Posts Tagged ‘Incentives’

Worst Practices

I have recently been involved with an enterprise that has somehow managed to embrace just about the worst transformation practices possible.  It all started with the vocabulary the leaders chose to employ.  They managed to paint a transformation picture that they apparently had no intention of pursuing.  While they portrayed fundamental change, their actions totally […]

Creating the Future

I am a student of history, particularly economic history.  Lately, I have been immersed in reading about technological innovation in the late 19th and early 20th centuries.  Transportation was transformed from stagecoaches and steamboats to railroads, automobiles and airplanes.  Electricity transformed communications from mail, telegraph and telephone to radio, television and now Internet. In the […]

The Toughest Problem

Over the past two decades, I have often asked executives about their toughest problem.  Not surprisingly, they use many different words to answer this question.  However, there is quite a consensus around, “Running the enterprise I have while trying to create the enterprise I want.” Keeping the existing enterprise running tends to be a very […]

Controlling the Costs of Healthcare

We continue to anguish over escalating healthcare costs.  To gain control of these costs, we need to understand one essential equation.   The total cost of healthcare is Total Cost = Costs Per Use x Number of Uses Careful design of delivery processes to eliminate unwarranted care process variations can decrease the costs per use.  Variations […]

Transforming Public-Private Enterprises: Energy

Most people seem to agree that we need to be more conservative when it comes to energy.  We need to conserve our stocks of fossil fuels while also investing in renewable energy sources.  Our electrical grid is rife with inefficiencies, ranging from transmission losses to power-hungry devices in our homes.  The notion of a Smart […]

Transforming Public-Private Enterprises: Defense

National defense, and acquisition of weapon systems in particular, has long been a target of transformation.  The Packard Commission in 1985 provided a very reasonable set of recommendations for reforming defense acquisition processes.  These recommendations resulted in relatively minor changes.  Blue ribbon committees both before and after the Packard Commission had comparably minor impacts. President […]

Transforming Public-Private Enterprises: Education

We often see dire assessments of our educational systems.  K-12 is judged to be quite poor compared to other developed countries, as reflected in comparisons of educational achievements across countries.  This is particularly true for STEM — science, technology, engineering, and mathematics.  More broadly, our high school graduation rate of roughly two thirds means that […]

Transforming Public-Private Enterprises: Healthcare

Healthcare presents a major challenge for the U.S.  We pay twice as much per capita as any other country; yet achieve much poorer results in terms of health and longevity.  The current system can be characterized as a federation of millions of entrepreneurs with no one in charge.  Even assuming that everyone is well intended, […]

On the Cutting Edge

Last week, I was a visiting faculty member as a Spine Symposium.  I gave three talks related to a systems approach to healthcare delivery.  The context of spine surgery was purely serendipitous, as the folks inviting me did not know in advance that I have spent several years doing my best to avoid spine surgery.  […]

Invention and Innovation

Invention is the creation of a new device or process.  Examples include computers, software products, chemical processes, junk foods, and kitchen gadgets.  Innovation is the introduction of change via something new.  Cable television and video rental stores were innovations, as were overnight mail and communication via fax and the Internet.  Each of these innovations took […]