In everyone’s life there comes a time that in order to make a change happen we must “deconstruct” rather than just “remodel”. Deconstruct is the opposite of construct, it means to take apart piece by piece the focus of the change; albeit environment, relationship, organization, etc. Remodels are typically changes where you are willing to make improvements, but unwilling to take things down to the bare studs for many reason; i.e., time, money, talent, FEAR etc.

Don’t get me wrong, remodels are good. The speed in getting to a finished result is faster, and as we know faster is often the name of the game. After the remodel we look really good, but really good for how long? How “sticky” (meaning it has traction and forward movement towards an anticipated goal) is this remodel before the cheap handle falls off the door, or the paint peels, and the new windows leak? If the change that we want is minor and doesn’t affect an entire system, then remodeling is probably an economic way to make a difference in the bottom-line. We hear all the time of small rapid cycles of change, Plan-Do-Study-Act cycles.

What happens when continuous process improvement doesn’t gain us the long term change that we want and we find ourselves at a juncture in our process improvement plan? Many executives are facing this exact quandary. As one analyst put it, “They (executives) know how to do business with our parents, but not our children.” Shifting and looking from a whole different window pane, even better, constructing a whole new wall with glass that goes floor to ceiling is maybe what we need to really make change happen.

I am not a political person and I often joke that “being Canadian”, I can’t impact the political system anyway; but when Obama and every other bandwagon player started to shout, “Yes We Can!” I shuttered and thought can what? Change? Was America really ready for “deconstruction”, because the “remodels” of the past had the doors hanging from the hinges.

So where am I going with all this talk of “deconstruct vs. remodel”? I am heading into the January buzz word of resolutions – which mean change. We notoriously ring in the New Year, with a cadre of resolutions in hand, looking to be different by the end of the year, or in some cases within the next 30 days. In business we might shake the dust off the old strategic plan and open it up, wondering why we have not accomplished what we wanted to and how are we going to set the course again?

I want to leave you with four simple steps to getting traction with your New Year’s resolutions.

1. Look at the goal you want to reach, your resolution, and be willing and able (these are not necessary mutually inclusive) to articulate the goal using metrics and benchmark data.

2. Assess your past pattern of behavior. Have you tried this before? If so,what did you learn last time your tried it? What will you do differently this time?

3. Is there more to this “resolution” than meets the eye? Does this “resolution” really force you to “deconstruct” your life in order to succeed, or will a simple “remodel” do.

4. Once you are clear if this is a “deconstruct” or a “remodel” then you can lay down a plan, incorporating the time, treasure, and talent necessary to be successful.

Well for me this is a year of total “deconstruction”, I will let you know how I fair along the way. In the meantime I will sit back and watch Tom Hanks and Shelly Long in the movie “Money Pit”, because inevitably in a “deconstruct”, it is far more emotionally and financially expensive than we ever imagined.

I just delivered an overview of our META – Model for Change “TADAP” at the 2011 4th Quarter Meeting for the Consortium of Advance Management International (CAM-I). TADAP is a transformational model of change that looks at the “we”; which is a complex and dynamic arrangement between an individual, the organization that the individual resides in, and the greater community that encompasses the organization. I must say the topic of the session was on how do we take performance management and make it what I call “sticky”.

“Sticky” to me means that we actually agree to look at performance management, analyze the data, formulate actions for improvement from this data, and then actually make the changes necessary to improve performance. Oh, and then measure that we actually improved performance!

Well it sure sounds easy, but it’s not as simple as it sounds. It all starts with what I spoke on at CAM-I; it starts with assessing one’s state of reality. Where are WE? (again see “we” above). Do WE accept this as fact? Do WE have agreement that WE want to do something about it?

So now begins the dance of data and desire and it is a rather profound dance. You must really be able to bridge both the behavioral side (socio) and the systems side (techno – world of data, processes, and analytics). As we start to recognize this need for seeing change and performance through a complex lens; we can then start to assess an organization’s ability to take a change initiative and actually take it through implementation and see measureable results.

I must say that CAM-I has published an outstanding work piece titled, “Performance Management Maturity Framework”. This tool might be just the first piece in the puzzle to use as your organization looks to evaluate its current state of reality.

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Appreciate (v) – The act of recognizing the best in people or the world around us; affirming past and present strengths, successes, and potentials; to perceive those things that give life (health, vitality, excellence) to living systems.

What a powerful description! A description that in a world of perceived fear, turmoil, and trepidation, we can actually take facts and unhook the negative meanings to attach new positive meanings. These positive meanings will create the energy for positive change to happen. Confused, well let me give you an example. I just finished an intensive workshop focused on a change initiative where we looked at cutting an organization’s FY2012 budgets by 15%. Our goal was to determine how to get buy-in from the stakeholders that would allow these cuts to be swiftly and effectively implemented. The first and most crucial need was to attach a new meaning to the word “budget cuts”. When we hear the word budget cuts we immediately attached the following meanings:

• They (whoever they are) want me to do more with less, I am already overworked.
• This is all about more layoffs and downsizing.
• I have no more to give, I have cut everything I can.
• Etc, etc, etc…all meanings based on some perspective of the word “budget cuts.

Through the “Art of Appreciation, ” we are able to recognize the best in people, affirm past and present strengths, successes, and potentials of the organization, and change the meaning of “budget cuts”. Through this process we were able to attach the following meanings:

• Budget cuts are a vehicle to focus us on realigning our people and resources to work at their highest potential utilizing their greatest strengths. It is a way we can celebrate what is best in our organization, seek out benchmarks, and realign in order for all people to have the opportunity for fulfillment in the organization.
• When we take time to focus on the best use of our people and resources we allow our people to create work environments where they are valued, respected, and able to work to their strengths; ultimately, creating a strong, progressive, agile workforce focused on organizational success.

These new meanings allow organizations to look for solutions and change initiatives focused on a positive new future. This is a whole new way to look at the word “budge cuts”. Changing the meaning and looking at this through “the lens of appreciation” changes the way we show up and accomplish our mission.

There are great thought thinkers and leaders in the world of appreciation. A few that I would love to share with you are Dr. Dianna Whitney, CEO and Founder of The Corporation for Positive Change. I consider Dianna one of my mentors, and honor her ability live and breathe appreciation. Dr. David Cooperrider, Professor at Case Western University is a powerful, thought provoking leader in the world of appreciative inquiry. There are also compelling organizations that have taken the unpredictable and reframed tough decisions they have had to make during these economic times. These organization give back and celebrate the best in life. They show their appreciation in amazing ways. One of these companies that has impacted the world is TOMS. Check out their new initiative which is focused on “improving vision (that is eyes!), because the eyes are the lens through which we see the world and all its beauty.

TOMS Eyewear – Nepal Giving Trip

On a less global scale, I want to mention a former client and now wonderful friends who I greatly appreciate, Structure Home. Structure Home has successfully navigated an unfathomable 15 year housing market decline. They have taken the unpredictable and reframed their market through a lens of appreciation. They have realigned the best and forged new inroads in the marketplace. Working from strengths they are solving challenges in the residential construction industry one positive change initiative at a time!

As positive eye™ looks to 2012, I personally want to appreciate the people in my life who make me value the “BEST” of what life has to give; my husband, my children, my family, my friends, my colleagues, and our clients. I “appreciate” the sandbox that I get to work in every day, helping people to build their castles for the future! Thank you 2011!

The Live Music Capitol of the World – Austin, Texas – has a different buzz downtown today. The convention center is filled with Texas’ volunteer and career emergency medical services caregivers. Held annually, the Texas EMS Conference rivals many national EMS conference events and draws industry leading faculty from across the country and caregivers from across the state.

Ernie Rodriquez, Director of EMS for Austin/Travis County EMS, has been a leader in advancing professional development for EMS leaders in the State. This year, he is joined by EMS leaders who strive to push EMS operations to the next level in a dedicated administration track. Dr. Dave Williams was invited to introduce the Model for Improvement – used throughout health care for process improvement – and share his experiences using the model with organizations across North America and Europe. The conference is always a great event and we welcome the opportunity to contribute.

More than a 100 people convened in Austin, TX at the Austin Convention Center for Wave 2011. Sponsored by ESO Solutions, a technology company developing solutions for emergency medical services organizations, Wave 2011 is a 2-day conference produced for its clients. It brings industry leaders and ESO’s deep pool of talented staff together to provide timely and pragmatic sessions on using patient data to improve care.

Dr. Dave Williams has had the pleasure of presenting at several of ESO Solutions’ national and regional education venues. ESO Solutions’ CEO – Chris Dillie – was Dr. Williams’s paramedic partner when they worked together at Austin EMS.

Today, he presented a session on using data for improvement and learning. With so much data, it’s easy for people to struggle with were to begin. Dr. Williams focused on identifying important metrics and measuring data over time to understand process variation and improvement. The audience included many innovative, local people striving to improve the reliability and quality of care in their communities. It’s always rewarding to see people really interested in improvement and change.

For the last few weeks, I have been testing an experiential exercise to quickly train large groups to use rapid cycle, small tests of change (i.e., PDSA cycles). The exercise involves teams learning through testing how to assemble a toy Mr. Potato Head. I modified the exercise after working with with Dr. Eric Dickson on the faculty for the Instituite for Healthcare Improvement (IHI) Impacting Cost & Quality collaborative. Dr. Dickson is the Senior Associate Dean and President, University of Massachusetts Memorial Medical Group in Worcester, Massachusetts. He uses Mr. Potato Head to teach emergency physicians and medical students about lean principles. You can read a description of a session he did for the American College of Emergency Physicians here.

The modified exercise I am testing includes teams developing theories, making predictions, carrying out tests, and measuring results on run charts. In addition, participants learn how to share knowledge across teams and harness the power of the collaborative learning process. I’ve now tested the exercise half a dozen times in public safety, health care, and education audiences and  each session has improved upon the last. And, I have received lots of positive feedback from participants. IHI even bought seven Mr. Potato Heads for the home office for use in the Patient Safety Officer Course and to teach internal staff about PDSA testing.

While the use of a toy produces an element of fun, this exercise, more than many I have used, really enables participants to discover the power of making predictions, using small PDSAs to test theories, and tracking data in real time using time series charts. It’s amazing how sometimes small experiential learning exercises can really connect people with the concepts and facilitate applying them to their improvement work.

Being a household with small kids, this weekend has been filled with Halloween events. Nate’s preschool had its annual party, which is great for the little ones and Ella’s elementary school produced another fantastic Highland Park Elementary HOOT Carnival. The HOOT is produced by the PTA and raised $40,000 last year for the school. This weekend also involved some pumpkin carving, which is always a yucky, but necessary family activity.

On CNN’s State of The Union, Candy Crowely interviewed Ellen Davis of the National Retail Federation for a brief discussion about the economics of Halloween. You can watch the full interview here. In down economies, consumer spending around holidays – like Christmas – goes down, indicating that people are cutting back. The opposite is true about Halloween, where consumers actually show an increase in spending during down years. Ms. Davis hypothesized this is true because it’s a brief holiday, that’s not tied to any religion or person, it’s accessible to all socio-economic classes, and, probably most importantly, it allows us an opportunity to take a break and have fun.

Have a safe and enjoyable Halloween. Trick or Treat!

It is a somber flight, Alaska Flight 30 – Portland to Boston, 9/11/11.  It all started on Friday when my little sister Bert emailed me and said, “You’re flying to the east coast on 9/11, be careful”.   The email felt like a bullet, and memories of 9/11 were now everywhere.  What was nestled in my subconscious was now vivid on the newsstands, radio, TV, internet etc.  I had felt this bullet before, in 1996 when the knock on my door came telling me my husband had been killed, I knew this bullet.

But, now time had passed and I had let the hedge grow up around me, filtering out the pain and letting new life in, new husband, grandchildren, new stepchildren, etc.  But this email reminded me that we must never grow dull and that each person’s painful journey is different.

Over the past 48 hrs there is somberness, a sadness that is hard to describe.  From lying safely in bed with my new husband, the somberness of flying on 9/11/11 was on my mind.

Arriving at the airport at 5:35 am to hear the announcement requesting 30 seconds of silence in memory of 9/11 was sobering.  30 seconds was not nearly enough time for anything.  Walking through security, waving good-bye and being thankful as the young man checked my ID…was sobering.

Ironically as I headed to my gate I kept thinking that today of all days I want to stay connected with my loved ones.  Ironically, I left my cell phone on the nightstand at home, now my only communication is via internet at 35,000 ft.

As I boarded my flight I was kindly taken aside by TSA and asked to check my briefcase one more time.  Again, a sober reminder but I was thankful they were there.
There is not a seat left on my flight, it is very quiet, very somber, I wonder if others are feeling like I am?

Mid-air somewhere between Portland and Boston I think of families, friends, colleagues and I know that we must treat each person as though it is our last meeting.
So from 35,000 ft. I am remembering and saying thank you to all the heroes past, all the heroes present, and all the heroes yet to be born.  I am also posting this picture of all the people I so love in my life; my husband, children, grandchildren and remembering all my family.

May today be one step closer in a deeper understanding of what the words gratitude, courage, faith, hope, and love truly mean.

Respectfully from 35, 000 ft.
Jean

David M. Williams, PhD

This week Saybrook University awarded Dave Williams - Principal & Chief Improvement Advisor at Positive Eye Consulting, Inc – with the 2011 Dissertation with Distinction Award. The award is earned by one doctoral student per graduating class year.

You can read the abstract for Dave’s dissertation here.

Dave’s PEC colleagues, clients, and friends are thrilled at his accomplishment and his continued contributions to improving organizational systems and we are pleased he has been recognized for his research. Please post your own comment to Dave below or email him here.

Quality Health Care by Robert Lloyd, PhD

This week, I have been reading a great book by my colleague Robert Lloyd, PhD, Executive Director of Performance Improvement at the Institute for Healthcare Improvement. Published in 2004, Quality Health Care: Developing and Using Indicators is a great resource for learning about process improvement in health care.

Last night, as I finished a chapter (Ch.3), I caught mention of a great little story Bob includes in the chapter notes (p.119). The origin is unknown, but his discovery of it comes from his mother. Reflecting on it, the story really describes what I witness, and many teams encounter in trying to plan, launch, and participate in improvement work.

The Facts of Life

The story that follows is about four (4) people named Everybody, Somebody, Anybody, and Nobody. There was an important job to be done and Everybody was asked to do it. Anybody could have done it, but Nobody did it. Somebody got angry about that because it was Everybody’s job. Everybody thought Anybody could do it, but Nobody realized that Everybody blamed Somebody when Nobody accused Anybody.

In the same chapter (Ch. 3), there is a great quote attributed to one of Bob’s graduate school professors – Dr. Bob Bealer – and how they would respond the the question about sampling, “How much data should we collect for our dissertation research?” Dr. Bealer would reply, “As much as you must and as little as you dare” (p.79). I can remember my own dissertation chair – Dr. John Adams – providing very similar sage advice.

I am very much enjoying Bob’s book. I’m only 1/4 of the way through it, so do not be surprised if other great snippets emerge later.