First Friday Book Synopsis

"…like CliffNotes on steroids…"

Jim Champy and Harry Greenspun provide a checklist for implementing new technologies

Jim Champy

In their recently published book, Reengineering Health Care, Jim Champy and Harry Greenspun, M.D. provide “a manifesto for radically thinking health care delivery.” They offer four implementation checklists that have profound significance to improving the quality of health care delivery. Here’s the first, one that suggests how to implement new technologies. They explain the significance of each question within the book’s narrative.

Have you developed the capabilities and acquired the capacity to implement the new technology?

Have you established a set of principles to guide you through the change journey?

Have you engaged the right people in the work redesign effort?

Have you identified the leaders who will shepherd the change?

Have you established a governance process to answer questions of policy and oversee effort?

Have you established a project management structure and methodology?

Are your project plans sufficiently detailed to allow you to manage all of the parts effectively?

Have you established training programs and practice facilities to enable people to become familiar with both the new technology and the new work processes?

Harry Greenspun, M.D.

“Technology isn’t the universal solution for reengineering health care, but it’s safe to say that technology will be a critical enabler of many reengineering initiatives. That, however, is just the beginning of reengineering, since a technological innovation will inevitably lead to changes in most or all of the processes in place at hospitals, medical groups, and individual physicians’ offices.”

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Champy and Greenspun offer excellent advice to those who need assistance with formulating and then implementaing an action plan. I also highly recommend Atul Gawande’s The Checklist Manifesto: How to Get Things Right, published by Metropolitan Books (2009). Other worthy sources include James Kilts’s Doing What Matters: How to Get Results That Make a Difference – The Revolutionary Old-School Approach co-authored with John F. Manfredi and Robert Lorber, Execution: The Discipline of Getting Things Done co-authored by Larry Bossidy and Ram Charan, and Guy Kawasaki’s Reality Check: The Irreverent Guide to Outsmarting, Outmanaging, and Outmarketing Your Competition.

Tuesday, August 24, 2010 Posted by | Bob's blog entries | , , , , , , , , , , , , , , , , , , | Leave a comment

Every checklist must be a work-in-progress

After a lengthy investigation of the landing of US Airways flight 1549 on the Hudson River sixteen months ago, the National Transportation Safety Board made 33 recommendations for safety improvements. All are sensible and do-able.

Although the plane’s crew members were praised for their composure while following directions, the Board noted that Flight 1549’s engines were “damaged beyond hope” and thus could not be restarted, as per the checklist in such a situation. The experts who testified called for cockpit instruments that would give more detailed information to pilots on the condition of their engines and also recommended new checklists based on low altitude engine failure; the one the US Airways pilots (i.e. captain Chesley B. Sullenberger III and first officer Jeffrey B. Skiles) had was for high-altitude failure, in which case more time would have been available during the descent.

Here’s my take: Every checklist must be a work-in-progress. Why? Because those with decision-making responsibilities change. Circumstances change such as technology and information change. Also, laws, rules, and regulations change.

Therefore, reviewing, evaluating, and updating checklists should be continuous. The single best source of information and advice on the subject is Atul Gawande’s The Checklist Manifesto: How to Get Things Right.

Wednesday, May 5, 2010 Posted by | Bob's blog entries | , , , , , , , , | 1 Comment

Long lists don’t get done

Jason Fried

Here is a series of brief excerpts from one of the chapters in Rework, co-authored by Jason Fried and David Heinemeier Hansson. It was published by Crown Business/Random House in 2010.

* * *

Start making small to-do lists. Long lists collect dust. When’s the last time you finished a long list of things? You might have knocked off the first few, but chances are you eventually abandoned it (or blindly check off items that weren’t done properly.)

Long lists are guilt trips. The longer the list of unfinished items, the worse you feel about it. And at a certain point, you just stop looking at it because it makes you feel bad. Then you stress out and the whole thing turns into a big mess.

There’s a better way. Break that long list down into a bunch of smaller lists. For example, break a single list of a hundred items into ten lists of ten items. That means when you finish an item on the list, you’ve completed 10 percent of that list, instead of 1 percent.

* * *

David Heinemeier Hansson

And a quick suggestion about prioritization: Don’t prioritize with numbers or labels. Avoid saying “This is high priority, this is low priority.” Likewise, don’t say, “This is a three, this a two, this a one, this a three,” etc. Do that and you’ll almost always end up with a ton of high-priority things. That’s not really prioritizing.

Instead, prioritize visually. Put the most important thing at the top. When you’re done with that., the next thing on the list becomes the most important thing. That way you’ll only have a single next most important thing to do at a time. And that’s enough.”

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Other than their dependence on using the word “thing” rather than specifics such as “task” or “objective,” Fried and Hansson offer some excellent advice. The best single source on checklists is Atul Gawande’s The Checklist Manifesto: How to Get Things [there’s that word again!] Right. I also highly recommend Pages 220-224 in Switch: How to Change Things [!] When Change Is Hard, co-authored by Chip and Dan Heath.

Wednesday, March 10, 2010 Posted by | Bob's blog entries | , , , , , , , , , , , , , | 1 Comment



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