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10 September 2009 • 7:00 am

Best Practice in Best Practice?

U.S. President Barack Obama delivers his speech on healthcare. REUTERS/Jason Reed

U.S. President Barack Obama delivers his speech on healthcare. REUTERS/Jason Reed

U.S. President Barack Obama gave his highly-anticipated speech on health care reform to a joint session of the U.S. Congress and a national TV audience yesterday evening. For those outside of the U.S., speeches to both houses of Congress are relatively rare (except for an annual ‘state of the union’ address), and this speech marked a crucial point in the intense health care reform debate that has been raging here for the past several months. I am sure that several other bloggers have already or will shortly provide their take on the speech itself, so I will spare you my own interpretation. But Obama used the ‘best practice’ term to describe a couple of U.S. regions in which per-capita health care costs are both significantly lower than average, while quality of care and outcomes are better than average (a theme in a New Yorker article I reviewed over the summer), in his desire to improve the cost and quality of health care across the country.

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28 August 2009 • 7:00 am

The Case of the Undermined Change Program – Part V

In Parts I through IV of this case, I recounted the history of an engagement I had several years ago with a particularly challenging client, WorldCo, a division of a large U.S. corporation. We met Reggie, the head of the WorldCo division, Karen, his head of strategy, and Linda, Karen’s deputy (all names and some details have been changed). Please read Parts I, II, III, and IV  now if you haven’t done so already.

The afterglow of the strategy map workshop didn’t last very long. Working closely with Linda, the next step was to recruit people in the WorldCo organization to identify prospective measures for the strategy map objectives. This process was designed to require minimal participation from leadership team members – the work was to be delegated deeper within the WorldcCo organization.

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27 August 2009 • 7:00 am

The Case of the Undermined Change Program – Part IV

In Parts I through III of this case, I recounted the history of an engagement I had several years ago with a particularly challenging client, WorldCo, a division of a large U.S. corporation. We met Reggie, the head of the WorldCo division, Karen, his head of strategy, and Linda, Karen’s deputy (all names and some details have been changed). Please read Parts I, II, and III  now if you haven’t done so already.

It would have been so easy for the workshop to have been awful. Forty-five executives and managers instead of the promised nine, many of whom had no advance understanding of what was going on. A not very cohesive leadership team, with at least some evidence of rivalry and political intrigue among them. Some open skepticism about the process (although this was typical), and an organization whose culture seemed to be all about impatience. And in me, a somewhat rattled facilitator.

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26 August 2009 • 7:00 am

The Case of the Undermined Change Program – Part III

In Parts I and II of this case, I recounted the history of an engagement I had several years ago with a particularly challenging client, WorldCo, a division of a large U.S. corporation. We met Reggie, the head of the WorldCo division, Karen, his head of strategy, and Linda, Karen’s deputy (all names and some details have been changed). Please read Parts I and II now if you haven’t done so already.

Each of the many dozens of strategy map workshops I have facilitated in my career has been different, but they have all been exhilarating. For up to eight hours, I (and typically a colleague) guide a group of executives to construct and agree to a concise yet richly detailed expression of the strategy for the organization (read more about the art and science of strategy map design). With only a few exceptions, executives emerged from their efforts highly satisfied with the result of their efforts, and energized about strategy execution.

Over the years, my colleagues and I have developed an understanding of the ingredients for a successful strategy map session. All members of the leadership team in attendance, and fully engaged (e-mail and telephone calls only permitted on breaks, no laptops or PDAs allowed). No more than about fifteen people in the room. A carefully developed draft strategy map that has been previewed with the leader of the organization. The pacing of the discussions that enhance and revise the draft map must be carefully managed, and it is important to “read the room” to sense when it is time to seek closure on a discussion.

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25 August 2009 • 7:00 am

The Case of the Undermined Change Program – Part II

In Part I of this case, I recounted the history of an engagement I had several years ago with a particularly challenging client, WorldCo, a division of a large U.S. corporation. We met Reggie, the head of the WorldCo division, Karen, his head of strategy, and Linda, Karen’s deputy (all names and some details have been changed). Please read Part I now if you haven’t done so already.

As I requested, Linda accompanied me to each of the interviews, and was able to provide valuable context and insight into what was revealed. Some members of Reggie’s leadership team were enthusiastic, and well informed about the intent of the program, but at least a couple of them had no idea what was going on, and seemed especially impatient with our use of an hour of their time for the interview. All knew of the upcoming full-day kick-off and strategy map workshop, but some were clearly skeptical. Linda wasn’t surprised. She told me that Reggie rarely met with his team as a whole, and that each of those managers was operating fairly autonomously. There were also some mild rivalries among those team members. Reggie was seen by Linda and others as having a “hands-off” leadership style.  

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24 August 2009 • 7:00 am

The Case of the Undermined Change Program – Part I

Current events in the U.S. have reminded me of a rather challenging client I had several years ago. Although all of the names and some of the details here have been changed to protect the identity of the client organization and individuals involved, it is very much a real experience, and sadly, not all that unusual in the annals of balanced scorecard programs.

Our firm was approached by Karen, the energetic and charismatic head of strategy for WorldCo, a major division of a large U.S. corporation whose name would be instantly recognizable to anyone reading this case. Her mission was to implement balanced scorecard in WorldCo as the basis for a strategic management system, and as a tool to drive an overarching strategic change program. She had proposed the idea and earned the blessing of the division head Reggie, an executive who appeared every so often in favorable interviews about leadership in business periodicals.

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20 August 2009 • 7:00 am

Saul Alinsky’s Rules for (Consultants)

Saul_AlinskyOne of the most memorable books I was required to read in graduate school was Saul Alinky’s Rules for Radicals. The class, as I recall, was called “Power and Politics in Organizations,” and Alinsky’s slim yet compelling text stood out among the three or four books my classmates and I had to complete during the ten weeks of that valuable class.

Saul Alinsky was born and raised in Chicago, where he became known for his organizing of meatpackers and later, civil rights groups. He is generally regarded as the originator of the term “community organizer” which was front and center in the rhetoric of last year’s U.S. presidential campaign – Alinsky’s teachings and writings influenced Barack Obama’s community organizing work in Chicago. Alinsky has always been a polarizing figure, even 37 years after his death in 1972. In the opening lines of Rules for Radicals, Alinsky wrote,

“What follows is for those who want to change the world from what it is to what they believe it should be. The Prince was written by Machiavelli for the Haves on how to hold power. Rules for Radicals is written for the Have-Nots on how to take it away.”

Alinsky wasn’t subtle, nor was he deferential. In plain language, he expressed his passion for change, and generations have learned from his wisdom.

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27 June 2009 • 12:29 pm

Economist: U.S. Health Care Reform is ‘Going to Hurt’

Today’s brief (some might say lazy) Saturday post points you to a concise piece in The Economist, an esteemed publication I admire for the quality of its writing, if not always for it’s political views.

What distinguishes The Economist’s writing from all of the noise and posturing is both its incisiveness and its moderation. Their introductory piece is a worthwhile five-minute read that summarizes the key issues without getting bogged down in rhetoric. And their Photo-shopped picture of Barack Obama might make you smile.

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24 June 2009 • 8:05 am

SUVs and the Law of Unintended Consequences

SUVs have become an icon for the regret some of us share for our recent history. Their inefficient use of fuel has increased U.S. dependence on foreign oil, and shrinking demand has pushed the once mighty U.S. auto industry and economy to the brink. SUVs were popular because people felt safe in them. But they were wrong.

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11 June 2009 • 6:22 pm

Required Reading in the White House

The New York Times reported this week that a recent New Yorker article on health care spending has become required reading in the White House, and that President Obama referred to the article in a briefing on health care reform with Democratic senators. The article, which is a lengthy but very worthwhile read, was written by Atul Gawande, who is both a staff writer for the New Yorker and general and endocrine surgeon at Brigham and Women’s Hospital in Boston. Along with President Obama, I recommend this article to anyone interested in the likely changes to U.S. health care policy that is on the political horizon.

Gawande’s article follows his curiosity and research into regional disparities in health care spending; why some places spend far more (per Medicare enrollee, an approximation of overall spending) than others, without significant differences in overall public health or patient outcomes. His research focused on the town of McAllen, Texas, “the most expensive town in the most expensive country for health care in the world,” where annual Medicare spending per enrollee (in 2006) was around $15,000, almost twice the national average.

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