I should estimate that in my experience most troubles and most possibilities for improvement add up to the proportions something like this: 94% belongs to the system (responsibility of management), 6% special.
Page 315 of Out of the Crisis by Dr. W. Edwards Deming.
I achieved my goal by not my aim. That happens a lot, we honestly translate aims to goals. And then we do stupid things in the name of the goal get it the way of the aim. We forget the aim sometimes and put the goal in its place.
That police departments cover up abuse by their own to the public is pitiful. So many good police officers serve these systems that are failing to stop criminal behavior against the public. It shouldn't fall to journalist to protect the public, but when the police perpetrate such bad practices journalists are a potential protection to the public. If we don't support real journalism we risk great damage to our society.
We need our watchman to care about our society. We need them to see themselves as servants of society. We don't need bullies. We need to stop accepting horrible practices from proponents of security theatre and we need to find watchmen in the vein of Sheriff Taylor not those that see SWAT teams as a sensible reaction thousands of times a year.
Technology also is often seen as this wonderful simple quick fix by executives - letting them avoid the gemba and just put hope in a essentially magic bullet solution.
The idea that bonuses are bad management is one of the more difficult management improvement ideas for people to accept. See related post links for much more on the problems with them and what to do instead...
There is great value in creating iterative processes with fast feedback to those attempting to design and improve. Box and Deming (with rapid turns of the PDSA cycle) and others promoted this 20, 30 and 40 years ago and now we get the same ideas tweaked for startups. The lean startup stuff is as closely related to Box’s ideas of experimentation as an iterative process as it is to anything else.
A single root cause is rare. Normally you can look at the question a bit differently see the scope a bit differently and get a different “root cause.” In my opinion “root cause” is more a decision about what is an effective way to improve the system right now rather than finding a scientifically valid “root cause.”
Revolutionary change is powerful but very difficult for entrenched people and organizations to actually pull off. It is much easy to dream about doing so.
Often even revolutionary ideas are adopted in a more evolutionary way: partial adoption of some practices based on the insight provided by the revolutionary idea.
Managers should be setting up the organization to take maximum advantage of the strengths of the people in the organization while minimizing the impact of weaknesses.
The USA health care system is broken and has been for a long time. Symptoms like the huge cost of health care, medical errors, ER problems etc. are all related.
Over time, I have become more and more focused on the overall system and figuring out how to look at whatever problem we're having within a larger context. And I find that usually leads me to a better solution. There are a couple of ways to see this in respect to leadership.
The first one is when you have one of Deming's deadly diseases (or his 14 points), like the mobility of top management...
A great improvement strategy. Determine what you are trying to do. Understand the system. Set up process measures that measure that system. Improve the system and track the results. Repeat. Maintain focus over the long term. Result: success.
There are those rare companies where interacting with them is not a dreaded experience: Trader Joe’s, Southwest Airlines, Ritz Carlton, Crutchfield...
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And then instead of fixing the system, just burn the toast (follow the link for an explanation). Then wait for those that get the burnt toast to tell everyone that you sold them burnt toast. Then, after they do that, go scrape it for them.
