1. Profiles in Courage (John F. Kennedy) - I read this book several years ago and really enjoyed it. Kennedy profiles several Congressional leaders in history that demonstrated what he called "courage", though he is really writing about leaders who demonstrated something that seems to be lacking in many political leaders today - integrity.
Life is all about metaphors and personal stories. I wanted a place to collect random thoughts, musings, and stories about leadership in general and more specifically on leadership and management in health care.
Thursday, December 31, 2020
2021 Leadership Reverie Reading List
1. Profiles in Courage (John F. Kennedy) - I read this book several years ago and really enjoyed it. Kennedy profiles several Congressional leaders in history that demonstrated what he called "courage", though he is really writing about leaders who demonstrated something that seems to be lacking in many political leaders today - integrity.
Top Ten Posts of 2020
Tuesday, December 22, 2020
Holiday Greetings
Saturday, December 19, 2020
"Leaders eat last"
Tuesday, December 15, 2020
"It's DoctorJill Biden!"
Wednesday, December 9, 2020
Don't be a crab!
The little girl asked, "Mister, why don't you cover your bucket so the crabs don't get away?"
The fisherman responded that he didn't need to cover the bucket. "The crabs won't get out. You see, if there was only one crab in the bucket, it would use its claws to grab the edge of the bucket and crawl out. But with all of these crabs in the same bucket, anytime one crab tries to grab the edge of the bucket and escape, the others pull it back down. They will all share the same fate."
Sunday, December 6, 2020
"The strength of the wolf is the pack..."
Perhaps not surprisingly, there's been a lot written in the management literature on teamwork. I recently came across an article that really peaked my interest. The article was written by a group of investigators from the Massachusetts Institute of Technology's Sloan School of Management. It was the title that caught my attention - "Establishing high performance teams: Lessons from health care." Please forgive me for being honest, but I wouldn't necessarily look to the health care industry for examples of great teamwork. So, I couldn't help myself but to take a closer look.
The MIT investigators, Michael Anne Kyle, Emma-Louise Aveling, and Sara J. Singer, studied 12 primary care clinics trying to focus on improvement and become high-performing, multidisciplinary teams. High-performing teams are foundational to organizations as they become high reliability organizations (HROs). These investigators identified three different approaches to establishing team-based care as part of a journey towards high reliability: pursuing functional change, pursuing cultural change, and pursuing both functional change and cultural change together at the same time.
Teams that focused on functional change only trained team members in quality improvement skills, such as PDSA cycles (plan-do-study-act), Lean/Six Sigma, and process improvement. By teaching everyone on the team the new skills of improvement, everyone would have the right set of tools to not only help with an improvement project, but also to lead an improvement project. Conversely, teams that pursued cultural change focused on improving communication, developing shared mental models, flattening the hierarchy, and being willing to accept failure and learn from it without fear of reprisal. Finally, some of the clinics pursued a dual approach, focusing on both functional change as well as cultural change.
Which approach was the most successful? It probably won't surprise you to learn that focusing on both functional change and cultural change together created the highest performing teams. When you think about it, we really shouldn't be surprised by these results. Functional change and cultural change, at least as described in the current study, are mutually reinforcing. You really can't have one without the other.
Wednesday, December 2, 2020
The Bridge Over the River Kwai Syndrome
Monday, November 30, 2020
The bicycle shed effect
Sunday, November 29, 2020
Dirigibles, the Windy City, and the Goldilocks Principle
Monday, November 23, 2020
Masks are kind of like marshmallows...
Sunday, November 22, 2020
The tale of the phantom reference
Van der Geer, J., Hanraads, J.A.J., Lupton, R.A., 2000. The art of writing a scientific article. J Sci Commun. 163 (2) 51-59.
Just to check out the article, I looked up the reference on the National Library of Medicine's PubMed website. Nothing. Occasionally, I've found that references cited in textbook chapters or research articles aren't always correct. So, I did what I always do in these cases, I looked up the first author. Nothing. There are six articles under the author "Van der Geer J" - not one of them refers to anything remotely close to an article on "scientific writing."
Thursday, November 19, 2020
Lincoln's Gettysburg Address
Wednesday, November 18, 2020
"There's no team without trust"
As it turns out, "who is on a team" matters a whole lot less than you think. What's really important is how the different team members interact. One of the most important variables was something called psychological safety. Timothy Clark (not at Google) defines four stages of psychological safety, in which humans feel (1) included, (2) safe to learn, (3) safe to contribute, and (4) safe to challenge the status quo.
Let's break those four stages down. First, everyone wants to have a sense of belonging or to be part of a group. As Clark states, "The need to be accepted often precedes the need to be heard." We want to be included. Recall one of my old posts about the "Jeep Wave" ("Why didn't you tell me about the Jeep Wave?"). I felt really great the first time a fellow Jeep Wrangler driver passed me and gave me a wave - it's great to share a group identity with others. Similarly, when we bring others into our group, we in turn give them a sense of identity and belonging. That builds respect and trust. And psychological safety depends upon mutual respect and trust.
Wednesday, November 11, 2020
Happy Veteran's Day 2020
Sunday, November 8, 2020
Another marshmallow challenge
Here is your list of supplies:
Saturday, November 7, 2020
"Make America Again"
Nope - not what you think. Not even close.
A good friend of mine tagged the following poem by the American poet Langston Hughes. It's a good one. And I think it fairly well describes what I am feeling right now. I am encouraged, and I am hopeful. I am ready to roll my sleeves up and get to work, because we have a lot of work to do to heal as a nation. Some of our wounds run very deep. Healing will take time. Langston Hughes says all of that much better than I ever could. Read and enjoy. It's called "Let America be America Again":
Wednesday, November 4, 2020
Are trick-or-treaters honest?
I wish I had found this article over the weekend! My wife and I were trying to decide whether we would offer Halloween candy to the neighborhood trick-or-treaters this year. She suggested that we put out a bowl of candy with a sign that said, "Be nice - take just one!" and not make the trick-or-treaters come to the door. I thought that would be okay, but my counter went something like, "Do you really think they will take just one?"
I assumed that we would find an empty bowl after the first group of trick-or-treaters. I should have read the weekend edition of the Wall Street Journal! The columnist and psychological guru, Dan Ariely was asked this very question and referenced a study that was performed in the 1970's.
The study was published by Edward Diener and colleagues in the Journal of Personality and Social Psychology in 1976. It's kind of a sneaky study performed in a real-world environment. Basically, "concealed raters" (think secret shoppers) monitored over 1,300 trick-or-treating children on Halloween. The study was conducted in only 27 homes - trick-or-treaters came to the home to find a bowl of candy bars and a bowl of pennies and nickels (devious!). The women answering the door would tell the children to take ONE candy bar (never mentioning the bowl of money) and would then leave the kids alone. There were a few experimental conditions to manipulate the situation even further. Some of the children were asked who they were, where they lived, etc (non-anonymous condition), whereas others remained anonymous (anonymous condition). Some of the children came to the bowls alone, while others came in groups.
The study investigators reported that 416 out of the 1,300 children took either more candy (65%), money (14%), or both (20%)! As anticipated, the percentage of children committing a transgression (stealing candy, money, or both) was significantly lower when a parent was present (But still not zero! Come on parents!). Children in groups or who remained anonymous were also less likely to commit a transgression. So, as it turns out, when trick-or-treaters are given the opportunity to take extra candy, they will do so!
I know - I am shocked as you are right now. But here's the surprise at the end of the blog post. The trick-or-treaters coming to the Wheeler household actually didn't take extra candy! Now, granted, we only had a few trick-or-treaters this year, but still. Right? Maybe there's hope for the future!!
Tuesday, November 3, 2020
(Mis)fortune
The ancient Stoic philosopher Seneca tells us, "I judge you unfortunate because you have never lived through misfortune. You have passed through life without an opponent - no one can ever know what you are capable of, not even you."
I've been thinking a lot about this quote today. I tend to be a fairly optimistic person, so I will start with the light-hearted anecdote first! Exactly four years ago yesterday evening (November 2nd), I was sitting in a hotel room in Washington, D.C. (due to an ill-timed business trip) watching Game 7 of the 2016 World Series. My favorite team, the Chicago Cubs, were playing in the World Series for the first time since 1945 - and as any baseball fan or Chicago native knows, they hadn't won the World Series in over 100 years (since 1908). They were playing the Cleveland Indians, another team with a famous amount of bad luck.
The game started off exactly the way I wanted it to do - the Cubs were playing well and their starting pitcher, Kyle Hendricks was dealing! By the bottom of the 5th inning, the Cubs were winning 5-1 and Hendricks was down to the last out of the inning. Hendricks walked the next batter, and Joe Maddon, the Cubs manager, made a decision (second-guessed by many still to this day) to bring in pitcher Jon Lester in relief. Lester came in a bit shaky, and after a throwing error by catcher David Ross and a wild pitch by Lester, the Cubs lead was down to 5-3.
David Ross hit a home run in the sixth inning (in what would turn out to be the final at bat of his career) to give the Cubs a 6-3 lead. Lester pitched brilliantly through the first two outs of the eighth inning, and Maddon made the decision to bring in his closer, Aroldis Chapman, after Lester gave up a hit. Chapman had pitched for more innings than he usually does in the previous game, and his fatigue showed. He gave up a double to make the score 6-4, and then a two-run home run to tie the game up. Cubs fans everywhere (this one included) couldn't believe it - would the Cubs blow it again?
Chapman came back to pitch in the ninth inning with the score still tied 6-6. He pitched great, and the game went into extra innings! And then it happened. The heavens opened up, and the rain came down (it wasn't actually as dramatic as that - it had been raining for a couple of innings by that point). A 17 minute rain delay. The Cubs came back to play and scored two runs in the top of the 10th inning to take the lead, 8-6.
Carl Edwards, Jr pitched in relief in the bottom of the 10th and retired the first two runners. The Indians scored a run to close it to 8-7. Maddon changed pitchers again, this time bringing in Mike Montgomery. Cubs third baseman, Kris Bryant made a great play to throw out the runner on first, and the world changed for the better. "Cubs Win! Cubs Win! Cubs Win!" I watched it all over again last night! What a great memory.
There was a lot that went wrong for the Cubs then, but they persevered and came through on top. I guess that's what Seneca meant. If you have never been faced with adversity, how can you truly know what you are capable of accomplishing? If you have never failed, how can you learn how to succeed?
Seneca would argue that we are truly fortunate when we experience misfortune. Therein lies one of the key paradoxes of Stoic philosophy. Misfortune is our fortune.
We are living through some difficult times. We are still dealing with a worldwide pandemic, and today is perhaps the most important presidential election in our lifetimes. I do think that, in the end, we will come out okay. We will be fortunate to have experienced the misfortunes of 2020. And we will truly know what we are capable of accomplishing.
Wednesday, October 28, 2020
LeeeeeeeeRoy Jenkins!
I've posted in the past about planning and preparation (for example, see "...plans are useless but planning is indispensable" or "Fools go aimlessly hither and thither..."). Over the years, a number of famous individuals have talked about the importance of planning and preparation too:
"It does not do to leave a live dragon out of your calculations, if you live near him." J.R.R. Tolkien
"By failing to prepare, you are preparing to fail." Benjamin Franklin
"Give me six hours to chop down a tree and I will spend the first four sharpening the axe." Abraham Lincoln
"If you don't know where you are going, you'll end up somewhere else." Yogi Berra
However, one of the most famous exampls of a failed plan comes from a video of a group of friends who were playing (I think) The World of Warcraft, a popular online fantasy role-playing computer game. The video was first posted on the fan site Warcraft Movies on May 11, 2005 and was later posted on YouTube the following November. The video has been copied and re-posted countless times (the most recent version with my link has over 16 million hits).
The video features a group of friends who meticulously plan a detailed battle for their next encounter. The character, Leeroy is away from his computer at the beginning of the video, and the plan is intended to help Leeroy obtain a piece of armor which everyone else seems to possess (so, the friends seem a little miffed with Leeroy anyway). At one point, the leader asks for a calculation on their chance of survival. However the survival probability is calculated, the answer is "32.33 repeating of course percent chance of survival." Once Leeroy returns, he rushes headlong into the battle, disrupting the whole plan. His friends follow him into the battle, and in the end, everyone dies!
It's a really funny video that illustrates what former President Dwight Eisenhower once said about combat, "Plans are useless but planning is indispensable." In other words, it's good to have a plan, but in the heat of the moment, some times those plans need to be changed.
I hate to disappoint you too much, but the video was apparently staged. Oh well - it's still quite amusing and it still makes a great point.
Saturday, October 24, 2020
"Remember, Orville Wright flew an airplane without a pilot's license."
Retired U.S. Marine Corps General and former Secretary of Defense, James Mattis reportedly onced told his troops, "Remember, Orville Wright flew an airplane without a pilot's license." I am not aware of the context in which he said this, so I can't say exactly what he meant. However, if you interpret General Mattis to mean that breaking rules and regulations is okay or that doing something that you aren't necessarily trained to do is perfectly acceptable, you would be wrong. Just read his superb book, Call Sign Chaos or spend 5 minutes with any Marine and you will quickly learn that this wasn't his meaning at all. What I believe General Mattis meant is that it is okay to stretch your boundaries and capabilities. In other words, innovation and progress ultimately necessitate taking a few risks. And we shouldn't be afraid to fail when we do take those risks.
The motivational speaker and author, Denis Waitley said it perhaps best when he said, "Life is inherently risky. There is only one big risk you should avoid at all costs, and that is the risk of doing nothing." The artist Pablo Picasso said, "I am always doing that which I cannot do, in order that I may learn how to do it." Finally, former First Lady and politician, Eleanor Roosevelt once said, "Do one thing every day that scares you."
All of these quotes are great - and they all have one thing in common. We have to be able to dare to learn. And we can only innovate and discover if we do learn. It's really a simple point to make, even if it is difficult to practice in real life.
There's a great story from Robert Iger's latest book, The Ride of a Lifetime: Lessons Learned from 15 years as CEO of the Walt Disney Company (it is awesome, by the way) about a meeting that Iger had with Pixar CEO Steve Jobs. The famous Disney Animation Studio was no longer making blockbuster hit animated movies - in many ways, they had stopped taking risks and were no longer seen as an innovative studio. In contrast, Pixar Studios seemed to have the magic touch, releasing hit after hit after hit. Disney wanted to buy Pixar, and Iger was meeting with Jobs in order to negotiate the purchase. Jobs was intrigued by the idea, but he wasn't exactly enamored with it either.
Iger met with Jobs at Pixar's corporate headquarters. They met in the boardroom, and Jobs had started the meeting off by listing the pros and cons of Disney purchasing Pixar (how many times have you made a similar list when making an important decision?). Iger writes, "Two hours later, the pros were meager and the cons were abundant, even if a few of them, in my estimation, were quite petty."
Iger told Jobs, "Well, it was a nice idea. But I don't see how we do this."
Jobs replied, "A few solid pros are more powerful than dozens of cons." In other words, don't be afraid to take a risk on something if there are strong reasons to do so - even if, as in this case, the cons appear on the surface to outnumber the pros!
We should not be afraid to sail in uncharted waters. As the American author, John A. Shedd said, "A ship is safe in harbor, but that's not what ships are for." That's not what we are for either - leave the harbor! Don't be afraid to take risks. Don't be afraid of failing - don't be afraid of learning.