quite famous on the traditional
    measures used to judge surgeons (experience, awards, publications in peer reviewed journals) and well-loved by those who work with him (rather than respected but deeply
    feared and disdained for his narcissism, which a
    re hallmarks of
    too many other
    world-class surgeons),
    he has a child-like enthusiasm about
    practicing his craf
    t.
    Dr.
    Gillinov  seems to bounce around the hospital spreading
    positive
    energy — one of is colleagues said her nickname for him was "Sparky."
      He loves his job as much as anyone I ever met —  the last time I encountered that same level of dedication, joy, and pursuit of perfection all in one package happened several years back when a group of us
    interviewed Brad Bird, Pixar's Academy Award winning director.
     

    Croke_225 I also want to give a huge thanks to my primary care doctor in Palo Alto, the amazing Jeffrey Croke (pictured to the left), who first detected the problem and provided clarity at a key moment when I was receiving conflicting opinions  and to Dr. Erik Price, my cardiologist in Palo Alto, who is better at explaining things than anyone I have ever met.  I was helped by so many doctors and nurses at Cleveland, and was sufficiently delirious much of the time, that I can't remember them all (I mentioned a few by first nake above), but I want to mention and thank Chris Webb, a Cardiothoracic Nurse Practioner who did such a great job of keeping track of my case as a whole and Dr. Colleen Koch for special help getting a great cardiothoracic anesthesiologist Michelle Capdeville My brain seems to be working just as well (or some would say just as badly) as before the surgery.  For this kind of surgery,  where I went on the heart-lung machine,  a big part of the anesthesiologist's job is to protect the brain.  And I was especially taken with the Dr. William Stewart, a cardiologist at Cleveland who showed remarkable wisdom — especially  the ability to treat me as a whole person rather a collection of symptoms.  I will eventually do a post about just Dr. Stewart, as I found him to be such an exceptional human-being.  

    Perimount I don't want to leave the impression that every thing went absolutely perfectly, that I was the perfect patient, or that the people at Cleveland are without flaws.  None of that is true, as I have more than my shares of human flaws, the Clinic is a human organization, and as in all places, some people are stronger and more caring than others. I also  can't assure anyone that they will have as positive an experience at Cleveland as I did — there are always risks and variation across cases.   But for me, the experience (and so far the outcome) have turned out better than I ever hoped.  Today, just two weeks after surgery, I feel far better than I ever thought was possible at this juncture.   This is serious surgery as they crack open your chest, put you on the heart lung machine, stop your heart, cut out (and repair) the bad parts and put in new good ones.   In my case, I have a new aortic valve that that is built around a cow's valve (see the picture to the left) and they also did repairs to the "aortic root"  by replacing much of the tissue with Dacron.  I have some aches and pains and am taking some pain pills.  But I am up and around, able to work three or four hours a day, and have
    done a 45 minute walk each of the last two days (with a little rest in
    the middle).  And my mind feels quite clear — although in evaluating this post and other things I write (as I slowly return to work) in the coming couple weeks, please keep in mind that they are written by a man who is slightly stoned on Oxycondone

    Thank so all of you who wrote comments and nice personal emails in response to my post saying I was out for awhile, and to my family, friends, and colleagues for being so supportive.  Please forgive me if I am a little slower to respond to things than is usual, as I am trying to pace myself.

  • NUMMI Story on This American Life

    Nummi

    I have been following the NUMMI plant (in Fremont California) in a haphazard way since it was opened as joint venture by Toyota and GM in the 1980s.  I have visited a few times and talked to lots of folks from GM, Toyota, and NUMMI since its inception.  As most of you probably know, the plant is closing on April 1.  It is just a shame for many reasons, the jobs lost, the failure of GM to learn what they should have from the joint venture, the feelings of helplessness and on and on.

    If you want to learn about the plant's history from its birth to (nearly) its death, check out the astounding episode of This American Life, a compelling tale of how it went from the worst of the worst GM plants (drug use and drinking were routine on the line, and you could buy sex in the plant — and the quality and cost numbers were awful), to how Toyota started the NUMMI plant (the only unionized Toyota plant in the country) with a workforce composed (85%) of the same people who worked at that awful plant, how they retrained them in Japan, how these same workers once put in a different system started making some of the highest quality cars in the U.S. — even the world –  from the day the plant opened, to all the twists and turns including how Toyota itself is repeating some of the same mistakes that nearly killed GM, and onto the near final sadness.

    I am a big fan of This American Life and I think this is one of their best episodes ever.  The lessons about the power of a good — versus a lousy — system are especially compelling, as is the rather pathetic tale of GM's inability to learn from NUMMI.  Their quality still trails behind most of the rest of the world now, over 25 years since the NUMMI plant opened.

    Fascinating stuff. I will start assigning this episode to my classes, there are so many great lessons and it is so emotionally compelling.

  • Boris Groysberg’s Research on Star Employees: Too Many Cooks Spoil the Broth

    I have written here fairly often about research by Harvard Business School's Boris Groysberg on the virtues and limits of star employees.  One of my posts described has delightful research that shows firms should steal superstar women, not men.  It turns out that when star men move to another firm, they tend to do a lot worse in the new setting.  In contrast, star women tend to sustain their performance when they go to another firm.  Groysberg suggests this difference is explained because women are more skilled at establishing new relationships and less likely to engage in dysfunctional internal competition in their new firms.

    Boris's new research is equally fascinating, a while back, he sent me an article he wrote with two colleagues called called "Too Many Cooks Spoil the Broth" (see complete reference below). They studied over 6000 industry analysts from 246 research departments in Wall Street firms — these are people who write reports about the current and expected performance of firms, and who specializes in particular industries. Their reports predict future earnings for companies and contain recommendations about whether to buy or sell stocks.  As Boris and his colleagues show, some of these analysts are stars, selected by the Institutional Investor as being the top person in their industry and being picked as a star is worth hundreds of thousands of dollars in compensation.  The results of this research are interesting because, while some leaders might think that there is no such thing as having too many stars, Boris and his colleagues found a curvilinear relationship between the number of stars in a group and overall performance — so, having a few stars help, have a few more doesn't hurt (but doesn't help), but groups reach a tipping point where too many stars seem to dampen performance. 

    Groysberg and his colleagues suggest that the "too many cooks" problem happens because partly because, when a group is filled with individual stars, the dynamics degenerate because people devote excessive attention to the the internal status game and competition and hesitate to share information that may help the group as a whole, but will threaten their standing in the group.  In other words, when there are too many stars, people focus on what is best for themselves, see other top performers as people who are in the way rather than people they should help, and the overall performance of the team seems less important.

    This is just one study, but a quite rigorous one one.  And it adds for evidence to the claim that Jeff Pfeffer made in the The Knowing-Doing Gap that dysfunctional internal competition is one of the most vile impediments to turning knowledge into action in groups and organizations.  Once the game becomes "I win when you lose," the team or organization suffers.

    Here is the complete reference: Groysberg, Boris, Jeffrey T. Polzer, and Hillary Anger Elfenbein. "Too Many Cooks Spoil the Broth: How High Status Individuals Decrease Group Effectiveness." Organization Science (forthcoming). 

  • Is It Time for a Stupid Rules Contest at Stanford?

    I love my university, I've been treated far better than I deserve during my 25 plus years at Stanford.  But as much a I love it, I wonder if it is time for us to run something like a "stupid rules contest" here.  I once met the CEO of a large bank in New England who explained to me how they had made things much better by running such a contest and taking the suggestions seriously. For example, they got rid of a rule that people waiting outside a branch could not be let in until official opening time.  They changed things so, if it was 10 or 15 minutes before opening time and, say, people were waiting outside in the cold, employees could open the door and let them wait in the warm lobby.

    I don't want to mention any specific rules at Stanford, as I don't want to point fingers at any group or person.  But although no doubt each was developed and implemented with the best of intentions, it seems to me that they accumulate like barnacles on a ship, with one after another being added.  Each one slows down the process of teaching and research, and the old ones never seem to be removed.

    Perhaps a stupid rules contest here would help. I admire Stanford's leaders, so this is not meant to be an attack on any individual, I just think it is something that happens to organizations over time, and I wonder if it would be a good time to haul our organizational ship into the dry dock and scrape off some of those old barnacles — and perhaps some new ones we have grown to that make things harder to do than need be. 

  • “William Safire is on Hiatus,” New York Times, October 4, 2009

    Alas, the hiatus is permanent. I guess they missed their own obituary for
    him on September 27, 2009. I just read this is in The Sunday New York Times
    Magazine
    on page 14 at the bottom of the "On Language" column,
    which he wrote for years.  The best part is the title of the article that
    appears above, called "Error-Proof." 
    Apparently, the Times caught their error, or just have such a long
    production lead time that it was too late, as the online version indicates:

    Postscript: October 3, 2009
    MAGAZINE

    A note with the “On Language” column on Page 14
    this weekend refers to the absence of the regular columnist, William Safire.
    Mr. Safire died last Sunday, after some copies had gone to press.

    I know that print
    journalism is a tough business, but I did note that the new Economist,
    which I got in the mail Friday, also had an obituary for Mr. Safire. 
    Mistakes in life are unavoidable and there is
    no doing anything without making them, but this one cracked me up
    because of the name of the article that it appeared under (which is a very nice
    essay, by the way, on how the obsession with grammatical correctness is a
    "schoolmarm's hallucination"). I suspect the author, Ammon Shea is a
    bit horrified by all this, but I hope he also sees the humor and takes heart in
    that more people will likely read his column as a result.

  • Netflix Culture: An Amazing Slideshow

    This slideshow was on a number of blogs over the summer (see here) , but I wanted to make sure that everyone saw it and, frankly, to get a post here so I have a record of it.  Apparently, Reed Hastings, the amazing CEO of Netflix, put-up a set of 128 slides that is a "reference guide to our freedom and responsibility culture."  I realize that most 128 page slide decks are deadly dull, but this is an exception.  You may not agree with all their values and approaches, but on the whole I think you will be fascinated by the detail and thought.  Now, I have no inside knowledge of what it is like to work at Netflix, but if this is accurate, it is a pretty impressive company — frankly far more enlightened than most in Silicon Valley. 

    They also don't pull any punches, the second slide says that these principles only for salaried employees not hourly. Before laying out their values, they acknowledge that most companies are unaffected by their written values. After laying out their values, they end by saying that a related core value is to question actions that clash with the values. Indeed, that is the real test of any social norm, what happens when someone breaks it?  Are they applauded, do people look the other way, and when people speak-up against the violation do they get slammed?  Or do bosses actually listen and try to make repairs?  Indeed, if you are or were at Netflix insiders, I would love to know if this is hollow rhetoric or a real living and breathing social norm.

     I could go on and on, but this is such an impressive document, you will find many things to get you thinking.  I doubt you will agree with everything — I didn't, as there was a bit too much emphasis on superstars. Indeed, there was a lot of debate in the comments about that.  Of course, I did love the assertion that, unlike many companies, they would not tolerate brilliant jerks. So it is nice to see another company with an (albeit polite version) of The No Asshole Rule.

    Tell me what you think about the deck. I am probably going to assign it next year in my introduction to organizational behavior class and ask the students to write a little on essay on it.

    P.S. Thanks to Whitney and Yosem for telling me about this slideshow.

  • Wal-Mart and Girl Scout Cookies: Thin-Minty Gate

    One interesting thing that happened while I was on vacation was the news that Wal-Mart is test-marketing imitations of the two best-selling Girl Scout cookies, Thin Mints and Tagalongs.  To get a "flavor" of the reactions to this move, check-out the post that CV Harquail did on her blog Wal-Mart Knocks-Off Girl Scout Cookies.  And see CV's follow-up post Thin-Minty Gate. Over 150 people commented on the first post and this news has spread far and wide.  As regular readers of this blog know, I am biased in this matter because my wife Marina Park is CEO of the Northern California Girl Scouts. My view (and I am not speaking for Marina, in fact, I didn't tell her I was writing this post) is that — holding things aside like ethics, financial damage done to the Girl Scouts, and other things that harm outsiders — this is a dumb business decision for Wal-Mart, and the real mystery is how the smart people at Wal-Mart (and they are smart and decent human-beings) could do something that:

    1. Further fuels their reputation as one of the most heartless and greedy companies on the planet (true or not, they are seen this way in many places).

    2. Damages their relationships in communities where they already have stores.  In many of those communities, Wal-Mart works closely with Girl Scouts to provide a place to sell the cookies in front of the store.  The weird dynamic of having very similar cookies sold inside Wal-Mart at a lower price may or may not hurt the cookie sales (because most of us realize that, after all, they are going to a good cause — allowing girls to go to camp, on trips, buy equipment for learning projects, supporting programs for inner-city girls and those in juvenile detention facilities, to pay remarkably dedicated and modestly compensated staff members, and on and on). But it clearly hurts Wal-Mart, creating the perception that they are going into direct competition with those girls and are acting out of pure greed.

    3. Makes it harder to open new stories. It turns out that when Wal-Mart wants to put a store in a community, there is organized resistance in about one third of cases and that, when it happens, this resistance is highly effective: the store is stopped about two-thirds of the time.  So, roughly, Wal-Mart fails to get stores where it wants in over 20% of cases as a result of resistance from communities.  And even when they do overcome the resistance, the fight costs them serious time and money.  In light of these facts, going toe-to-toe with Girl Scouts is sheer idiocy because it provides a compelling rallying cry ("Wal-Mart isn't only going to be competing with the local merchants, they are also going to undercut the Girl Scouts") that increases both the likelihood of resistance and the success. I have no access to the numbers, but I am willing to bet that if Thin Minty Gate results in the failure of even one store opening for Wal-Mart, any profits from the knock-off will not offset the cost of losing that one store.

    Perhaps the most interesting question here is how such smart people could do something that is so dumb.  It sounds more like an Onion story that a real story. I don't claim to  have deep or extensive knowledge of Wal-Mart, but we did work with some fairly senior executives from Wal-Mart several years back in one of our d.school classes (see here and here), and I was quite impressed with their action orientation and focus on cost-saving and efficiency.  The brilliance –and the Achilles heel — of Wall-Mart is that they talk and act as if the answer to every problem is to use their scale, bargaining power, and speedy implementation to tackle any problem by driving down the price they pay and pass it along to consumers.  This is great, for example, when they use their bargaining power to bring down the cost of environmental friendly LED lights in their refrigerators so that they become cheaper than traditional lights.  But when "everyday low prices" is the solution to every problem and — despite lip service to other constraints — almost nothing else drives your behavior even when it hurts you badly (as in this cookie caper), your core cultural values can hurt you badly.

    As far as I know, Wal-Mart hasn't announced that they are stopping the knock-offs.  My prediction is that they will come-up with some bullshit business reason to do so.  If they were smart (and there is research on this, on how to deal with mistakes, which we talk about in Hard Facts and I touch on  here and here) they would: 1. Confess it was a mistake, that they should have been more sensitive to the importance cookies to Girl Scouts; 2. Explain this episode has made them more sensitive to how pure business decisions need to be considered in light of community relationships and their corporate image; 3. Announce and take formal steps to show they have learned this lesson. 

    Let's see what happens.  My experience with Wal-Mart is that these are good people who mean well, they are extremely competent, but sometimes are blinded by their culture — this appears to be a case where they suffered from a severe knowing-doing gap that could have been averted by simply asking a few objective outsiders to react to what they were doing.   But asking others for honest feedback and listening to them is something that we human-beings often fail to do, despite the best of intentions. 

  • “Sir, we don’t actually do what we propose. We just propose it.”

    I just ran across an old UPS commercial on YouTube that I sometimes play when I give talks on The Knowing-Doing Gap and how to close the Smart-Talk Trap.  It is quite funny and quite true of many consultants, and I love the punchline: "Sir, we don't actually do what we propose.  We just propose it."  The commercial does a lovely job of making the point that knowledge without action is just as bad as no knowledge at all. I am sorry it is grainy, but I love the content and the acting.

    I should also confess that there are times when I am those guys in the commercial  –giving advice that I don't implement.  I do believe that there are times when businesses clients benefit from sound advice that they then implement themselves (Exhibit one here might be W. Edwards Deming's impact on the Japanese auto industry). But there are still too many times in business when people act as if once they hear and talk about a good idea, their work is done even if no one ever actually gets around to testing or implementing it. That is the disease that Jeff Pfeffer and I take aim at in The Knowing-Doing Gap.

  • Dependicitis

    'The situation when no one feels comfortable giving an
    answer other than "it depend
    s"

    This is similar to the
    "teeter-totter syndrome" in The Peter Principle, defined in their amazing glossary as simply the "inability to make decisions," in fact, I guess dependicitis is a special case — or root cause — of the teeter-totter syndrome.

    Thanks Xaio!

  • Dilbert and The Smart Talk Trap: The Dangers of Skilled Bullshitting

    44411.strip

    One of the main themes on The Knowing-Doing Gap is something that we call "The Smart Talk Trap," that there are too many times in organizations when executives, managers, and other people say smart things instead of doing smart things, and somehow after they have said all the right things, they feel so much better that they believe no other action is necessary or somehow their magical words will turn into action without having to do anything else.  Another variation is when bosses do seemingly brilliant talk, talk that they believe is brilliant too, and then — because they don't know what they are talking about — people either resist turning it into action or, when they try, it turns out to be impossible (I recall a stage gate system at one of my client's organizations that was impossible to use.)  Indeed, bad ideas of this last variety helped inspire Jeff Pfeffer and I to write Hard Facts because we kept dealing with organizations where people believed that they were doing the right thing, but we believed it was wrong based on the best evidence– they suffered from doing-knowing gaps, as we came to call them.

    The above cartoon is intriguing because it seems to reflect a case of skilled bullshitting leading to dumb action — and the bullshitter knows it is dumb.  Dilbert thought it he was talking about garbage, he just threw together a presentation to get through a meeting. Unlike many bosses and others who do this,however, Dilbert realizes his ideas are garbage — but now it seems they are being acted upon!  The only other thing I've ever heard like this in real corporate life happened with a talking Barney doll at Microsoft.  Here is the story from Weird Ideas That Work — note that like Dilbert, it was an idea that the team believed was bad from the start, yet somehow it was turned into action.  The extra twist was whether or not the product sucked, it was a commercial success.  This story was told to me in 2000 by Justin Kitch, CEO and founder of Homestead, a dotcom start-up that still exists and apparently was bought by Intuit.  I am also impressed to see that Justin is still CEO, and in fact, most of his founding team is still intact.   I have to learn more about what happened. 

    Here is the Barney story:

    Right after he graduated from Stanford,
    Justin went to work for Microsoft in a group that developed educational software
    for young children.  One day, Justin led a brainstorming session on “What
    would be the worst product we could possibly build.”  His idea was 
    “Let’s do that, and think opposite.  Think about what’s the worst
    characteristics it could have?  What’s the least educational thing we
    could do?”   The result was  “A talking Barney Doll, it was
    called Barney 1, 2, 3.  It was a Barney doll that talked to you and taught
    you numbers.   I still have the drawing.   I made it as a
    total joke and I gave it to my boss.” 


    To Justin’s dismay, Microsoft came out with pretty much the same product a
    couple years later.  He said  “I couldn’t believe it.  They
    built exactly what we brainstormed would be the worst possible product.” 

    Note that Justin seemed confident that “my
    team's little chuckle over Barney had nothing to do with the eventual project,” but
    others I talked to were less sure — in any event Justin made clear to me that he refused to take any credit for that "piece of shit."  This little incident and Dilbert’s cartoon suggest that you have to
    be careful who you show your silly ideas to – and in Justin’s case, the lesson is also that ideas
    that seem dumb may have more merit than you think – at least by commercial
    standards.

    P.S. The phrase "Smart Talk Trap" was actually invented by Suzy Welch, yes Jack's wife, when she was an editor at the Harvard Business Review and worked on a paper based The Knowing-Doing Gap. Suzy was a damn good editor.