In Their Own Words

In our 4th interview podcast of 2019, Donald Berwick, co-founder and former President and CEO of IHI, the Institute for Healthcare Improvement, shares his Deming Journey. Dr. Berwick, who presented at The Deming Institute's 2018 Conference, is one of the nation's leading authorities on healthcare quality and improvement.

(This is Tripp's first interview with Dr. Berwick)

Highlights include:

• His training as a pediatrician
• His efforts to apply quality management, before his introduction to the Deming Philosophy
• Co-Founded IHI in 1989 as a non-profit organization
• Appointed by President Obama, in July 2010, to the position of Administrator of the Centers for Medicare and Medicaid Services (CMS), which he held until December, 2011
• Ran for governor of Massachusetts in 2014
• 4 children and 7 grandchildren
• Attended a Four-day Seminar with Dr. Deming in 1986, leaving early and then returning
• Prior to meeting Dr. Deming, serving as "VP of Inspection"
• In the world of inspection, everything stayed the same
• Waiting times of 2 minutes for x-rays were reported to him (with falsification) by the radiology department
• "Do something about it"
• Question: What is the pushback that you see today in healthcare?
• The Red Bead Experiment was "electrifying," including triggering a vicious cycle of blame by management and withdrawal by willing workers.
• The workforce (willing workers) wants to do well
• The influence of Dr. Deming, and others, on IHI
• Prescriptions for fixing healthcare - "It takes leadership"
• General tone of healthcare today; "measure enough, yell enough, things get better"
• Continued focus today (backsliding) on measurement for inspection
• Question: What are physicians learning today about management? Answer: "Heroism as the route to excellence"

In our 4th interview podcast of 2019, Donald Berwick, co-founder and former President and CEO of IHI, the Institute for Healthcare Improvement, shares his Deming Journey.  Dr. Berwick, who presented at The Deming Institute's 2018 Conference, is one of the nation's leading authorities on healthcare quality and improvement. 

(This is Tripp's first interview with Dr. Berwick)

Highlights include:

• His training as a pediatrician
• His efforts to apply quality management, before his introduction to the Deming Philosophy
• Co-Founded IHI in 1989 as a non-profit organization
• Appointed by President Obama, in July 2010, to the position of Administrator of the Centers for Medicare and Medicaid Services (CMS), which he held until December, 2011
• Ran for governor of Massachusetts in 2014
• 4 children and 7 grandchildren
• Attended a Four-day Seminar with Dr. Deming in 1986, leaving early and then returning
• Prior to meeting Dr. Deming, serving as "VP of Inspection"
• In the world of inspection, everything stayed the same
• Waiting times of 2 minutes for x-rays were reported to him (with falsification) by the radiology department 
• "Do something about it"
• Question: What is the pushback that you see today in healthcare?
• The Red Bead Experiment was "electrifying," including triggering a vicious cycle of blame by management and withdrawal by willing workers.
• The workforce (willing workers) wants to do well
• The influence of Dr. Deming, and others, on IHI
• Prescriptions for fixing healthcare - "It takes leadership"
• General tone of healthcare today; "measure enough, yell enough, things get better"
• Continued focus today (backsliding) on measurement for inspection
• Question: What are physicians learning today about management? Answer: "Heroism as the route to excellence"

In our 4th interview podcast of 2019, Donald Berwick, co-founder and former President and CEO of IHI, the Institute for Healthcare Improvement, shares his Deming Journey.  Dr. Berwick, who presented at The Deming Institute's 2018 Conference, is one of the nation's leading authorities on healthcare quality and improvement. 

(This is Tripp's first interview with Dr. Berwick)

Highlights include:

• His training as a pediatrician
• His efforts to apply quality management, before his introduction to the Deming Philosophy
• Co-Founded IHI in 1989 as a non-profit organization
• Appointed by President Obama, in July 2010, to the position of Administrator of the Centers for Medicare and Medicaid Services (CMS), which he held until December, 2011
• Ran for governor of Massachusetts in 2014
• 4 children and 7 grandchildren
• Attended a Four-day Seminar with Dr. Deming in 1986, leaving early and then returning
• Prior to meeting Dr. Deming, serving as "VP of Inspection"
• In the world of inspection, everything stayed the same
• Waiting times of 2 minutes for x-rays were reported to him (with falsification) by the radiology department 
• "Do something about it"
• Question: What is the pushback that you see today in healthcare?
• The Red Bead Experiment was "electrifying," including triggering a vicious cycle of blame by management and withdrawal by willing workers.
• The workforce (willing workers) wants to do well
• The influence of Dr. Deming, and others, on IHI
• Prescriptions for fixing healthcare - "It takes leadership"
• General tone of healthcare today; "measure enough, yell enough, things get better"
• Continued focus today (backsliding) on measurement for inspection
• Question: What are physicians learning today about management? Answer: "Heroism as the route to excellence"

In our 26th "Deming Lens" episode, host Tripp Babbitt shares his interpretation of wide-ranging aspects and implications of Dr. Deming's theory of management.

Topics in this episode include:

• The 11th of Dr. Deming’s 14 Points –  11A -  Eliminate work standards.  11B - Eliminate Management by Objective, MBO.  Substitute leadership
• Dr. Deming, “Quality, for the plant manager, is getting his 1200 items out today. He jolly well better get them out.   He doesn’t mind that he doesn’t have quality.    That’s perfectly alright.    But, numbers.  What people need is leadership and help, not just be required to turn out so many.   That will not bring improvement.  That will not decrease cost.”
• Trouble calls, being placed on hold – not a people problem, rather a system problem
• AHT, Average Handle Time, the average time to handle a call
• What about variation in Handle Time?
• AHT goals can make service worse, not better
• The usual games of meeting Handle Time goals, including calls being ended early by the agent
• Look for evidence of Handle Time goals when watching service providers at work
• Other than the worker having numerical goals (quotas) placed upon them, they are also placed on members of management
• Goals for quarterly dividends
• Game being played, including early shipments, making the numbers “look better”
• MBO still prevalent today
• SMART goals, Specific, Measureable, Attainable, Relevant, and Timely
• What about seeing systems and understanding variation?
• Neo-Taylorism, serving to reduce synergies
• Deming, “A quota is incompatible with never-ending improvement”
• By what method (will the goal be achieved)?
• Once you hit the goal, are you done?

Dr. Deming's 14 Points are fully covered in Out of the Crisis. The New Economics presented his later thinking about the 14 points. 

In our 3rd interview podcast of 2019, Wendi Middleton, Director of Continual Quality Improvement, from the Aging Adult Services Agency within the State of Michigan's Department of Health and Human Services, and Dennis Sergent, President, Sergent Results Group, share reflections on the "Challenges and Opportunities in Applying the Deming Philosophy in Government."

(This is Tripp's first interview with Wendi and Dennis)

Highlights include:

• A 5-year history of applying the Deming Philosophy within the State of Michigan's Department of Health and Human Services (HHS)
• The development of Aging and Disability Resource Centers
• Learning "Who are our partners?"
• Where to start? / Who does what to whom?
• Family services and a cat
• First exposure to the Deming Red Bead Experiment
• Getting to know each other better within Michigan's HHS
• Creation of the BOLD ("Building Options for Long Term Decision-Making") Council
• Acronyms as an art-form
• Detailing the processes - Where to start and where to integrate?
• Exposure to control charts within the Bell Telephone System
• Education and steps to move forward
• Creation of the BOLD ("Be OLD") Councils
• Acronyms as an art-form
• Grant funding provided consulting help
• Process steps, including road blocks and issues
• Subject Matter Experts (SME) and Design Teams
• A focus on quality improvement, not change
• Policy changes, with improvements
• Living at home, using improvements in non-emergency transportation services
• Weekly Stand-and-Deliver meetings to review ongoing PDSA efforts
• Continual Improvement efforts are not always "linear," with forward improvement (sometimes they go backwards)
• State government is a culture all by itself
• People sometimes become their job (position)
• Getting people on board with improvement; not always happy fits, some move on to other positions
• Managing "Level-of-Care Determinations"
• When facing system obstacles, take inspiration from Eleanor Roosevelt, Don't take a "No" (answer) from someone without the authority to say "Yes"
• Setting new standards for working with state vendors
• New skills by Design Team members
• "Everything is designed around getting money from the federal government"
• Design Team roles are about improving access to state services, not finding sources of funding
• Effectiveness (doing the right thing), before efficiency (faster, better, cheaper)
• Cost savings have been measured, yet the bigger impact is serving more people for a given budget allocation
• Reducing the waiting list for services
• Instead of asking for more money, ask if the existing process can be improved to provide better service
• Discovering a mindset that if some don't have a problem with a given process, others won't as well (meaning, the process is deemed to be OK as is, while it may well need improvement)
• Impact on Design Teams after attending The Deming Institute's "Me vs We workshop"
• Getting over self-interest issues
• T-Shirt idea, "The Status Quo is Not an Option"
• Avoiding doing better what needs not be done
• Design Teams need ongoing support, including starting with on-boarding and ground rules
• Emergence of self-respect and respect for others

In our 3rd interview podcast of 2019, Wendi Middleton, Director of Continual Quality Improvement, from the Aging Adult Services Agency within the State of Michigan’s Department of Health and Human Services, and Dennis Sergent, President, Sergent Results Group, share reflections on the "Challenges and Opportunities in Applying the Deming Philosophy in Government."

(This is Tripp's first interview with Wendi and Dennis)

Highlights include:

• A 5-year history of applying the Deming Philosophy within the State of Michigan's Department of Health and Human Services (HHS)
• The development of Aging and Disability Resource Centers
• Learning "Who are our partners?"
• Where to start? / Who does what to whom?
• Family services and a cat
• First exposure to the Deming Red Bead Experiment
• Getting to know each other better within Michigan's HHS
• Creation of the BOLD ("Building Options for Long Term Decision-Making") Council
• Acronyms as an art-form
• Detailing the processes - Where to start and where to integrate?
• Exposure to control charts within the Bell Telephone System
• Education and steps to move forward
• Creation of the BOLD ("Be OLD") Councils
• Acronyms as an art-form
• Grant funding provided consulting help
• Process steps, including road blocks and issues
• Subject Matter Experts (SME) and Design Teams
• A focus on quality improvement, not change
• Policy changes, with improvements
• Living at home, using improvements in non-emergency transportation services
• Weekly Stand-and-Deliver meetings to review ongoing PDSA efforts
• Continual Improvement efforts are not always “linear,” with forward improvement (sometimes they go backwards)
• State government is a culture all by itself
• People sometimes become their job (position)
• Getting people on board with improvement; not always happy fits, some move on to other positions
• Managing “Level-of-Care Determinations”
• When facing system obstacles, take inspiration from Eleanor Roosevelt, Don’t take a “No” (answer) from someone without the authority to say “Yes”
• Setting new standards for working with state vendors
• New skills by Design Team members
• “Everything is designed around getting money from the federal government”
• Design Team roles are about improving access to state services, not finding sources of funding
• Effectiveness (doing the right thing), before efficiency (faster, better, cheaper)
• Cost savings have been measured, yet the bigger impact is serving more people for a given budget allocation
• Reducing the waiting list for services
• Instead of asking for more money, ask if the existing process can be improved to provide better service
• Discovering a mindset that if some don’t have a problem with a given process, others won't as well (meaning, the process is deemed to be OK as is, while it may well need improvement) 
• Impact on Design Teams after attending The Deming Institute’s “Me vs We workshop” 
• Getting over self-interest issues
• T-Shirt idea, “The Status Quo is Not an Option”
• Avoiding doing better what needs not be done
• Design Teams need ongoing support, including starting with on-boarding and ground rules
• Emergence of self-respect and respect for others

In our 3rd interview podcast of 2019, Wendi Middleton, Director of Continual Quality Improvement, from the Aging Adult Services Agency within the State of Michigan’s Department of Health and Human Services, and Dennis Sergent, President, Sergent Results Group, share reflections on the "Challenges and Opportunities in Applying the Deming Philosophy in Government."

(This is Tripp's first interview with Wendi and Dennis)

Highlights include:

• A 5-year history of applying the Deming Philosophy within the State of Michigan's Department of Health and Human Services (HHS)
• The development of Aging and Disability Resource Centers
• Learning "Who are our partners?"
• Where to start? / Who does what to whom?
• Family services and a cat
• First exposure to the Deming Red Bead Experiment
• Getting to know each other better within Michigan's HHS
• Creation of the BOLD ("Building Options for Long Term Decision-Making") Council
• Acronyms as an art-form
• Detailing the processes - Where to start and where to integrate?
• Exposure to control charts within the Bell Telephone System
• Education and steps to move forward
• Creation of the BOLD ("Be OLD") Councils
• Acronyms as an art-form
• Grant funding provided consulting help
• Process steps, including road blocks and issues
• Subject Matter Experts (SME) and Design Teams
• A focus on quality improvement, not change
• Policy changes, with improvements
• Living at home, using improvements in non-emergency transportation services
• Weekly Stand-and-Deliver meetings to review ongoing PDSA efforts
• Continual Improvement efforts are not always “linear,” with forward improvement (sometimes they go backwards)
• State government is a culture all by itself
• People sometimes become their job (position)
• Getting people on board with improvement; not always happy fits, some move on to other positions
• Managing “Level-of-Care Determinations”
• When facing system obstacles, take inspiration from Eleanor Roosevelt, Don’t take a “No” (answer) from someone without the authority to say “Yes”
• Setting new standards for working with state vendors
• New skills by Design Team members
• “Everything is designed around getting money from the federal government”
• Design Team roles are about improving access to state services, not finding sources of funding
• Effectiveness (doing the right thing), before efficiency (faster, better, cheaper)
• Cost savings have been measured, yet the bigger impact is serving more people for a given budget allocation
• Reducing the waiting list for services
• Instead of asking for more money, ask if the existing process can be improved to provide better service
• Discovering a mindset that if some don’t have a problem with a given process, others won't as well (meaning, the process is deemed to be OK as is, while it may well need improvement) 
• Impact on Design Teams after attending The Deming Institute’s “Me vs We workshop” 
• Getting over self-interest issues
• T-Shirt idea, “The Status Quo is Not an Option”
• Avoiding doing better what needs not be done
• Design Teams need ongoing support, including starting with on-boarding and ground rules
• Emergence of self-respect and respect for others

In our 25th "Deming Lens" episode, host Tripp Babbitt shares his interpretation of wide-ranging aspects and implications of Dr. Deming's theory of management.

Topics in this episode include:

• The 10th of Dr. Deming’s 14 Points – "Eliminate slogans, exhortations, and targets for the workforce...."
• “Do it right the first time”
• “Asking people to do what they cannot do”
• “Take pride in your work”
• “Safety is a choice you make”
• Who can fix the stairs and conveyor belts?
• “The worker is not the problem…”
• Eldon Mayo at the Hawthorne Plant
• The “Hawthorne Effect” has been found to be short-lived
• The continued use of slogans, exhortations, and targets reveals a lack of appreciation of the System of Profound Knowledge
• A goal without a method is nothing more than a hope
• In OOTC, Dr. Deming endorses two types of goals, constancy of purpose and continual improvement

Dr. Deming's 14 Points are fully covered in Out of the Crisis. The New Economics presented his later thinking about the 14 points. 

In our 2nd interview podcast of 2019, Steven Haedrich, President of New York Label & Box Works (NYLBW), shared reflections on his continued admiration and application of the Deming Philosophy.

(This is Tripp's second interview with Steven. Link here for the first interview.)

Highlights include:

• Update on NYLBW
• Immersed in the Deming Philosophy every day
• Everything is moving much faster; quality has been a selling/differentiator
• Also, a focus on innovation
• Deming Chain Reaction, less rework/fewer mistakes/creating good paying jobs; the ONLY way to survive!
• Continual improvement on a daily basis
• Impact of a Total Cost focus? NO! Lowest price still gets the bid
• Interaction with your peers in sharing the Deming Philosophy; sharing it every day with both private and public companies – explaining the old ways of sale commissions, performance appraisals, etc.
• Other obstacles; clients and vendors adverse to partnering
• Steven's 2014 podcast – Deming is it!
• Wonderful opportunity to join the board of directors of The Deming Institute
• Deming Online – worldwide access to online learning with the potential to reach millions of students of the Deming Philosophy
• How to get the word out on the Deming Philosophy
• Steven's speaking engagements – Graduate School USA, Conestoga College, upcoming printing conference
• People are beginning to realize the limits of the prevailing system of management
• People are beginning to see the prospects of a changing world and the need to be more effective with management systems
• Where to start – The New Economics, 3rd edition, with Chapter 11 by Kelly Allen
• The world is finally realizing that the old ways that we have accepted as the standards of thinking are no longer going to prepare us for the complexities, for the challenges, for the true globalization of the world.
• The Deming Philosophy captures the essence of collaboration and cooperation and teamwork and systems thinking and continual improvement; including joy in work!
• The Deming Philosophy allows for a different end of the day experience; allowing us to make the world a better place!

In our 2nd interview podcast of 2019, Steven Haedrich, President of New York Label & Box Works (NYLBW), shared reflections on his continued admiration and application of the Deming Philosophy.

(This is Tripp's second interview with Steven.  Link here for the first interview.)

Highlights include:

• Update on NYLBW
• Immersed in the Deming Philosophy every day
• Everything is moving much faster; quality has been a selling/differentiator
• Also, a focus on innovation
• Deming Chain Reaction, less rework/fewer mistakes/creating good paying jobs; the ONLY way to survive!
• Continual improvement on a daily basis
• Impact of a Total Cost focus?  NO!   Lowest price still gets the bid
• Interaction with your peers in sharing the Deming Philosophy; sharing it every day with both private and public companies – explaining the old ways of sale commissions, performance appraisals, etc.
• Other obstacles; clients and vendors adverse to partnering
• Steven’s 2014 podcast – Deming is it!
• Wonderful opportunity to join the board of directors of The Deming Institute
• Deming Online – worldwide access to online learning with the potential to reach millions of students of the Deming Philosophy
• How to get the word out on the Deming Philosophy
• Steven’s speaking engagements – Graduate School USA, Conestoga College, upcoming printing conference
• People are beginning to realize the limits of the prevailing system of management
• People are beginning to see the prospects of a changing world and the need to be more effective with management systems
• Where to start – The New Economics, 3rd edition, with Chapter 11 by Kelly Allen
• The world is finally realizing that the old ways that we have accepted as the standards of thinking are no longer going to prepare us for the complexities, for the challenges, for the true globalization of the world.  
• The Deming Philosophy captures the essence of collaboration and cooperation and teamwork and systems thinking and continual improvement; including joy in work!
• The Deming Philosophy allows for a different end of the day experience; allowing us to make the world a better place!