Harvard Business Review - September 2011


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It must be hundreds of times. Sure, the articles are long although they are shorter than they used to be , but being an effective manager requires that you take time to contemplate the business world from a perspective larger than that of your own company. And reading HBR does that! This classic article on delegation and time management can help even the most harried manager. Make sure that subordinates leave your office with the monkeys that they brought in!

Written by Peter Drucker, the article walks readers through a self-analysis that reveals just how they can contribute the most to their organizations and achieve professional satisfaction at the same time. Work to improve the way you perform.

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Good people leave. Those who remain are unhappy.

DIS 2018: Maureen Hoch, Harvard Business Review

We also experience the failure-to-ask-why syndrome and neglect to investigate the causes of good performance. To overcome these three learning impediments, executives should examine successes with the same scrutiny they apply to failures. Such organizations are missing a big opportunity: Failure may be inevitable but, if managed well, can be very useful. McGrath describes several principles that can help you put intelligent failure to work.

You should decide what success and failure would look like before you start a project. Document your initial assumptions, test and revise them as you go, and convert them into knowledge.


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Limit the number of uncertainties in new projects, and build a culture that tolerates, and sometimes even celebrates, failure. Finally, codify and share what you learn. They will help you use small losses to attain bigger wins over time. Politicians and winning sports teams draw their biggest lessons from their toughest losses, he says, and the same has been true for him.

Most business failures—such as engineering disasters, product malfunctions, and PR crises—are foreshadowed by near misses, close calls that, had luck not intervened, would have had far worse consequences. The problem is that near misses are often overlooked—or, perversely, viewed as a sign that systems are resilient and working well. Seven strategies can help managers recognize and learn from near misses: They should be on increased alert when time or cost pressures are high; watch for deviations in operations from the norm and uncover their root causes; make decision makers accountable for near misses; envision worst-case scenarios; be on the lookout for near-misses masquerading as successes; and reward individuals for exposing near misses.

Failure is a familiar trauma in life, but its effects on people differ widely. Some reel, recover, and move on with their lives; others get bogged down by anxiety, depression, and fear of the future. Seligman, who is known as the father of positive psychology, has spent three decades researching failure, helplessness, and optimism. He created a program at the University of Pennsylvania to help young adults and children overcome anxiety and depression, and has worked with colleagues from around the world to develop a program for teaching resilience.

That program is being tested by the U.

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Army, an organization of 1. Nevertheless, businesspeople can draw lessons from resilience training, particularly in times of failure and stagnation. MRT focuses on enhancing mental toughness, highlighting and honing strengths, and fostering strong relationships—core competencies for any successful manager. Seven CEOs, entrepreneurs, and venture capitalists tell stories of personal failures—and what they learned from them.

Anthony Tjan describes the ups and downs of his start-up when the irrationally exuberant dot-com boom went bust. Wayne Pacelle , head of the Humane Society, talks about the importance of closing the deal. Just look at the first cross-border acquisitions that Chinese companies made. Chinese acquirers have learned to steer clear of deals that involve costly turnarounds or tricky integration. And where they once tried to buy market share abroad, today they focus on acquisitions that will help them strengthen their share in China.

When Antioco joined Blockbuster, in , outsiders were predicting that the bricks-and-mortar video rental business would be killed off by market shifts and technological advances. But he believed the company could remain relevant. Then the company jumped into the online business and eliminated its late fees, which had been a major customer irritant. Icahn launched a successful proxy fight and secured seats on the board for himself and two others, putting Antioco on the defensive over his strategies for growth.

Similarly, equipment costs can be avoided if changes in processes, treatment protocols, or patient mix eliminate the demand for the resources. Equipment no longer needed can be retired or sold to other health care institutions that are expanding their capacity.

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Any accurate costing system must, at a fundamental level, account for the total costs of all the resources used by a patient as she or he traverses the system. That means tracking the sequence and duration of clinical and administrative processes used by individual patients—something that most hospital information systems today are unable to do. In the meantime, it is possible to determine the predominant paths followed by patients with a particular medical condition, as our pilot sites have done.

With good estimates of the typical path an individual patient takes for a medical condition, providers can use the time-driven activity-based costing TDABC system to assign costs accurately and relatively easily to each process step along the path. This improved version of activity-based costing requires that providers estimate only two parameters at each process step: the cost of each of the resources used in the process and the quantity of time the patient spends with each resource.

See Robert S. Kaplan and Steven R. In its initial implementation, such a costing system may appear complex. As health care providers begin to reorganize into units focused on conditions, standardize their protocols and treatment processes, and improve their information systems, using the TDABC system will become much simpler.

Consider Patient Jones, who makes an outpatient visit to a clinic. Just three clinical resources are required: an administrator Allen , a nurse White , and a physician Green.

We begin by estimating the first of the two parameters: the quantity of time capacity the patient uses of each resource at each process. From information supplied by the three staffers, we learn that Jones spent 18 minutes 0. Next, we calculate the capacity cost rate for each resource—that is, how much it costs, per hour or per minute, for a resource to be available for patient-related work—using the following equation:.

The numerator aggregates all the costs associated with supplying a health care resource, such as Allen, White, or Green. It starts with the full compensation of each person, including salary, payroll taxes, and fringe benefits such as health insurance and pensions. To that we add the costs of all other associated resources that enable Allen, White, and Green to be available for patient care. These typically include a pro rata share of costs related to employee supervision, space the offices each staffer uses , and the equipment, information technology, and telecommunications each uses in the normal course of work.

Supervision cost, for example, can be calculated on the basis of how many people a manager supervises. This calculation starts with days per year and subtracts all the time that the employee is not available for work. The calculation for Nurse White is as follows:. Nurse White is therefore available for patient work hours per month 6 hours a day for As this example demonstrates, accurately calculating the cost of delivering health care is quite straightforward under the TDABC system. Although the example is admittedly simplified, it captures almost all the fundamental concepts any health care provider needs to apply to estimate the cost of treating patients over their full cycles of care.

They can calculate total and average costs for any category or subcategory of patients while still capturing the detailed data on individual patients needed to understand the sources of cost variation within each category. For each condition, we define the beginning and end of the patient care cycle.


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For chronic conditions, we choose a care cycle for a period of time, such as a year. The CDVC focuses providers on the full care cycle rather than on individual processes, the typical unit of analysis for most process improvements and lean initiatives in health care. This overall view of the patient care cycle helps to identify the relevant dimensions along which to measure outcomes and is also the starting point for mapping the processes that make up each activity.

Next we prepare detailed process maps for each activity in the care delivery value chain. Process maps encompass the paths patients may follow as they move through their care cycle.

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They include all the capacity-supplying resources personnel, facilities, and equipment involved at each process along the path, both those directly used by the patient and those required to make the primary resources available. In addition to identifying the capacity-supplying resources used in each process, we identify the consumable supplies such as medications, syringes, catheters, and bandages used directly in the process.

These do not have to be shown on the process maps. Our pilot sites used several approaches for creating process maps. Even at this early stage in the project, the sessions occasionally identified immediate opportunities for process and cost improvement. We also estimate how much time each provider or other resource spends with a patient at each step in the process.

Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011
Harvard Business Review - September 2011 Harvard Business Review - September 2011

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