Wednesday, August 8, 2007

SICKO; Problems Being Solved

Michael Moore’s
SICKO Problems Being Solved

“If ever there was an idea whose time has come, this is the idea and this is the time.” -- Cal Thomas syndicated columnist

“…a documentary about healthcare that makes it an opportunity rather than a problem or a crisis,” - Sander Vanocur.

Good News…How Hospitals Heal Themselves
is a PBS documentary about using “Toyota” production methods to make hospitals safer and health care more affordable. It has generated intense viewer responses, international interest, and excellent reviews and it also answers the concerns raised by Michael Moore’s SICKO.

Good News, hosted by Lloyd Dobyns, clearly outlines how to reduce escalating costs, unnecessary deaths, and waste in America’s hospitals. Doctors and nurses tell how they did their best—working overtime—while hospital conditions worsened. They were initially dubious and then delighted to learn a new way—systems thinking— to improve patient care dramatically and reduce unnecessary deaths, suffering, errors, infections and costs without additional r
esources or government regulations.

Complexity and Blame
The surprising and significant lesson from the documentary broadcast is that most health professionals don’t know how to view modern, complex healthcare delivery as a process. That means they can’t understand that more effective healthcare requires that the hospital be managed as a system, problems identified and continual improvement practiced to eliminate waste and errors.

The media, the healthcare industry and the politicians are locked into the dramatic, single event anecdote. and, of course, blame. Blame defeats learning and improvement and the unnecessary deaths, suffering and waste continue to multiply because of increasing complexity and change. The documentary explains that “doing your best” without systems knowledge almost always makes situations worse in the modern world.

It reports how to avoid hospital infections. The Center for Disease Control predicts that one of every 22 patients will get an avoidable infection this year and
cost hospitals billions of dollars in un-reimbursed costs to treat them. Dr. Richard P. Shannon, who eliminates infections at a Pittsburgh hospital in the documentary, told the New York Times that the average infection costs a hospital an un-reimbursed $27,000. The healthcare industry needs to be educated about managing complex social systems. Policymakers and politicians need to understand that extending health insurance coverage will make care more expensive unless local hospitals begin to improve. Our national hospital system unnecessarily allows a jet load of patients to die each day.

The Need
This has been a pro-bono project by the producers, writers, cameraman and talent, who have reported these ideas for more than 25 years, helping many organizations begin to apply them.

More funds are needed to help PBS stations promote and feature the
documentary in prime time, particularly in major cities.

Another approach would be to distribute the companion book and documentary to the more than 6000 hospitals across the country so the administration, staff and board could see local possibilities for improvement.


Distributing/airing this program would help hospitals:

• Pioneer more efficient and effective health care.
• Demonstrate that the spiraling cost of health care, hospital-acquired infections and errors result from inadequate and antiquated management methods.
• Learn that the real cost of universal healthcare coverage can be paid by making present health care delivery more efficient and effective.

Washington Post critic Tom Shales wrote about the film:
"Good News: How Hospitals Can Heal Themselves" more than lives up to its title.
Overflowing with fascinating facts and enlightening anecdotes, this public-TV documentary about the much-discussed topic of health care in America goes where more TV journalism should go: beyond stating that potentially crippling problems exist and into the realm of how they can be corrected and catastrophe avoided. Host-writer Lloyd Dobyns and producer Clare Crawford-Mason take viewers on a tour of hospital nightmares that shows how intelligent thinking, systematically applied, can save time, save stress, and save lives. Potentially daunting subjects like not-so-comical nosocomial infections, Toyota's "five why's" approach to problem solving and dizzily spiraling health-care costs are made understandable; Dobyns' straightforward, no-nonsense presentation always clarifies and never confuses.

“(It is about) improving the odds for everybody who'll ever find themselves where they may least want to be: in a hospital hoping they don't come out sicker than when they went in. "Good News" really is good news, and good work as well.”

Viewer Reactions

Linda Sue Johnson of Lake Villa, Illinois believes her mother died from a hospital-acquired infection. After seeing Good News on PBS, she confronted the hospital’s administrators: They could view the documentary and begin quality improvement measures or she would bring suit for medical malpractice. She reports that the hospital’s risk manager has begun to show the documentary to staff and that the hospital is “already changing over to [systems thinking and process improvement] explained in the documentary.

Jim Duffy of the Dundee Scotland Community Health Partnership reported,
“The program provides great examples of how systems thinking delivers for the patient. It shows that concentrating on the patient is the way to improve services,
patient care, and to improve staff morale. The program is not challenging to watch – it is fascinating. But it is very challenging to think about the issues it raises. It has certainly made people wonder, “If it can happen in St. Joseph’s Hospital, (in America) why can’t it happen in Scottish hospitals?”

The Scottish National Health Service is now using the documentary and companion book throughout its health systems. And representatives of the Scottish government have formed a committee to investigate how to adopt these ideas across the government and in schools. Their purpose is that Scotland would become the first continual learning country.

Finney Mathew of Oklahoma City called to purchase a copy for his boss. He did not work for a hospital and was not in charge of training for his company. He was only a “wrench” (a mechanic) in his words who works for a car dealer. He saw the program and knew that his organization needed the same improvement principles being applied in hospitals.

Good Citizen Retiree Spreads the Word
Thomas Delehanty in Alton, Illinois, a retired postal worker, volunteers for hospice service in several hospitals. He purchased 12 copies of Good News so he could give one to each hospital in his county.

University Health Study
A committee of the University of Michigan is testing the documentary and book as a training tool in its health science programs according to regent Donald
Petersen, retired CEO of Ford Motor Company.

Hospital Trains with Good News…

Pardee Memorial Hospital in Hendersonville, NC
, ordered 80 copies of The Nun and the Bureaucrat… for study by their staff members. Many other hospitals are using it to educate personnel. To date, 149 health organizations in 34 states have ordered copies. It has not yet been aired in a number of states.

Prof. Ralph F. Mullin of Central Missouri State University has redesigned his
Design and Management of Quality Systems course to begin with the documentary and companion book, The Nun and The Bureaucrat: How They Found an Unlikely Cure for a America’s Sick Hospitals. “The students believe this book will best capture students' attention and excitement about learning systems thinking and design and transformation (implementation) of quality systems, he said.

Kevin Gilson is using the documentary in the Howard County, Md. Public School Career Academy to teach students and teachers about the cost of process of quality, problem solving and quality concepts. “The documentary provides real information to the students about what they might encounter in their internships
and how systems thinking has helped other organizations improve the quality of healthcare.” Other teachers are planning to use it next year.

They are learning what Toyota executives explain when asked what they do, “We are not in the business of making cars; we are in the business of making cars better.” Or in the case of hospitals, of taking better care of patients.

The Complaints?
Spokesmen for two national associations of hospitals and hospital executives said they didn’t like the documentary. It reported too many problems in
hospitals, they said, and their members would find nothing new. They knew about fixing hospitals.

Actions You Can Take

• Call your Public Television Station for a broadcast date.
• Check for a free discussion guide to the documentary and chapters of the companion book.
• Circulate this information to doctors, nurses, hospital administrators, patients, potential patients, members of hospitals boards, foundations, policy makers, people interested in reforming healthcare delivery, etc. etc.

To Order the DVD

Monday, July 23, 2007

Better Questions, Wiser Answers

Clare Crawford Mason
July 1, 2007
Washington Times Commentary

Why is no national leader or candidate discussing or studying solutions for

three of the country's most pressing problems: unsafe and wasteful
hospitals, the failing auto industry and an inadequate K-12 school system?
This is especially puzzling when there is an answer—unexpected — nearby.

A significant number of hospitals and schools are applying Toyota management
principles — originally developed by an American — and cutting costs,
reducing errors and deaths and turning out pleased patients or educated
students. But there is little notice or discussion of these successes.

American auto companies are exporting jobs and losing money. Toyota is
building more factories in the United States and making big profits.

The hospital crisis discussion is about funding health insurance for more
people. More effective, efficient and safer hospitals would save enough
money to extend care to all. No national leader or political candidate
questions the wisdom of extending insurance coverage for an American
hospital system that daily allows hundreds of patients to die from
preventable errors and infections.

Hand-wringing over the failing auto industry focuses on worker and retiree
benefits and foreign manufacturers. The school policy to combat lack of
quality is to administer more tests. It hasn't helped teachers or students
to achieve the real objective of better-prepared minds.

The long-term solution to all of them is not more money or better
technology. The problem is managerial. Surprisingly, although the auto
assembly line, the surgical unit and the classroom seem vastly different,
productive questions and solutions are similar and can be found in the same
management thinking.

The solution requires looking with "new eyes" at the 2007 school, hospital
or organization as a system and using problems as opportunities for
continual learning and improvement. This is the "Toyota method" and it
allows us to manage what we can't control. The idea of lack of control is a
difficult hurdle for Americans and their politicians.

Meanwhile, each day hundreds of people die from avoidable errors and
infections and millions of dollars are wasted in hospitals. Auto companies
and jobs are declining more rapidly than auto profits. And more and more
students are dropping out or not learning.

Americans like quick fixes and are suspicious of solutions "not invented
here," so it is important to note that the man who developed the theory to
better manage modern organizations began to devise his ideas as a young man
on the Wyoming frontier in the early 20th century. W. Edwards Deming
understood that Western towns prospered from barn raisings, quilting bees
and other cooperative efforts, not lone rugged individualists.

From 1950, he led Toyota and other Japanese export companies to work
"smarter not harder" with his revolutionary ideas of continual improvement
of products, processes and workers. His methods led to lower costs and
better products and more profits. Dr. Shoichiro Toyoda, chairman and former
president of Toyota, said, "Dr. Deming is the heart of our management."

Mr. Deming warned that hard work, cost-cutting and people doing their best
would not work in the complex enterprises of the 21st century.

For example, doctors and nurses from SSM Health Care, a Midwest system, with
22,000 employees and the Pittsburgh Regional Health Initiative, a group of
40 competing hospitals, report how they did their best in the past, working
overtime, while hospital conditions worsened. They were initially dubious
and then delighted to learn systems thinking and Toyota methods to improve
patient care dramatically and reduce unnecessary deaths, suffering, errors,
infections and costs without additional resources or government regulations.

SSM is the first hospital system to win the Baldrige National Quality Award,
which is a Commerce Department program based on the Japanese Deming Prize
dedicated to spreading these quality management ideas.

The Baldrige criteria, a practical approach to better management, are
virtually ignored by most government agencies and American businesses or
practiced piecemeal, which does not work.

Scotland's National Health Service uses these ideas to train its clinical
workers and a government task force is at work on a plan to make Scotland
the world's first learning society based on this approach.

The Deming-Toyota-Baldrige method and systems thinking can improve schools,
government agencies or any organization, even military invasions and
occupations, because it offers new ways to look at the bigger picture. It
allows an organization to be greater than the sum of its parts as the people
in the system learn to work together more effectively.

One thing more. The doctors and nurses in the successful hospitals frankly
say the patient has been lost amidst new technology, regulations,
reimbursements, etc. They say the Toyota approach allows the medical staff
to spend more time with patients and deliver more effective care. So the
solution is not computers or information. It is a new way of seeing and

And the puzzling question is why more hospitals, schools, government
agencies, etc. are not trying it.

Why is there no national debate on more effectively managing these critical
systems of our society? Why don't leaders/candidates investigate and discuss
new ways of approaching problems? The role of leadership is to identify
problems and propose solutions. If new ways of thinking and defining
problems are needed, that should be the subject of the presidential

Television news interested in delivering audiences to advertisers will
continue to concentrate on sick celebrities and missing persons, so raising
the pertinent issues is up to the candidates.
Effective management ideas don't fit in 15-second sound bites or on bumper
stickers. Perhaps our leaders and candidates have too short attention spans
to propose and debate complex solutions or are worried about boring the

Hopefully, it is not as G. K. Chesterton said, "It isn't that they can't see
the solution. It is that they can't see the problem."

Clare Crawford-Mason is the producer of "Good News: How Hospitals Heal
Themselves" on PBS stations and co-author with Louis Savary of the companion
book, "The Nun and the Bureaucrat — How They Found an Unlikely Cure for
America's Sick Hospitals" and co-author with Lloyd Dobyns of "Quality or
Else: The Revolution in World Business," and "Thinking About Quality:
Progress, Wisdom and the Deming Philosophy."

Washington Times Commentary

To Order This Book; Click Here

Watergate's Deep Throat; A Systems Thinker

by Clare Crawford-Mason

  • Deep Throat, the Watergate era informer, was most certainly a systems thinker.
  • Systems thinking allowed him to put the pieces together to reveal the big picture.
  • The United States needs systems thinking today to solve urgent problems, including its national security, education and healthcare crises.

    Deep Throat may be even more important in 2004 than he was in l974. In this year marking the 30th anniversary of President Richard Nixon’s resignation following the Watergate scandal, Americans will recall the informer who blew the whistle on all the president’s men. Deep Throat, nicknamed after a pornographic movie, was a mysterious White House insider who has become a historic figure--a popular icon like Paul Revere.

    Deep Throat understood, when no one else did, that a two-bit burglary and many other unconnected events and so-called “dirty tricks” were, in fact, the work of top administration officials, and he believed their cover-up was undermining the U.S. government and the Constitution.

    Everyone else—lawyers, the president, some of the perpetrators, investigators and the press corps—saw only separate, isolated pieces but did not know how to put them together to reveal the big picture.

    Seeing a system invisible to the rest of the participants helped Deep Throat connect the myriad dots of the puzzle amid tense circumstances. Moreover, he understood all dots are not created equal. He knew as an intuitive systems thinker certain important dots might be invisible, and he had an instinct for where those invisible dots could be found—for example, in the Department of Justice, the Committee for the Re-election of the President and the Oval Office.

    Once Upon a Time Most modern explanations of systems thinking involve jargon and, to the uninitiated, tedious details about technology, processes and automobile production lines.

    That detail may help academics and management experts begin to understand how systems and organizations might work better, but it is not an appealing route for the rest of us.

    For the rest of us, storytelling is a much quicker and more interesting introduction to systems thinking and a new mind-set for better understanding our world, our choices and other people. It also allows us to recognize leaders who can see the system and manage a continually improving future.

    Studying Deep Throat is a good place to start learning how a mind with systems intelligence works (see the sidebar “How and Why I Wrote This Article”).

    A number of books and articles over the years have speculated on Deep Throat’s identity. Washington Post reporter Bob Woodward, the only one who knows, has never revealed his source publicly.

    The more urgent and interesting question, however, is not who Deep Throat was, but how he did it. Possessing systems thinking allowed him to connect apparently unrelated events, weave together long threads of scattered evidence and ask perceptive questions that did not occur to the rest of us.

    What Deep Throat did, in effect, was lead Woodward, his colleague Carl Bernstein and the rest of us Watergate observers through an experiential workshop in systems thinking. The general instruction he gave the reporters to unravel the plot was, “Follow the money.”

    He assured them the money would connect the dots for them and eventually reveal the conspiracy’s entire “circulatory” system. Identifying resources is one way to sketch in the outlines of some systems.

    Deep Throat was not a conventional journalistic source, according to former Nixon White House counsel. In his book In Search of Deep Throat,1 Leonard Garment profiles Deep Throat and analyzes a number of possible candidates.

    Only occasionally did Deep Throat supply the reporters with new facts, according to Garment. “Instead, he gave them confirmation, usually cryptic, of information they had gathered elsewhere,” Garment wrote. “More important, Deep Throat provided Woodward and Bernstein with a general ‘perspective,’ to use his word, on the disparate pieces of information that the two journalists were uncovering.”

    Woodward described Deep Throat this way in a 1997 online conversation on the Washington Post Watergate website:2

    The source known as Deep Throat … provided a kind of roadmap through the scandal. His one consistent message was that the Watergate burglary was just the tip of the iceberg, part of a scheme and a series of illegal activities that amounted to a subversion of government. The interlocking nature of the crimes gave it weight and provided the context, and in fact one of the incentives for us to continue our investigations.

    Other Examples
    Systems thinkers—looking at the same events as others—are able to draw a bigger picture, ask different questions, make more accurate predictions and identify new opportunities and unsuspected problems. In mystery novels the detective or private investigator is usually a systems thinker who is able to weave scores of seemingly unrelated clues into a surprising resolution of the murder.

    Certain people throughout history—from Leonardo da Vinci to the fictional Sherlock Holmes—have randomly and intuitively accessed systems intelligence. Unfortunately, these geniuses did not decipher the elements of systems thinking in a way they could teach to others. Only recently have the elements of systems thinking been synthesized into a teachable skill.3

    Systems thinkers learn how to expand the tunnel vision of the ordinary thinker and comprehend more than the linear and tangible aspects of the larger picture. Using systems intelligence, they see and understand it as more than the sum of the parts.

    For example, in the children’s fable of the blind men and the elephant, the confusing and separate parts felt by the blind men become a whole elephant when assembled. Systems thinkers can also see when the whole is less than the sum of its parts—or less than its potential—as it is in most organizations, businesses, schools, individuals and teams today. They then understand how to begin to make improvements.

    The U.S. founding fathers were systems thinkers. No one of them alone could have created the American system of democracy. And their outcome was greater than the sum of their individual efforts.

    Wilkes and Barre, the men for whom Wilkes Barre, PA, was named, also saw a bigger picture. They were members of King George III’s parliament in the l8th century and urged the king not to tax the American colonists. They predicted it would only anger the colonists and bring them together to fight the English. And that’s what happened.

    Why Systems Thinking Is Important Today
    Systems thinking is suddenly vital to our survival, because it allows us to recognize, create and manage a future different from our immediate past and its dangerously outdated worldview.

    For the first time in history, our world is changing so rapidly that unconscious assumptions, beliefs and practices that helped us succeed in simpler yesterdays may be sabotaging our present and future. Systems thinking gives us new ways to see these outdated ideas and allows us to create a more accurate and useful worldview and a more desirable future.

    Today, when l9 terrorists in commercial aircraft can do more damage in a few minutes than an infantry platoon can in days or weeks, we need not only such systems thinkers, but also systems listeners and observers like Deep Throat. Both shuttle disasters, the 9-11 intelligence problems and the failure to plan how to occupy Iraq are examples of a lack of adequate systems thinking.

    The 9-11 Commission’s description of a “failure of imagination” could be explained as a failure of systems thinking.4

    In certain academic, government and business circles, a systems mind-set is now recognized as the most effective and perhaps the only way to manage the chaotic situations created by the confluence of revolutions in information sciences, technology, transportation and communication, not to mention the revolutions in terrorism and weapons of mass destruction.

    More and more, such big picture, long-term thinkers are needed in today’s changing, complex world. The short-term, personal gain, quick fix solutions of a traditional, linear, mechanical mind-set, which were usually successful in the past, are today actively damaging the government, the economy and individual citizens.

    Practicing systems intelligence also works in improving Fortune 500 companies, kindergarten classrooms, the government, hospital operating rooms and the family. Most of these people systems are capable of producing dramatically better results than the individuals acting separately can.

    Each person in a company, school system, hospital or White House can and do usually act alone on his or her separate task. When they can act together with agreed methods and common aim—the essence of a conscious systems approach—they can produce a greater and more effective result than the sum of their individual efforts. Common aims could be to reduce hospital-acquired infections, eliminate on-the-job accidents or teach l0-year-olds to read with higher levels of comprehension.

    Great efforts and good intentions, which sometimes worked well enough in the past, are not effective in today’s uncertain world. In fact, good intentions without knowledge of the larger system and the effects of change and complexity can be destructive and produce unintended, even dangerous consequences.

    Again, the Watergate burglary is an example. Nixon’s aides, Nixon’s own decision to cover up and the Washington Post reporters unintentionally came together into an unintended system of scandal, which for the first time in history drove out of office a U.S. president. It was the opposite of what the Nixon people wanted. It is a compelling example of the dangerous and unintended consequences of acting without understanding the big picture or system.

    Identified and managed, the unending multiplicity of systems—in which we all mostly unconsciously live and work—can produce better cars, better students, better medical care, better national security and a better quality of life. Conversely, ignored, misunderstood or sabotaged by unwitting good intentions, the community, family and national systems can and do wreak havoc—albeit unintentionally. And our standard of living and quality of life deteriorate.

    How Deep Throat did it is more important than who he was. How he did it suggests why it is imperative for all of us to improve our systems thinking and systems listening skills.

    How To Be a Systems Thinker
    Most of us could learn systems intelligence or thinking but don’t know how to begin. It is an ongoing process and requires commitment and practice. In fact, practicing and improving understanding of it is a lifelong process. The unexpected payoff is that it works in relationships at work and at home, as well as in your important relationship with yourself.

    A systems mind-set cannot be taught in any traditional academic manner. It must be learned and developed experientially, much like becoming proficient as an artist or musician or in speaking a new language. And like music and a new language, systems thinking must be practiced.

    Systems thinking is about organizing and planning to achieve an aim. Successful global manufacturers have used it in the past 25 years to capture world markets. It works not only on the production line, but on the personal and organizational level. It allows continually improving products, services and relationships with less effort and fewer resources, produces greater profits and, most importantly, gives joy and meaning to work and relationships.

    The first step is understanding such a powerful skill or mind-set exists and is within grasp. The second step is understanding every system from a global organization or a person to a tiny cell must have an aim. The next step is challenging your own and popular assumptions and surfacing your unconscious and unwarranted beliefs and asking whether they are true now.

    In the slower past, it usually didn’t matter whether assumptions about why things happened or what could be changed or improved were true. Today with more people and more technology producing more and more complex interactions—for example, the delivery of healthcare or weapon `s—we need to develop new ways of seeing what is happening and what is possible.

    Systems intelligence is about interactions: the interactions of people with each other and with technology. It is also about acknowledging the system and the world are always changing.

    Another step is to begin to look for the intangible connections between people and events. Systems thinkers must keep in mind that cause and effect can be widely separated in time and space.

    A useful practice is to imagine situations in which two plus two can equal four or five or three or 22 and begin to look for greater wholes. Greater wholes are more than the sum of their parts and can be anything from a fabulous soufflé or a prize winning drama to a successful marriage, symphony, family or individual.

    The musical composition of the instruments and notes played in order and proper time is a system or a greater whole. Other familiar examples of powerful wholes or systems are the human body and its individual organs or an automobile and its parts. None of the body organs or parts works on its own or has a separate agenda. A hand can’t write; only a person can. An eye doesn’t see; a human being does.

    A greater whole can be seen in teams that can accomplish more than the sum of the efforts of the individual members. It often happens that a group of ordinary players acting as a team can beat a team of stars merely trying to raise their personal scoring averages.

    Some experienced system teachers and sports coaches believe individuals can only achieve their greatest potential in a system or on a team. In other words, the best and most effective you can probably be is as a member of a well-managed system.

    Both NASA shuttle disasters, the problems of occupying Iraq, the education dropout rate, medical errors estimated to kill thousands of people yearly and much more can be traced to failures to consider the systems implications of apparently small problems and unwarranted assumptions.

    That is why the significant news on this 30th anniversary year of Nixon’s resignation is how Deep Throat did it rather than who he was.

    References and Notes
    1. Leonard Garment, In Search of Deep Throat, Basic Books, 2000.
    3. of the Ackoff Center has papers and conversations on systems thinking. There is also systems information on Pegasus Communications Inc.’s website at and on In2:InThinking Network’s website at Books on systems thinking include several by both Russell L. Ackoff and C. West Churchman, plus An Introduction to General Systems Thinking by Gerald M. Weinberg (Dorset House Publishing, May 2001) and Eve’s Seed Biology, the Sexes and the Course of History by Robert S. McElvaine (McGraw-Hill, 2001).
    4. Final Report of the National Commission on Terrorist Attacks Upon the United States, official government edition,

    Clare Crawford-Mason is the producer of “How To Heal a Hospital,” which will air on PBS in early 2005; “If Japan Can Why Can’t We?,” which aired on NBC-TV in l980; the “The Deming Video Library,” 28 volumes, 1986-1996; and “Quality or Else: the Revolution in World Business,” which aired on PBS in l991. Crawford-Mason co-authored Thinking About Quality: Progress Wisdom (Random House, 1995) and the Deming Philosophy and Quality or Else: The Revolution in World Business (Houghton Mifflin, 1992).


    How and Why I Wrote This Story

    By Clare Crawford-Mason
    In August 2002 I read that former deputy United Nations Ambassador Charles Lichenstein, a longtime Nixon staffer, had died in Washington. I recalled a long ago talk with him and began to wonder whether his story might be an interesting way to explain the power of systems thinking to a general audience.

    Ambassador Lichenstein was the mythic faceless bureaucrat, the John le Carré mystery novel figure no one notices, the man who seems not to be there but knows the secrets and wields the ultimate power.

    At a dinner party in the early l980s, he told me he was Deep Throat. Because I was a journalist, he immediately followed his admission with, “And that’s off the record.” I nodded.

    He proceeded to build an intimate and convincing mosaic of details about the Nixon White House and executive branch. Surprisingly to me if he was Deep Throat, he offered much praise for President Nixon.

    In l984 I asked him to step forward as Deep Throat on the l0th anniversary of Nixon’s resignation in a story for Esquire Magazine. After some days of agonizing, he finally said he could not agree to do the story. President Nixon, with whom he was still close, his Republican colleagues and friends would not understand, he explained.

    After his funeral, I discussed what Lichenstein had told me with other friends and colleagues. A year-long investigation turned up confirming evidence for Deep Throat as a systems thinker, Lichenstein as Deep Throat and a surprising motive for Liechtenstein, which fit with what he had told me. His friends believe he was trying to save President Nixon, the Republican Party and the country and was repulsed by Nixon lieutenants H.R. Haldeman and John Ehrlichman and their methods.

    Lichenstein’s résumé shows he was everywhere Deep Throat had to be. He worked throughout the executive branch and eventually as an assistant to President Nixon. He was the ghostwriter for Nixon’s 1962 book, Six Crises. Everyone trusted him. He had been director of research for the Republican National Committee and for the 1964 Goldwater campaign. He had also been a former CIA trainer.

    Besides being in the Nixon inner circle, he fit the oddball profile of Deep Throat in the book and movie All the President’s Men: mild and scholarly bachelor who talked like a lawyer, understood journalism, smoked heavily and drank Scotch. Lichenstein was also the first person to have said he was Deep Throat.

    After going through some of Lichenstein’s papers and interviewing most surviving Watergate figures except for Bob Woodward, who refused to be interviewed, I conclude Lichenstein is almost certainly the main source for Woodward and they probably met in that underground garage at least once or twice. Woodward has not denied Lichenstein was Deep Throat but said it was much more complex.

    But that is not important from a systems view. Deep Throat, both as characterized in the book and movie and in the man I talked with at the dinner party, offers an approachable example to understanding systems thinking.

    And the good news is that Deep Throat can perform another important and urgent service for Americans. This time we can learn how wider, more long-term viewpoints can help us improve complex and dangerous situations, prevent undesirable outcomes and create desirable ones Cutline

    NIXON SAYS GOODBYE: Richard Nixon boards a helicopter after resigning the presidency on Aug. 9, 1974. His resignation came after approval of an impeachment article against him by the House Judiciary Committee for withholding evidence from Congress.

  • Byline: Charles S. Lauer

    Unlikely pair find a cure; How applying theories that aid factories can help turn around hospitals.(Lauer's Letter)(Letter to the editor)

    Byline: Charles S. Lauer

    There are so many books about the healthcare industry that I often wonder who has the time to sort through them all. I must get a couple of dozen new ones a year. Most of these I set aside, thinking I might come back to them, but I seldom do. Occasionally, however, there is one that I pick up and have trouble putting down. One recent such book is The Nun and the Bureaucrat-How They Found an Unlikely Cure for America's Sick Hospitals by Louis Savary, a statistician and theologian, and Clare Crawford-Mason, a journalist.

    The book has a powerful ...

    Read the rest of this article

    Clare Crawford - Mason's Speech to the Deming Institute

    Profound Knowledge: A New Synthesis from a Transcending Perspective to Personal Improvement

    Remarks to the Deming Institute, April 27, l997, Alexandria, Va. By Clare Crawford-Mason

    As you know I am a recovering journalist who reported on the White House from late LBJ to early Ronald Reagan and I was quite sure I knew how the world worked until I met Dr. Deming. Then I learned I didn't know what I didn't know.

    It is a pleasure and honor to be with you all today, people who are interested and actively working to further Dr. Deming's ideas. I want to share with you one of my favorite video clips of Dr. Deming at the dedication of a room named for him at GM telling one of his best jokes and then, more importantly, describing his philosophy as a work in progress.

    Dr. Deming's description of his ideas as work in progress, something to be improved upon each day, continuing improvement, and continuing evolution are the themes of my remarks today.

    Most of you are familiar with how I met Dr. Deming in his basement in 1979, interviewed him there several times, understood nothing of what he said except the statement, "I taught the Japanese to work smarter not harder." However, I recognized that he was a prophet ignored in his homeland and knew that this was a story and reported it with Lloyd Dobyns in "If Japan Can," the NBC White Paper in l980.

    The Deming segment was less than l5 minutes of a 90-minute report including commercials; it was never shown over the air again, yet that small story and Dr. Deming's ideas have forever changed how we all work and live.

    We are all familiar with the systems diagram Dr. Deming put on the blackboard in l950 to show the Japanese industrial leaders that manufacturing was a system and should include the customer and supplier and be continually improved.

    I think of this drawing as a revolutionary artifact like Newton's falling apple and James Watt's mother's tea kettle. All involve ideas that changed the world. Today I want to bring you up to date on a sequel to that original story about Dr. Deming and his philosophy.

    First, Lloyd Dobyns and I have again met an unusual man whom we interviewed and after an entire day with him for the second time we did not understand what he was saying. This man, who is in the audience today, and whom some of you may have met yesterday, is Jefferson Vander Wolk. He is a successful businessman, manager and thinker. He wrote to Lloyd and me after reading our two books on quality. He said he thought that Dr. Deming's ideas had wider implications than are now recognized and wider applications then are now being made.

    Jeff said that he wanted to talk to us about writing a book on philosophy. Some of you know Dr. Louis Savary, a theologian, statistician and author of or collaborator on more than l00 books on management and spirituality. We took Lou with us to meet Jeff and translate, but he didn't understand in the beginning either.

    Since then the three of us, Lloyd, Lou and I, have been meeting with Jeff and writing together for more than a year and a half and we have two books underway, we have created some operational definitions and the end is not in sight.

    Today I am going to tell you about some of our conclusions that I believe will interest you. But first I must introduce you to three other 20th Century thinkers in addition to Dr. Deming.

    The first is Teilhard de Chardin, a French Jesuit and anthropologist who discovered Peking man. About l990 I introduced Dr. Deming to Father Thomas King, a Jesuit from Georgetown University and an expert on the philosophy of Teilhard.

    Earlier this century Teilhard had predicted a continuing improvement of human consciousness. I had been a student of Tom King's and produced a video about Teihard in the late eighties. Dr. Deming and Father King had several long, enjoyable lobster dinners and discussions.

    Father King said a special Teilhard mass at which Dr. Deming's music was played and he blessed Dr. Deming as a successor to Teilhard. We videotaped it but Dr. Deming didn't like the singer's rendition of his music.

    The second man is Georg Gurdjieff, a Turkish-Armenian teacher. In the late l980s at about the same time Dr. Deming was trying explain Profound Knowledge to me for the Deming Video Library, I became interested in a system of understanding yourself and others called the Enneagram. I learned that it stemmed from the work of Gurdjieff, a contemporary of Freud and Jung, who had started the Institute for the Harmonious Development of Man in Paris in the l920s.

    Frank Lloyd Wright, John Dewey, Georgia O'Keefe and others were among his followers. He wanted to teach individuals how to live more consciously in the world using practices that had only been attempted before by people who had withdrawn to monasteries or caves. His work is still studied and he has a home page on the internet and many links.

    I found a similarity between Dr. Deming's ideas and Gurdjieff's Enneagram. Both were interested in:
    • Continuing improvement,
    • Awareness of facts or what is really happening and
    • The elimination of personal blame.
    In l994 at a Stanford University conference, I made a presentation on Dr. Deming and the Enneagram. Incidentally, the Enneagram is the basis of the most popular class at Stanford Business School. We are producing a series of videos on leadership and the Enneagram with one of the two Stanford professors teaching that popular class.

    Some six months after the Stanford Conference, I received the first letter from Jefferson Vander Wolk asking Lloyd and me to consider doing a philosophy book. His letter had been prompted by our reports of Dr. Deming's work.

    We learned that Jeff had been reading Gurdjieff since the l970s in his own quest to be a better manager. Incidentally, Jeff's vision of a better manager was to reduce management time as much as possible. He wanted to create an environment where his people did not need his physical presence in his distant enterprises so he might devote more time not just to perfecting his golf and tennis, but to pursuing some key philosophical questions he had encountered in his business career.

    The third thinker is P.D. Ouspensky, a Russian mathematician, who wrote a book called "Tertium Organum, A Key to the Enigmas of the World," in l9l2. Jeff had read this book and had thought about the ideas in it for decades. In the book, which is still in print, Ouspensky predicts there is a second or higher level of logic waiting to be discovered. It is different from our ordinary linear logic. Linear logic addresses the world we see and says in effect that the whole must equal the sum of its parts. Two plus two must equal four. All of our present thinking and our present language is predicated on this visible world linear logic.

    Ouspensky predicted the discovery of a different logic, a higher logic that would parallel higher physics and higher math and would lead to a higher evolutionary path for mankind. As I said, he called the book Tertium Organum or the third organum of thought. Aristotle's Organon was the first and Bacon's Novum Organum was the second.

    Ouspensky, whose followers have created a homepage and many links on the world wide web, did not pursue the development of this higher logic after he predicted it. But in a truth-is-stranger-than-fiction drama Ouspensky met Gurdjieff and in the l920s carried to England his ideas about ways to develop human consciousness.

    Some 70 years later, Jefferson Vander Wolk, confined to bed with the flu, read our books on Deming and concluded that Deming had provided empirical proof of Ouspensky's prediction of a second or higher logic. A logic where the whole can be greater than the sum of its parts. A logic to plan, predict and manage in the complex, dynamic world we can't see, the world of interactions.

    Now, here is a way to describe these two kinds of logic, a way that Jeff and we have found clarified them for us: conventional logic and higher logic. Conventional logic addresses the visible world or, as the late Physicist David Bohm calls it, the "explicit" world. It is:
    • Linear
    • Quantitative
    • Static
    • Fragmented
    In contrast, higher logic addresses the non-visible or "implicate" world. It is:
    • Non-linear
    • Qualitative
    • Dynamic
    • Holistic
    Remember that Dr. Deming talked about "the most important numbers being unknown and unknowable," that would be the qualitative world, as would the variation in all things, processes, and statistics.

    Now as you managers and teachers who have applied Dr. Deming's principles know, we have been thrust into this new world by the speed of technological change. Adjusting to such change is not easy. The Industrial Revolution occurred over the span of several lifetimes and it caused great social disruption. We see today in the developing countries the great cultural difficulty in trying to make such a leap in a single lifetime or two.

    Meanwhile, we in the first world now are undergoing an apparently pleasanter, but much more difficult and jarring adjustment. There has been more change in our lifetimes than in all of history until now. The new, non-visible world enfolds the old and we must know how to operate in both and to move confidently and competently between them. Deming has helped us do this, even before most of us knew there was another world.

    This new logic requires that we modify our thinking and expand our language. You will remember that Dr. Deming said it took at least three exposures for anyone to begin to understand his ideas. Some student's left the four-day seminars transformed and some left angry.

    Physicist David Bohm describes this new world in his book "Wholeness and The Implicate Order." The Implicate Order (from the Latin "to be enfolded") is "a level of reality beyond our normal everyday thoughts and perceptions, as well as beyond any picture of reality offered by a given scientific theory."

    In the Implicate Order, Bohm says that "everything in the universe affects everything else because they are all part of the same unbroken whole." He says that "the inclination towards fragmentation is embedded in the subject-verb-object structure of our grammar, and is reflected at the personal and social levels by our tendency to see individuals and groups as 'other' than ourselves, leading to isolation, selfishness and wars," what Dr. Deming called barriers.

    We can now observe that, seemingly without knowing it, Dr. Deming in his approach to managing organizations devised a case of the higher logic predicted by Ouspensky and Bohm, the first broad-based and readily verifiable case of that logic.

    But exciting and perplexing as that theory is, that general conclusion is only half the story on which Jeff, Lloyd, Lou and I are working. To explain the other half, I want to talk to you about a concept called Convergent Integration, which is the common thread tying Dr. Deming and all of these others together.

    The term "convergent integration" was first used by the English philosopher Julian Huxley to describe the human trend toward central convergence, increasing organization and growth. And that is what Jeff and we are calling this new logic, which says that when certain conditions of assembly are met, the whole can be greater than the sum of its parts.

    Convergent Integration: a new logic which says that then when certain conditions of assembly are met, the whole can be greater than the sum of its parts.

    This may be the time to further explain that what prompted Jeff to contact Lloyd and me was that he had developed and pursued a problem solving logic in his management work and he kept reaching conclusions that contradicted conventional wisdom. As he read our books, he saw similar results of Deming's that contradicted conventional wisdom. He also saw that both his logic and Deming's were based on the concept that a properly integrated whole will be greater than the sum of its parts.

    Which brings us back to Convergent Integration. Convergent integration can be seen in a jigsaw puzzle; when assembled, a picture or transcending perspective appears. It can be seen in an automobile; the parts assembled produce something greater than their sum: a means of transportation. In problem solving, the solution is a greater whole brought into being by assembling the facts. A winning sports team can be greater than the sum of its parts, so can an orchestra, so can a marriage, and so on.

    Some historic examples of this happening at random would be the Founding Fathers setting up the conditions of democracy or the men who split the atom. None of them could have done it alone, but together they could.

    Dr. Deming practiced convergent integration without having a name for it. In Profound Knowledge he integrated four disciplines: systems thinking, statistical thinking, epistemology, and psychology, into a revolutionary system of management.

    None of the four disciplines is a philosophy of management by itself; yet taken together they created a management force no one had ever imagined. Profound knowledge is greater than the sum of its parts.

    Another way to describe Dr. Deming's Profound Knowledge is as a system of application of convergence logic toward the continuing improvement of products and services. The successful business practicing Deming becomes a whole that is greater than the sum of its parts.

    Deming showed the way to a method where a group or team of people working together for a common purpose can be greater than the sum of its parts. Through Profound Knowledge, Dr. Deming helped Japanese and American industries eliminate cross purposes between labor and management, which lead to the elimination of cross purposes among divisions.

    Deming's Profound Knowledge created a greater whole in these industries. Jeff explains that he saw that this greater whole resulted from a reversal within the organization that transformed conflict into complementarity. And in doing so it created internal momentum toward continual improvement.

    "Eliminating cross purposes" is Jeff's term and I think it makes understanding Profound Knowledge easier.

    Cross purposes and divergences prevent the creation of unity. Deming's system effectively eliminates cross purposes and divergences between groups working in association; however, two additional sets of cross purposes and divergences remain largely unresolved. One occurs between individuals. The other within an individual.

    Eliminate cross purposes
    • Organizational level: (labor and management)
    • Departmental level
    • Relational level (between persons)
    • Personal Level (within individuals)
    We can use the principles of Convergent Integration to take Deming's ideas to the next level, a level he already intuited but did not have time to elaborate.

    First, we can use Convergent Integration for the systemic elimination of cross purposes between persons, which are perpetuated by biases, unnecessary speculations and personal agendas.

    And then we can use Convergent Integration to remove cross purposes within individuals. We do this by helping them (or ourselves) eliminate biases, unnecessary speculations and become conscious of various conflicting internal agendas and personalities. This is the work of the Enneagram. Gurdjieff said that a person who begins to achieve interior integration of various personalities is developing "unified presence."

    A practical application of this would mean that the same logic applied by Dr. Deming to achieve unity in an organization and the continual improvement of products and services can be utilized in a directed approach to achieve radical improvements in problem-solving and teamwork skills

    And there is an even more significant promise of this new logic. Jeff, Lou, Lloyd and I have come to believe that if you take:

    *Deming's practical application of higher logic, the Convergent Integration of people to create an organization with internal unity; Recognize it as a validation of: *Ouspensky's prediction and description of precisely such a logic and then add to it: *Gurdjieff's theory of the development of individual consciousness, and *Teilhard's theory of group evolution to a higher level of understanding and convergence in human consciousness, you arrive not only at breakthrough potentials in problem solving and teamwork, but at a complete theory of evolution in consciousness.

    A philosophy of the evolution of consciousness
    • Deming
    • Ouspensky
    • Gurdjieff
    • Teilhard
    Once again, like Deming integrating four disciplines into Profound Knowledge, we are integrating the ideas of these four men. None of their ideas taken individually is a complete theory of the evolution of consciousness, but the ideas convergently integrated together produce just such a theory.

    And we are thinking that this new integration of the four philosophers could be called Profound Consciousness or the systemic application of higher logic toward the continuing improvement of people.

    Or to build on what Dr. Deming specified, Profound Knowledge opens the way to joy in work and joy in learning, while Profound Consciousness would enhance these values and lead to joy in relationship and joy in self --in short-- better and better quality of life.

    Of course, the implications reach far beyond the business world. We are talking about the next step in evolution and also saying that consciousness has potential control over its own evolution. Just as a corporation has potential control over its own success.

    Jeff and we are saying that a group of people who have been able to achieve unified presence and are practicing Deming's logic would be able to, again and again, predictably produce results greater than the sum of their parts. Results that most of us can hardly imagine. Neither James Watt nor Isaac Newton -- or their neighbors -- could have imagined today's world.

    This new and higher world of Profound Knowledge and Profound Consciousness could well lead to a different view of space, time, human consciousness and what is important.

    We conclude that Deming and David Bohm were beginning to describe this. Deming, as he drew the systems diagram for the Japanese industrialists, told them you must see manufacturing as a system, not just bits and pieces.

    David Bohm said: "At present, people create barriers between each other by their fragmentary thought. Each one operates separately. When these barriers have dissolved, then there arises one mind, where they are all one unit, but each person also retains his or her own individual awareness."

    Teilhard and Bohm both believed that if you were able to get a group of people working together with one another at a different plane, they might find a new way to operate that would not be simply individual.

    We call a basic version of this new way of operating a "team." An ordinary team is a group of people who have a shared task. But imagine how powerful a team could be if the individuals in it would operate as if with one mind yet retain their individuality.

    We all know or suspect that we do not use all of our intelligence. Gurdjieff spoke of humans as having three centers of intelligence, the head, the heart and the instinctive. His work was aimed an integrating them into a greater intelligence for the individual, just as Deming was interested in integrating individuals into a team.

    Einstein said, "We have to think, with feelings in our muscles." I would like to give you an idea of what this means about individual and group potential and a personal metaphor to take away. Imagining our potential is as complex and as simple as this: when you ride a bicycle or drive an automobile, you are engaging in a movement you can't describe or even comprehend. That's the implicate order that is enfolded in you. You have capacities within you that are phenomenal, if you only knew how to release them.

    Jeff is working on a series of principles, not lists of things to do, but principles of how individuals and organizations might begin to practice these ideas and utilize these phenomenal capacities within each of us. We hope these methods can help us begin to achieve what has only been random in the past. It is an exciting project.

    Practically, what we are talking about is a directed approach to radically increasing the problem-solving and teamwork skills of people working in Deming organizations. Or using this problem solving and teamwork building to introduce Deming to organizations. These are skills that have surfaced in the past, but randomly. We are working on devising a directed approach.

    In that regard, our books will depend on the quality of our examples and metaphors, and for that we need your help. If you have examples of extraordinary teamwork or if you have found an effective way to describe and teach related ideas, please contact us.

    We have an inkling that perhaps these ideas can only be learned, not taught. And we are well aware of how rewarding or frustrating that can be for student and teacher. We are interested in your experiences.

    Please contact us by e-mail, regular mail, telephone, whatever. Leave your comments on our feedback page or send us an e-mail message.

    Sunday, July 22, 2007

    Quality or Else

    Quality or Else (Magill Book Reviews)

    At a glance:

    For most of the last fifty years, the United States was the leading economic force in the world, at one point controlling a third of the total world economy and making half of the manufactured goods. Yet today Americans buy more from other countries than we sell to them: what happened? While U.S. companies were concentrating on producing the greatest quantity at the lowest price—the strategy which resulted in economic world domination after World War II—the rules of the game changed. The focus now is not how many you make, but how well you make them, an approach first perfected by the Japanese.

    Ironically, it was Americans who taught Japan about managing for quality. QUALITY OR ELSE describes the training program instituted to help rebuild the Japanese economy after the war. The teaching of W. Edwards Deming had the profoundest and most lasting impact, and an entire chapter is devoted to an analysis of the differences between his theories and those of the other three major quality experts (Juran, Crosby, and Feigenbaum). This sort of theoretical discussion is not the authors’ strong suit (they cheerfully admit that they’re journalists, not technical experts), but the bulk of the book is devoted to more practical matters.

    These include success stories: small companies (Romac Industries), large corporations (Motorola), even a public school (Mount Edgecumbe High in Sitka, Alaska). Chapters cover the current state of U.S. business education and the government deficit (part of the problem), and the Malcolm Baldrige National Quality Award (part of the solution). Personal interviews were the main research technique (the book is a companion to a PBS series), so this is certainly not a rigorous survey; but Dobyns and Crawford-Mason did interview the right people, and quotes read better than statistics.

    This casual quality is the main drawback of QUALITY OR ELSE: Reported rather than researched, much of its argument directed at the heart rather than the head, it ignores complexities in its urgent call to action. But it does offer a broad, readable discussion of an important area largely dominated by books devoted to the theories of one of the quality gurus.

    To Purchase Quality or Else...

    Click Here