Archive for 'General' category
- Health, Personal Change and My Blockbuster Drug
by Jim Kupel
Health coaches or navigators are a great idea – and one that has demonstrated results. But implicit in Scott’s recent blog is the idea of personal change. A navigator may get to know the patient’s personal and health goals, help identify barriers (e.g., childcare, transportation, family issues, and others), and help develop a realistic plan to the overcome the barriers and achieve the goals. But navigators can only help. We need to do the hard work ourselves. Patient engagement is at the center of changing the system.
So, if I have a chronic health condition and have been marginally compliant with what I know I need to do (lose weight, use less salt, etc.) what are the characteristics and activities of the navigator that will make me more likely to follow the care plan?
This is a very different approach for most of the health care system that has been reactive in nature.
While Judith Hibbard and others have been saying patient activation is central to improving healthcare for years, the idea has been rekindled by the meme that “patient engagement is the block buster drug of the century.”
Last week at Quality Counts 13, both Don Berwick and Rosemarie Gibson – in separate talks – repeated the notion from Leonard Kish’s blog last summer:
“… it’s surprising that it has taken us this long to focus on patient engagement because the results we have thus far are nothing short of astounding. If patient engagement were a drug, it would be the ...
- America's Changing Healthcare Landscape: Some Basic Points
by Scott Good
The landscape of healthcare in America is changing – like it or not. There are a myriad of proscribed changes, yet many of them revolve around a few key issues. One of the issues involves the elusive tripartite goals of improving health, enhancing patient experiences, and better managing costs.
Organizations such as the Institute for Healthcare Improvement (IHI, www.ihi.org) are implementing a number of initiatives to help organizations achieve the “triple aim” goals.
To help focus the discussion, let’s look at diabetes care. Over 11% of U.S. adults age 20 and older have diabetes, and 27% of seniors. The total cost of care is approaching $200 billion annually with about two-thirds for direct care and the rest for indirect costs such as lost workdays, restricted activity, and disability due to diabetes (www.cdc.gov/diabetes/consumer/research.htm). Care models – like those for most other disease states – typically involve a fee for service approach.
Projects, such as those being utilizing the IHI approach, are encouraging organizations to revise care models and take more of a population health, proactive approach. However, there are a myriad of operational and implementation challenges. For example, one of the often used strategies is to add case managers – or “navigators” – to help higher risk patients (those using the greatest percentage of services) adhere to health regimens. Yet, there are not many established evidence-based best practices for their use – not to mention a consistent definition of their role.
In this time of inevitable change, there is an ...
- Greater Good
by Scott Good
I just saw a headline that Pope Benedict XVI is resigning. I am not Catholic but being an “armchair researcher” of the development of early religious institutions, I find his resignation particularly interesting. The previous time that a pope resigned was about 600 years ago to help resolve the “Great Schism” between the papacy established in Rome and the one in Avignon, France. Without going into a lot of detail, I prefer to stay at about 30,000 feet. To me, regardless of any other factors, the pope who resigned in 1417 (Gregory XII), probably did so for the greater good of the church – most likely, as Benedict is also doing.
So why talk about this on a Crescendo blog? Well, it’s like this … More and more, we are seeing people do difficult things for the right reasons, and this gives me hope. We all know that the face of healthcare is changing (and probably education, soon too – but that will be in a future blog). Increasingly, physicians, payers, healthcare educators, and affiliated community groups are working together to improve patient care, enhance patient experiences, and better manage costs. These decisions to collaborate are difficult because they often threaten revenue streams or channels of power.
So are people making decisions like these because they are serving the greater good or because they realize that if they do not do so, they may be increasingly vulnerable to future changes? In the pope’s case, I say that it is for the greater good ...
- Getting Over It
By Beth Austin
With the new year comes new possibilities, new opportunities, and, of course, a slew of New Year's resolutions on which we will make varying degrees of progress throughout the year. People are generally used to making (and breaking) personal New Year's resolutions, but for business leaders, the list should also include goals for their organizations. One's personal and professional goals are often inter-related - and the process for successfully achieving the milestones is similar for both.
I was reminded of this once again last weekend in the midst of my efforts to make a change in my personal life. It's an important change that is long overdue and I just need to get over it already. I reflected a bit on why my particular issue had been going on so long and I realized that without conscious effort, our approach to addressing either personal or business challenges is often ineffectual. As a critical thinker who favors processes, I almost immediately got a visual in my head that looked something like this:
Cycle of a Failed New Year's Resolution
Since I'm blogging this right now, I can't gauge the reaction, but I imagine that if I shared this in a public forum it would be met with some sheepish looks and nervous laughter - along with chorus strenuous denials (see Step 1 above). So, how can this process improve?
Although one should always iterate, measure, and improve once a new process or behavior is put in place, it is ...
- Discipline, Gratitude and Thankfulness
posted by Jim Kupel
Strange as it seems, there is an incredible amount of thankfulness in the latest Ken Burns special on the Dust Bowl. As I watched, I saw the essential American juxtaposition of thankfulness and discipline. Dustbowl farmers were irate at their neighbors who didn't work hard to adopt good land management. Simultaneously they were incredibly thankful that their neighbors and the federal government could offer assistance.
The other revelation is that gratitude can also change our body chemistry and actually help us through our present difficulties. The Harvard Mental Health letter explains that "in positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships."
My eldest daughter, while far removed from the dust bowl, has shown me a simple, but much appreciated connection between discipline and thankfulness. She and her friends are using Facebook to share their thankfulness during this Thanksgiving season.
It reminds me of the three-blessings exercise described in an ABC story about how thankfulness is linked to positive changes in brain and body. "One of the most well-known practices uncovered from this research is known as the Three Blessings exercise," said Renee Jain. "Each night before going to bed you write down three good things (ordinary or extraordinary) that happened to you during the day. Studies reveal those who continue this exercise for one week straight can increase their happiness and decrease depressive symptoms for up to ...
- Tell Me More
Posted By Beth Austin
It's "Trade Show Season." Marketers out there will need no explanation for this, but for the rest of you, the fall is a busy time for many of us due the preponderance of trade shows and conferences that happen in September and October. This season has been a busy one for the folks here at Crescendo, as we have been attending shows everywhere from Bangor, Maine, to West Palm Beach, Florida and a number of places in between. Over the last couple of months, I've had the opportunity to present at several conferences and, as always, I'm reminded of what a great learning opportunity it is. Although it seems somewhat counterintuitive, but the times when you'd think I'd really be doing all the talking is when I get some of the best listening in. The reason for this is because of the one-on-one conversation and information sharing that follows a talk. Regardless of the subject matter is, attendees will always approach me after a presentation and share their story about the topic at hand. I find this part of the job to be the most rewarding.
These conversations provide a great opportunity to make a connection. Sometimes the information shared is no different than what we've learned from our research or what you might be able to find on the internet, but that person-to-person networking and the opportunity to "hear it from the horse's mouth" makes it all the more powerful.
One of the topics ...
- Solving the Economic Paradox
posted by Jim Kupel
A recent New York Times headline read: "Economy still weak, but more feel secure." This is an apparent paradox to many. I'm not sure it is all that much of a paradox. There may be a simple answer to the question of why the economy is growing slowly and consumer confidence is increasing solidly.
Could it be that Americans have adjusted their expectations and are getting along with their lives without listening to the media doom & gloom or looking towards the government to solve all their problems? We're looking hard for better jobs, helping our kids with their school work, and learning to enjoy life despite substantial difficulties.
I'm sure there are larger economic changes we don't yet understand, e.g. baby boomers retiring. But there is something we do know: Americans know how to push ahead with a good attitude despite lots of difficulties.
- America Works and Innovates
Posted by Jim Kupel
Edward Hopper was accurate in his portrayal of Americans. We are a thoughtful and serious bunch and for the most part we like to work and innovate. I have been thinking about Edward Hopper's portrayal of Americans since viewing an exhibit at the Bowdoin Art Museum. If you look at many of the people in his paintings - Office at Night; Nighthawks, Automat - you would not say they are happy.
My companions suggested that Hopper saw Americans as troubled. I disagreed and suggested that his paintings are realistic view of what we look like going about our lives. Part of their realism involves catching Americans off guard. In other words, it is as if Hopper captured our private moments in a number of settings and in doing so captured our countenance at the time. I suggested that most people don't go through their lives with a smile on their face, but that does not mean they are troubled.
To test my hypothesis I've been watching people in airports as I travel largely for work. Certainly there are exceptions - families on vacation and obviously having fun; travelers who are having a problem with their connections who are clearly upset. But for the most part people in American airports look serious and thoughtful regardless of whether they are traveling for work or pleasure or working in the airport itself as pilots, food service workers or gate personnel.
Hopper captured an essential component of the American psyche-we work. In a way it was ...
- Slow Down Now
Posted by Heidi Wurpel
If you are looking for an interesting read, go to the library and borrow Dan Ariely's Predictably Irrational. While the book is enthralling for many reasons and the implications of his research are incredibly far reaching, what truly fascinates is that in each and every experiment, he teases out how the two forces that pull most at humans - logic and emotions - are inextricably interwoven and can easily trounce one and other based on the framework of inputs and subtle cues that surround the decision.
As marketers, human resource professionals, and entrepreneurs we innately know that what we do makes a difference - that the inputs we create affect the outputs - however, sometimes in the day-to-day "To Do List" it is easier to get something done quickly in a typical format instead of carefully questioning why we are crafting our work as we are. Terrifyingly, Ariely shows that even the seemingly small choices we make (the boxes we ask people to check on a form, the number of options we present on a shelf, etc.) can have significant effects on how our employees and customers act.
His words of wisdom and mad-scientist experiments have made me realize that the most dangerous thing we can do as professionals is rush through even a seemingly simple task or decision. It is in our haste and heightened emotional states when we seem most susceptible to making predictably irrational decisions and creating inputs that encourage those around us to do the same. Hence, my advice for the ...
- America the Problem Solver
Posted by Jim Kupel
Reading Unbroken, the amazing survival story of Louis Zamperini, and watching the Clint Eastwood super bowl ad provide a sharp contrast to the recent Florida primary contest. The former remind us that Americans are problem solvers with a strong spirit of shared sacrifice.
Laura Hillenbrand's historical novel about U. S. POWs who survived being adrift in the Pacific for more than 45 days without food or water and then had to survive prisoner of war camps through the remainder of World War II is an incredible tale of American determination and problem solving. The book introduces dozens of American innovations during the War years that enabled us to succeed.
One of these demonstrations of ingenuity and determination occurred right across the harbor from our office. During World War II the shipyards in South Portland, Maine produced over 200 liberty ships. During roughly the same time period from 1942 to 1946 Boeing, Bell Aircraft, and the Glenn L. Martin Company built over 4000 of the B-29 "Super-fortress" aircraft that helped end the war.
Hillenbrand conveys the American spirit through the eyes of prisoners of war in Tokyo. "... the POWs looked up. There, so high that they appeared to be gleaming slits in the sky, were acres and acres of B-29s, 111 of them, flying toward an aircraft factory on the rim of the city. Caught in what would later be called the jet stream the planes were flying along at speeds approaching 445 miles per hour, almost 100 miles per hour faster ...
- Ted Talks and RSA Animates - What do you do?
Posted by Heidi Wurpel
TedX's "Ted Talks" and RSA Comment's "RSA Animate" are two incredibly popular websites from America and the United Kingdom that do essentially the same thing, in two different ways, with similar results. Both websites share a brief (less than 20 minute) presentation or lecture from an expert via online video. TED Talks makes use of a slightly more traditional speaker-at-a-conference setting for their videos - ensuring that their speakers are incredibly dynamic and interesting performers; while, RSA Animates turn the speaker's lecture into a voiceover and a hand draws pictures of what the speaker is saying on a white board. The effect of both of these websites is that the viewer is absolutely enthralled - deeply engaging in whatever this leading thinker has to say. The viewer then goes on to tell people about points made in the video, which (here's the "kicker") drives more traffic to these two organizations' websites, thanks to word of mouth advertising and viral marketing through sharing of the videos online.
So, TED talks, RSA animates; what do you do?
I can't tell you how many times people have said, "no one is interested in the specifics of what I'm working on" or "our work is esoteric and therefore we can't get the word out." I'd posit that if you have ever said these things, TED and RSA have proved you wrong.
It is true that when working with clients on website copy, I always have to remind them not to ...
- How to Conduct a Great Interview
Posted by Heidi Wurpel
As consultants we often have "executive interviews" as part of our methodology. Interviews can help you extract valuable qualitative data and give you a better sense of the importance of or passion behind an idea. However, there are also pitfalls to avoid with interviews. For example, many interviewees try and give you the answers that they think you want or will be wary of airing "dirty laundry." To avoid pitfalls and collect the most objective data as possible try the following:
Be on their turf, in a private room. Going to the interviewee can make them feel more comfortable. It is important that their workspace provides someplace where they can be sure no one can hear their responses to increase honesty.
Let them know the purpose of your interview on a macro-level without any subjectivity. Telling them "We are looking to discover information to help further shape our efficiency project" is much better than stating, "We want to know if you are doing too much or too little work and if someone else can do the work faster and for less money."
Start with a question you know they will ace. Asking a broad question that everyone in their field would have an answer to helps create a sense that this isn't a test, they can do this, and we will not make this painful or hard.
Ask extremely open-ended questions, without pre-cursor statements. An example of a good open-ended question is this, "Does work ever get slowed down for any ...
- The End of Rugged Individualism
Posted by Jim Kupel
The idea that "the rugged individual" is the foundation of America's greatness is an outmoded idea. In the 21st century America's greatness is tied to vision and teams - teams that perform exceptionally well under a wide variety of circumstances.
This point was illustrated to me this month while we worked with a client that operates the largest proton treatment facility in the world. Developing and managing this facility is a team enterprise. And there are lots of similar examples over recent decades of how teams with a mission and vision excel - from Navy Seals to Google.
We need teamwork now more than ever, but we're caught in a political discussion from the last-century of "rugged individualism" versus government - an argument originally championed by Hoover.
Americans greatness is rooted in men and women with entrepreneurial vision and passion - but let's not mistake that truth with the idea that it is Government that destroys political equality and stifles initiative. It isn't bureaucracy alone that threatens us - it is a lack of vision, teamwork and the ability to implement complex solutions in an increasingly complex world that threatens our dreams.
- ARTHUR!
Posted by Heidi Wurpel
I recently had a rather frustrating consumer experience as I was shopping for a new mattress. I thought it might be helpful to create a "case study" of my experience to explore ways in which the situation could be improved.
Industry: Retail, National Chain, Mattresses
Services (Needed): Research, marketing, employee communications
Situation: In pursuit of a good mattress, I drove around Portland, Scarborough, and South Portland to various stores carrying one of the "Big Three" mattress brands (Serta, Sealy, Simmons). I began the process of trying the mattresses I knew I might be interested in. Through my shopping experience thus far, I had a specific level of quality mattress in mind, I knew the materials and I wanted the bed to be made from. I also knew what price I could get online and the price for comparable mattresses at every competitor in town. I was in short, a very knowledgeable consumer ready to purchase if the price was right.
I was pleasantly surprised when on my last stop of the day when I walked into a large, national chain, mattress retailer (the subject of this case study) and discovered that they carried all of the major brands plus a great selection of lesser known ones. A first impression of "I should have just come here first; what a great selection of mattresses!" is a very positive customer reaction; however, this is where the positive reactions end.
I quickly noticed that the walls were in dire need of a paint job, the ...
- Dance, Hot Dog, Dance
Posted by Beth Austin
A couple of years ago a friend and I went to a roller derby event to try something new. Our viewing experience from the competition perspective was unremarkable, but we did find a source of entertainment from the team's mascots. For reasons that are still unclear to me, the local roller derby team has a pair of hot dogs as their mascot(s). The costumes consisted of full hot dog regalia - bun included - with a face cut out. For the entire event we watched these two very enthusiastic hot dogs jump and cheer and dance. They would bust a move at even the slightest provocation - and it didn't appear that the dancing thing came all that easily decked out in the hot dog suit. My friend and I became mildly obsessed with these dancing hot dogs, and for the weeks following, any conversation could be interrupted with random non sequiturs and casual musings such as "Do you think the hot dogs practice?"
Not long after the roller derby experience I had a bad day at work. This day resulted in my sending an e-mail to my friend that read something like this:
Subject: Is it too late to be a roller derbyist?
Dear [friend],
My experiences today at work have prompted me to make a career change. Thus, I've decided to join the roller derby. I briefly considered becoming a dancing hot dog, but then realized that I already am.
Love,
Beth
Last week I had another one of ...
- Innovation, Government and Technology
Posted by Jim Kupel
John Seely Brown* has been quoted as saying "I think right now we are experiencing something we've never experienced in the history of civilization. All past infrastructures have unfolded slowly at first, until they reached a critical mass which then sparked explosive expansion and adoption. Finally things level off and stabilize for decades at the time often 70 to 100 years. What's interesting for me is that the infrastructure we're moving into is in exponentially increasing infrastructure because technology is exponentially increasing."
He also reminds us that "all infrastructure is social/ technical." The example he uses is the development of the nationwide electrical grid. That was a huge social and business innovation.
If John Seely Brown is correct and technology continues to increase exponentially, developing governmental processes that are able to respond to these changes is essential.
We have already seen that technology has the power to alter the fate of nations. This is demonstrated as recently as the events in Egypt and Lybia. Clearly the recent debt ceiling debate in Congress suggests that even in the most technologically advanced nation on earth our human social infrastructures are not keeping up.
By helping our governmental representatives solve real problems we help adjust to new technologies that stand to alter the face of the planet.
- My Red Herring Nightmare
Posted by Heidi Wurpel
Last night I had a nightmare in a common theme for me: I am rushing about trying to get a long list of things done but then I see something that needs to be “saved”. Last night, it was a little girl with a very scary man following her. The dream ends when I rush the at-risk character into the protection of my car and speed away from the trouble. I share this dream because I have learned to use it as a reminder in my life that has applications for business.
As managers, we often get so bogged down in our day-to-day to do list that we forget to stop and nurture the small, less-pressing, but often more important, visions or goals of our organization until they are on the brink of disaster. While these ‘at risk’ items turn into puppies, birds, and children in my nightmare, they almost always represent a burgeoning strategic objective or goal that has been sitting on the back-burner of my task list for too long in the real world.
In my dream, my car is there to whisk me away from the danger, but life isn’t always so convenient. Thus, it is important to have a group of people available to you that you can call on to help you move your goal out of harm’s way quickly so that you may keep your business growing, and perhaps get a better night’s sleep.
What are the red-herrings on your list keeping you ...
- Inspiration
Posted by Beth Austin
I admit it. I had writer's block last week. I now sheepishly submit my blog post a week late because the muse just didn't move me when it was supposed to.
It happens to all of us (and to some of us more than others). And "writer's block" isn't limited only to writing, as we have all found ourselves "stuck" on various work projects, whether it is creating a new marketing piece, working on business strategy, or picking up the phone to make that sales call. So how do we un-stick ourselves?
As I stared at my blank piece of paper for far too long, I thought about a video a colleague had recently shared with me. The video is long, but the gist of it is that the people who are most successful at what they do are the ones that have passion for what they do (think Steve Jobs, the Wright Brothers, etc.) It's not what you do, it's why you do it. It's the inspiration behind what we do that frees us from arbitrary limitations.
To find inspiration, I've always found it helps to look at things in a different way. Taking a new perspective is sometimes all it takes. The Blue Ocean Strategy is an example of this. In their book on the topic, the authors encourage us to separate ourselves from our competition by being truly different. Even though we may be starting with the same product or service ...
- Indy 500 Lessons
Posted by Scott Good
The Indy 500 is this weekend. Going an average of 225 miles per hour, the 500 miles is traversed in about two hours and fifteen minutes. Does this mean that the race is more equivalent to a sprint or a marathon? The answer is, "Yes." The Indy 500 requires the razor sharp attention and presence of mind of sprinting and the endurance of a marathon. Racer Patti Sue Plummer once said, "Racing teaches us to challenge ourselves. It teaches us to push beyond where we thought we could go. It helps us to find out what we are made of. This is what we do. This is what it's all about." Whether a sprint or a marathon, this saying rings true.
Think about what goes into a successful racing team ... A driver (sure, the focal point), the guys who function as the pit crew during the race, a man or woman who drives the trucks who transport all the equipment from city to city, accountants, lawyers, marketing people who promote the sponsors, people who clean the garages, schedulers, and the person or organization who sponsors the whole thing. Now consider your own business. You probably have the same - or equivalent - functions: C-suite leaders, accountants, lawyers, support people, and the woman or man out front who is actually getting the work or generating the revenue. If the Indy car driver fails, they all fail. If your salesman (or, "rainmaker") fails, you all fail. If the supporting team fails, all fail, as well ...
- Non-Zero and the Defense of Optimism
Posted by Jim Kupel
The title - An Optimist's Guide of the Future - makes Mark Stevenson's new book sound like a self-help treatise, but it's not - unless you are wed to the notion that the human race is bound for early extinction without an immediate intervention. Then the book has a self-help sort of appeal as it explores some great ideas for solving many of our most vexing problems.
Human genomics that eliminate disease; bacteria that excrete fuel; nano-manufacturing that changes the energy dynamic of the planet; and space travel that makes us realize that in fact we are on "spaceship earth[1]" are just a few of the current explorations that Stevenson introduces. As you read this funny and stimulating book, you may find yourself asking "why don't we read about one of these ideas on the front page of the paper every day - instead of the daily doom and gloom?
One idea Stevenson introduces in his chapter of the future of the Internet and the Web, is that human progress is not a zero-sum game: "just because I win, doesn't mean you lose." The idea was pioneered in the book Nonzero - The Logic Of Human Destiny[2] By Robert Wright. It has since been restated by Bill Gates (on our relationship with China), Bill Clinton, and others.
Despite the painful changes in our current economy, the huge implications of Arab Spring and the many advances in science and business today, suggest we need another model to inspire our progress. Another ...