Endless Knots

The glamour of travel

So with no need for further explanation, you get the picture. Traveling earlier this week for a quick one-day with a lovely client, two workshops back-to-back. Flight, despite its customary lack of room, very pleasant, including the incredible good luck of sitting next to a Microsoft exec who, after hearing my woes with Word, hands me a "magic card" (his words) marked "Quick Assistance," which allowed me to call a Microsoft support line, be greeted by "Kathy," who with some instructions, enabled me to trash a few troublesome files and presto! I can drag-and-drop text again. Thanks, Steve Resnick!

OK, we land. Progress to the shuttle bus at this airport, which is approximately the size of Massachusetts, arrive at car rental. No hybrids, no Garmins. Off I go in a car that doesn't use a key. A terrible light goes on. One I've never seen before. I pull over, search the glove compartment in hopes of looking up the light problem, but there's only a CD in it. A CD. I return to rental place. Attendant gives me the "boy, are you stupid, lady" routine, says it's, of course, as everyone knows, the tire pressure light, then says he'll feel the tires for me (no comment) and that I should just ignore it because the tires are just fine. Now it's getting dark and I'm watching the time and I'm about to be late for the dinner so I take off. (He was right, I am stupid.)

This is a city, if you can call a metropolis the size of, say, Dallas-Fort Worth a city, with no lights on their road signs. Or signs with the number of miles to the next destination. And no match between the printed maps and the number of miles apparently ahead.

This post is getting too long. A purported 45-minute journey takes two hours. The exit numbers don't match the printed exit numbers - as in I am supposed to get off at 465E but the numbers are like, Exit 81 and 82. I end up on a one-way street with no exit other than the Chuck-E Cheese (is that how you even spell it?) parking lot. My room key (key, ha!) at the hotel doesn't work. My breakfast doesn't come via room service ("there was a problem with your order so we didn't know what to do" - uh, er, call me?). I can't get the trunk of the car open (remember, only a CD in the glove compartment).

Skip to the event, which is great. Very nice people, good thinkers, and a wonderful time is had by all.

Then I'm leaving and ask the locals for directions back to the airport. "Take 35 East. No, take 35 West. I don't know. You can take 35 East or West." Finally, it's decided I should take 35 West. I do. No problem other than it's growing dark again and I can't see the road signs and there are no signs to the airport until 1.5 miles before I get there. Arrive in about an hour's time at airport. Pull into car rental and am asked about car. The light is still on so I explain what happened. "Well, *that's* not the tire light," says the attendant. "Who told you that? You never should have been put in this car." Result = $40 credit.

Then I get on the shuttle bus back to the terminal.

Wrong bus. Turns out there are three American terminals. Silly me.

Skytrain to proper terminal.

Grab a sandwich.

Get on plane.

Have whole row to myself.

Ah, the enchanting life of the consultant.

Socially responsible healthcare consuming?

The Boston Globe is looking into the dirty little secrets of the healthcare world around here in a two-part Spotlight series ("Spotlight Team members [are] Scott Allen, Marcella Bombardieri, Michael Rezendes, and editor Thomas Farragher, as well as Liz Kowalczyk and Jeffrey Krasner of the Globe staff. It was written by Allen and Bombardieri."]

The first article, which ran a couple of days ago, "A healthcare system badly out of balance," discloses that the same tests and procedures receive wildly different reimbursements from insurers depending on where they're done. Look and ye shall see:

So why am I posting this? Because I need an MRI. This is not an unusual situation for me - as previously revealed, I have MS and MRIs are one principal way of tracking whether more plaque is building up in the brain, which is, like plaque on your teeth, not a good thing. My wonderful, beloved, attentive (and suffering from the flu) neurologist promptly returned my call yesterday, listened to my symptoms, and said the expected, that I should subject myself to the impossible hammerjack procedure once again (painless yet intensely annoying, for those of you who haven't had it - and not for the claustrophobic, i.e. take the Valium, if they offer it).

Then I remembered the chart, where I had instantly gone to the column with the MRIs earlier this week. If I go to his hospital, it will cost my health insurer roughly twice what it would if I go to the hospital just across town. Both are excellent hospitals - though this series has lifted up another blind, i.e. in many regards, the less expensive hospitals have superior results. I don't know about MS or MRI comparisons so I won't comment. What I do now is that I have a truly superior relationship with my neurologist and that I've been astonishingly healthy under his care, i.e. why tamper with something that works?

But...here's where the socially responsible reflex comes in. Can I in good conscience cost our overburdened healthcare system another half a thou to get the results of a pretty standard procedure? Now that the info is out there, it's really hard to know how to proceed. What would you do?

Ice cream for Rwanda

Newton, Mass., native, actor, and Brooklyn ice-cream-store founder, Jennifer Dundas (click for the many films, plays, etc that she's been in), with her Blue Marble Ice Cream (all organic, all green) business partner Alexis Miesen, are teaming up with Odile Gakire Katese, a Rwandan drummer and playwright, to bring the sweet treat - and a message of hope and possibility - to her homeland. Check out this touching initiative in today's New York Times online, "A Taste of Hope for a Tragic Land," by Jake Mooney. Great story - Jennie and Odile met at Sundance, where they were taking part in a theatre workshop.

To help out with this important initiative, click here.

Biology and high performance teams: conference call

This sounds very interesting:

Ken Thompson, author of Bioteams ("a blueprint and how-to guide for using nature’s most successful designs in building and working in human teams") partners with friend-of-Endless-Knots and expert in just about everything related to collaboration, Lisa Kimball, for Biology and High Performance Teams, a webcast sponsored by Plexus Institute.

Friday, November 21, 2008, 1-2 PM EST
Call in to: 641-715-3300, access code 485743#

For my Dutch friends: please read "Helemaal Alleen"

Daja Wangchuk Meston's memoir, Comes the Peace, is now out in Dutch, as Helemaal Alleen (All Alone). Even English-only speakers may want it just for the incredibly adorable - and at the same time sad - picture of little Wangchuck in his monk robes. Congrats, Wangchuk. May there be many more translations.

 

And while we're at it, how about a few more "family photos?"

Wangchuk on right with Madhubani artist, Sunanda Sahay, at Karma, the gorgeous Asian arts store, he runs with his wife, Phuni, last week

Phuni

Choices in childbirth

Sighing.

The past is back and it isn't good news for women who want to have their babies simply and as naturally as possible.

In "Birth center's possible demise ignites protest" (today's Boston Globe), Kay Lazar and Steven Rosenberg report that only two hospital-affiliated birth centers remain in Massachusetts and one of them is being led up the stairs to the guillotine.

Back in the last century, when I was pregnant, we faced the same situation here in the state. There were no birth centers then - zero - and only one hospital that permitted women to deliver in "labor rooms," as opposed to the operating theatre.

So with Joan Labby, another friend who'd recently given birth, we organized "Choices in Childbirth," a conference whose purpose was both to make women aware that they could make choices and to prod the medical community into offering more. I've written about it before here.

I don't think our conference can take much credit in the end for the explosion of birth centers around the country, even if 350 people turned out during the Great Blizzard of 1978 and we got coverage in lots of places. Market forces were driving hospitals to respond to my generation's demand for more modern approaches to women's oldest responsibility. Birth centers, both attached literally to hospitals and by affiliation, sprung up everywhere, along with midwifery centers...I won't go through the long history here though I did make a bit of a writing profession of tracking it for a while (even wrote an unpublished book about it, One Birth, Many Births, which I rewrote into a chapter of a novel, excerpted here--I know, lots of reuse of material but the writers reading here will understand).

And I won't review why hospitals and docs might be paranoid about birthing centers given the malpractice situation. Judy Norsigian, the great leader in women's health, describes the "irony" perfectly in the Globe article:

"The irony here is, if the [hospital] lawyers cave in to a not-well-thought-through judgment that they have to do this to protect themselves financially, they will worsen outcomes for women overall giving birth in that system," Norsigian said in a phone interview. "These are safe choices being denied to women who are well-informed."

The medicalization of childbirth has a sad history. Please, Beverly Hospital Trustees, don't cave. We really need choices in childbirth.

"Transparency for Trust" (Part 2)

Transparency for Trust: Mapping the Government and Our Money - Part 2
By Jeffrey Stamps and Jessica Lipnack


“Seeing is Believing”

We can map the inherently public organizational structure of the OFS federal-contractor partnership that makes the deals and doles out the funds. Imagine this organizational topography visualized and navigated as you can with Google Earth (for example, see our dynamic map of the US Government in transition with an illustrative OFS overlay).

What does the organizational network map do for us? Two things: more accountability and more minds.

First, By making the whole network transparent as the OFS grows and makes deals, oversight and accountability become simple by-products of its actions. Those involved will be much more likely to act responsibly if the results of their work are visible to all, not just to their supervisors.

Second, we naturally engage many more minds with a shared view of the whole as the mixed agency-consultant enterprise develops and responds to the onrush of events. Never has it been more true that, in the face of such monumental complexity, the whole is smarter than any of us individually.

Using common tools for displaying networks, it’s relatively easy to map the $700 billion network as it grows. Each new job will report (i.e., link) to another position that eventually reports to a lead-contractor post that reports to an official assignment that reports to Mr. Kashkari. People come with the jobs. Their concrete work will result in contracts with specific clients, deals with precise dollar values.

We can link the agreements to the actual organizational units, teams, and positions that transacted them. Now we have a single network representing the whole OFS organization, its clients, and its deals, all appropriately sized by their slices of our at-risk taxpayer money. We then can roll these slices up through the executive ranks to Mr. Kashkari’s level, where we can see the running total of taxpayer commitment.

Of course, we can apply this idea of mapping how the government spends our economic rescue money more widely—for example, to all the other instant organizations managing billions (they seem to be a-borning daily). Why not tie all the taxpayer-funded pieces of the whole thing together? Where does the AIG money sit? Who transacted and who holds the Fannie and Freddie billions? Who handles the proposed $25 billion for the auto industry?

As a practical matter, transparency requires both detail and context. A "Google for Government" OFSpending.gov database could provide searchable detail on all the quasi-public deals—including who got them and who transacted them. The network map hooks the organizations, people, and contracts together, connecting the dots, giving context. By drawing the public map from public information, everyone shares a common mental model of the whole rescue network, the basis for more cross-boundary collaboration and smarter decisions.

In order for the next president and his advisors to get a grip on the whole Federal Government, just reverse the process and follow the money we already spend. Again, start with the OMB database to reverse-engineer the underlying organizational network along the lines of the OFS mapping idea described here. Each government award/grant/deal has been generated by some front-line team with a supervisor who reports to someone who reports to someone in a chain up to the Secretary of Something, an agency like HHS, Homeland Security, or Defense. Track the money up the reporting chains of jobs and you map much of the federal bureaucracy from the bottom up. The result is a single, navigable network with links to each recipient who, in turn, controls a slice of our precious annual trillions.

And, while we’re at it, why not map the rest of government? The OMB, by virtue of its mandate, has the budgets and headcount for each agency and sub-agency down to the level of every job, sized by its slice of the federal budget as well as its spending in contracts and grants.

Sounds like a big job, constructing this open government network map, but all the information is just sitting there in federal financial systems from OMB to the many human resource and information technology systems that run the government payroll and cut the checks.

We just need to connect the dots and all becomes clear, a visible foundation for rebuilding trust—priority one for enabling all the hard stuff to come.

 
--Jeffrey Stamps, PhD, and Jessica Lipnack, are management consultants and authors of six books, including The Age of the Network and Virtual Teams.

"Transparency for Trust" on NetAge site (Part 1)

We're happy to announce the opening of "Transparency for Trust," a new section of the NetAge website. Here, you'll find the org chart of the new US administration as  President-elect Obama fills those positions...

...and our continued tracking of the rather dramatic developments in the economy.

The map is important. It allows a level of transparency unfamiliar to most of us. Who walks around with an org chart of the government in their head? Not me. And given that the government is now literally giving out our money in ways they never have before, it's mandatory that we at least be able to "see" it.

Today and tomorrow, we're posting (in two parts) the essay we've written about "Transparency for Trust," critical ingredients, we believe, to rebuilding our government and our economy. We welcome feedback of all sorts

---------------------------------------------------------

Transparency for Trust: Mapping the Government and Our Money: Part 1
By Jeffrey Stamps and Jessica Lipnack

What do Barack Obama and Neel Kashkari have in common? One well known, the other not so much, but both are young men shaping this moment of transforming change. Both need organizational transparency to be successful, a way to see the new government taking shape and its now-burgeoning role in the economy.

On Monday, October 6, the US government, under threat of imminent global financial meltdown, gave birth to a new agency and handed it a budget equal to twice the expense to date of the Iraq War.

Unprecedented in US—and perhaps world—history, the Office of Financial Stability has few, if any, successful organizational models to follow. And, the 451-page bill authorizing its creation offers zero guidance in regard to its structure.

Common sense suggests that the OFS, as it already is known, is likely to yield an unwieldy bureaucratic edifice, a clumsy construct of the same Industrial-Era thinking that produced the debacle in the first place.

Neel Kashkari, the former Goldman Sachs executive appointed to head the new agency set out in the “Emergency Economic Stabilization Act of 2008,” would be well advised to bring transparency not only to his financial decisions but to his organizational ones as well.
On Tuesday, November 4, the American people selected Barack Obama as their next President. President-Elect Obama is already a fan of transparency and made it a staple of his campaign narrative. His early and deep interest is indicated by his co-authorship of the “Google for Government” law.

Known to some, but completely unknown to most, the bipartisan Coburn-Obama Bill directed the Office of Management and Budget (OMB) to create a searchable database of almost $3 trillion (in 2007 dollars) in federal grants. Officially the “Federal Funding Accountability and Transparency Act of 2006,” it was the first law Barack Obama introduced when he came to the Senate. The legislation called for tracking contracts, earmarks, direct payments, and loans by January 1, 2008. OMB made its deadline (see www.USAspending.gov for the result of this useful piece of 21st-century legislation).

Why is transparency so important? In a word, trust. “Trust, but verify,” said Ronald Reagan. Only trust with openness and verification will allow widespread confidence to develop, which is the key to market recovery. The word “credit,” after all, comes from the Latin credere, “to believe in or trust.”

Trust is also the basic coin of the political realm. Trust in and of the People grows social capital within the body politic. Today, however, trust will only come through transparency. It is key to rebuilding confidence in government, especially as it dramatically changes to meet the accelerating challenges of our time.

Given the urgency of cleaning up so many messes and restoring a modicum of faith in government, the new administration should make mapping newly-vacant positions from the top down an initial priority. A relatively small network of a few thousand political appointees soon will move into these key positions, hubs in the vast bureaucratic networks they will lead. Real organizational transparency can begin here.

But this is past and future government organization and visualization. Right now, new structures and cross-cutting relationships of the economic rescue efforts are being formed and vast sums committed.

On Monday, October 13, with markets surging to record levels, Kashkari announced the outline of the new structure, and several key appointments. However, much of OFS’s work is about to be outsourced. On the very day that OFS came to life, the Treasury Department announced it would hire a single company to act as the “financial agent” to set up the whole system.

We are poised to fail before we start. With minimal oversight and jargon-ridden reports guaranteed to lag, mistakes and problems with the warp-speed implementation of the Troubled Asset Relief Program (TARP) will accumulate, likely causing more harm than good. For starters, the Financial Stability Oversight Board is five levels away from the OFS organization in Treasury.

Trust will develop with real transparency that gives everyone a shared picture of what’s going on as the program progresses, not after the fact. Who runs it? Who works for whom? Who has control of which aspect of the project? From the outset, we can chart the $700 billion territory as it emerges.

See tomorrow for Part II...

Cleaning the schnozzle

Neti Pot photo thanks to Sara Hutter's blog

I received a text message from an ailing friend this morning. The problem: he has a bad cold. In turn, I suggested using a Neti Pot, aka sinus cleanse, which, in the spirit of our times, has its own YouTube video. I am not posting the video here so as to avoid offending squeamish readers. Actually, it's not that squeamish AND IT REALLY WORKS. Long short: dissolve very fine salt in warm water, pour through one nostril at a time, thus removing evil little bacteria, repeat. Three times daily and your cold will vanish along with the post-nasal drip that can contribute to coughing (thank you, Dr. Jess).

Now the famous family story about the Neti Pot.

Sick husband, if you can call someone with a bad cold sick. Wife away. Husband calls daughter or vice-versa (can't recall the sequence at the moment).

Daughter #1: Dad, you should use the Neti Pot.

Husband #1: I know, she already told me to - several times.

D#1: Dad, just because Mom hectors us about it doesn't mean it doesn't work.

H#1: OK, I'll try it.

He did and does (with reminders - oh, Je-eff, gezundheit, ahem).

America's first CTO? Are CKO and CLO next?

Those of us who follow such things are delighted to hear that the Prez-elect is thinking about appointing the first Chief Technology Officer for the United States of America. Among the earliest to report this, I believe, was Tom Lowry on Oct 19 in Business Week, listing a bunch of possible appointees ("Vint Cerf, Google's ... "chief internet evangelist," who is often cited as one of the fathers of the Internet; Microsoft ... chief executive officer Steve Ballmer; Amazon ... CEO Jeffrey Bezos; and Ed Felten, a prominent professor of computer science and public affairs at Princeton University"). Then Claire Cain Miller wrote again about it the day after the election in the NY Times. Yesterday comes the news via Roger Smith's Information Week piece that Google's CEO Eric Schmidt has taken himself out of the running, happy where he is. Smith's piece, btw, has a nice summary of the Obama tech platform (more on the campaign site here).

So that's the gossip for the moment but bigger here is what President BarackObama.com is thinking about re: technology, reported today by that font of good journalism, Hiawatha Bray in our hometown rag, The Boston Globe, "Obama brings cyber sensibility to office:"

Barack Obama's Internet-fueled campaign has transformed the way Americans choose a president. Now, the president-elect's administration plans to change the way Americans use technology.

If Obama gets his way, all Americans will have broadband Internet access, whether they live in big cities or remote villages. Online life will be safer, with better defenses against cybercriminals. And there will be greater access to government, with online services to let anyone question members of the president's Cabinet or track every dime of the federal budget.

So why is this important? Because the existing agencies, Commerce, FCC, FTA, DoD, OTA (RIP) and others that touch on and shape technology, are not leaders in the way that we need now. Indeed much "leading" has been following if not retrograding at best. We have a chance here to do something truly extraordinary, as per the work of such intrepid pioneers as Congressman Ed Markey, who was concerned about the "digital divide," whereby the tech haves and have-nots part ways never the twain to meet, long before most others, and certainly nearly all law-makers, were thinking about it.

OK, so we have a CTO on the docket. (Let's skip the argument about whether this should be Chief Information Officer for now.) Next up, Mr. President "who-can-think-around-the-next-bend-in-the-road," as some say, what about a Chief Knowledge Officer for the US of A? And, while we're at it, maybe throw in a Chief Learning Officer, both positions that are spurring the forward-thinking of many organizations, including the US military.