Collaboration

Collaboration is Powerful Medicine

January 19, 2012 By Wendi Leave a Comment

True collaboration involves a team in which authority relationships are flat rather than hierarchical. For this reason, true collaboration cannot take place without every team member having open access to all information. Otherwise, the relationship is not flat. True collaboration also requires belief that the shared information is accurate and complete. True collaboration requires trust. While these requirements may seem obvious, they are not easy to meet for most organizations that seek to increase collaboration among employees and other stakeholders. So why go to the trouble? Because, it seems that true collaboration is as powerful as taking the right medicine when it comes to improving outcomes.

OpenNotes, a collaborative research project that invites patients to view and ultimately contribute to writing their medical records, is trying to determine whether collaborative interaction (between the patient and healthcare provider) with the information in individual health records can create “knowledge-medicine” that positively impacts actual health.

The theory being tested is that collaboration – merging divergent perspectives among parties interested in achieving a mutual goal, interacting in a flat relationship with open access to complete information – will yield actionable knowledge held with high conviction. Based on this high conviction knowledge, behaviors (decisions and actions) and outcomes will be positively affected. That is, what I am labeling “true collaboration” can produce a health impact similar to medicine.

The transition to electronic health records which will hold legible, accessible content has the power to change the perception of who rightfully owns the information. Although individuals technically own their medical records, gaining access to them has been challenging at best. A doctor’s handwritten notes scrawled in the standard joke of indecipherable physician scribble sets up a barrier of privacy that feels as if it goes in the opposite direction – as if the notes belong to the physician rather than the patient. When medical information is stored and accessed in the same way as financial information, it will level the playing field, creating the expectation that this information rightfully belongs to the individual and is being shared with the healthcare provider. In the OpenNotes experiment, the combination of the patient’s ability to access information directly, removing the healthcare provider as a gatekeeper, coupled with the ability of the entire health team and the patient to review the information together builds trust that the information is accurate and complete, and flattens the authority hierarchy, creating the conditions for true collaboration.

The emphasis of the OpenNotes project is on improving patient outcomes by changing patient behavior. But there are tantalizing hints that it will also transform the healthcare providers’ practices as well. One physician is quoted as saying: “’It might be better to say the patient is ’20 percent over ideal body weight’ rather than ‘a jovial obese man came into my clinic,’….” because using the term obese risks alienating the patient. But changing how physicians document what they observe subtly alters the very act of observing. It forces the physician to view healthcare as a process that involves human beings (both patients and healthcare providers) who need to be engaged in ways that will actually alter behaviors over time. The patient needs more specificity to understand what is required (reducing weight by 20 percent) and the physician needs to consider how best to motivate productive behavior change.

An article on placebo research (see below) suggests why viewing healthcare as a human-centered process is necessary:

There has always been a distinction between disease and illness. Disease is a biological condition that we have historically treated with drugs, surgery, and other technological solutions. Illness, on the other hand, defines the context of a medical encounter, including the relationship between doctor and patient…[It] is essential to consider both the science and art of medicine – to think about diseases as illnesses, and not to rely solely on short-term, high-tech solutions.

Of course, the OpenNotes endeavor is fraught with concerns:

Will physicians’ notes change if they know patients are reading them? [I think so, but the question is, will they change for the better?] Will patients withhold information they don’t want to see recorded? [The classic "knowledge is power" problem.] Will they be more likely to seek a second or third opinion?” [Driving up costs at a time when this is precisely the opposite of what is needed.]

In addition to improving health outcomes, true collaboration needs to do it along classical economic improvement dimensions – better, faster, cheaper, less risky. At present, whether it can achieve improved health outcomes faster, cheaper and with less risk remains unclear. But, the OpenNotes project sounds a hopeful note – with a nod towards not letting the perfect be the enemy of the good – stating that this collaboration is “…designed to help more people than it hurts, but… medicines are never perfect.” The reason to sit up and take notice of initiatives like OpenNotes is that the power of true collaboration to change behaviors and alter outcomes extends well beyond the boundaries of individual health to the health of all of the organizational systems on which our livelihoods depend.

Sources:

“Project Puts Records in the Patient’s Hands,” Roni Caryn Rabin, The New York Times, Tuesday, January 10, 2012 page D6.
“The Power of Nothing, Michael Specter,” The New Yorker, December 12, 2011.

Addendum:

The article on placebo research was fascinating in its own right. Below is a brief snippet of what intrigued me:

The Program in Placebo Studies and the Therapeutic Encounter is a Harvard-sponsored institute that is studying the role of placebos in clinical practice. And what, at the end of the day, is a placebo but trust in the information about a medical intervention that alters patients’ perceptions and, in some cases the biochemistry, of illness? Placebos are mind-boggling to contemplate, because many times they represent false knowledge. Patients believe that a medical intervention (a pill, injection, salve, a procedure) is designed to alleviate some discomforting aspect of their condition. This belief in or expectation of a particular outcome triggers the body to contribute to the anticipated outcome. For example, on being told that they are receiving high doses of morphine (when in fact they are receiving saline) some patients experience pain relief. The belief that they are receiving morphine triggers their bodies to produce endorphins (the body’s natural opiates). But even without deception, it seems that placebos provide a benefit. Recent research involves disclosure to the patient that the therapeutic treatment is a placebo along with what is known about the benefits of placebos. This research demonstrates that even when patients know that they are receiving a placebo, many derive a positive health benefit.

Filed Under: Change, Collaboration

Friendship – the perfect blendship!

September 12, 2011 By Wendi Leave a Comment

Pixar makes magical films – Toy Story, Up, Wall-E, Cars – so you might expect that it would be magical place to work. And yes, it seems to be every bit as employee-friendly as every other high tech enterprise in Silicon Valley you have ever read about (even though it is not located in Silicon Valley, but in Emeryville – also outside of San Francisco, but in another universe altogether apparently).

You know what I’m talking about – the carefully designed workspaces that encourage collaboration and serendipitous interactions, the mind-body solicitousness of the fitness center and outdoor sports areas, the “you could live your entire life here” cafes, bars, and eateries. But what I think is really remarkable about Pixar is this: employees really like each other.

When John Lasseter, Pixar’s CEO, describes how the Toy Story team “saved” the project when it was imperiled, he says, “’We went back to what we wanted, and that was: the characters liked each other. Because we liked each other.’” And this, according to Anthony Lane, one of The New Yorker’s film critics and the author of a Pixar profile story, is the essence of Pixar distilled in the message of Toy Story – “You got a friend in me.” At Pixar, friendship is cemented by intense devotion to craft that is married inextricably to technologies that continue to extend the possibilities for the special brand of enchantment that the company produces. Lane notes that friendship is often the most enduring form of human relationships He writes: “[friendship is]…that practical momentum, conservative in its emotions, but radical in its taste for adventure….”

But (I can imagine you thinking out loud) they are Pixar – a smallish company with highly skilled (PhD-techno nerd-graphic design-type) employees operating in a rarified atmosphere making animated movies. What does this have to do with anything other than a highly specialized corner of the entertainment industry? What indeed? To me, the idea of friendship – its practical momentum, conservative emotions and radical taste for adventure – is the energizing, forward-moving spirit that the corporate world says it wants and then crushes with a deadening, faint-hearted version that it calls “employee engagement.”

Just compare the two – would you rather be friends with the people you work with or engaged to the company you work for? (I know that you don’t really get engaged to a company, you are engaged with the work you do for the company, but just humor me a bit.) The whole construct of employee engagement seems devoid of feeling which is odd because it’s supposed to be about attachment. Just imagine, for a moment, if organizational life was built on friendship. If products and services were really all about making friends with customers, suppliers, and other stakeholders. If the strong bonds of friendship were what underpinned business decisions – a balancing of short and long term consequences, a desire to sustain relationships, trying to make something last beyond the ups and downs of the moment.

I believe that the nascent corporate social responsibility movement (another label that just kills all of the passion and power of what’s going on) at its most basic is an embodiment of friendship There is something in the air these days and it’s bigger than engagement.

Perhaps it’s a consequence of how quickly changes that once seemed to take more than one person’s lifetime to experience have now become observable well within the boundaries of one person’s lifetime. We might just well have come to a point in history when kicking the can down the road doesn’t really achieve the goal of palming problems off to another generation. It may be that we are going to have to dig in and be responsible for the world in which we live – whether we inherited it or we created it.

How observable? In an article discussing the US government’s investment in lithium battery production as part of a highly controversial US-style industrial policy (betting on certain industries having the potential to create jobs and economic leadership in the world economy), the unforeseen consequences of having outsourced industrial production to Asia in the 1960s is identified as one of the major contributing factors to our lagging position industrial technologies. The author quotes a seminal article by Pisano and Shih, two Harvard professors, who believe that globalization has had the unwitting effect of tearing apart the ecosystem that generates future innovation.

Pisano and Shih write that “…US corporations, by offshoring so much manufacturing work over the past few decades, have eroded our ability to raise living standards and curtailed the development of new high-technology industries.” When consumer products companies offshored production to Asia, the drive to improve battery technology migrated to that part of the world too, because that was where it was needed – for toys and then small electronic devices. Fast forward to 2010 and now the transportation industry (manufacturers of essentially large consumer electronic devices) needs this technology, but its locus is in Asia.

While no one is prescient enough to foresee how the arc of history will bend, if one takes a long view, it’s easy to see that caring for interlocking relationships in the present might serve to strengthen the foundation for future endeavors. And what else is friendship but relationships that we tend today with a view towards tomorrow?

If we want our organizations and our economic systems to have a better chance at withstanding the vicissitudes of time, perhaps friendship is the best template we have.

Sources:

“The Fun Factory,” Anthony Lane, The New Yorker, May 16, 2011
“Make or Break,” Jon Gertner, The New York Times Sunday Magazine, August 28, 2011

And, another take on Friendship (thanks to Cole Porter, Ethel Merman and Bert Lahr)

Filed Under: Business Model, Collaboration, Sustainability

The Collaboration Cure

November 22, 2010 By Wendi Leave a Comment

Recently, a series of articles have appeared in which collaboration is offered up as the cure for what ails us – as a species, as a country, and as organizations.

Collaboration (in the form of trade or exchange) is a form of cultural evolution – when practiced, ideas have sex.
Our better than average position as a collaboration hub could be what keeps the US in its top economic position.
Collaboration is the key to long term organizational health.

Matt Ridley, speaking at TED and blogging for Frog Design by way of FAST Company, provocatively states that ideas having sex is the bedrock of innovation. (I say that ideas having sex = collaboration.) Ridley argues that human beings in our capacity for trade or exchange beyond our tribe or clan are distinct from every other living creature on the face of the earth. Other living creatures have cultures and pass on traditions, but these traditions remain within the tribe or clan. Only human beings trade objects and ideas with those who live outside the boundaries of the tribe or clan. This capacity to embed ideas in other cultures is analogous to the formation of genomes during sexual reproduction. During procreation it gives rise to incredible diversity and vitality in the species, during trade or exchange the same occurs in human civilization.

Fast forward thousands of years and we have evolved to the point where everyone works for everyone else because no one knows enough about anything to make it on his or her own. Ridley cites the pencil and the computer mouse as cases in point – very different technologies, but even in the mid 1800’s when something like the modern pencil came to be, no one person or company possessed sufficient knowledge to make a pencil. Graphite had to be mined, trees had to be felled, machines had to be fabricated to shape the pencil and insert grooves for the lead. The computer mouse is infinitely more complicated, involving industries spanning oil & gas, chemicals, electronics, and consumer retail. As with the pencil, no one person or company knows how to make a computer mouse. Radical collaboration (many ideas having lots of sex) has pushed innovation beyond the capacity of the human brain by uniting millions of human brains in a complex web of connections that is constantly evolving. For Ridley, the computing cloud, with its limitless potential to connect all human brains will boost our innovation capacity even further by providing a totally accessible collaboration platform, freed from constraints of time, place, and (almost) cost.

Modulating downward from the computing cloud to the US economy, David Brooks in his New York Times editorial column, The Crossroads Nation, makes essentially the same point as Ridley that innovation will be the economic driver of success in the future. But Brooks is more focused on the infrastructure of collaboration than on the act of collaboration itself. For Brooks, America’s economic identity in the future might lie in the very openness and diversity that permeates our culture making us the ideal “hub” nation. He quotes an essay by Anne-Marie Slaughter – “In a networked world, the issue is no longer relative power, but centrality in an increasingly dense global web.” Collaboration flourishes in places that are free, but fair, where people can come together with relative ease to connect with ideas and resources. Brooks wants America to invest in connections to cement our potential position as “the crossroads nation.” If collaboration is the bedrock of innovation, then to be the “go-to” place/space for innovation means nurturing the United State’s potential to provide the infrastructure and cultural openness that create a vibrant collaboration hub.

Finally, an interview with Martha Samuelson, president and CEO of the Analysis Group, a consulting firm, speaks to what collaboration actually looks like on a day-to-day basis in a company. Ridley and Brooks get you thinking, but Samuelson addresses the nitty gritty – how do you make it happen? What encourages people to collaborate once the tools are in place? To foster cooperation, the Analysis Group operates as one P&L even though they have 10 offices and multiple practice areas. “We have a trust-based system for setting partner compensation, and it’s based on a belief that we’re in a long game together.” Samuelson goes on to state that sometimes they get the compensation a little wrong in the short term, but “[t]he people who have stayed and thrived have been people for whom this collaboration issue is so important that they’re willing to leave some money on the table over it.” They are not a precision shop when it comes to getting it exactly right about compensation (which Samuelson notes is ironic since they are economists). The Analysis Group gets greater accountability from individuals by measuring at the group level than it would if it measured at the level of the individual – current “best practice” in most performance management systems. For people to pull together, to collaborate, they have to be in it together and being in it together means compromise and getting it approximately right (which means it is slightly wrong). In practice, getting ideas to have sex is a messy, nearly right sort of thing that relies on goodwill and trust which take time to establish and can be extinguished in an instant.

Collaboration is essential for innovation – at the level of the species, the country, and the organization. Ridley believes we have what it takes as a species. Brooks implores political leaders to embrace the moment and invest in a future in which the US is the collaboration hub par excellence. Samuelson knows that for her organization, collaboration is so critical to success that even economists are willing to live with imprecise measurement. Collaboration requires freedom to think and act, incentive to move beyond the boundaries of what is known and safe, an infrastructure to support exchange, a willingness to embrace messiness and uncertainty, and a very long view. Does your organization have what it takes to innovate?

Sources:

When Ideas Have Sex , Matt Ridley http://www.fastcodesign.com/1662632/frog-design-when-ideas-have-sex
http://www.pencilmuseum.co.uk/timeline_1900.aspx (Pencil History Timeline)
“The Crossroads Nation,” David Brooks, The New York Times, The Opinion Pages, November 8, 2010
“Ask Your Mentor for Help, Not Brownie Points,” Adam Bryant, The New York Times, Corner Office, November 7, 2010

Filed Under: Collaboration, Innovation

Frameworks: Evolution’s way of solving problems

August 16, 2010 By Wendi Leave a Comment

During one four-year period early in my career, I had the privilege of working with a leader in the then nascent field of family business consulting. Barbara Hollander was among those pioneering the application of family systems theory (in her case, Bowen Theory) to business dynamics as a way of helping family-owned business leaders better plan for and manage growth – especially transitions from one generation to the next. Barbara taught me that having a framework is useful because it brings messy and seemingly chaotic situations into focus. Frameworks provide boundaries and a point-of-view for understanding the gestalt of a situation (what is important, how things fit together or are related, etc.)

For a much longer stretch of my career, I’ve been surrounded by consultants who are essentially applied mathematicians – people who use mathematical models to approximate the way the world works in an attempt to make recommendations about which actions should be taken today that are most likely to achieve desired outcomes in the future. These models are also frameworks, but unlike the kind of frameworks that Barbara Hollander applied successfully to family business systems, many of these models have failed. They have proven themselves to be too narrowly construed and brittle to accommodate extreme events and their unforseen consequences in an increasingly inter-connected world. As a result, some of these applied mathematicians are expanding their frameworks to blend human judgment with output from mathematical models – a marriage of mathematics and social sciences that to-date has produced behavioral economics and will undoubtedly have more offspring.

At the same time, psychologists, neuroscientists, and artificial intelligence technologists are uncovering astonishing new insights about frameworks. Human beings appear to be hard-wired with a built-in problem-solving framework that starts as a survival mechanism and blossoms into a highly nuanced point of view as we develop. “One lesson from the study of artificial intelligence (and from cognitive science more generally) is that an empty head learns nothing: a system that is capable of rapidly absorbing information needs to have some prewired understanding of what to pay attention to and what generalizations to make. Babies might start off smart, then, because it enables them to get smarter.”(1) So, frameworks appear to be literally encoded in our DNA and are an essential element in acquiring insights that help us solve problems.

Frameworks are even more important when a group needs to problem-solve. When we talk about “getting everyone on the same page,” we are talking about formulating or using a common framework to give us at least a partial understanding of the problem. A common framework does the same thing for a group that it does for babies – it makes us collectively smart enough to use all of the attributes that individuals and groups apply to solving really difficult problems. Andrew McAfee’s latest blog describes these attributes in a post about how individuals and groups have achieved superior results developing solutions to the extremely complex problem of protein folding (a topic beyond the scope of this blog post – see McAfee’s blog to get a reference to the paper in Nature on protein folding that he is discussing).

Attributes that make human beings good at solving complex problems:

Spatial reasoning or seeing solutions (is this the DNA of frameworks?)
Intuition or hunches that are the result of experience
Adaptivity or the ability to change our approach
Language which biases us towards collaboration – an effective way to build and share knowledge
Self-organization, a kind of group adaptivity that uses each person’s capabilities to collectively solve problems
Competition, a motivating desire to win or be recognized in some way spurs us on

As the problems we face become increasingly complex, we appear to be well-suited as a species to solving them. Our DNA-encoded frameworks hard-wire us for ”smartness” and we possess a strong set of complex problem-solving attributes. In addition, we seem to be evolving our ability to invent frameworks in ways that blend soft judgment and hard data to achieve closer approximations of the true problems at hand. With this more “true” picture of the problem, we have a much better chance of zeroing in on a more effective solution.

(1) “The Moral Life of Babies,” Paul Bloom, The New York Times Magazine, May 9 , 2010

Filed Under: Collaboration, Decision-making

Leadership in the Age of Influence

August 2, 2010 By Wendi 1 Comment

Influence. Control. The line has been drawn in the sand. There are some who say that the battle has already been won or lost, depending on your point of view. However, few would dispute that a battle is underway. Twitter, Facebook, YouTube: Are they the three Furies of Social Networking sent to torment those who still believe that what it means to be in charge, in control, has not changed irrevocably?

In an article(1) describing how social networking is changing the face of diplomacy in the State Department, Hillary Clinton’s position is described as weighing in on the side of the benefits being greater than the risks of engaging in experiments that test the value of “…breaking through..by having people who are doing the work of our government be human beings, be personalized, be relatable.” The article showcases two relatively young members of the State Department who share not only information about their work, but also about their personal lives via Twitter, and who encourage others to engage with them to share information about the political goings on in their parts of the world. Compared with the tightly controlled environment in which most State Department communication takes place, this is the Wild West.

Supposedly, before the explosion of social networking, information and people could be controlled. Information leaks could be kept to a manageable minimum and if they did occur, broad dissemination could be contained. Now, the argument goes, that kind of control is gone. Proof point du jour: WikiLeaks recently scored a major coup with the publication of tens of thousands of pages of intelligence reports that have been dubbed the Afghan War Diary (http://wardiary.wikileaks.org/) detailing the bleak state of US Army efforts in that beleaguered country from 2004-2010. While not top secret, the information is secret and its release has prompted investigations and news coverage. The information has generated global debate which has doubled and redoubled the information that is available on the topic, an information spiral that has achieved a self-sustaining momentum, spinning out of control.

These developments in the public domain are affecting what goes on inside organizations. It is no longer acceptable, productive, or even possible to rely exclusively on control as a means of eliciting desired behaviors among employees. As someone who is interested in the confluence of knowledge management, radical collaboration, and innovation within organizational systems, the tension between control and influence seems to be stirring the pot when these three domains intersect (or collide). As information becomes harder to control, it seems that people are harder to control as well. Those who are charged with stewardship of an organization’s brand may understand that they are no longer in control when it comes to consumers or customers, but they are now grappling with the challenge of not being securely in control when it comes to employees either. For this reason, understanding what it means to lead in the age of influence seems acutely important.

Fast Company is running a project to find “2010’s Most Influential Person Online” (http://influenceproject.fastcompany.com/). This is what it says about influence:

Real influence is about being able to affect the behavior of those you interact with, to get others in your social network to act on a suggestion or recommendation. When you post a link or recommend a site, how many people actually bother to check it out? And what’s the likelihood of those people then forwarding it on? How far does your influence spread?

So, what are ways that people affect the behavior of others through influence rather than control. What really is the difference? (2)

Control – to exercise restraint or direction over; dominate; command.
Influence – to move or impel to some action.

Control implies that individuals have no real choice or freedom to act, influence suggests that they do, that there is no negative consequence if individuals choose to act in a way other than what is being suggested. Perhaps this is why in most organizational systems, reality lies somewhere between control and influence. In many cases, there are very real, very negative consequences to not acting in the way that is being suggested. Career development may evaporate, demotion or sidelining may occur – the subtle or not so subtle understanding may develop that it’s time to go elsewhere. If in organizational systems today, reality is more complicated than being on one side or the other of the control/influence divide, how do leaders determine when it is best to impel rather than compel? Can both be true at the same time or then is neither true? How do leaders inspire if they must also control?

The fact that the answers to these questions are murky is one reason why there is debate about how open and transparent organizations must be to succeed in the marketplace and society. It makes choices about knowledge management, innovation, and radical collaboration complicated and fraught with uncertainty. Learning how to lead in the age of influence might well be the next critical leadership skill.

Sources: